【摘要】 目的 分析1990-2021年中国消化道肿瘤发病和死亡现状，估计2022-2041年发展趋势，为中国消化道肿瘤的防控制定提供科学依据。方法 从全球疾病负担（GBD）2021数据库中提取1990-2021年中国消化道肿瘤的标化发病率（SIR）、标化死亡率（SMR）等相关数据，并通过描述性统计学方法分析中国消化道肿瘤不同性别的发病和死亡现状。采用R 4.4.0计算消化道肿瘤SIR和SMR的年估计百分比变化（EAPC）及其95%CI,以此评估1990-2021年消化道肿瘤的发病和死亡趋势。采用贝叶斯年龄-时期-队列（BAPC）模型预测2022-2041年中国消化道肿瘤的发病和死亡情况。结果 1990-2021年结直肠癌、胰腺癌和胆囊癌的SIR及胰腺癌SMR呈上升趋势(EAPC_{结直肠癌发病}=1.75%,EAPC_{胰腺癌发病}=0.68%,EAPC_{胆囊癌发病}=0.50%,EAPC_{胰腺癌死亡}=0.50%),其余均呈下降趋势(EAPC_{结直肠癌死亡}=-0.49%,EAPC_{食管癌发病}=-1.88%,EAPC_{食管癌死亡}=-2.26%,EAPC_胃癌发病=-1.64%,EAPC_胃癌死亡=-2.54%,EAPC_肝癌发病=-0.28%,EAPC_肝癌死亡=-0.76%,EAPC_{胆囊癌死亡}=-0.75%)。2021年消化道肿瘤SIR和SMR前4位依次是胃癌、食管癌、结直肠癌和肝癌。BAPC模型预测，2022-2041年结直肠癌SIR呈显著上升趋势，食管癌、胰腺癌和胆囊癌SIR及结直肠癌、胰腺癌SMR均呈平稳上升趋势，胃癌、肝癌SIR和SMR及食管癌和胆囊癌SMR呈下降趋势；2041年消化道肿瘤SIR前4位分别为结直肠癌（50.04/10万）、胃癌（23.76/10万）、食管癌（15.93/10万）和肝癌（8.99/10万）,SMR前4位分别为胃癌（14.98/10万）、结直肠癌（13.44/10万）、食管癌（12.99/10万）和肝癌（8.34/10万）;男性SIR和SMR整体高于女性；SIR及SMR均随着年龄的增长呈上升趋势，50岁及以上呈明显上升。结论 中国消化道肿瘤发病和死亡情况非常严峻，尤其是结直肠癌SIR呈显著上升趋势。男性和50岁以上人群更应该加大消化道肿瘤的防控力度。更多还原

【Abstract】 Objective To analyze the incidence and mortality of digestive tract tumors in China from 1990 to 2021,and to estimate the development trend from 2022 to 2041,in order to provide a scientific basis for the formulation of prevention and control measures for digestive tract tumors in China.Methods Data on standardized incidence rate（SIR） and standardized mortality rate（SMR） of digestive tract tumors in China from 1990 to 2021 were extracted from the 2021 Global Burden of Disease（GBD） database.Descriptive statistics were used to analyze trends in digestive tract tumors by gender.R 4.4.0 was used to calculate the estimated annual percentage change（EAPC） and 95% CI for SIR and SMR to evaluate the incidence and mortality trends of digestive tract tumors from 1990 to 2021.A Bayesian age-period-cohort（BAPC）model was developed to predict the incidence and mortality of digestive tract tumors in China from 2022 to 2041.Results From 1990 to 2021,the age-standardized incidence rates of colorectal cancer,pancreatic cancer,and gallbladder cancer,as well as the age-standardized mortality rate of pancreatic cancer,showed an upward trend(EAPC_{colorectal cancer incidence}=1.75%,EAPC_{pancreatic cancer incidence}=0.68%,EAPC_{gallbladder cancer incidence}=0.50%,EAPC_{pancreatic mortality}=0.50%).Other cancers exhibited a downward trend(EAPC_{colorectal cancer mortality}=-0.49%,EAP_{Cesophageal cancer incidence}=-1.88%,EAPC_{esophageal cancer-mortality}=-2.26%,EAPC_{gastric cancer incidence}=-1.64%,EAPC_{gastric cancer mortality}=-2.54%,EAPC_{liver cancer incidence}=-0.28%,EAPC_{liver cancer mortality}=-0.76%,EAPC_{gallbladder cancer mortality}=-0.75%).In 2021,the top four types of digestive tract tumors in terms of age-standardized incidence and mortality rates were gastric cancer,esophageal cancer,colorectal cancer,and liver cancer.The BAPC model projected a significant increase in the age-standardized incidence rate of colorectal cancer from 2022 to 2041.The age-standardized incidence rates of esophageal cancer,pancreatic cancer,and gallbladder cancer,along with the age-standardized mortality rates of colorectal cancer and pancreatic cancer,might be expected to rise steadily.The age-standardized incidence and mortality rates for gastric cancer and liver cancer,as well as the age-standardized mortality rates for esophageal cancer and gallbladder cancer,were projected to decline.By 2041,the top four age-standardized incidence rates of digestive tract tumors were colorectal cancer（50.04/100 000）,gastric cancer（23.76/100 000）,esophageal cancer（15.93/100 000） and liver cancer（8.99/100 000）.The top four age-standardized mortality rates were gastric cancer（14.98/100 000）,colorectal cancer（13.44/100 000）,esophageal cancer（12.99/100 000） and liver cancer（8.34/100 000）.Males had higher overall age-standardized incidence and mortality rates compared to females.Both rates increased with age,showing a significant increase in those aged 50 and above.Conclusions The incidence and mortality of digestive tract tumors in China remain severe,particularly with a significant rise in the age-standardized incidence rate of colorectal cancer.Enhanced preventive measures should target males and individuals over 50 years old.更多还原