Objectives: To analyze the disease burden and trend from 1990 to 2020 of melanoma among middle-aged and elderly populations in China, and to predict the future trend from 2022 to 2035.
Methods: Data from the Global Burden of Disease Study (GBD) 2021 were utilized to collect incidence and mortality rates of melanoma, disability-adjusted life years (DALYs), and corresponding age crude rates among the middle-aged and elderly population in China. Additionally, the estimated annual percentage change (EAPC) was employed to assess the temporal trends. Age-period-cohort (APC) and Bayesian age-period-cohort (BAPC) models were utilized to compute age, period, and cohort effects on incidence and mortality rates of melanoma, as well as to predict future trends up to 2035.
Results: During 1990-2021, the incidence rate of melanoma for males was higher than that for females among the middle-aged and elderly population in China, and the overall incidence rate increased annually with an EAPC of 2.13 (1.90, 2.36), while the overall mortality rate and DALY rate showed a declining trend with an EAPC of －0.28 (－0.41, －0.15) and －0.54 (－0.68, －0.41),respectively. The results of the APC model analysis revealed that age effects on both incidence and mortality rates of melanoma in China's middle-aged and elderly population were significant, with both increasing with age. Period and cohort effects showed an upward trend for incidence rates but a downward trend for mortality rates. Moreover, the period and cohort effects for mortality rates were not significant among females. In the BAPC prediction model, the number of incidences of melanoma in middle-aged and elderly people in China would increase dramatically. By 2035, the number of incidence cases is expected to reach approximately 9600 (males) and 10 300 (females), corresponding to an incidence rate of 2.66/105 and 2.67/105, respectively; the number of deaths is projected to be about 2600 (males) and 3500 (females) by 2035, corresponding to a mortality rate of 0.72/105 and 0.91/105, respectively.
Conclusions: The disease burden of melanoma among the middle-aged and elderly population in China remains substantial and is expected to increase over the next decade.
目的: 明确中国中老年人黑色素瘤的疾病负担以及未来发展趋势，为制订相关卫生政策、合理分配卫生资源和临床管理提供参考。方法: 从全球疾病负担2021数据库中获取中国中老年人群黑色素瘤的发病、死亡和伤残调整生命年（DALY）数据，并利用估计年度百分比变化（EAPC）评估上述指标时间变化趋势。采用年龄-时期-队列（APC）模型评估中国中老年黑色素瘤患者的发病率和死亡率的年龄、时期和队列效应，并通过贝叶斯年龄-时期-队列（BAPC）模型预测2022—2035年黑色素瘤在该人群中的趋势。结果: 1990—2021年中国中老年黑色素患者中，男性发病率均高于女性，总发病率逐年增加［EAPC=2.13（1.90，2.36）］，而总死亡率和DALY率趋势有所降低［EAPC分别为－0.28（－0.41，－0.15）和－0.54（－0.68，－0.41）］。APC模型分析结果表明，中国中老人群黑色素瘤发病率和死亡率的年龄效应显著，均随年龄增长而上升，而时期和队列效应在发病率中呈上升趋势，在死亡率中则呈下降趋势，且女性患者死亡率的时期和队列效应不显著。BAPC模型预测结果显示，中国中老年人群黑色素瘤的发病数将大幅增加。到2035年，预计发病数将达到0.96万（男性）和1.03万（女性），发病率分别为2.66/10万和2.67/10万，预计死亡人数约为0.26万（男性）和0.35万（女性），死亡率为0.72/10万和0.91/10万。结论: 中国中老年人群的黑色素瘤疾病负担十分巨大，在2022—2035年该负担将持续加重。.
Keywords: China; Disease burden; Melanoma; Middle-aged and elderly; Trend analysis.