Table 1_Shifting burden of nasopharyngeal carcinoma: global patterns and forecasts to 2050 from the GBD 2021.docx

BackgroundNasopharyngeal carcinoma (NPC) exhibits pronounced geographical variation, with a high burden in specific regions. We assessed global, regional, and national trends in NPC burden from 1990 to 2021 and projected estimates to 2050.
MethodsWe analyzed data from the Global Burden of Disease (GBD) 2021 study for 204 countries and territories across 21 regions. Age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized disability-adjusted life-years (DALYs) rate were estimated, and temporal trends were assessed using estimated annual percentage change (EAPC) by socio-demographic index (SDI), sex, and age group. Future burden from 2022 to 2050 was projected using a Bayesian age–period–cohort model.
ResultsIn 2021, there were 118,878 incident cases, 75,359 deaths, and 2,490,191 DALYs due to NPC globally. The global ASIR was 1.38 per 100,000 population (EAPC −1.06), the ASDR was 0.87 (EAPC −2.17), and the age-standardized DALYs rate was 28.91 (EAPC −2.29). Incidence rate peaked at ages 65–69 years (4.23 per 100,000 population), with consistently higher rates in males than in females. East Asia had the highest regional ASIR, and Japan bore the highest age-specific disease burden. Projections indicate continued declines in apparent ASDR and DALYs rates globally to 2050, but rising ASIR in males, particularly in East Asia and high-middle SDI regions.
ConclusionsOver the past three decades, global mortality and disability burden from NPC have decreased, whereas incidence has increased in selected populations. The projected rise in ASIR among males in high-risk regions highlights the need for targeted interventions, equitable resource allocation, and sustained surveillance to mitigate future burden.

背景：鼻咽癌（Nasopharyngeal carcinoma, NPC）具有显著的地理分布差异，在部分地区疾病负担沉重。本研究分析了1990年至2021年全球、区域及国家层面的鼻咽癌疾病负担趋势，并对2050年的相关数据进行了预测估算。

方法：本研究分析了全球疾病负担（Global Burden of Disease, GBD）2021研究中覆盖21个区域的204个国家和地区的数据。研究估算了年龄标化发病率（Age-standardized incidence rate, ASIR）、年龄标化死亡率（Age-standardized death rate, ASDR）以及年龄标化伤残调整寿命年（Disability-adjusted life-years, DALYs）率，并通过社会人口指数（Socio-demographic index, SDI）、性别与年龄组，采用估计年度百分比变化（Estimated Annual Percentage Change, EAPC）分析了时间趋势。本研究采用贝叶斯年龄-时期-队列模型（Bayesian age–period–cohort model），对2022年至2050年的未来疾病负担进行了预测。

结果：2021年，全球范围内因鼻咽癌导致的新发病例达118878例，死亡病例75359例，伤残调整寿命年共计2490191年。全球年龄标化发病率为1.38/10万（估计年度百分比变化为-1.06），年龄标化死亡率为0.87/10万（EAPC -2.17），年龄标化伤残调整寿命年率为28.91（EAPC -2.29）。发病率在65~69岁年龄组达到峰值（4.23/10万），且男性发病率始终高于女性。东亚地区的区域年龄标化发病率最高，日本的年龄别疾病负担最重。预测结果显示，至2050年全球范围内观察到的年龄标化死亡率与伤残调整寿命年率将持续下降，但男性的年龄标化发病率将呈上升趋势，尤其是在东亚地区与高-中等社会人口指数区域。

结论：过去三十年间，全球鼻咽癌相关的死亡与伤残负担有所下降，但部分人群的发病率呈上升趋势。高危区域男性的年龄标化发病率预测将持续升高，这提示我们需要开展针对性干预、实现公平的资源分配，并持续开展监测工作，以减轻未来的疾病负担。