近日，英国伦敦帝国理工学院的Majid Ezzati团队研究了非传染性疾病的基准进展：2001年至2019年特定原因死亡率的全球分析。相关论文发表在2025年9月10日出版的《柳叶刀》杂志上。

非传染性疾病（NCDs）在全球和大多数国家都得到了大量的政策关注。该研究旨在量化2010年至2019年不同国家非传染性疾病死亡率的变化，特别是与前十年和每个区域表现最好的国家相比，以及导致变化的具体非传染性疾病死亡原因。

研究组使用了来自《2021年世卫组织全球卫生估计数》的185个国家和地区按性别、年龄组和潜在死亡原因划分的非传染性疾病死亡率数据。研究组的主要结局是在没有竞争死亡原因的情况下，从出生到80岁之间死于非传染性疾病的概率，并使用非传染性疾病和生命表的年龄特异性死亡率来计算方法。研究组将死亡概率的变化计算为每个时期（2001-10年和2010-19年）最后一年和第一年数值之间的差异。对于51个拥有高质量死亡率数据的国家和12个区域内人口众多的国家，该课题组使用Horiuchi分解方法来计算具体死亡原因和5年年龄组对以下因素的贡献：(1)2010年至2019年非传染性疾病死亡率的上升或下降；(2)与前十年（2001 - 2010年）相比有所改善或恶化；(3)与各地区降幅最大的国家的差异。

2010年至2019年，185个国家中有152个（82%）国家的女性和147个（79%）国家的男性在出生至80岁期间死于非传染性疾病的概率下降；在其余33个国家（18%）的女性和38个国家（21%）的男性中，这一比例有所增加。2019年，女性非传染性疾病死亡率下降的国家占世界女性人口的72%，男性非传染性疾病死亡率下降的国家占世界男性人口的73%。非传染性疾病死亡率在所有高收入西方国家都有所下降，丹麦男女死亡率下降幅度最大，美国下降幅度最小。在其他区域人口最多的国家中，中国、埃及、尼日利亚、俄罗斯和巴西的非传染性疾病死亡率男女均有所下降，而印度和巴布亚新几内亚的非传染性疾病死亡率男女均有所上升。平均而言，中亚、中东和北非地区国家的女性非传染性疾病死亡率下降幅度最大，其次是中欧和东欧国家。对于男性来说，减少幅度最大的是中欧和东欧国家，其次是中亚、中东和北非国家。下降幅度最小的是太平洋岛国。在大多数国家，循环系统疾病是2010年至2019年非传染性疾病死亡率下降的最大原因，一些癌症（例如，两性胃癌和结直肠癌、女性宫颈癌和乳腺癌、男性肺癌和前列腺癌）也导致许多国家2019年非传染性疾病死亡率低于2010年。

2010年至2019年，大多数国家的神经精神疾病、胰腺癌和肝癌导致非传染性疾病死亡率上升。在一些国家，非传染性疾病死亡率在工作年龄和年龄较大（≥65岁）人群中呈同一方向变化，导致总体大幅下降或上升；在其他情况下，它向相反的方向变化，减少了整体变化的幅度。在185个国家中，有75个（41%）国家的女性和73个（39%）国家的男性，2010年至2019年非传染性疾病死亡率的变化与2001年至2010年的变化相比有所改善（即下降幅度较大，上升幅度较小，或上升趋势逆转）。这些国家分别占世界女性和男性人口的29%和63%，其中包括俄罗斯和埃及的两性，以及中国、印度和巴西的男性。在其余110个（59%）国家的女性和112个（61%）国家的男性中，包括美国、尼日利亚和巴布亚新几内亚的两性以及中国、印度和巴西的女性，年代际变化出现了恶化（即下降幅度较小、增加幅度较大或下降逆转）。从2010年到2019年，在大多数高收入西方国家、拉丁美洲和加勒比地区的大多数国家、东亚和东南亚的大多数国家以及南亚的女性中，与前十年相比，两性的变化在方向或规模上都有所恶化。在中欧和东欧（如俄罗斯）、中亚以及中东和北非部分地区的许多国家，变化的方向或规模十年来有所改善。二十年来非传染性疾病死亡率变化的方向或规模的改善或恶化是由多种非传染性疾病死亡原因造成的。在死因中，大多数国家2010年至2019年循环系统疾病死亡率的下降幅度小于2001年至2010年，但中欧和东欧国家以及中亚一些国家除外，这些国家2010年至2019年的死亡率下降幅度大于2001年至2010年。在许多国家，尤其是男性，肺癌的发病率十年来有所改善，而许多其他癌症的发病率则有改善也有恶化。

研究结果表明，从2010年到2019年，世界上每5个国家中就有4个国家的非传染性疾病死亡率下降。对大多数国家来说，由于多种非传染性疾病造成的死亡率下降幅度较小，这些改善不如前十年那么大。

附：英文原文

Title: Benchmarking progress in non-communicable diseases: a global analysis of cause-specific mortality from 2001 to 2019

Author: James E Bennett, Olivia N ODriscoll, Gretchen A Stevens, Nestor Aldea-Ramos, Freddie Bray, Farshad Farzadfar, Michel Guillot, Jürgen Rehm, Vikram Patel, Gill Livingston, Pablo Perel, Shekhar Saxena, Margaret E Kruk, Ole F Norheim, Rachel Nugent, Jean Claude Mbanya, Jonathan Pearson-Stuttard, Amirhossein Takian, Leanne M Riley, Robert Beaglehole, Katie Dain, Majid Ezzati

Issue&Volume: 2025-09-10

Abstract:

Background

Non-communicable diseases (NCDs) have received substantial policy attention globally and in most countries. Our aim was to quantify how much NCD mortality changed from 2010 to 2019 in different countries, especially compared with the preceding decade and with the best-performing country in each region, and the specific NCD causes of death that contributed to change.

Methods

We used data on NCD mortality by sex, age group, and underlying cause of death for 185 countries and territories from the 2021 WHO Global Health Estimates. Our primary outcome was the probability of dying from an NCD between birth and age 80 years in the absence of competing causes of death, and was calculated using age-specific death rates from NCDs and lifetable methods. We calculated change in the probability of death as the difference between values in the final and first year of each period (2001–10 and 2010–19). For 51 countries with high-quality mortality data and 12 countries with large populations within their region, we used the Horiuchi method of decomposition to calculate how much specific causes of death and 5-year age groups contributed towards: (1) increases or decreases in NCD mortality from 2010 to 2019; (2) improvements or deteriorations compared with the preceding decade (2001–10); and (3) differences from the country that had the largest reduction in each region.

Findings

From 2010 to 2019, the probability of dying from an NCD between birth and age 80 years decreased in 152 (82%) of 185 countries for females and in 147 (79%) countries for males; it increased in the remaining 33 (18%) countries for females and 38 (21%) countries for males. The countries where NCD mortality declined for females accounted for 72% of the world female population in 2019, and those where NCD mortality declined for males accounted for 73% of the world male population. NCD mortality declined in all high-income western countries, with Denmark experiencing the largest decline for both sexes and the USA experiencing the smallest decline. Among the largest countries in other regions, NCD mortality declined for both sexes in China, Egypt, Nigeria, Russia, and Brazil, and increased for both sexes in India and Papua New Guinea. On average, females in countries in the central Asia, Middle East and north Africa region had the greatest reduction in NCD mortality followed by those in central and eastern Europe. For males, the largest reduction was among countries in central and eastern Europe, followed by those in central Asia, Middle East and north Africa. The smallest declines were those in the Pacific Island nations. Circulatory diseases were the greatest contributors to declines in NCD mortality from 2010 to 2019 in most countries, with some cancers (eg, stomach and colorectal cancers for both sexes, cervical and breast cancers for females, and lung and prostate cancers for males) also contributing towards lower NCD mortality in 2019 than in 2010 in many countries. Neuropsychiatric conditions and pancreatic and liver cancers contributed towards higher NCD mortality from 2010 to 2019 in most countries. In some countries, NCD mortality in working and older (≥65 years) ages changed in the same direction leading to large overall declines or increases; in others, it changed in opposite directions, diminishing the magnitude of the overall change. In 75 (41%) of 185 countries for females and in 73 (39%) countries for males, the change in NCD mortality from 2010 to 2019 was an improvement (ie, larger decline, smaller increase, or reversal of an increase) compared with the change from 2001 to 2010. These countries accounted for 29% and 63% of the world female and male population, respectively, and included both sexes in Russia and Egypt, and males in China, India, and Brazil. Decadal changes saw a deterioration (ie, smaller decline, larger increase, or reversal of a decline) in the remaining 110 (59%) countries for females and 112 (61%) countries for males, including in both sexes in the USA, Nigeria, and Papua New Guinea, and females in China, India, and Brazil. Change from 2010 to 2019 saw deterioration in direction or size compared with the preceding decade for both sexes in most high-income western countries, most countries in Latin America and the Caribbean, and in east and southeast Asia, and for females in south Asia. There was a decadal improvement in the direction or size of change for many countries in central and eastern Europe (eg, Russia) and central Asia, and in parts of the Middle East and north Africa. Improvements or deteriorations in the direction or size of change in NCD mortality between the two decades resulted from multiple NCD causes of death. Among causes of death, the decline in mortality from circulatory diseases was smaller from 2010 to 2019 than from 2001 to 2010 in most countries, except in countries in central and eastern Europe and some countries in central Asia, where these declines were larger from 2010 to 2019 than from 2001 to 2010. Change in lung cancer saw a decadal improvement in many countries, especially for males, and many other cancers saw a mix of improvement and deterioration.

Interpretation

From 2010 to 2019, NCD mortality declined in four of every five countries in the world. These improvements were not as large as the preceding decade for most countries, driven by smaller declines in mortality from multiple NCDs.

DOI: 10.1016/S0140-6736(25)01388-1

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01388-1/abstract