Abstract
BACKGROUND: Cervical spondylosis (CS) is a degenerative disease with an increasing burden due to aging populations and lifestyle changes. Large-scale epidemiological studies are lacking in China, and early-stage cases are often overlooked. This study aimed to assess the incidence and cost of clinically recognized CS among adult people in China. METHODS: This population-based cohort study was conducted by using national-wide data from Urban Employee Basic Medical Insurance and Urban Resident Basic Medical Insurance between 2013 and 2017, covering approximately 300 million residents in 23 provincial regions in China. CS were identified by the primary diagnosis. The incidence and cost of these clinically recognized CS in urban China were calculated. FINDINGS: A total of 2,928,103 patients with clinically diagnosed CS were identified in this study (60.58% females and 39.42% males). CS was most common in people aged 50-59 years old (25.1%). The overall crude incidence of CS in urban China in 2017 was 405.65 per 100,000 person-years. The crude incidence among females was higher than males. Incidence was highest in East China and lowest in North China. During the five-year period from 2013 to 2017, the overall annual costs of patients with CS increased from 145.17 million US dollars to 1064.17 million US dollars, and the estimated annual cost per-patient increased from 597.32 US dollars to 970.67 US dollars. INTERPRETATION: As the population ages, China will face an ever-increasing burden from CS. Strategies targeting elder population and high-risk groups should be prioritized in the establishment of management related to CS. FUNDING: National Natural Science Foundation.