Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
National Office for Cancer Prevention and Control, National Cancer Center, Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Cancer. 2015 Sep 1;121 Suppl 17:3107-12. doi: 10.1002/cncr.29603.
Lung cancer incidence and mortality rates have increased substantially in China despite improvements in clinical diagnosis and treatment approaches as well as significant advances in the implementation of tobacco-control policies in recent decades.
Age-standardized mortality rates and age-specific rates of lung cancer in China were estimated for the periods 1973 to 1975, 1990 to 1992, and 2004 to 2005 using data from 3 National Death Surveys. Among patients with lung cancer who were identified from a hospital-based information system, the percentages of ever-smokers were analyzed according to histologic and demographic variables.
Age-standardized mortality from lung cancer in China dramatically increased from 7.30 per 100,000 during 1973 through 1975 to 27.62 per 100,000 during 2004 through 2005. Increases in lung cancer age-standardized mortality were consistent among men and women in urban and rural populations. Among men ages 75 to 79 years, lung cancer mortality increased remarkably to 453.67 per 100,000 in 2004 and 2005 (from 246.78 per 100,000 during 1990-1992 and from 53.65 per 100,000 during 1973-1975). Among 6674 patients with lung cancer who were identified from 2003 to 2007 from a hospital-based database, 82.97% of men were ever-smokers (73.35% of men with adenocarcinoma and 91.8% of men with squamous cell carcinoma), and 11.18% of women were ever-smokers (6% of women with adenosquamous carcinoma and 39.02% of women with squamous cell carcinoma). Differences in the numbers of ever-smokers were observed between age groups but not according to the year of diagnosis.
The consistent and rapid increases in lung cancer mortality rates observed in the Chinese population and the high prevalence of exposure to smoking in China prompt a strong call for the implementation of a comprehensive tobacco-control policy and specific public health educational strategies.
尽管近几十年来临床诊断和治疗方法有所改进，以及在实施烟草控制政策方面取得了重大进展，但中国的肺癌发病率和死亡率仍大幅上升。
利用 3 次全国死亡调查的数据，估算了 1973 年至 1975 年、1990 年至 1992 年和 2004 年至 2005 年期间中国肺癌的年龄标准化死亡率和特定年龄的肺癌发病率。从医院信息系统中确定的肺癌患者中，根据组织学和人口统计学变量分析了曾吸烟者的百分比。
中国肺癌的年龄标准化死亡率从 1973 年至 1975 年的每 10 万人 73.0 人急剧上升到 2004 年至 2005 年的每 10 万人 276.2 人。城乡人口中，男性和女性的肺癌年龄标准化死亡率均呈上升趋势。在 75 岁至 79 岁的男性中，2004 年和 2005 年的肺癌死亡率显著上升至每 10 万人 453.67 人（1990-1992 年每 10 万人 246.78 人，1973-1975 年每 10 万人 53.65 人）。从 2003 年至 2007 年从医院数据库中确定的 6674 名肺癌患者中，82.97%的男性是曾吸烟者（腺癌患者中 73.35%，鳞癌患者中 91.8%），11.18%的女性是曾吸烟者（腺鳞癌患者中 6%，鳞癌患者中 39.02%）。在年龄组之间观察到曾吸烟者的数量存在差异，但与诊断年份无关。
中国人群中肺癌死亡率的持续快速上升以及中国人群中吸烟暴露的高流行率强烈呼吁实施全面的烟草控制政策和具体的公共卫生教育策略。
