Deputy Director, National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China.
Associate Researcher, National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China.
CA Cancer J Clin. 2016 Mar-Apr;66(2):115-32. doi: 10.3322/caac.21338. Epub 2016 Jan 25.
With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China's massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high-quality data from an additional number of population-based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population-based cancer registries (2009-2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000-2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age-standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year; P = .1), whereas they increased significantly (+2.2% per year; P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (-1.4% per year; P < .05) and females (-1.1% per year; P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.
在中国,癌症发病率和死亡率不断上升,已成为主要的公共卫生问题。由于中国人口众多(13.7 亿),之前的全国发病率和死亡率估计仅限于使用 20 世纪 90 年代的数据或基于特定年份的小样本人群。随着中国国家癌症中心现有的更多基于人群的登记处提供高质量的数据,作者分析了来自 72 个地方、基于人群的癌症登记处(2009-2011 年)的数据,这些登记处代表了 6.5%的人口,以估计 2015 年的新发病例和癌症死亡人数。22 个登记处的数据用于趋势分析(2000-2011 年)。结果表明,2015 年中国预计将有 429.2 万例新发癌症病例和 281.4 万例癌症死亡,肺癌是最常见的癌症,也是癌症死亡的主要原因。胃癌、食管癌和肝癌也很常见,被确定为癌症死亡的主要原因。农村居民的所有癌症合并年龄标准化(塞吉人口)发病率和死亡率均显著高于城市居民(发病率分别为每 10 万人 213.6 例和 191.5 例;死亡率分别为每 10 万人 149.0 例和 109.5 例)。在所有癌症中,2000 年至 2011 年期间,男性的发病率保持稳定(每年增长 0.2%;P = .1),而女性的发病率显著增加(每年增长 2.2%;P < .05)。相比之下,自 2006 年以来,男性(每年下降 1.4%;P < .05)和女性(每年下降 1.1%;P < .05)的死亡率均显著下降。通过降低危险因素的流行率,提高临床护理的有效性,特别是对生活在农村地区和弱势群体的人,可以预防许多估计的癌症病例和死亡。