Yang Zhixun, Zheng Rongshou, Zhang Siwei, Zeng Hongmei, Xia Changfa, Li He, Wang Li, Wang Yanhong, Chen Wanqing
National Office for Cancer Prevention and Control, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Chin J Cancer Res. 2017 Oct;29(5):385-394. doi: 10.21147/j.issn.1000-9604.2017.05.02.
In this research, the patterns of cancer incidence and mortality in areas with different gross domestic product per capita (GDPPC) levels in China were explored, using data from population-based cancer registries in 2013, collected by the National Central Cancer Registry (NCCR).
Data from 255 cancer registries were qualified and included in this analysis. Based on the GDPPC data of 2014, cities/counties were divided into 3 levels: high-, middle- and low-GDPPC areas, with 40,000 and 80,000 RMB per year as cut points. We calculated cancer incidences and mortalities in these three levels, stratified by gender and age group. The national population of the Fifth Census in 2000 and Segi's population were applied for age-standardized rates.
The crude incidence and mortality rates as well as age-standardized incidence rate (ASIR) showed positive associations with GDPPC level. The age-standardized mortality rate (ASMR) nevertheless showed a negative association with GDPPC level. The ASMR in high-, middle- and low-GDPPC areas was 103.12/100,000, 112.49/100,000 and 117.43/100,000, respectively. Lung cancer was by far the most common cancer in all three GDPPC levels. It was also the leading cause of cancer death, regardless of gender and GDPPC level. Negative associations with GDPPC level were found for the ASIRs of lung, stomach, esophageal and liver cancer, whereas colorectal and breast cancer showed positive associations. Except for breast cancer, the ASMRs of the other five cancers were always higher in middle- and low-GDPPC areas than in high-GDPPC areas.
The economic development is one of the main factors of the heavy cancer burden on Chinese population. It would be reasonable to implement cancer control strategies referring to the local GDPPC level.
本研究利用国家癌症中心(NCCR)收集的2013年基于人群的癌症登记数据,探讨中国不同人均国内生产总值(GDPPC)水平地区的癌症发病率和死亡率模式。
255个癌症登记处的数据符合要求并纳入本分析。根据2014年的GDPPC数据,将市/县分为3个级别:高、中、低GDPPC地区,划分切点为每年40,000元和80,000元。我们计算了这三个级别按性别和年龄组分层的癌症发病率和死亡率。应用2000年第五次全国人口普查的全国人口和世标人口计算年龄标准化率。
粗发病率、死亡率以及年龄标准化发病率(ASIR)与GDPPC水平呈正相关。然而,年龄标准化死亡率(ASMR)与GDPPC水平呈负相关。高、中、低GDPPC地区的ASMR分别为103.12/10万、112.49/10万和117.43/10万。在所有三个GDPPC水平中,肺癌是迄今为止最常见的癌症。无论性别和GDPPC水平如何,它也是癌症死亡的主要原因。肺癌、胃癌、食管癌和肝癌的ASIR与GDPPC水平呈负相关,而结直肠癌和乳腺癌呈正相关。除乳腺癌外,其他五种癌症的ASMR在中、低GDPPC地区总是高于高GDPPC地区。
经济发展是中国人群癌症负担沉重的主要因素之一。参照当地GDPPC水平实施癌症控制策略是合理的。