Li H, Zheng R S, Zhang S W, Zeng H M, Sun K X, Xia C F, Yang Z X, Chen W Q, He J
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.
Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2018 Mar 23;40(3):166-171. doi: 10.3760/cma.j.issn.0253-3766.2018.03.002.
To estimate the incidence and mortality of female breast cancer in China based on the cancer registration data in 2014, collected by the National Central Cancer Registry (NCCR), and to provide support data for breast cancer prevention and control in China. There were 449 cancer registries submitting female breast cancer incidence and deaths data occurred in 2014 to NCCR. After evaluating the data quality, 339 registries' data were accepted for analysis and stratified by areas (urban/rural) and age group. Combined with data on national population in 2014, the nationwide incidence and mortality of female breast cancer were estimated. Chinese population census in 2000 and Segi's population were used for age-standardized incidence/mortality rates. Qualified 339 cancer registries covered a total of 288 243 347 populations (144 061 915 in urban and 144 181 432 in rural areas) in 2014. The morphology verified cases (MV%) accounted for 87.42% and 0.59% of incident cases were identified through death certifications only (DCO%), with mortality to incidence ratio of 0.24. The estimates of new breast cancer cases were about 278 900 in China in 2014, accounting for 16.51% of all new cases in female. The crude incidence rate, age-standardized rate of incidence by Chinese standard population (ASRIC), and age-standardized rate of incidence by world standard population (ASRIW) of breast cancer were 41.82/100 000, 30.69/100 000, and 28.77/100 000, respectively, with a cumulative incidence rate (0-74 age years old) of 3.12%. The crude incidence rates and ASRIC in urban areas were 49.94 per 100 000 and 34.85 per 100 000, respectively, whereas those were 31.72 per 100 000 and 24.89 per 100 000 in rural areas. The estimates of breast cancer deaths were about 66 000 in China in 2014, accounting for 7.82% of all the cancer-related deaths in female. The crude mortality rate, age-standardized rate of mortality by Chinese standard population(ASRMC) and age-standardized rate of mortality by world standard population (ASRMW) of breast cancer were 9.90/100 000, 6.53/100 000, and 6.35/100 000, respectively, with a cumulative mortality rate of 0.69%. The crude mortality rates and ASRMC in urban areas were 11.48 per 100 000 and 7.04 per 100 000, respectively, whereas those were 7.93 per 100 000 and 5.79 per 100 000 in rural areas. The incidence and mortality rates of breast cancer were higher in areas than those in rural areas. The age-specific incidence rates of breast cancer increased greatly after 20 years old and peaked at the age group of 55-60. The age-specific mortality rates increased rapidly with age, particularly after 25 years old. They remained at a relative stable level from 55 to 65 years of age, and then increased dramatically and peaked in the age group of 85 and above. Breast cancer is still one of the most common malignant tumor threatening to famale health in China. The disease is more prevalent in urban areas at the age group of 55-60. Comprehensive prevention and control strategies referring to local status and age groups should be carried out to reduce the burden of breast cancer.
基于国家癌症中心（NCCR）收集的2014年癌症登记数据，估算中国女性乳腺癌的发病率和死亡率，为中国乳腺癌的预防和控制提供支持数据。2014年有449个癌症登记处向NCCR提交了女性乳腺癌发病和死亡数据。在评估数据质量后，接受了339个登记处的数据进行分析，并按地区（城市/农村）和年龄组进行分层。结合2014年全国人口数据，估算了全国女性乳腺癌的发病率和死亡率。采用2000年中国人口普查数据和Segi人口数据计算年龄标准化发病率/死亡率。2014年，合格的339个癌症登记处共覆盖288243347人（城市144061915人，农村144181432人）。形态学确诊病例（MV%）占87.42%，仅通过死亡证明确定的病例（DCO%）占0.59%，死亡率与发病率之比为0.24。2014年中国乳腺癌新发病例估计约为278900例，占女性所有新发病例的16.51%。乳腺癌的粗发病率、中国标准人口年龄标准化发病率（ASRIC）和世界标准人口年龄标准化发病率（ASRIW）分别为41.82/10万、30.69/10万和28.77/10万，累积发病率（0至74岁）为3.12%。城市地区的粗发病率和ASRIC分别为49.94/10万和34.85/10万，而农村地区分别为31.72/10万和24.89/10万。2014年中国乳腺癌死亡估计约为66000例，占女性所有癌症相关死亡的7.82%。乳腺癌的粗死亡率、中国标准人口年龄标准化死亡率（ASRMC）和世界标准人口年龄标准化死亡率（ASRMW）分别为9.90/10万、6.53/10万和6.35/10万，累积死亡率为0.69%。城市地区的粗死亡率和ASRMC分别为11.48/10万和7.04/10万，而农村地区分别为7.93/10万和5.79/10万。乳腺癌的发病率和死亡率城市地区高于农村地区。乳腺癌的年龄别发病率在20岁后大幅上升，在55 - 60岁年龄组达到峰值。年龄别死亡率随年龄迅速上升，特别是在25岁后。在55至65岁保持相对稳定水平，然后大幅上升，在85岁及以上年龄组达到峰值。乳腺癌仍然是威胁中国女性健康的最常见恶性肿瘤之一。该疾病在城市地区55 - 60岁年龄组更为普遍。应根据当地情况和年龄组实施综合防控策略，以减轻乳腺癌负担。
