中国高致死风险癌症导致的生命损失模式。
Patterns of Life Lost to Cancers with High Risk of Death in China.
机构信息
Department of Public Health, Shihezi University School of Medicine, Shihezi 832002, China.
Department of Chronic Diseases, Shihezi Center for Disease Control and Prevention, Shihezi, 832002, China.
出版信息
Int J Environ Res Public Health. 2019 Jun 19;16(12):2175. doi: 10.3390/ijerph16122175.
To inform public health policy and research, we analyzed the patterns of life lost to cancers and evaluated the cancer burden in China. Based on the published Chinese Cancer Registry Annual Report and related literature in 2013, we calculated the cancer-related mortality and potential years of life lost (PYLL) by age, sex, districts (urban or rural), to describe the patterns of life lost to cancers. The high death-risk cancers in China were lung, liver, stomach, esophageal, colorectal, breast, pancreatic, brain and nervous system, and ovarian cancers, and leukemia. Liver and esophageal cancers were more prominent among males, while breast and colorectal cancers were more prevalent among females. The most obvious differences of mortality between urban and rural areas were found in liver, esophageal, and colorectal cancers. Cancer-related mortality increased significantly after the age of 30 years, and peaking at 70-79 years. The PYLL rate of cancer in urban areas was higher than that in rural areas (21.49 vs. 19.20/1000), and significant regional and gender differences of PYLL ranks can be observed. For people aged over 60 years, cancer PYLL mainly came from lung, stomach, and esophageal cancers; for middle-aged people, it was mainly induced by liver, colorectal, and female reproductive systems' cancers; and for those under 30 years, life lost to cancer was mainly caused by leukemia and brain, nervous system cancers. Moreover, disparities in age distribution of PYLL from different regions and sexes can be found. In short, three categories of people, including those in urban areas, males and people over 60 years, were suffering from more serious cancer deaths and life lost. These variations pose considerable challenges for the Chinese health care system, and comprehensive measures are required for cancer prevention and treatment.
为了为公共卫生政策和研究提供信息,我们分析了癌症导致的生命损失模式,并评估了中国的癌症负担。基于 2013 年发布的《中国癌症登记年报》和相关文献,我们按年龄、性别、城乡地区计算了癌症相关死亡率和潜在寿命损失年数(PYLL),以描述癌症导致的生命损失模式。中国高死亡风险的癌症为肺癌、肝癌、胃癌、食管癌、结直肠癌、乳腺癌、胰腺癌、脑和神经系统癌以及卵巢癌,还有白血病。男性中肝癌和食管癌更为突出,而女性中乳腺癌和结直肠癌更为普遍。城乡地区死亡率的最明显差异见于肝癌、食管癌和结直肠癌。癌症相关死亡率在 30 岁以后显著增加,并在 70-79 岁时达到峰值。城市地区癌症相关死亡率高于农村地区(21.49 比 19.20/1000),且可观察到明显的城乡和性别差异。对于 60 岁以上人群,癌症 PYLL 主要来自肺癌、胃癌和食管癌;对于中年人,主要由肝癌、结直肠癌和女性生殖系统癌症引起;对于 30 岁以下人群,癌症导致的生命损失主要由白血病和脑、神经系统癌症引起。此外,不同地区和性别的 PYLL 年龄分布差异也较大。简而言之,城市地区、男性和 60 岁以上人群这三类人群面临着更为严重的癌症死亡和生命损失。这些差异给中国的医疗保健系统带来了巨大挑战,需要采取综合措施来进行癌症的预防和治疗。