Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, 100005, P. R. China.
Cancer Commun (Lond). 2021 May;41(5):404-413. doi: 10.1002/cac2.12143. Epub 2021 Mar 3.
Cancer has become a global health problem, and assessments of cancer mortality are important for effective public health policy-making and adequate resource allocation. In this study, we aimed to predict the mortality rates and numbers of deaths related to four common cancers (lung, liver, stomach, and esophagus) in China from 2020 to 2030 and to estimate the corresponding cancer burden caused by population aging and tobacco smoking.
Cancer mortality data (2004-2017) were extracted from China's death surveillance datasets, and China's population figures (2020-2030) were obtained from the United Nations population projections. Smoking prevalence data were retrieved from a World Health Organization global report, and relative risks of smoking and cancers were derived from large-scale Asian studies. We predicted the deaths related to the four major cancers and age-standardized mortality rates using joinpoint regression and linear regression models. The tobacco smoking-related burden of these four major cancers was estimated using the population attributable fraction.
Unlike lung cancer mortality which was predicted to continue to increase, the age-standardized mortality rates for digestive cancers (liver, stomach, and esophageal cancers) are predicted to decline over the next decade. The number of deaths caused by the four major cancers is predicted to increase from 1,490,304 in 2020 to 1,823,960 in 2030. The age-specific mortality rates of the four major cancers are predicted to increase with age after 40-45 years, peaking in the age groups of 80-84 and ≥85 years. In 2030, the combined number of deaths from the four examined cancers among adults aged ≥65 years is predicted to be 1,167,153, accounting for 64% of all deaths from these cancers. Tobacco smoking is predicted to contribute to nearly 29% of deaths from these cancers, corresponding to 527,577 deaths.
The overall trend in the combined total mortality from four major cancers is predicted to decline over the next decade; however, the corresponding death toll is expected to surge, in the context of China's population aging and high smoking prevalence. These estimates provide data-driven evidence for China to implement effective cancer control measures in the future.
癌症已成为全球健康问题，对癌症死亡率进行评估对于制定有效的公共卫生政策和合理配置资源至关重要。本研究旨在预测 2020 年至 2030 年中国四种常见癌症（肺癌、肝癌、胃癌和食管癌）的死亡率和死亡人数，并估算人口老龄化和吸烟对癌症负担的影响。
从中国死因监测数据集提取癌症死亡率数据（2004-2017 年），从联合国人口预测中获取 2020 年至 2030 年中国人口数据。从世界卫生组织全球报告中获取吸烟流行数据，从大型亚洲研究中得出吸烟与癌症的相对风险。采用 Joinpoint 回归和线性回归模型预测四种主要癌症相关死亡人数和年龄标准化死亡率。采用人群归因分数估计这四种主要癌症的吸烟相关负担。
与肺癌死亡率持续上升的预测结果不同，预计未来十年消化系统癌症（肝癌、胃癌和食管癌）的年龄标准化死亡率将下降。四种主要癌症导致的死亡人数预计将从 2020 年的 1490304 例增加到 2030 年的 1823960 例。四种主要癌症的年龄特异性死亡率预计将在 40-45 岁后随年龄增长而增加，在 80-84 岁和≥85 岁年龄组达到峰值。2030 年，≥65 岁成年人中四种被检癌症的死亡总数预计为 1167153 例，占这些癌症总死亡人数的 64%。预计吸烟将导致这些癌症近 29%的死亡，相当于 527577 人死亡。
在未来十年中，四种主要癌症的总死亡率预计呈下降趋势；然而，在中国人口老龄化和高吸烟率的背景下，预计死亡人数将大幅增加。这些估计为中国未来实施有效的癌症控制措施提供了数据驱动的证据。
