Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Chin Med J (Engl). 2022 Feb 9;135(5):584-590. doi: 10.1097/CM9.0000000000002108.
BACKGROUND: The cancer burden in the United States of America (USA) has decreased gradually. However, China is experiencing a transition in its cancer profiles, with greater incidence of cancers that were previously more common in the USA. This study compared the latest cancer profiles, trends, and determinants between China and USA. METHODS: This was a comparative study using open-source data. Cancer cases and deaths in 2022 were calculated using cancer estimates from GLOBOCAN 2020 and population estimates from the United Nations. Trends in cancer incidence and mortality rates in the USA used data from the Surveillance, Epidemiology, and End Results program and National Center for Health Statistics. Chinese data were obtained from cancer registry reports. Data from the Global Burden of Disease 2019 and a decomposition method were used to express cancer deaths as the product of four determinant factors. RESULTS: In 2022, there will be approximately 4,820,000 and 2,370,000 new cancer cases, and 3,210,000 and 640,000 cancer deaths in China and the USA, respectively. The most common cancers are lung cancer in China and breast cancer in the USA, and lung cancer is the leading cause of cancer death in both. Age-standardized incidence and mortality rates for lung cancer and colorectal cancer in the USA have decreased significantly recently, but rates of liver cancer have increased slightly. Rates of stomach, liver, and esophageal cancer decreased gradually in China, but rates have increased for colorectal cancer in the whole population, prostate cancer in men, and other seven cancer types in women. Increases in adult population size and population aging were major determinants for incremental cancer deaths, and case-fatality rates contributed to reduced cancer deaths in both countries. CONCLUSIONS: The decreasing cancer burden in liver, stomach, and esophagus, and increasing burden in lung, colorectum, breast, and prostate, mean that cancer profiles in China and the USA are converging. Population aging is a growing determinant of incremental cancer burden. Progress in cancer prevention and care in the USA, and measures to actively respond to population aging, may help China to reduce the cancer burden.
背景：美国（USA）的癌症负担逐渐减轻。然而，中国的癌症谱正在发生转变，以前在美国更为常见的癌症发病率更高。本研究比较了中美两国最新的癌症谱、趋势和决定因素。
方法：这是一项使用开源数据的比较研究。使用 GLOBOCAN 2020 提供的癌症估计数和联合国提供的人口估计数，计算了 2022 年的癌症病例和死亡人数。使用美国监测、流行病学和最终结果计划和国家卫生统计中心的数据，计算了美国癌症发病率和死亡率的趋势。中国的数据来自癌症登记报告。使用 2019 年全球疾病负担数据和分解方法，将癌症死亡人数表示为四个决定因素的乘积。
结果：2022 年，中国和美国将分别有大约 482 万和 237 万新发癌症病例，以及 321 万和 64 万癌症死亡病例。中国最常见的癌症是肺癌，美国最常见的癌症是乳腺癌，肺癌也是两国癌症死亡的主要原因。美国最近肺癌和结直肠癌的年龄标准化发病率和死亡率显著下降，但肝癌发病率略有上升。中国的胃癌、肝癌和食管癌发病率逐渐下降，但总体人群结直肠癌、男性前列腺癌和其他七种女性癌症的发病率有所上升。成年人口规模和人口老龄化的增加是癌症死亡人数增加的主要决定因素，两国的病死率都有助于减少癌症死亡人数。
结论：中国肝癌、胃癌和食管癌的癌症负担减少，肺癌、结直肠癌、乳腺癌和前列腺癌的癌症负担增加，意味着中国和美国的癌症谱正在趋同。人口老龄化是癌症负担增加的一个日益增长的决定因素。美国在癌症预防和治疗方面的进展，以及积极应对人口老龄化的措施，可能有助于中国减轻癌症负担。
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