Chen Hongsen, Xu Jie, Liu Wenbin, Chen Xi, Li Ping, Cao Guangwen
Shanghai Key Laboratory of Medical Bioprotection, Second Military Medical University, Shanghai, China.
Department of Epidemiology, Second Military Medical University, Shanghai, China.
Front Oncol. 2025 May 28;15:1579378. doi: 10.3389/fonc.2025.1579378. eCollection 2025.
Mainland China accounts for 18.66% of the world's population, 24.17% of global cancer new cases, and 26.44% cancer-related death worldwide in 2022. We aim to characterize the spatiotemporal distribution patterns of cancer burden, elucidate the main causes of high cancer burden, and propose evidence-based strategies for the prevention and control of major cancer types in Mainland China. We conducted a systematic search for relevant articles in PubMed and CNKI. We also analyzed the related data from two key databases: the 2022 dataset of the International Agency for Research on Cancer (IARC) and the records of China's National Mortality Surveillance System (from 2004 - 2018). Lung cancer, primary liver cancer (PLC), gastric cancer, colorectal cancer (CRC), and esophageal cancer accounted for 67.50% of all cancer-related deaths. Age-standardized incidence rates (ASIR) and mortality rates (ASMR) of PLC, gastric cancer, and esophageal cancer showed downward trends, while their crude rates kept increasing. The ASMR of lung cancer kept decreasing in urban but increasing in rural populations. The burden of CRC kept increasing. Increase in cancer incidence could be attributed to the co-existence of the poverty-related risk factors like chronic infections and affluence-related ones like metabolic disorders. Primary prevention targeting to these modifiable risk factors is cost-effective. Aerobic exercise could decrease cancer occurrence and cancer-related death via decreasing systemic low-grade inflammation. The second and tertiary prophylactic options should be epidemiologically optimized. Targeting the major risk factors co-existed during economic transformation should be a cost-effective strategy to decrease cancer burden in transforming countries.
2022年，中国大陆人口占世界人口的18.66%，全球癌症新发病例的24.17%，以及全球癌症相关死亡人数的26.44%。我们旨在描述癌症负担的时空分布模式，阐明癌症高负担的主要原因，并提出基于证据的中国大陆主要癌症类型的预防和控制策略。我们在PubMed和中国知网系统检索了相关文章。我们还分析了两个关键数据库的相关数据：国际癌症研究机构（IARC）2022年数据集和中国国家死亡率监测系统记录（2004 - 2018年）。肺癌、原发性肝癌（PLC）、胃癌、结直肠癌（CRC）和食管癌占所有癌症相关死亡人数的67.50%。PLC、胃癌和食管癌的年龄标准化发病率（ASIR）和死亡率（ASMR）呈下降趋势，而其粗发病率持续上升。肺癌的ASMR在城市持续下降，但在农村人口中上升。CRC的负担持续增加。癌症发病率的增加可归因于与贫困相关的危险因素（如慢性感染）和与富裕相关的危险因素（如代谢紊乱）并存。针对这些可改变的危险因素进行一级预防具有成本效益。有氧运动可通过减轻全身低度炎症来降低癌症发生和癌症相关死亡。二级和三级预防方案应进行流行病学优化。针对经济转型期间并存的主要危险因素应是转型国家降低癌症负担的一种具有成本效益的策略。
