首页|《2005-2020年中国国家和地方癌症负担趋势:国家死亡率监测数据分析》要点解读

《2005-2020年中国国家和地方癌症负担趋势:国家死亡率监测数据分析》要点解读

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目的 评估2005-2020年我国癌症负担变化趋势,为我国制定癌症防控策略提供参考依据.方法 对《2005-2020年中国癌症负担变化》报告进行解读,了解我国的总体癌症死亡变化情况,同时分析不同性别、不同年龄、城市和农村以及全国不同地区的癌症死亡变化情况.结果 2020年相较于2005年我国癌症负担变化趋势:①在全人群中,我国与癌症相关的死亡例数和生命损失年数分别增加了 21.6%和5.0%,癌症死亡率顺位排序前3位依次是肺癌、肝癌及胃癌.②在不同性别人群中,男性的癌种死亡顺位排序前5位较2005未发生变化(均分别是肺癌、肝癌、胃癌、食管癌及结直肠癌),前10位癌症中年龄标准化死亡率的平均年度百分比变化增加的癌种有4种,从高到低依次是前列腺癌、胰腺癌、淋巴瘤及结直肠癌(其值分别为1.70/10万、0.95/10万、0.33/10万及0.31/10万);女性的癌种死亡顺位排序除了肺癌仍是排第1位外,其他癌种死亡顺位排序较2005发生了明显变化,如胃癌由第2位下降至第3位、肝癌由第3位上升至第2位、结直肠癌由第5位上升至第4位、乳腺癌由第6位上升至第5位、胰腺癌由第9位上升至第8位;前10位癌症中年龄标准化死亡率的平均年度百分比变化增加的癌种只有1种即胰腺癌(其值为0.67/10万).③不同年龄段人群中,我国因癌症相关死亡率在年轻人(18~44岁)和中年人(45~59岁)中远低于老年人(60岁及以上).④城市和农村地区,癌症死亡率和生命损失年数率均是农村地区高于城市地区(癌症死亡率:177.62/10万比161.30/10万;生命损失年数率:4204.02/10万比3 791.52/10万).⑤不同地区,安徽等11个省或直辖市的癌症死亡率高于全国平均水平,广西壮族自治区、河北、新疆维吾尔自治区、河南和青海的男性以及江苏、河南、广西壮族自治区、新疆维吾尔自治区和上海的女性所有癌症类型的死亡率、年龄标准化死亡率、生命损失年数率、年龄标准化生命损失年数率在2020年较2005年均有所下降,部分省份或地区结直肠癌和胰腺癌的年龄标准化死亡率增加幅度较大.结论 总体而言,2005-2020年我国癌症相关死亡例数和生命损失年数呈增加趋势,且癌症负担存在性别、年龄、城乡和地区分布差异,防控形势严峻,亟待全面的癌症防控策略来应对我国不断变化的癌症负担状况.
National and subnational trends in cancer burden in China,2005-2020:an interpretation of national mortality surveillance data
Objective To analyze the changing trend of cancer burden in China from 2005 to 2020,so as to provide reference for the formulation of cancer prevention and control strategies.Method Based on the report"National and subnational trends in cancer burden in China,2005-20",the overall changes in cancer deaths in China by gender,age,urban and rural areas,and different regions of the country were analyzed.Results ① Among the whole population,the number of cancer-related deaths and years of life lost(YLLs)in China increased by 21.6%and 5.0%respectively,and the top third leading cause of cancer-related deaths ranked by mortality rate were tracheal,bronchus,and lung cancer,liver cancer,and stomach cancer.② In different gender groups,for the males,the top five leading cause of cancer-related deaths by mortality rate remained unchanged from 2005 to 2020,they were tracheal,bronchus,and lung cancer,liver cancer,stomach cancer,oesophageal cancer,and colon and rectum cancer.The average annual percent change(AAPC)of the age-standardized mortality rate(ASMR)increased in 4 of the leading 10 cancers,followed by prostate cancer(1.70 per 100 000),pancreatic cancer(0.95 per 100 000),lymphoma(0.33 per 100 000),and colon and rectum cancer(0.31 per 100 000).For the females,the tracheal,bronchus,and lung cancer remained the first leading cancer from 2005 to 2020,the second to the fifth leading cancers by mortality rate showed evident changes,with the liver cancer moving from the third to the second position,the stomach cancer moving from the second to the third position,the colon and rectum cancers moving from the fifth to the fourth position,and the breast cancer moving from the sixth to the fifth position,the pancreatic cancer moving from the ninth to the eighth position.Among the top 10 cancers,only the pancreatic cancer had an increase in AAPC of ASMR(0.67 per 100 000).③ Among different age groups,the cancer-related mortality in young people(18-44 years old)and middle-aged people(45-59 years old)was much lower than that of the elderly(over 60 years old).④ The mortality and YLL rates due to cancer in rural areas were higher than those in urban areas for both sexes.The cancer mortality rates of 11 provinces or regions such as Anhui were higher than those the national average value.The mortality,ASMR,YLL rates,and age-standardized YLL rates of all cancer types in Guangxi Zhuang Autonomous Region,Hebei,Xinjiang Uygur Autonomous Region,Henan,and Qinghai decreased in the males and which in Jiangsu,Henan,Guangxi Zhuang Autonomous Region,Xinjiang Uygur Autonomous Region,and Shanghai in the females also decreased.The ASMR of the colon and rectum cancer and pancreatic cancer increased significantly in some provinces or regions.Conclusions From 2005 to 2020,there are rising trends in the number of cancer-related deaths and YLLs in China,and there are differences in the gender,age,urban and rural,and regional distribution of cancer burden.The prevention and control situation is grim,there is an urgent need for a comprehensive cancer prevention and control strategy to deal with the changing cancer burden in China.

cancermortalitycancer burdenepidemiology

冯薇、张伟

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四川大学华西公共卫生学院(成都 610041)

四川大学华西医院医院管理研究所(成都 610041)

恶性肿瘤 死亡率 癌症负担 流行病学

2024

中国普外基础与临床杂志
四川大学华西医院

中国普外基础与临床杂志

CSTPCD
影响因子:0.858
ISSN:1007-9424
年,卷(期):2024.31(7)
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