目的 解读和对比2018-2022年全球和中国的胃癌发病与死亡的流行病学数据,分析我国的胃癌疾病负担.方法 基于国际癌症研究机构发布的GLOBOCAN 2018、2020、2022全球癌症登记数据,提取全球和中国的胃癌发病和死亡的粗数据与年龄标化数据,对比中国与全球的胃癌发病、死亡情况.结果 与全球胃癌发病和死亡情况比较,虽然我国胃癌发病率和死亡率均呈持续降低趋势,但是新发和死亡例数仍居全球首位,是我国严重的癌症疾病负担之一.2022年,全球胃癌新发及死亡病例数分别为96.8万例和66.0万例,其中中国胃癌新发和死亡病例数最高,分别为35.8万例(占全球的37.0％)和26.0万例(占全球的39.5％);全球胃癌年龄标准化发病率(age-standardized incidence rate,ASIR)和年龄标准化死亡率(age-standardized mortality rate,ASMR)分别为9.2/10万和6.1/10万,我国胃癌ASIR和ASMR分别为13.7/10万和9.4/10万,均处于全球较高水平;同样,以人群病死指数(population mortality index,PMI)评估来看,我国的胃癌病例病死风险呈下降趋势,但仍高于全球水平;非常高和高人类发展指数(human development index,HDI)国家/地区胃癌的ASIR和ASMR高于中等和低HDI国家/地区,按人均国民总收入(gross national income,GNI)分层表现出与之相似的趋势,而非常高HDI或高GNI国家/地区的PMI均低于其他分层国家/地区.我国胃癌ASMR分布存在一定的地域差异,西部地区特别是青藏高原地区胃癌死亡负担最重,此外中东部地区的少数省份胃癌死亡负担亦重.与全球相同的是,中国男性人群的胃癌发病和病死风险均高于女性人群,男性ASIR和ASMR均高于女性2倍以上,而男性和女性PMI相当.全球在50岁及以上、中国在45岁及以上进入胃癌高发病率阶段.结论 我国胃癌疾病负担仍然沉重且高于全球水平.HDI、GNI、地区分布、性别及年龄是影响胃癌发病和病死风险的相关因素.我国胃癌防治主要的发力点应聚焦在全人群癌防健康意识提高、基层三级预防体系建设、规模性人群筛查项目支撑、系统性高危人群监测、规范化癌症诊疗技术推广、全生命周期患者管理与照护等方面.
Epidemiologic features and trends of gastric cancer in the world and China:interpretation of the GLOBOCAN 2018-2022
Objective To interpret and compare the epidemiologic data of gastric cancer incidence and mortality in the world and China during 2018-2022,and to evaluate the disease burden of gastric cancer in China.Method Based on the GLOBOCAN 2018-2022 cancer registry data released by the International Agency for Research on Cancer(IARC),both the crude and the age-standardized incidence and mortality data of gastric cancer were retrieved,while the situation of gastric cancer incidence and mortality was compared between China and the world.Results Comparing with the global incidence and mortality of gastric cancer,although the incidence and mortality of gastric cancer in China showed a consistently declining trend,the numbers of incident cases and deaths kept the greatest in the world,which was one of the important cancer disease burdens in China.In the 2022 report,there were 968 350 incident cases and 660 175 deaths from gastric cancer worldwide.Therein,China had the greatest number of incident cases and deaths from gastric cancer,i.e.358 000(37.0％of the global total)and 260 000(39.5％of the global total),respectively.The age-standardized incidence rate(ASIR)and age-standardized mortality rate(ASMR)for gastric cancer worldwide were 9.2/100 000 and 6.1/100 000,respectively;in China,the ASIR and ASMR were 13.7/100 000 and 9.4/100 000,respectively,both of which were higher than the global average levels.Similarly,in terms of the assessment on population morbidity index(PMI),the risk of death from gastric cancer in China appeared a declining trend,but it was still at a higher level compared to the global average.In very high and high human development index(HDI)countries/regions,the ASIR and ASMR of gastric cancer were higher than those in medium and low HDI countries/regions,while the trend was similar when stratified by gross national income(GNI)per capita.In countries/regions with very high HDI or high GNI per capita,the PMI was lower than those in other stratified countries/regions.There were certain geographic disparities in the ASMR of gastric cancer in China.The western region,especially the Qinghai-Tibet Plateau region,had the heaviest burden of gastric cancer deaths,and a few provinces in the central and eastern regions also faced a heavy burden of gastric cancer deaths.Similar to the global situation,the incidence and death risk of gastric cancer were higher among males in China.The ASIR and ASMR in males were more than two times to those in females,while the PMI in males and females were comparable.Globally,subpopulation ≥50 years old entered the age-groups with high incidence of gastric cancer,while in China,the high incidence age-groups were since 45 years old.Conclusions The burden of gastric cancer is still heavy in China and higher than the global level.HDI,GNI per capita,regional distribution,gender,and age are associated with the incidence and death risks of gastric cancer.The key points of gastric cancer prevention and control in China should be focused on raising awareness of cancer prevention among the public population,establishing tertiary prevention system in subnational areas,supporting large-scale population screening projects,systematically surveilling the high-risk subpopulation,promoting standardized cancer diagnosis and treatment,and whole-life managing and caring cancer patients.
gastric cancerepidemiologyincidencemortalitypopulation mortality indexcancer prevention and control
万方数据
