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2013年中国恶性肿瘤发病和死亡分析

Report of Cancer Incidence and Mortality in China,2013

【作者】 陈万青郑荣寿张思维曾红梅邹小农赫捷

【Author】 CHEN Wan-qing;ZHENG Rong-shou;ZHANG Si-wei;National Cancer Center , Cancer Hospital , Chinese Academy of Medical Sciences and Peking Union Medical College;

【机构】 国家癌症中心/中国医学科学院北京协和医学院肿瘤医院

【摘要】 [目的]根据2016年全国肿瘤登记中心收集的全国各登记处恶性肿瘤登记资料,估计我国2013年恶性肿瘤的发病与死亡情况。[方法]按照全国肿瘤登记中心制定的审核方法和评价标准,对全国上报2013年肿瘤登记数据的347个登记处数据进行评估,255个登记处的数据符合标准。将入选的登记处按地区(城乡)、性别、年龄别以及恶性肿瘤类型的发病率和死亡率分层,结合2013年全国人口数据,估计全国恶性肿瘤发病、死亡情况。标准人口以2000年全国人口普查的人口和Segi’s标准人口结构为标准。[结果]2013年纳入分析的255个登记处共覆盖登记人口226 494 490人(其中城市111 595 772人,农村114 898 718人)。病理诊断比例(MV%)为67.89%,只有死亡医学证明书比例(DCO%)为1.81%,死亡/发病比(M/I)为0.62。据估计,全国2013年新发恶性肿瘤病例约368.2万例,死亡病例222.9万例。全国恶性肿瘤发病率为270.59/10万(男性293.79/10万,女性246.21/10万),中国人口标化发病率为190.17/10万,世界人口标化发病率为186.15/10万,累积发病率(0~74岁)为21.60%。城市地区发病率为283.79/10万,中国人口标化发病率为193.53/10万;农村地区发病率为255.27/10万,中国人口标化发病率为185.42/10万。全国恶性肿瘤死亡率为163.83/10万(男性201.67/10万,女性124.06/10万),中国人口标化死亡率为109.95/10万,世界人口标化死亡率为108.94/10万,累积死亡率(0~74岁)为12.33%。城市地区死亡率为161.48/10万,中国人口标化死亡率为104.57/10万;农村地区死亡率为166.57/10万,中国人口标化死亡率为116.42/10万。肺癌、胃癌、肝癌、结直肠癌、女性乳腺癌、食管癌是我国主要的常见的恶性肿瘤,约占全部肿瘤新发病例的66%。肺癌、肝癌、胃癌、食管癌、结直肠癌是主要的肿瘤死因,约占全部肿瘤死亡病例的70%。[结论]肿瘤登记作为肿瘤防治工作的基础,可为制定中长期肿瘤防治策略提供可靠依据。我国城乡地区肿瘤负担差异明显,应根据实际情况有重点地开展防治工作。

【Abstract】 [Purpose] In 2016,National Central Cancer Registry(NCCR) collected registration data in 2013 from local cancer registries to estimate cancer incidence and mortality in China. [Methods] Registration data from 347 cancer registries were evaluated according to the criteria of quality control from NCCR and data from 255 registries were qualified as pooled data for final analysis.Individual cases were stratified by areas(urban/rural),gender,age group and cancer sites. Cancer incidence and mortality were estimated using national population. The fifth Chinese population census in 2000 and Segi’s population were applied to the age-standardized incidence/mortality rates.[Results] The coverage of population from 255 cancer registries(88 in urban and 167 in rural) were 226 494 490(111 595 772 in urban and 114 898 718 in rural areas). The estimates of new cancer cases and cancer deaths were 3 682 thousands and 2 229 thousands in 2013,respectively. The morphology verified cases(MV%) accounted for 67.89% and 1.81% of incident cases were identified through death certifications only(DCO%) with a mortality to incidence ratio(M/I) of0.62. The crude incidence rate in China was 270.59/105(males 293.79/105,females 246.21/105),age-standardized incidence rates by Chinese standard population(ASIRC) and by world standard population were 190.17/105 and 186.15/105 with the cumulative incidence rate(0~74 years old) of21.60%. The cancer incidence and ASIRC were 283.79/105 and 193.53/105 in urban areas whereas in rural areas,they were 255.27/105 and 185.42/105,respectively. The cancer mortality in China was 163.83/105(201.67/105 in males and 124.06/105 in females),age-standardized mortality by Chinese standard population(ASMRC) and by world standard population were 109.95/105 and 108.94/105,and the cumulative mortality rate(0~74 years old) was 12.33%. The cancer mortality and ASMRC were161.48/105 and 104.57/105 in urban areas,whereas in rural areas,they were 166.57/105and116.42/105,respectively. Lung cancer,gastric cancer,liver cancer,colorectal cancer,female breast cancer,esophageal cancer were the most common cancers,accounting for about 66% of all cancer cases in urban and rural areas. Lung cancer,liver cancer,gastric cancer,esophageal cancer,colorectal cancer accounted for about 70% of all cancer deaths. [Conclusion] As the basis of cancer control program,cancer registry plays an important role in making anti-cancer strategy in medium and long term in China. As cancer patterns are different between urban and rural areas in China,prevention and control should be implemented based on practical situation.

【关键词】 肿瘤登记; 恶性肿瘤; 发病率; 死亡率; 中国;

【Key words】 cancer registry; malignant tumor; incidence; mortality; China;

【分类号】R735.1;R197.322;R181.37;

【基金】 科技基础性工作专项(2014FY121100);国家自然科学基金(81602931)

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