2012年中国恶性肿瘤发病和死亡分析

Report of Cancer Incidence and Mortality in China,2012

[目的]对2015年全国肿瘤登记中心收集的全国各登记处上报的2012年恶性肿瘤登记资料进行分析,估计我国恶性肿瘤的发病与死亡。[方法]全国肿瘤登记中心共收到261个登记处上报的2012年肿瘤登记数据,通过审核和评估,共193个肿瘤登记处的数据符合入选标准。将入选的登记处按地区（城乡）、性别以及年龄别、肿瘤别发病率和死亡率分层,结合2012年全国人口数据,估计全国恶性肿瘤合计和主要肿瘤的发病、死亡情况。标化率采用2000年全国人口普查人口和Segi’s标准人口结构为标准。[结果 ]全国193个登记处共覆盖登记人口198 060 406人（其中城市100 450 109人,农村97 610 297人）,报告的恶性肿瘤新病例556 163例,死亡病例345 483例。病理诊断比例为69.13%,只有死亡证明书比例为2.38%,死亡发病比为0.62。据估计,全国2012年新发恶性肿瘤病例约358.6万例,死亡病例218.7万例。全国恶性肿瘤发病率为264.85/10万（男性289.30/10万,女性239.15/10万）,中国人口标化率（中标率）为191.89/10万,世界人口标化率（世标率）为187.83/10万,累积率（0~74岁）为21.82%。城市地区发病率为277.17/10万,中标发病率为195.56/10万,农村地区发病率为251.20/10万,中标发病率为187.10/10万。全部地区恶性肿瘤死亡率为161.49/10万（男性198.99/10万,女性122.06/10万）,中标死亡率为112.34/10万,世标死亡率为111.25/10万,累积死亡率（0~74岁）为12.61%。城市地区死亡率为159.00/10万,中标死亡率107.23/10万。农村地区恶性肿瘤死亡率为164.24/10万,中标死亡率118.22/10万。肺癌、胃癌、肝癌、结直肠癌、食管癌、女性乳腺癌、甲状腺癌、宫颈癌、脑瘤和胰腺癌是我国主要的恶性肿瘤,约占全部新发病例的75%。肺癌、肝癌、胃癌、食管癌、结直肠癌、胰腺癌、乳腺癌、脑瘤、白血病和淋巴瘤是主要的肿瘤死因,约占全部肿瘤死亡病例的80%。[结论]全国肿瘤登记中心定期发布我国恶性肿瘤负担情况,为制定肿瘤防治策略和科学研究提供可靠的基础依据。随着覆盖人群逐渐增加和数据质量不断提高,肿瘤登记在肿瘤防治中正在发挥越来越大的作用。

[Purpose] The National Central Cancer Registry（NCCR） collected registration data in2012 from local cancer registries in 2015,and analyzed to estimate cancer incidence and mortality in China. [Methods] On basis of the criteria of data quality from NCCR,data submitted from 261 registries were checked evaluated,and 193 registries＇ data qualified for cancer registry annual report. Descriptive analysis included of incidence and mortality stratified by areas（urban/rural）,gender,age group and cancer site. The top 10 common cancers in different groups,proportion and cumulative rate were also calculated. Chinese population census in 2000 and Segi＇s population were used for age-standardized incidence/mortality. [Results] All 193 cancer registries（74 in urban and 119 in rural） covered a total of 198 060 406 population（100 450 109 in urban and 97 610 297 in rural areas）. The estimates of new cancer cases and cancer deaths were 3586 thousands and2187 thousands in 2012,respectively. The morphology verified cases（MV%） accounted for 69.13%and 2.38% of incident cases were identified through death certifications only（DCO%） with mortality to incidence ratio of 0.62. The crude incidence rate in Chinese cancer registration areas was264.85/10~5（males 289.30/10~5,females 239.15/10~5）,age-standardized incidence rates by Chinese standard population（ASIRC） and by world standard population were 191.89/10~5 and 187.83/10~5 with the cumulative incidence rate（0~74 age years old） of 21.82%. The cancer incidence and ASIRC were 277.17/10~5 and 195.56/10~5 in urban areas whereas in rural areas,they were 251.20/10~5and187.10/10~5,respectively. The cancer mortality in Chinese cancer registration areas was 161.49/10~5（198.99/10~5 in male and 122.06/10~5 in female）,age-standardized incidence by Chinese standard population（ASMRC） and by world standard population were 112.34/10~5 and 111.25/10~5,and the cumulative incidence rate（0 ~74 age years old） was 12.61%. The cancer mortality and ASMRC were 159.00/10~5 and 107.23/10~5 in urban areas,whereas in rural areas,they were 164.24/10~5and118.22/10~5 respectively.Cancers of lung,stomach,liver,colon and rectum,esophagus,breast,thyroid,cervix,brain and pancreas were the most common cancers,accounting for about 75% of all cancer cases in urban and rural areas. Lung cancer,liver cancer,stomach cancer,esophageal cancer,colorectal cancer,pancreatic cancer,breast cancer,brain cancer,leukemia and lymphoma were the most fatal cancer deaths,accounted for about 80% of all cancer deaths. [Conclusions] The National Central Cancer Registry reports cancer statistics,providing basic data for policy making and scientific research. Along with the increase of population coverage and improvement of data quality,cancer registry is playing an important role in cancer control.