中国2008年肝癌发病、死亡和患病情况的估计与预测

Estimation and prediction of incidence, mortality and prevalence on liver cancer, in 2008, China

目的估计中国2008年肝癌发病、死亡和患病情况，并预测未来20年发病数和死亡数。方法根据中国36个肿瘤登记点的数据以及全国第三次死因调查（2004--2005年）的结果，估计中国2008年肝癌发病、死亡和患病情况，并预测2010、2015、2020、2025和2030年肝癌的发病数和死亡数。结果2008年中国肝癌新发病例数约为40．2万（占所有恶性肿瘤发病例数的14．3％），死亡病例数约为37．2万（占所有恶性肿瘤死亡例数的19．0％）。世界人口标化发病率和标化死亡率分别为25．7／10万（居所有恶性肿瘤第3位）和23．7／10万（居所有恶性肿瘤第2位）。2008年中国15岁以上人群肝癌5年患病数约为29．6万，占所有恶性肿瘤5年患病数的6．4％，5年患病率为27．7／10万，排在所有恶性肿瘤的第6位。在肝癌新发病例中72．8％为男性，男女性别比为2．7：1；死亡病例中74．3％为男性，男女性别比为2．9：1。在任何年龄段，男性肝癌的发病率和死亡率均高于女性。40岁以上人群，尤其是男性，是肝癌的高发人群；未来20年，中国肝癌的发病数和死亡数均将呈现上升趋势。结论肝癌是中国主要癌症之一，其死亡率仅次于肺癌，发病和死亡情况在未来20年将越来越严峻，40岁以上男性是肝癌重点防控人群。

Objective To estimate the incidence, mortality and 5-year prevalence rates of liver cancer in 2008, China. Methods Data from both 36 cancer registries and the Third National Death Survey in China （2004-2005） were used to estimate the incidence, mortality and 5-year prevalence of liver cancer in 2008 in the country by using the mathematical models to predict the liver cancer incidence and mortality in the next 20 years. Results In 2008, the incident cases of liver cancer was 402 208 （ 14.3% of the total cancers） and the number of deaths from liver cancer was 372 079 （19.0% of the total cancers）. The incidence rate was 25.7/100 000, ranking the third among all cancers. The mortality rate was 23.7/100 000, ranking the second among all the cancers. The 5-year prevalence of liver cancer was 296 082 （6.4% of the total cancers） with the proportion as 27.7/ 100 000, ranking the sixth among all the cancers. 72.8% of the liver cancer cases appeared in men and the sex ratio of male to female was 2.7 ： 1. In terms of deaths due to liver cancer, 74.3% of them occurred in men, with sex ratio of male to female as 2.9 ： 1. At any age group, the incidence and mortality of liver cancer among males were higher than those of females. Liver cancer happened more frequently among people older than 40 years of age, particularly among males. Data under our prediction showed that the incidence and mortality of liver cancer in China would gradually increasein the next 20 years. Conclusion Liver cancer is one of the most important public health issues in China. Both incidence and mortality of liver cancer have been increasing in China. The key populations for liver cancer prevention and control programs should be those who were older than 40-year-old. oarticularlv on men.