2014年中国膀胱癌发病和死亡分析

Incidence and mortality of bladder cancer in China, 2014

目的分析2017年全国肿瘤登记中心收集的全国各登记处上报的2014年膀胱癌登记资料，估计全国肿瘤登记地区2014年膀胱癌的发病和死亡情况。方法按照全国肿瘤登记中心制订的审核和评估标准，对449个登记处上报的2014年肿瘤登记数据进行评估，共339个肿瘤登记处的数据符合纳入标准。将入选的登记处按地区（城乡）、性别、年龄别的发病率和死亡率分层，并结合2014年全国人口数据，估计全国膀胱癌的发病和死亡情况。中国人口标化率（中标率）采用2000年全国人口普查的人口构成，世界人口标化率（世标率）采用Segi′s标准人口构成。结果2014年纳入分析的339个登记地区覆盖人口为288 243 347人，其中城市地区144 061 915人，农村地区144 181 432人。膀胱癌病理诊断比例为74.86%，仅有死亡证明书比例为1.45%，死亡发病比为0.41。2014年全国膀胱癌新发病例约为7.81万例，发病率为5.71/10万，中标发病率为3.61/10万，世标发病率为3.56/10万，累积发病率（0～74岁）为0.41%。城市地区发病率为6.88/10万，中标发病率为4.07/10万；农村地区发病率为4.29/10万，中标发病率为2.96/10万。2014年全国膀胱癌死亡病例约为3.21万例，死亡率为2.35/10万，中标死亡率为1.30/10万，世标死亡率为1.30/10万，累积死亡率（0～74岁）为0.12%。城市地区死亡率为2.79/10万，中标死亡率为1.41/10万；农村地区死亡率为1.81/10万，中标死亡率为1.14/10万。结论中国膀胱癌的发病和死亡在城乡间存在差异，城市高于农村，男性高于女性，应加强重点人群尤其是城市地区男性膀胱癌的预防和控制。

Objective To estimate the incidence and mortality of bladder cancer in China based on the cancer registration data in 2014, collected by the National Central Cancer Registry （NCCR）. Methods There were 449 cancer registries submitted bladder cancer new cases and deaths occurred in 2014 to NCCR. After evaluating the data quality, 339 registries＇ data were finally accepted for analysis. According to the national population data of 2014, the nationwide incidence and mortality of bladder cancer were estimated by stratification in the area （urban or rural） , gender, and age. Chinese population census in 2000 and Segi＇s population were used for age-standardized incidence/mortality rates. Results covered a total of 288 243 347 populations （ 144 061 915 in urban and 144 181 All 339 cancer registries 432 in rural areas）. The percentage of morphologically verified cases and death certificate-only cases were 74.86% and 1.45%, respectively. The mortality to incidence ratio was 0.41. The estimates of new bladder cancer cases were 78 100 in China in 2014, with a crude incidence rate of 5.71/100 000. The age-standardized incidence rates by China standard population （ASR China） and world standard population （ASR world） of bladder cancer were 3.61/100 000 and 3.56/100 000, respectively. Cumulative incidence rate of bladder caneer in China was 0.41%. The crude and ASR China incidence rates in urban areas were 6.88/100 000 and 4.07/100 000, respectively, whereas those were 4.29/100,000 and 2.96/100 000 in rural areas. The estimates of bladder cancer deaths caused by bladder cancer were about 32 100 in China in 2014, with a crude mortality rate of 2.35/100 000. The ASR China and ASR world mortality rates were both 1.30/100 000 with a cumulative mortality rate （0-74 years old） of 0.12%. The crude and ASR China mortality rates were 2.79/100 000 and 1.41/100 000 in urban areas, respectively, whereas those were 1.81/100 000 and 1.14/100 000 in rural areas. Conelusions The incidence and mortality pattern of bladder cancer were different in urban and rural areas. The incidence and mortality were higher in urban areas than that in rural areas, and higher for male than for female. We should focus on strengthening the prevention and control of bladder cancer in key population, especially men in urban areas.