2015年中国胃癌流行特征分析

Epidemiological characteristics of gastric cancer in China,2015

目的估算2015年我国胃癌的发病死亡情况和分布特征,为肿瘤防控研究和政策制定提供参考依据。方法对2018年全国肿瘤登记中心501个登记处的2015年肿瘤登记数据进行评估,其中368个肿瘤登记处的数据符合入选标准,按城乡、性别以及年龄分层,结合2015年全国人口数据,估计全国胃癌的发病和死亡情况。中国人口标化率(中标率)采用2000年全国人口普查的标准人口年龄构成,世界人口标化率(世标率)采用Segi's世界标准人口结构计算。结果2015年368个登记地区覆盖人口309553499人,男性156934140人,女性152619359人。估计全国胃癌新发病例40.3万例,发病率为29.31/10万,中标率为18.68/10万,世标率为18.57/10万,0~74岁累积发病率为2.29%,居发病癌谱第二位。胃癌死亡病例29.09万例,死亡率为21.16/10万,中标率为13.08/10万,世标率为12.92/10万,0~74岁累积死亡率为1.5%,居癌症死亡顺位第三位。总体上,胃癌发病率(男性中标率为26.54/10万,女性中标率为11.09/10万)和死亡率(男性中标率为18.75/10万,女性中标率为7.72/10万)男性均高于女性,农村地区均高于城市地区(农村中标发病率为21.82/10万,城市中标发病率为16.37/10万;农村中标死亡率为15.84/10万,城市中标死亡率为11.05/10万)。胃癌年龄别发病率和死亡率在40岁之前较低,40岁后开始上升,在80~岁达到高峰。胃癌病例数自50~岁开始显著增多,高峰出现在60~70岁组,大量病例累积在55~80岁。不同性别、城乡地区年龄别发病率和死亡率与全人群总体趋势相似,但男性高于女性,农村高于城市。结论我国胃癌发病有明显的性别、年龄和城乡分布差异,可根据高发年龄和高危人群特征优化筛查项目和防控方案,以期降低我国胃癌的疾病负担。

Objective To estimate the morbidity and mortality of gastric cancer and its distribution in China in 2015 and provide information for future cancer prevention and control study and policy decision.Methods In 2018,a total of 501 cancer registry systems reported data to the office of National Central Cancer Registry,and the data from 368 cancer registry systems met the criteria.The overall,gender specific,age specific and area specific morbidity and mortality rates of gastric cancer in China were estimated based on national population data in 2015.Chinese standard population in 2000 and World Segi's population data were used to calculate the age-standardized rates(ASR)of morbidity and mortality,including ASR of China and the world.Results In 2015,the qualified 368 cancer registry system covered a total of 309553499 population in China,including 156934140 males and 152619359 females.We estimated that there were 403000 new gastric cancer cases,with the crude morbidity rate of 29.31 per 100000,ASR China of 18.68 per 100000,ASR world of 18.57 per 100000,and a cumulative rate of 2.29%for 0-74 years.There were 290900 new gastric cancer deaths,with the crude mortality rate of 21.16 per 100000,ASR China of 13.08 per 100000,ASR world of 12.92 per 100000,and a cumulative rate of 1.5%for 0-74 years.Gastric cancer ranked second as the most common cancers and third as the most common cancer causes of death in China.In general,both the morbidity rate(ASR China,male:26.54 per 100000;female:11.09 per 100000;rural area:21.82 per 100000;urban area:16.37 per 100000)and mortality rate(ASR China,male:18.75 per 100000;female:7.72 per 100000;rural area:15.84 per 100000;urban area:11.05 per 100000)were higher in males than those in females,and higher in rural area than those in urban area.The morbidity and mortality rates of gastric cancer increased from the age of 40 years and peaked in age group of 80-years.The case number of gastric cancer significantly increased from the age group of 50-years,peaked at 60-70 years,and the majority of cases occured in age group of 55-80 years.There was an overall consistent trend of the age-specific morbidity and mortality rates across different subgroups by sex and geographic areas,with the rates were higher in males than those in females,and higher in rural area than that in urban area.Conclusions The incidence of gastric cancer varied with sex,age and areas(urban area and rural area).The present analysis provides the latest data on the prevalence of gastric cancer in China,which can help optimize the current screening guidelines and the prevention and control strategies of gastric cancer to reduce the disease burden caused by gastric cancer in China.