2016年中国归因于人乳头瘤病毒感染的肿瘤发病与死亡分析

Analysis on cancer incidence and mortality attributed to human papillomavirus infection in China,2016

目的分析2016年我国归因于人乳头瘤病毒(HPV)感染的肿瘤发病和死亡情况。方法结合肿瘤发病率、死亡率、全国人口数及人群归因分值(PAF)计算2016年全国不同地区、不同年龄及男性和女性人群归因于HPV感染的肿瘤发病数和死亡数。使用Segi's人口计算年龄标化发病率和年龄标化死亡率。结果2016年全国有124772例(6.32/10万)肿瘤新发病例归因于HPV感染,包括女性肿瘤117118例,男性肿瘤7654例。宫颈癌居发病首位,其次为肛门癌、口咽癌、阴茎癌、阴道癌、喉癌、口腔癌和外阴癌。全国归因于HPV感染的肿瘤死亡41282例(2.03/10万),包括女性37417例,男性3865例。死亡数依次为宫颈癌、肛门癌、口咽癌、阴茎癌、喉癌、阴道癌、口腔癌、外阴癌。宫颈癌的发病率和死亡率随年龄增长快速上升,在50~54岁达高峰,之后大幅下降;非宫颈癌部位肿瘤发病率和死亡率随年龄增长呈上升趋势。农村地区可归因于HPV感染的肿瘤发病数(57089例)和死亡数(19485例)小于城市地区(发病67683例、死亡21797例),农村宫颈癌年龄标化发病率和死亡率均高于城市,非宫颈部位肿瘤的年龄标化发病率和死亡率在城乡之间未见明显差异。结论中国归因于HPV感染的肿瘤发病率低于全球平均水平,但发病人数占比较大,且发病死亡呈现增高趋势。宫颈癌和男性肛门癌的防控是遏制归因于HPV肿瘤发病和死亡增高趋势的关键。

Objective We aim to evaluate the morbidity and mortality of cancer attributable to human papillomavirus(HPV)infection in China in 2016.Methods Based on the cancer incidence and mortality rates,national population data,and population attributable fraction(PAF)in China,we calculated the number of incidence and death cases attributed to HPV infection in different areas,age groups,and gender in China in 2016.The standardized incidence and mortality rates for cancer attributed to HPV infection were calculated by using Segi's population.Results In 2016,a total of 124772 new cancer cases(6.32 per 100000)were attributed to HPV infection in China,including 117118 cases in women and 7654 cases in men.Of these cancers,cervical cancer was the most common one,followed by anal cancer,oropharyngeal cancer,penile cancer,vaginal cancer,laryngeal cancer,oral cancer,and vulvar cancer.A total of 41282(2.03 per 100000)deaths were attributed to HPV infection,of which 37417 occurred in women and 3865 in men.Most deaths were caused by cervical cancer,followed by anal cancer,oropharyngeal cancer,penile cancer,laryngeal cancer,vaginal cancer,oral cancer,and vulvar cancer.The incidence and mortality rates of cervical cancer increased rapidly with age,peaked in age group 50-54 years,then decreased obviously.The morbidity and mortality rates of non-cervical cancer increased with age.The cancer case and death numbers in rural areas(57089 cases and 19485 deaths)were lower than those in urban areas(67683 cases and 21797 deaths).However,the age-standardized incidence rate(ASIR)and age-standardized mortality rate(ASMR)of cervical cancer were higher in rural areas than in urban areas.There were no significant differences in ASIR and ASMR of non-cervical cancers between urban areas and rural areas.Conclusions The incidence of cancers attributed to HPV infection in China was lower than the global average,but the number of incidences accounted largely,furthermore there is an increasing trend of morbidity and mortality.The preventions and controls of cervical cancer and male anal cancer are essential to contain the increases in cancer cases and deaths attributed to HPV infection.