2016年中国恶性肿瘤流行情况分析

Cancer statistics in China,2016

目的根据全国各肿瘤登记处上报至全国肿瘤登记中心的2016年恶性肿瘤登记数据,估计2016年中国恶性肿瘤流行特征。方法根据全国肿瘤登记中心对肿瘤登记数据的质量控制和审核流程,对各省上报的683个登记处数据进行审核评估,纳入符合数据质控标准的487个登记处数据。按性别、城乡、年龄分层计算不同肿瘤的发病率和死亡率。结合中国人口数据,估计2016年中国恶性肿瘤发病、死亡情况。标准人口采用2000年中国人口普查人口和Segi′s世界标准人口。结果纳入分析的487个登记处共覆盖人口381565422人,其中城市地区192628370人,农村地区188937052人。病理诊断比例为68.31%,只有死亡证明书比例为1.40%,死亡发病比为0.61。2016年中国新发恶性肿瘤病例约406.40万,粗发病率为293.91/10万(男性315.52/10万,女性271.23/10万),中国人口标化率(简称中标率)190.76/10万,世界人口标化率(简称世标率)186.46/10万,累积率(0~74岁)为21.42%。城市地区粗发病率为314.74/10万,中标发病率196.38/10万;农村地区粗发病率为265.90/10万,中标发病率182.21/10万。2016年中国恶性肿瘤死亡病例约241.35万,粗死亡率为174.55/10万(男性216.16/10万,女性130.88/10万),中标死亡率106.00/10万,世标死亡率105.19/10万,累积死亡率(0~74岁)为11.85%。城市地区粗死亡率为180.31/10万,中标死亡率104.44/10万;农村地区粗死亡率为166.81/10万,中标死亡率108.01/10万。中国当前的主要恶性肿瘤包括肺癌、结直肠癌、胃癌、肝癌、女性乳腺癌等,前5位恶性肿瘤发病约占全部新发病例的57.27%。肺癌、肝癌、胃癌、结直肠癌、食管癌是主要的肿瘤死因,约占全部肿瘤死亡病例的69.25%。结论中国恶性肿瘤负担依旧较重,恶性肿瘤负担地区差异及性别差异明显,癌谱结构仍然呈现发达国家癌谱与发展中国家癌谱共存的局面,恶性肿瘤防控形势严峻。

Objective Data for 2016 from cancer registries were used to estimate cancer incidence and mortality in China in 2016.Methods According to the quality control process of the National Central Cancer Registry,the data from 683 cancer registries submitted by each province were evaluated,and the data of 487 cancer registries were qualified and included in the final analysis.Age-specific incidence and mortality rates were calculated by area(urban/rural),sex,age and cancer site,combined with national population data to estimate cancer incidence and mortality in China in 2016.Chinese population census in 2000 and Segi′s population were used for age-standardized incidence and mortality rates.Results Total population covered by 487 cancer registries was 381565422(192628370 in urban and 188937052 in rural areas).The percentages of morphologically verified(MV%)and death certificate-only cases(DCO%)accounted for 68.31%and 1.40%,respectively,and the mortality to incidence ratio was 0.61.It was estimated about 4064000 new cases occurred in China in 2016,with the crude incidence rate being 293.91/100000(the rates of males and females were 315.52/100000 and 271.23/100000),age-standardized incidence rates by Chinese standard population(ASIRC)and by world standard population(ASIRW)were 190.76/100000 and 186.46/100000,with the cumulative incidence rate(0-74 years old)being 21.42%.The crude incidence and ASIRC were 314.74/100000 and 196.38/100000 in urban areas,whereas in rural areas,they were 265.90/100000 and 182.21/100000,respectively.It was estimated about 2413500 cancer deaths occurred in China in 2016,the crude mortality rate was 174.55/100000(216.16/100000 in males and 130.88/100000 in females),the age-standardized mortality rates by Chinese standard population(ASMRC)and by world standard population(ASMRW)were 106.00/100000 and 105.19/100000,and the cumulative mortality rate(0-74 years old)was 11.85%.The crude mortality and ASMRC were 180.31/100000 and 104.44/100000 in urban areas,whereas in rural areas,they were 166.81/100000 and 108.01/100000,respectively.The most common cancer cases include lung,colorectal,stomach,liver and female breast cancers.The top five cancers accounted for about 57.27%of all cancer cases.The most common cancer deaths included lung,liver,stomach,colorectal and esophageal cancers.The top five cancers accounted for about 69.25%of all cancer deaths.Conclusions The burden of cancer shows a continuous increasing trend in China.Regional and gender differences in cancer burden are obvious.The cancer patterns still show the coexistence of cancer patterns in developed countries and developing countries.The situation of cancer prevention and control is still serious in China.