2020年中国与全球结直肠癌流行概况分析

Prevalence of colorectal cancer in 2020:a comparative analysis between China and the world

目的分析2020年中国与全球各地区结直肠癌的发病及死亡数据,探讨中国及全球结直肠癌的疾病负担和流行病学特征。方法全球结直肠癌发病率和死亡率的估算数据来自GLOBOCAN 2020数据库,对比中国与全球20个地区的结直肠癌发病和死亡情况、年龄标化发病率(ASIR)和年龄标化死亡率(ASMR),分析人类发展指数(HDI)与ASIR及ASMR的相关性。结果2020年全球结直肠癌新发病例数达193.16万,死亡病例数达93.52万。全球各地区发病率及死亡率均在50岁以上年龄别组出现持续上升,男性疾病负担高于女性。全球结直肠癌发病及死亡人数最多的地区为东亚地区,分别为74.00万和36.01万。全球各地区之间结直肠癌的发病率及死亡率差异显著。ASIR最高的地区为北欧(33.61/10万),最低的地区为中南亚(5.46/10万);ASMR最高的地区为东欧(14.53/10万),最低的地区为中南亚(3.16/10万)。HDI与ASIR(r^(2)=0.59,P<0.001)和ASMR(r^(2)=0.38,P<0.001)呈正相关。中国结直肠癌新发病例达55.55万,ASIR为24.07/10万;死亡病例达28.62万,ASMR为12.07/10万。中国结直肠癌新发病例数及死亡病例数均占全球约30%,占东亚地区的75%以上。中国ASIR在全球处于中等水平而ASMR处于高水平。结论结直肠癌发病率及死亡率与社会发展水平相关。中国是全球结直肠癌疾病负担较为沉重的国家之一。

Objective To demonstrate the disease burden and epidemiological characteristics of colorectal cancer in different regions by analyzing the incidence and mortality data in China and worldwide in 2020.Methods Estimation of the incidence and mortality data of colorectal cancer were obtained from the GLOBOCAN 2020 database.The incidence,death,age standardized incidence rate(ASIR)and age standardized mortality rate(ASMR)of colorectal cancer in China and 20 regions in the world were compared.The correlation between the Human Development Index(HDI)and ASIR/ASMR was analyzed.Results In 2020,the number of new cases of colorectal cancer in the world reached 1931600,and the number of deaths reached 935200.The incidence and mortality in all regions of the world continued to rise in the age group above 50 years old.The morbidity and mortality in male were higher than those in female.East Asia ranked the highest number of incidence cases and deaths in the world,which were 740000 and 360100 respectively.There were significant differences in incidence and mortality among regions in the world.The highest ASIR and ASMR were observed in Northern Europe(33.61/100000)and Eastern Europe(14.53/100000),whereas the lowest ASIR and ASMR were both observed in South-Central Asia(5.46/100000 and 3.16/100000).HDI had significant exponential relationship with ASIR(r^(2)=0.59,P<0.001)and ASMR(r^(2)=0.38,P<0.001).There were 555500 new cases and 286200 death cases of colorectal cancer in China,accounting for about 30%of the world and more than 75%of East Asia.The ASIR of China was 24.07/100000,ranking at the medium level,while the ASMR was 12.07/100000,ranking at the high level of world.Conclusion The incidence and mortality of colorectal cancer are highly correlated with HDI.China is one of the countries with the heaviest disease burden of colorectal cancer in the world.