2022年中国甲状腺癌流行情况分析:基于《中国肿瘤登记年报》2005-2018年数据

Analysis of prevalence of thyroid cancer in 2022 in China:based on the data of China Cancer Registry Annual Report(2005–2018)

目的根据全国肿瘤登记中心及《中国肿瘤登记年报》报道的甲状腺癌登记数据分析2005–2018年我国甲状腺癌的流行趋势,同时了解中国2022年估计甲状腺癌的流行病学情况。方法纳入符合质量审核的约700个全国肿瘤登记处2018年的数据及《中国肿瘤登记年报》报道的2005–2018年的数据,按性别、年龄、城市和农村以及地区分别分析甲状腺癌的发病和死亡情况,同时结合2020年的中国人口统计数据分析2022年中国甲状腺癌的估计发病和死亡情况。结果①2005–2018年期间我国甲状腺癌的中国人口年龄标准化发病率(简称“标化发病率”)和中国人口年龄标准化死亡率(简称“标化死亡率”)情况:在全人群中,标化发病率整体呈较快速上升趋势,标化死亡率呈缓慢上升趋势;男性的标化发病率和标化死亡率均低于女性且变化趋势也更平缓;城市全人群甲状腺癌的标化发病率明显高于农村且城市和农村分别以6.31%和0.38%的平均年增长速度增长,而标化死亡率在城市和农村人群相比无明显差别(平均年增长速度分别为3.23%和2.33%);我国甲状腺癌的标化发病率以东部地区最高且增长程度也最为明显但其标化死亡率却增长较为低缓,在西部地区标化发病率增长较为低缓且标化死亡率也呈现下降趋势,而中部地区的标化死亡率增长程度较为明显。②2022年我国甲状腺癌的估计发病和死亡情况:全人群的估计标化发病率和标化死亡率在2022年相较于2018年均处于上升趋势(标化发病率:24.64/10万比12.01/10万;标化死亡率:0.45/10万比0.37/10万);2022年甲状腺癌估计标化发病率和标化死亡率在女性中远高于男性(标化发病率:36.51/10万比13.25/10万;标化死亡率:0.55/10万比0.35/10万);在城市与农村人群中,城市估计标化发病率仍远高于农村(标化发病率27.87/10万比17.66/10万),而估计标化死亡率差别不明显(0.41/10万比0.52/10万),与2018年相比,标化发病率发展趋势仍处于增长趋势(城市:27.87/10万比15.58/10万;农村:17.66/10万比8.95/10万)。2022年甲状腺癌年龄别标化发病率呈明显的性别差异,即女性自20~30岁组开始快速上升,至45~50岁组时达高峰(最高标化发病率为97.00/10万);而男性从0~20岁组一直处于缓慢上升趋势,而从20~25岁组开始出现了快速上升,在30~35岁组时达高峰(最高标化发病率为31.60/10万)。2022年甲状腺癌年龄别标化死亡率在男性与女性中整体趋势相似,从0~35岁开始缓慢上升,至85岁及以上时仍持续上升。结论我国甲状腺癌发病和死亡均呈上升趋势,疾病负担仍较严重且存在城乡、性别、年龄及地区差异,防控形势复杂且严峻。

Objective To analyze the epidemic trend of thyroid cancer in China from 2005 to 2018,and understand the estimated epidemiological situation of thyroid cancer in China in 2022 based on the thyroid cancer registration data reported by the National Cancer Registration Center and the China Cancer Registration Annual Report.Methods The cases of new thyroid cancer and deaths in China were analyzed according to the data of approximately 700 cancer registries in 2018 and the data of 106 cancer registries from 2005 to 2018,then stratified by sex,age,urban and rural areas,and main regions in China.And the estimated incidence and mortality of thyroid cancer in China in 2022 were analyzed based on the population data in 2020.Results①The age standardized incidence rate(ASIR)and age standardized mortality(ASMR)of thyroid cancer in China from 2005 to 2018:in the whole population,the ASIR showed a relatively rapid upward trend and the ASMR showed a relatively slower upward trend;The ASIR and ASMR of men were lower than those of women and the trend of change was also slower than that of women;The ASIR of thyroid cancer in the whole urban population was markedly higher than that in the rural population and the average annual rising rate(AARR)in the urban and rural areas was 6.31%and 0.38%respectively,while the ASMR had no obviously difference between the urban and rural populations(the AARR was 3.23%and 2.33%respectively);The ASIR of thyroid cancer was the highest in the eastern region with a markedly rising,but its ASMR had a relatively lower rising rate,while the ASIR in the western region was relatively lower and the ASMR also showed a downward trend,and the ASMR in the central region had a relatively obvious rising rate.②The estimated incidence and mortality of thyroid cancer in China in 2022:the estimated ASIR and ASMR of the whole population in 2022 was still rising as compared with in 2018(ASIR:24.64 per 100000 vs.12.01 per 100000;ASMR:0.45 per 100000 vs.0.37 per 100000);The estimated ASIR and ASMR in women were still much higher than in men(ASIR:36.51 per 100000 vs.13.25 per 100000;ASMR:0.55 per 100000 vs.0.35 per 100000);Among the urban and rural populations,the estimated ASIR in urban was still higher than in rural areas(27.87 per 100000 vs.17.66 per 100000),while the estimated ASMR had no marked difference between them(0.41 per 100000 vs.0.52 per 100000).Compared with 2018,the development trend of the ASIR was still rising(urban:27.87 per 100000 vs.15.58 per 100000;rural:17.66 per 100000 vs.8.95 per 100000).The age specific ASIR of thyroid cancer showed a marked sex differences,that is,it began to rise rapidly from the 20–30 years old group,and reached the peak at the 45–50 years old group(the highest ASIR was 97.00 per 100000)in women;However,which had been in a slower upward trend from the 0 to 20 years old group,while it had been rising rapidly from the 20 to 25 years old group,reaching the peak at the 30–35 years old group(the highest ASIR was 31.60 per 100000)in men.The overall trend of age specific ASMR for thyroid cancer was similar for both males and females,with a slower increase starting from the 0–35 years old age group and continuous rising till 85 years old and above.Conclusions The incidence and mortality of thyroid cancer in China are rising,and the disease burden is still severe and the differences are existed in urban and rural areas,sex,age,and main regions.Overall,the prevention and control situation is complex and severe in China.