Comprehensive Analysis of Cancer Incidence and Mortality Trends in Costa Rica: Implications for Public Health

This commentary delves into the evolving landscape of cancer incidence and mortality in Costa Rica, presenting a comprehensive analysis of the data. Key findings reveal a concerning upward trajectory in cancer incidence rates, placing Costa Rica at the forefront within Central America. While prostate cancer and breast cancer dominate, disparities emerge when scrutinizing gender-specific trends. Notably, stomach and cervical cancers show declines, potentially attributed to targeted interventions. However, colorectal and liver cancers witness mortality increases, necessitating strategic responses. Geographical disparities persist across provinces, highlighting the need for equitable healthcare access. In conclusion, this commentary underscores the urgency of addressing the burgeoning cancer burden in Costa Rica, calling for evidence-based interventions and collaborative efforts on a global scale.

Patterns and trends in esophageal cancer incidence and mortality in China:An analysis based on cancer registry data

Background:Esophageal cancer poses a significant global burden,while its patterns and trends remain to be clarified.The aim of this study is to provide an update on the incidence and mortality rates of esophageal cancer and their trends in China based on data from the National Cancer Registry.Methods:We extracted data from the National Central Cancer Registry(NCCR)of China from 2000 to 2016 and performed comprehensive quality control.We calculated age-standardized rates of China(ASR China)and world(ASR world)using the Chinese population in 2000 and the Segi’s world standard population,and performed a joinpoint regression analysis to examine the trend in incidence and mortality of esophageal cancer.The annual percent change(APC)and weighted average APC(AAPC)over the entire study period were estimated to measure the changing trend.Subgroup analyses were conducted by sex,region and pathological type.Results:A total of 487 eligible cancer registries were included in the data analysis and 22 registries with unin-terrupted registration data were used for trend analysis.In 2016,there were an estimated of 184,500 incident cases of esophageal cancer and 142,300 deaths in China.The crude incidence,ASR China and ASR world were 25.25/100,000,11.00/100,000 and 11.13/100,000,respectively.And the crude mortality,ASR China and ASR world were 19.38/100,000,8.25/100,000 and 8.28/100,000,respectively.Esophageal squamous cell carcinoma(ESCC)was the most common histological type,accounting for 85.79%of all cases,followed by esophageal ade-nocarcinoma(EAC)(11.00%)and others(3.21%).There was a decreasing trend of ASR world in incidence and mortality during 2000-2016 with the AAPC of-4.6%(95%CI:-5.7%,-3.4%)and-4.6%(95%CI:-5.2%,-3.9%).The pattern and trend of esophageal cancer differ in sex,region and pathological type.Conclusions:The burden of esophageal cancer in China remains high with sex,regional and subtype differences.The incidence and mortality of esophageal cancer have continued to decline over the past decade,which was due in part to the reductions in risk factor exposure and the implementation of screening.

Gastric cancer incidence and mortality in Zhuanghe,China,between 2005 and 2010

AIM： To investigate the incidence and mortality of gastric cancer （GC） in Zhuanghe region, northeast China and the influencing factors for their changing trends.METHODS： All new cancer cases and deaths registered from 2005 to 2010 in Zhuanghe County were reviewed. The annual GC cases, constituent ratio, crude rates,age-standardized rates, their sex and age distribution and temporal trends were assessed. The method of annual percentage change （APC） was used to estimate the trends of GC.RESULTS： Altogether 2634 new cases of GC and 1722 related deaths were registered, which accounted for 21.04% and 19.13% of all cancer-related incidence and deaths, respectively. The age-standardized incidence rate steadily decreased from 57.48 in 2005 to 44.53 in 2010 per 10^5 males, and from 18.13 to 14.70 per 10s females, resulting in a APC of -5.81% for males and -2.89% for females over the entire period. The magnitude of APC in GC mortality amounted to -11.09% and -15.23%, respectively, as the agestandardized mortality rate steadily decreased from 42.08 in 2005 to 23.71 in 2010 per 10^5 males, and from 23.86 to 10.78 per 10^5 females. Females had a significantly lower incidence （a male/female ratio 2.80, P 〈 0.001） and mortality （a male/female ratio 2.30, P 〈 0.001）. In both genders, the peak incidence and mortality occurred in the 80-84 years age group. The age-standardized mortality/incidence ratio also decreased from the peak of 0.73 in 2005 to 0.53 in 2010 for males, and from 1.32 to 0.73 for females.CONCLUSION： Encouraging declines of incidence and mortality of GC were observed in Zhuanghe region between 2005 and 2010, possibly due to the economic development and efficient GC control strategies.

Global and regional trends in the incidence and mortality burden of endometrial cancer,1990–2019:Updated results from the Global Burden of Disease Study,2019

Background:The disease burdens for endometrial cancer(EC)vary across different countries and geographical regions and change every year.Herein,we reported the updated results of the Global Burden of Disease Study 2019 on EC with respect to age-standardized incidence and mortality from 1990 to 2019.Methods:The annual percentage change(APC)of incidence and mortality was evaluated using joinpoint regression analysis to examine the temporal trends during the same timeframe in terms of the global landscape,different sociodemographic indices(SDI),and geographic regions.The relationship between Human Development Index(HDI)and incidence and mortality was additionally explored.Results:The age-standardized incidence rates(ASIRs)revealed a significant average global elevation by 0.5%per year(95%confidence interval[CI],0.3–0.7;P<0.001).The age-standardized mortality rates(ASMRs),in contrast,fell by an average of 0.8%per year(95%CI,−1.0 to−0.7;P<0.001)worldwide.The ASIRs and ASMRs for EC varied across different SDIs and geographical regions.We noted four temporal trends and a significant reduction by 0.5%per year since 2010 in the ASIR,whereas we detected six consecutively decreasing temporal trends in ASMR during the entire period.Notably,the estimated APCs were significantly positively correlated with HDIs(ρ=0.22;95%CI,0.07–0.35;P=0.003)with regard to incident cases in 2019.Conclusions:Incidence rates for EC reflected a significant increase overall(although we observed a decline since 2010),and the death rates declined consecutively from 1990 to 2019.We posit that more precise strategies can be tailored and then implemented based on the distinct age-standardized incidence and mortality burden in different geographical areas.

Incidence And Mortality Trend of Cervical Cancer in 11 Cancer Registries of China

Objective：In many countries,the cervical cancer prevalence has declined but less information about the changes is available in China.This study aims to understand the epidemiological characteristics and trend of cervical cancer in China.Methods：Cervical cancer data of 11 cancer registries during 1988-2002 in China were analyzed.The age and urban/rural differences and trend of cervical cancer incidence and mortality were described and discussed.Results：During 1988-2002,a total of 6007 incidence cases and 3749 mortality cases of cervical cancer were reported in the 11 cancer registries.The incidence crude rate of cervical cancer was 3.80/100,000 and the world age adjusted rate was 2.78/100,000.In the same period,the mortality crude rate was 2.37/100,000 and the world age adjusted rate was 1.66/100,000.Declined incidence and mortality trends were observed during this period in urban as well as in rural areas.When calculating the rates by age group,we found that the declining trends were only for older women and increasing trends for younger women,especially for women in the rural areas.Conclusion：The incidence and mortality rates declined during the period of 1988-2002 in China for older women.The younger women showed an increasing trend during the same period,especially for women in rural area.

Colorectal cancer incidence and mortality:the current status,temporal trends and their attributable risk factors in 60 countries in 2000–2019

Background:Globally,colorectal cancer(CRC)imposes a substantial burden on healthcare systems and confers considerable medical expenditures.We aimed to evaluate the global and regional burden in epidemiological trends and factors associated with the incidence and mortality of CRC.Methods:We used data from the GLOBOCAN database to estimate CRC incidence and mortality worldwide in 2020 and their association with the human development index(HDI).Trends of age-standardized rates of incidence and mortality in 60 countries(2000–2019)were evaluated by Joinpoint regression analysis using data of Global Burden of Disease 2019.The association between exposure to country-level lifestyle,metabolic and socioeconomic factors obtained from the World Health Organization Global Health Observatory and World Bank DataBank data and CRC incidence and mortality was determined by multivariable linear regression.Results:CRC incidence and mortality varied greatly in the 60 selected countries,and much higher incidence and mortality were observed in countries with higher HDIs,and vice versa.From 2000 to 2019,significant increases of incidence and mortality were observed for 33 countries(average annual percent changes[AAPCs],0.24–3.82)and 18 countries(AAPCs,0.41–2.22),respectively.A stronger increase in incidence was observed among males(AAPCs,0.36–4.54)and individuals<50 years(AAPCs,0.56–3.86).Notably,15 countries showed significant decreases in both incidence(AAPCs,0.24 to2.19)and mortality(AAPCs,0.84 to2.74).A significant increase of incidence among individuals<50 years was observed in 30 countries(AAPCs,0.28–3.62).Countries with higher incidence were more likely to have a higher prevalence of alcohol drinking,higher level of cholesterol level,higher level of unemployment,and a poorer healthcare system.Conclusions:Some high-HDI countries showed decreasing trends in CRC incidence and mortality,whereas developing countries that previously had low disease burden showed significantly increased incidence and mortality trends,especially in males and populations≥50 years,which require targeted preventive health programs.

Global and regional trends in incidence and mortality of female breast cancer and associated factors at national level in 2000 to 2019

Background: Female breast cancer (FBC) has become the most prevalent malignancy worldwide. We aimed to evaluate the global and regional burden in epidemiological trends and factors associated with the incidence and mortality of FBC.Methods: FBC incidence and mortality in 60 selected countries by cancer registry data integrity in 2020 were estimated from the GLOBOCAN database, and their association with the human development index (HDI) was further evaluated. Trends of age-standardized rates of incidence and mortality in 60 countries from 2000 through 2019 were evaluated by joinpoint regression analysis using data of Global Burden of Disease 2019. The association between potential behavioral, metabolic, and socioeconomic risk factor exposure at the nation level retrieved from the World Bank and Global Health Observatory and the incidence and mortality of FBC were evaluated by multivariate linear regression.Results: FBC incidence and mortality varied greatly in the 60 included countries. Higher incidence and mortality rates were typically observed in countries with higher HDIs and vice versa. During 2000 to 2019, significantly increasing trends in incidence and mortality were observed in 26 (average annual percent changes [AAPCs], 0.35-2.96) and nine countries (AAPC, 0.30-1.65), respectively, while significantly decreasing trends in both incidence and mortality were observed in 22 countries, most of which were high-HDI countries. Among the population aged ≥40 years, there were 26 and 11 countries showing significantly increased trends in incidence and mortality, respectively. Ecological analysis showed that countries with higher prevalence rates of high cholesterol and higher health expenditures were more likely to have higher FBC incidence, and countries with higher rates of obesity and poorer universal health coverage were more likely to have higher FBC mortality.Conclusions: Despite decreased or stabilized FBC incidence and mortality rates were observed in some countries with high HDI over the past decades, disease burden became even severer in developing countries, especially for the population aged ≥40 years. Effective targeted preventive programs are strongly encouraged to reduce the FBC disease burden worldwide.

Esophageal cancer global burden profiles, trends, and contributors

Objective:This study aimed to provide a comprehensive overview of the global burden of esophageal cancer(EC)and determine the temporal trends and factors influencing changes in the global burden.Methods:The latest incidence and mortality data for EC worldwide were obtained from GLOBALCAN 2022.The mortality and disability-adjusted life years(DALYs)rates for EC from 1990±2019 were sourced from the 2019 Global Burden of Diseases.Trends in EC mortality and DALYs attributable to 11 risk factors or clusters of risk were analyzed using the joinpoint regression model.The trends in age-related EC burden were assessed using a decomposition approach.Results:An estimated 511,054 new cases of EC were diagnosed in 2022 with 445,391 deaths worldwide.Approximately 75%of cases and deaths occurred in Asia.Nearly 50%of global EC deaths and DALYs were attributed to tobacco use in men in 2019,while 20%were attributed to high body mass index(BMI)in women.From 1990±2019,EC deaths and DALYs attributable to almost all risk factors had declining trends,while EC deaths and DALYs attributed to high BMI in men had upward trends.The age-related EC burden exhibited an upward trend driven by population growth and aging,which contributed to 307.4 thousand deaths and 7.2 million DALYs due to EC.Conclusions:The EC burden remains substantial worldwide.Effective tobacco and obesity control measures are critical for addressing the risk-attributable burden of EC.Population growth and aging pose challenges for EC prevention and control efforts.

Global patterns of breast cancer incidence and mortality:A population-based cancer registry data analysis from 2000 to 2020

Background:Breast cancer is the most commonly diagnosed cancer and leading cause of cancer death among women worldwide but has patterns and trends which vary in different countries.This study aimed to evaluate the global patterns of breast cancer incidence and mortality and analyze its temporal trends for breast cancer prevention and control.Methods:Breast cancer incidence and mortality data in 2020 were obtained from the GLOBOCAN online database.Continued data from the Cancer Incidence in Five Continents Time Trends,the International Agency for Research on cancer mortality and China National Central Cancer Registry were used to analyze the time trends from 2000 to 2015 through Joinpoint regression,and annual average percent changes of breast cancer incidence and mortality were calculated.Association between Human Development Index and breast cancer incidence and mortality were estimated by linear regression.Results:There were approximately 2.3 million new breast cancer cases and 685,000 breast cancer deaths worldwide in 2020.Its incidence and mortality varied among countries,with the age-standardized incidence ranging from the highest of 112.3 per 100,000 population in Belgium to the lowest of 35.8 per 100,000 population in Iran,and the age-standardized mortality from the highest of 41.0 per 100,000 population in Fiji to the lowest of 6.4 per 100,000 population in South Korea.The peak age of breast cancer in some Asian and African countries were over 10 years earlier than in European or American countries.As for the trends of breast cancer,the age-standardized incidence rates significantly increased in China and South Korea but decreased in the United States of America(USA)during 2000-2012.Meanwhile,the age-standardized mortality rates significantly increased in China and South Korea but decreased in the United Kingdom,the USA,and Australia during 2000 and 2015.Conclusions:The global burden of breast cancer is rising fast and varies greatly among countries.The incidence and mortality rates of breast cancer increased rapidly in China and South Korea but decreased in the USA.Increased health awareness,effective prevention strategies,and improved access to medical treatment are extremely important to curb the snowballing breast cancer burden,especially in the most affected countries.

Lung cancer burden and trends from 2000 to 2018 in China:Comparison between China and the United States

Objective: This study aims to provide an analysis of the current status and trends of lung cancer incidence and mortality rates in China, comparing trends with those in the United States(U.S.).Methods: Data on lung cancer incidence and mortality rates spanning 2000 to 2018 were extracted from the China Cancer Registry Annual Report and the Surveillance, Epidemiology, and End Results database for China and the U.S., respectively. Crude incidence and mortality rates were calculated by sex and age, with age-standardized incidence rates(ASIR) and mortality rates(ASMR) calculated using the Segi-Doll world standard population.Trend analyses employed Joinpoint regression models to determine average annual percentage change(AAPC).The study also assessed the proportion of new cases and deaths by sex and age.Results: In 2018, the ASIR of lung cancer for males in China was 50.72 per 100,000 and the ASMR was 39.69 per 100,000, the ASIR for females was 26.25 per 100,000 and the ASMR was 15.24 per 100,000. Both ASIR and ASMR were higher in males and the highest in the population aged 65 years and older, with the lowest among those aged 20-49 years. In China, female ASIR demonstrated an increasing trend(AAPC: 1.16%), while ASMR decreased in both sexes(AAPCs:-0.48% for males,-1.00% for females). The U.S. exhibited decreasing trends in both ASIR and ASMR across sexes and age groups.Conclusions: The study identified an increasing trend in lung cancer incidence among females and a decreasing mortality trend in both sexes in China. These trends are likely linked to factors such as smoking prevalence,advancements in cancer screening, and improved medical care. The findings underscore the need for tailored lung cancer prevention measures in China, particularly the reinforcement of anti-smoking policies.

Trend analysis of cancer incidence and mortality in China

The National Central Cancer Registry of China （NCCRC） up- dated their nationwide statistics of cancer incidence and mor- tality in China according to 2013 population-based cancer registration data （due to the time required for data collection, quality control and analysis, the latest cancer statistics avail- able in China have a 3-year lag behind the current year）.

Cancer statistics and trends in China:the potential of natural product application

Cancer presents a significant global challenge,impacting individuals,communities,and healthcare systems worldwide[1,2].Fundamentally,cancer involves the uncontrolled growth and proliferation of cells,driven by genetic and epigenetic alterations orchestrated by a complex array of molecular entities,including oncogenes,tumor suppressor genes,and various regulatory factors[3-5].This intricate interplay complicates early detection,often resulting in a significant mortality burden.Accounting for nearly 30%of premature deaths globally,cancer is a major barrier to increasing human life expectancy[6,7].The urgent need for continued research,innovation,and collaborative efforts highlights the importance of combating this relentless disease.

Cancer incidence,mortality,and burden in China:a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020

Background:Cancer is one of the leading causes of death and a main economic burden in China.Investigating the differences in cancer patterns and control strategies between China and developed countries could provide reference for policy planning and contribute to improving cancer control measures.In this study,we reviewed the rates and trends of cancer incidence and mortality and disability-adjusted life year(DALY)burden in China,and compared them with those in the United States(US)and the United Kingdom(UK).Methods:Cancer incidence,mortality,and DALY data for China,US and UK were obtained fromtheGLOBOCAN2020 online database,Global Burden of Disease(GBD)2019 study,and Cancer Incidence in Five Continents plus database(CI5 plus).Trends of cancer incidence and mortality in China,US,and UK were analyzed using Joinpoint regression models to calculate annual percent changes(APCs)and identify the best-fitting joinpoints.Results:An estimated 4,568,754 newly diagnosed cancer cases and 3,002,899 cancer deaths occurred in China in 2020.Additionally,cancers resulted in 67,340,309 DALYs in China.Compared to the US and UK,China had lower cancer incidence but higher cancer mortality andDALY rates.Furthermore,the cancer spectrum of China was changing,with a rapid increase incidence and burden of lung,breast,colorectal,and prostate cancer in addition to a high incidence and heavy burden of liver,stomach,esophageal,and cervical cancer.Conclusions:The cancer spectrum of China is changing from a developing country to a developed country.Population aging and increase of unhealthy lifestyles would continue to increase the cancer burden of China.Therefore,the Chinese authorities should adjust the national cancer control program with reference to the practices of cancer control which have been well-established in the developed countries,and taking consideration of the diversity of cancer types by of different regions in China at the same time.

Epidemiology of pancreatic cancer

Cancer of the pancreas remains one of the deadliest cancer types. Based on the GLOBOCAN 2012 estimates, pancreatic cancer causes more than 331000 deaths per year, ranking as the seventh leading cause of cancer death in both sexes together. Globally, about 338000 people had pancreatic cancer in 2012, making it the 11^(th) most common cancer. The highest incidence and mortality rates of pancreatic cancer are found in developed countries. Trends for pancreatic cancer incidence and mortality varied considerably in the world. A known cause of pancreatic cancer is tobacco smoking. This risk factor is likely to explain some of the international variations and gender differences. The overall five-year survival rate is about 6%(ranges from 2% to 9%), but this vary very small between developed and developing countries. To date, the causes of pancreatic cancer are still insufficiently known, although certain risk factors have been identified, such as smoking, obesity, genetics, diabetes, diet, inactivity. There are no current screening recommendations for pancreatic cancer, so primary prevention is of utmost importance. A better understanding of the etiology and identifying the risk factors is essential for the primary prevention of this disease.

The epidemiology of colorectal cancer in China

Objective:Colorectal cancer(CRC)is one of the most common cancers and the major cause of cancer death in China.The aim of this study was to estimate the burden of CRC in China.Materials and methods:Data from the National Cancer Center(NCC)of China was used and stratified by area(urban/rural),sex(male/female)for analyzing the age-speci c incidence and mortality rates.Time trend of colorectal cancer was calculated based on the 22 high-quality cancer registries in China.National new cases and deaths of colorectal cancer were estimated using age-speci c rates multiplied by the corresponding national population in 2014.The Chinese population in 2000 and Segi’s world population were used to calculate age-standardized rates of colorectal cancer in China.Results:Overall,370,400 new colorectal cancer cases and 179,600 deaths were estimated in China in 2014,with about 214,100 new cases in men and 156,300 in women.Meanwhile,104,000 deaths cases of colorectal cancer were men and 75,600 deaths were women,which accounted for 9.74%and 7.82%of all cancer incidence and deaths in China,separately.Relatively higher incidence and mortality was observed in urban areas of China.And the Eastern areas of China showed the highest incidence and mortality.The age-standardized incidence and mortality rate of colorectal cancer has increased by about 1.9%per year for incidence and about 0.9%per year for mortality rate from 2000 to 2014.Conclusion:With gradually higher incidence and mortality rate in the past 15 years,colorectal cancer became a major challenge to China’s public health.E ective control strategies are needed in China.

Cancer statistics in China and United States,2022:profiles,trends,and determinants

Background:The cancer burden in the United States of America(USA)has decreased gradually.However,China is experiencing a transition in its cancer profiles,with greater incidence of cancers that were previously more common in the USA.This study compared the latest cancer profiles,trends,and determinants between China and USA.Methods:This was a comparative study using open-source data.Cancer cases and deaths in 2022 were calculated using cancer estimates from GLOBOCAN 2020 and population estimates from the United Nations.Trends in cancer incidence and mortality rates in the USA used data from the Surveillance,Epidemiology,and End Results program and National Center for Health Statistics.Chinese data were obtained from cancer registry reports.Data from the Global Burden of Disease 2019 and a decomposition method were used to express cancer deaths as the product of four determinant factors.Results:In 2022,there will be approximately 4,820,000 and 2,370,000 new cancer cases,and 3,210,000 and 640,000 cancer deaths in China and the USA,respectively.The most common cancers are lung cancer in China and breast cancer in the USA,and lung cancer is the leading cause of cancer death in both.Age-standardized incidence and mortality rates for lung cancer and colorectal cancer in the USA have decreased significantly recently,but rates of liver cancer have increased slightly.Rates of stomach,liver,and esophageal cancer decreased gradually in China,but rates have increased for colorectal cancer in the whole population,prostate cancer in men,and other seven cancer types in women.Increases in adult population size and population aging were major determinants for incremental cancer deaths,and case-fatality rates contributed to reduced cancer deaths in both countries.Conclusions:The decreasing cancer burden in liver,stomach,and esophagus,and increasing burden in lung,colorectum,breast,and prostate,mean that cancer profiles in China and the USA are converging.Population aging is a growing determinant of incremental cancer burden.Progress in cancer prevention and care in the USA,and measures to actively respond to population aging,may help China to reduce the cancer burden.

Disparities in the global burden of tracheal,bronchus,and lung cancer from 1990 to 2019

Background:Tracheal,bronchus,and lung(TBL)cancer imposes a high disease burden globally,and its pattern varies greatly across regions and countries.This study aimed to explore the global burden and temporal trends of TBL cancer from 1990 to 2019.Methods:Data on incidence,mortality,and disability-adjusted life years(DALYs)metrics(number,crude rate,and age-standardized rates),and the attributable risk fraction of DALY of TBL cancer from 1990 to 2019 in 21 Global Burden of Disease(GBD)regions,four World Bank income regions,204 countries and territories,and the globe were obtained from the up-to-date GBD 2019 study.We applied estimated annual percentage changes(EAPCs)to the age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and age-standardized DALY rate(ASDR)to quantify the temporal trends of the TBL cancer burden from 1990-2019.Associations of EAPC of age-standardized rates with universal health coverage(UHC)index at the national level were evaluated with Pearson correlation analysis.Results:Globally,approximately 2,260,000 new TBL cancer cases,2,042,600 deaths,and 45,858,000 DALYs were reported in 2019.Combination of all modifiable risk factors,behavioral,environmental,and metabolic risk factors accounted for 79.1%,66.4%,33.3%,and 7.9%of global lung cancer DALYs,respectively.The overall ASIR(EAPC:-0.1[95%confidence interval[CI]:-0.2,-0.1]),ASMR(EAPC:-0.3[95%CI:-0.4,-0.3]),and ASDR(EAPC:-0.7[95%CI:-0.7,-0.6])decreased from 1990 to 2019.The highest mortality rate of TBL cancer occurred in the>85-year-old age group for both sexes among high-income countries(HICs)and upper-middle-income countries(UMCs),and in males aged 80-84 years and females aged>85 years in lower middle-income countries(LMCs).HICs experienced the largest declines in ASIR(-12.6%),ASMR(-20.3%),and ASDR(-27.8%)of TBL cancer between 1990 and 2019,while UMCs had the highest increases in ASIR(16.7%)and ASMR(8.0%)over the period.Eleven(52.4%),14(66.7%),and 15(71.4%)regions of the 21 GBD regions experienced descending trends in ASIR,ASMR,and ASDR of TBL cancer between 1990 and 2019,respectively,with the greatest mean decrease per year(EAPC:-1.7[95%CI:-2.0,-1.5]for ASIR,-1.9[95%CI:-2.2,-1.7]for ASMR,and-2.2[95%CI:-2.5,-2.0]for ASDR)being observed in eastern Europe.The ASIR,ASMR,and ASDR of TBL cancer were deemed to be in decreasing trends in 85,91,and 104 countries and territories,with the largest decrease in Bahrain(EAPC:-3.0[95%CI:-3.3,-2.7]for ASIR,-3.0[95%CI:-3.3,-2.6]for ASMR,and-3.4[95%CI:-3.8,-3.1]for ASDR).ASIR(r=0.524),ASMR(r=0.411),and ASDR(r=0.353)of TBL cancer were positively associated with UHC index at the national level in 2019.Conclusions:The TBL cancer burden shows a downward trend at the global level but varies greatly across regions and countries.A decreasing trend in the TBL cancer burden was observed in the most of the 21 GBD regions and 204 countries from 1990 to 2019.UMCs had the highest burden of TBL cancer and showed the largest increases in ASIR and ASMR.

2019年甘肃省肿瘤登记地区女性乳腺癌流行特征及2010-2019年趋势分析

目的分析2019年甘肃省肿瘤登记地区女性乳腺癌发病和死亡情况及2010-2019年女性乳腺癌发病和死亡的变化趋势,为乳腺癌的防治工作提供数据支持。方法收集2010-2019年甘肃省所有肿瘤登记地区的乳腺癌发病和死亡数据以及相关人口数据。根据城乡分布和年龄分组计算各肿瘤登记地区女性乳腺癌的发病率、死亡率、中标发病率、中标死亡率、世标发病率、世标死亡率以及累积率等关键指标;采用Joinpoint线性回归分析2010-2019年甘肃省肿瘤登记地区女性乳腺癌发病率和死亡率的年度变化趋势。结果2019年甘肃省肿瘤登记地区女性乳腺癌新发病例数为1502例,占女性所有新发恶性肿瘤数的13.14%,发病率为33.00/10万,中标发病率和世标发病率分别为23.83/10万和23.81/10万,0~74岁累积率为2.34%。城市和农村地区乳腺癌中标发病率分别为22.25/10万和26.59/10万。2019年甘肃省肿瘤登记地区女性乳腺癌死亡病例数为254例,占女性全部恶性肿瘤死亡病例的5.61%,死亡率为5.58/10万,中标死亡率与世标死亡率分别为3.70/10万和3.90/10万,0~74岁累积率为0.39%。城市和农村地区乳腺癌中标死亡率分别为3.63/10万和3.79/10万。2010-2019年全省女性乳腺癌的中标发病率年度变化趋势无统计学意义(APC=-0.35%,P=0.81),中标死亡率平均每年下降9.85%(APC=-9.85%,P=0.03)。结论乳腺癌是威胁甘肃省女性居民身心健康的高发恶性肿瘤,是女性重点关注的癌种,有关部门应积极对各类风险人群做好筛查工作。

基于JoinPoint回归模型的2000—2019年我国肝癌发病与死亡变化趋势

目的分析2000—2019年我国肝癌发病与死亡趋势,为我国肝癌防治策略的制订提供科学依据。方法收集2000—2019年全球健康数据交换(the Global Health Data Exchange,GHDx)数据库中我国肝癌发病与死亡个案信息,运用JoinPoint回归模型以平均年度变化百分比(average annual percent change,AAPC)和年度变化百分比(annual percent change,APC)分别描述全人群、不同性别及不同年龄肝癌发病与死亡的变化趋势。结果2000—2019年我国肝癌发病和死亡总例数分别为4322652例和4093855例,标化发病率和死亡率分别为11.31/10万和9.68/10万。2000—2019年我国肝癌的发病率呈下降趋势(AAPC=-2.11%),其中2000—2002年和2002—2005年均呈下降趋势,APC分别为-10.55%和-15.45%;2005—2010年和2010—2019年均呈上升趋势,APC分别为0.44%和3.39%;男性和女性人群的发病率均呈下降趋势(AAPC=-1.95%,-2.43%)。2000—2019我国肝癌的死亡率呈下降趋势(AAPC=-2.41%),其中2000—2005年呈下降趋势,APC为-13.52%,2005—2012年和2012—2019年均呈上升趋势,APC分别为0.18%和3.64%;男性和女性人群的死亡率均呈下降趋势(AAPC=-2.34%,-2.60%)。我国肝癌的年龄别发病率及死亡率随着年龄的增长呈不断上升的趋势(AAPC=5.94%,7.10%),其中男性年龄别发病率在10~40岁之间增长较快,80岁之后增长速度有所下降,女性则整体呈上升趋势;男性年龄别死亡率在5~10岁之间增长率较大,女性则随着年龄的增长整体呈上升趋势。结论2000—2019年我国肝癌发病率及死亡率整体呈下降趋势,男性的发病率和死亡率大于女性,且随年龄增长呈上升趋势,男性及老年人群是肝癌重点关注人群。

2020年云南省肿瘤登记地区宫颈癌发病和死亡情况及2012-2020年趋势分析

目的分析2020年云南省肿瘤登记地区宫颈癌发病和死亡情况及2012—2020年发病和死亡的变化趋势,为云南省开展宫颈癌防治工作提供依据。方法收集整理2012—2020年云南省肿瘤登记地区宫颈癌的发病和死亡资料,统计分析2020年宫颈癌的粗发病率、粗死亡率、世界人口标化发病率(简称世标发病率)、世界人口标化死亡率(简称世标死亡率)等指标。2012—2020年宫颈癌的发病和死亡变化趋势使用年度变化百分比(Annual percent change,APC)进行评价,采用GM(1,1)模型对2021—2025年宫颈癌粗发病率和世标发病率进行预测。结果2020年云南省肿瘤登记地区宫颈癌发病2426例,居女性恶性肿瘤发病第5位,粗发病率和世标发病率分别为15.83/10万、11.16/10万;宫颈癌死亡例数831例,居女性恶性肿瘤死亡第6位,粗死亡率和世标死亡率分别为5.42/10万、3.52/10万。农村地区世标发病率(11.86/10万)高于城市地区世标发病率(9.11/10万),城市地区世标死亡率(3.63/10万)略高于农村地区世标死亡率(3.48/10万)。宫颈癌年龄别发病率在20岁后迅速上升,55~59岁年龄组达到发病高峰;宫颈癌年龄别死亡率在35岁后快速上升,75~79岁年龄组达到高峰。2012—2020年云南省肿瘤登记地区宫颈癌世标发病率随年度变化呈下降趋势(APC=-7.54%,95%CI:-13.19%~-1.53%),趋势变化存在统计学意义(P<0.05)。GM(1,1)模型预测显示,2021—2025年云南省宫颈癌粗发病率和世标发病率将持续下降。结论宫颈癌在云南省发病和死亡水平较低,但仍是云南省女性常见恶性肿瘤。云南省宫颈癌发病呈年轻化趋势,农村女性是防治的重点人群。