GLOBOCAN数据库架构介绍及数据分析方法

癌症是影响人类健康的主要疾病之一,其发病率和死亡率等数据的准确统计对于开展疾病预防及制定干预策略极为重要。GLOBOCAN是国际癌症研究机构(International Agency for Research on Cancer,IARC)的一个项目,统计了世界上185个国家/地区中的36种癌症发病率、死亡率和患病率等相关数据,并且数据会不断更新,为研究者做疾病预测及疾病负担分析提供了宝贵的资料。本文通过对GLOBOCAN数据库架构及数据分析方法的详细介绍,帮助需要的研究者快速获取数据库相关知识,高效快捷地开展相关研究。

GLOBOCAN 2020全球癌症统计数据解读

GLOBOCAN 2020于2020年12月发布,估计了全球185个国家/地区的36种癌症发病率、死亡率以及癌症发展趋势等相关数据,分析了癌症的地区和性别差异,并新增2040年癌症负担的预测数据。GLOBOCAN 2020数据库显示,2020年全球新发癌症19292789例,9958133例癌症患者死亡。女性乳腺癌首次超过肺癌成为最常见的癌症,2020年新发乳腺癌2261419例,占总体癌症发病的11.7%,其次是肺癌(11.4%)、结直肠癌(10.0%)、前列腺癌(7.3%)和胃癌(5.6%)。肺癌仍是导致癌症死亡的首要原因,估计有1796144人死于肺癌,占总体癌症死亡的18.0%,其次是结直肠癌(9.4%)、肝癌(8.3%)、胃癌(7.7%)和女性乳腺癌(6.9%),癌症发病和死亡呈明显的地区和性别差异。本文对更新的数据库的重要内容进行了整理并加以解读。

基于2020年全球流行病学数据分析中国癌症发病率、死亡率和负担的时间趋势及与美国和英国数据的比较

背景与目的 癌症是中国人群的主要致死原因之一,也是中国的主要经济负担。研究中国与发达国家在癌症模式和控制策略上的差异,可为政策规划提供参考,有助于改善癌症防控措施。本研究回顾了中国癌症发病率、死亡率和伤残调整生命年(disability-adjusted life year,DALY)负担的比率及趋势,并与美国(United States,US)和英国(United Kingdom,UK)进行了比较。方法 本研究从GLOBOCAN 2020在线数据库、2019年全球疾病负担(global burden of disease,GBD)研究和五大洲癌症发病率plus数据库(Cancer Incidence in Five Continents plus database,CI5 plus)中获取中国、美国和英国的癌症发病率、死亡率和DALY数据。使用Joinpoint回归模型分析中国、美国和英国癌症发病率和死亡率的趋势,计算年度百分比变化(annual percent change,APC),并确定最佳拟合连接点。结果 2020年估算的中国新发癌症病例为4,568,754例,癌症死亡病例为3,002,899例。此外,在中国,癌症引起的DALY为67,340,309。与美国和英国相比,中国的癌症发病率更低,但癌症死亡率和DALY率更高。此外,中国的癌症谱正在发生变化,除了肝癌、胃癌、食管癌和宫颈癌的发病率高和负担沉重外,肺癌、乳腺癌、结直肠癌和前列腺癌的发病率和负担正在迅速增长。结论 中国的癌症谱正在从发展中国家向发达国家转变。人口老龄化和不健康生活方式将继续增加中国的癌症负担。因此,中国应参考发达国家已建立的癌症防控策略,并结合中国不同地区癌症类型的多样性,调整国家癌症控制政策。

2018全球癌症统计报告解读

近期,世界卫生组织/国际癌症中心团队在A Cancer Journal for Clinicians(CA)杂志发表了最新的全球癌症统计数据。这份全球癌症负担现状的报告重点阐述了185个国家的36种癌症的发病和死亡情况,分析了癌症的区域性差异,并预估全球2018年将新增1810万癌症病例和970万癌症死亡病例。北京市肿瘤防治研究办公室团队对该报告进行了整理,并结合中国肿瘤登记现况进行简要解读。

2020全球癌症统计报告解读

2021年1月,国际癌症研究机构团队在美国癌症学会旗下权威杂志《临床医师癌症杂志》(CA:A Cancer Journal for Clinicians)发表了最新的全球癌症统计报告。该报告阐述了2020年36种癌症在全球185个国家的发病和死亡情况,分析了其性别和地理分布差异,并根据2020年估计的发病和死亡数据预估了2040年全球可能面临的癌症疾病负担。北京大学肿瘤医院流行病学研究室团队对该报告进行了整理,结合中国主要癌症的流行趋势与疾病负担对该报告进行简要解读。

宫颈癌的发病与死亡变化趋势及其预防策略进展

本文基于GLOBOCAN 2020与《中国肿瘤登记年报》数据,概括宫颈癌在全球及我国的发病与死亡变化趋势,总结我国宫颈癌三级防控的发展、现状及挑战,并探讨中国如何完善宫颈癌防控网络,以达到世界卫生组织"90-70-90"目标,最终实现"消除宫颈癌"的愿景。

Digestive cancer incidence and mortality among young adults worldwide in 2020:A population-based study

BACKGROUND Digestive cancer has traditionally been thought of as a disease that mainly occurs in elderly individuals,and it has been ignored in young adults by both patients and physicians.AIM To describe the worldwide profile of digestive cancer incidence,mortality and corresponding trends among 20–39-year-olds,with major patterns highlighted by age,sex,development level,and geographical region.METHODS I performed a population-based study to quantify the burden of young adult digestive cancers worldwide.Global,regional,sex,and country-specific data estimates of the number of new cancer cases and cancer-associated deaths that occurred in 2020 were extracted from the GLOBOCAN Cancer Today database.To assess long-term trends in young adult digestive cancer,cancer incidence data and mortality data were obtained from the Cancer in Five Continents Plus database and the World Health Organization mortality database,respectively.The associations between the human development index(HDI)and digestive cancer burden in young adults were evaluated by linear regression analyses.RESULTS In 2020,there were an estimated 19292789 new cancer cases,resulting in 9958133 deaths worldwide,which equated to an age-standardized incidence rate(ASIR)of 5.16 and age-standardized mortality rate(ASMR)of 3.04,accounting for 12.24%of all new cancer cases and 25.26%of all cancer deaths occurring in young adults.The burden was disproportionally greater among males,with male:female ratios of 1.34 for incidence and 1.58 for mortality.The ASIRs were 2.1,1.4,and 1.0 per 100000 people per year,whereas the ASMRs were 0.83,1.1,and 0.62 per 100000 people per year for colorectal,liver,and gastric cancer,respectively.When assessed by geographical region and HDI levels,the cancer profile varied substantially,and a strong positive correlation between the mortality-to-incidence ratio of digestive cancer and HDI ranking was found(R^(2)=0.7388,P<0.001).CONCLUSION The most common digestive cancer types are colorectal,liver and gastric cancer.The global digestive cancer burden among young adults is greater among males and exhibits a positive association with socioeconomic status.The digestive cancer burden is heavy in young adults,reinforcing the need for primary and secondary prevention strategies.

2020年中国与全球结直肠癌流行概况分析

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。

Global burden prediction of gastric cancer during demographic transition from 2020 to 2040

Background: Despite the decline in the incidence and mortality rates of gastric cancer (GC), the impact of demographic transition on the global burden of GC remains unclear. The current study aimed to estimate the global disease burden through 2040 by age, sex, and region. Methods: GC data for incident cases and deaths by age group and sex were taken from The Global Cancer Observatory (GLOBOCAN) 2020. The incidence and mortality rates were predicted through 2040 by fitting a linear regression model over the most recent trend period with the Cancer Incidence in Five Continents (CI5) data. Results: The global population will grow to 9.19 billion by 2040, accompanied by increasing population ageing. The incidence and mortality rates of GC will show a persistent decrease, with an annual percent change of -0.57% for males and -0.65% for females. East Asia and North America will have the highest and lowest age standardized rates, respectively. A slowdown in the growth of incident cases and deaths will be observed worldwide. The proportion of young and middle-aged individuals will decline, while the percentage of the elderly will increase, and the number of males will be almost twice the number of females. East Asia and high human development index (HDI) regions will be heavily burdened by GC. East Asia had 59.85% of the new cases and 56.23% of deaths in 2020;these will increase to 66.93% and 64.37% by 2040, respectively. The interaction between population growth, the change in ageing structure and the decline in incidence and mortality rates will lead to an increased burden of GC. Conclusions: Ageing and population growth will offset the decline in the incidence and mortality rate of GC, resulting in a substantial increase in the number of new cases and deaths. The age structure will continue to change, especially in high HDI regions, requiring more targeted prevention strategies in the future.

Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020

Background:Cancer is one of the leading causes of death globally,but its burden is not uniform.GLOBOCAN 2020 has newly updated the estimates of cancer burden.This study summarizes the most recent changing profiles of cancer burden worldwide and in China and compares the cancer data of China with those of other regions.Methods:We conducted a descriptive secondary analysis of the GLOBOCAN 2020 data.To depict the changing global profile of the leading cancer types in 2020 compared with 2018,we extracted the numbers of cases and deaths in 2018 from GLOBOCAN 2018.We also obtained cancer incidence and mortality from the 2015 National Cancer Registry Report in China when sorting the leading cancer types by new cases and deaths.For the leading cancer types according to sex in China,we summarized the estimated numbers of incidence and mortality,and calculated China’s percentage of the global new cases and deaths.Results:Breast cancer displaced lung cancer to become the most leading diagnosed cancer worldwide in 2020.Lung,liver,stomach,breast,and colon cancers were the top five leading causes of cancer-related death,among which liver cancer changed from the third-highest cancer mortality in 2018 to the second-highest in 2020.China accounted for 24%of newly diagnosed cases and 30%of the cancer-related deaths worldwide in 2020.Among the 185 countries included in the database,China’s age-standardized incidence rate(204.8 per 100,000)ranked 65th and the age-standardized mortality rate(129.4 per 100,000)ranked 13th.The two rates were above the global average.Lung cancer remained the most common cancer type and the leading cause of cancer death in China.However,breast cancer became the most frequent cancer type among women if the incidence was stratified by sex.Incidences of colorectal cancer and breast cancer increased rapidly.The leading causes of cancer death varied minimally in ranking from 2015 to 2020 in China.Gastrointestinal cancers,including stomach,colorectal,liver,and esophageal cancers,contributed to a massive burden of cancer for both sexes.Conclusions:The burden of breast cancer is increasing globally.China is undergoing cancer transition with an increasing burden of lung cancer,gastrointestinal cancer,and breast cancers.The mortality rate of cancer in China is high.Comprehensive strategies are urgently needed to target China’s changing profiles of the cancer burden.

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.

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.