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 ca...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.展开更多
Objective:To estimate the incidence and mortality of cervical cancer in China based on the cancer registration data in 2015,collected by the National Central Cancer Registry(NCCR).Methods:There were 501 cancer registr...Objective:To estimate the incidence and mortality of cervical cancer in China based on the cancer registration data in 2015,collected by the National Central Cancer Registry(NCCR).Methods:There were 501 cancer registries that submitted data to the NCCR,whose data were the basis for estimating the incidence and mortality of cervical cancer in China in 2015.After evaluating the data quality,368 registries’data were accepted for the analysis and stratified by area(urban/rural)and age group.Combined with data on the national population in 2015,the nationwide incidence and mortality of cervical cancer were estimated.Cervical Cancer cases of 22 cancer registries were applied for temporal trends from 2000 to 2015.The Chinese population census in 2000 and Segi’s population were used to calculate age-standardized incidence and mortality rates.Results:An estimated 111,000 new cases were attributed to cervical cancer in China in 2015,accounting for 6.24%of all female new cancer cases in that year in China.The crude rate(CR)of incidence and age-standardized incidence rates by the China standard population(ASIRC)and by Segi’s world standard population(ASIRW)of cervical cancer were 16.56/100,000,11.78/100,000,and 10.86/100,000,respectively.The cumulative incidence rate from birth to 74 years old was 1.15%,whereas the calculation of incidence rates over the truncated age range of 35-64 years by Segi’s world standard population(T-ASIRW)was 27.66/100,000.The estimates of cervical cancer deaths were about 33,800 and 3.94%of all female cancer-related deaths in China in 2015,with a crude mortality rate of 5.04/100,000.The age-standardized mortality rates adjusted by the Chinese standard population(ASMRC)and by world Segi’s population(ASMRW)were 3.29/100,000 and 3.15/100,000,respectively,with a cumulative mortality rate(0-74 years old)of 0.35%.Both the incidence and mortality were higher in rural than in urban areas.The age-specific cervical cancer incidence significantly increased with age,particularly after age 25 years,and peaked at 50-54 years old,whereas age-specific mortality increased rapidly after 35 years old,peaking at 80-84 years old.The age-standardized incidence rates increased by about 8.6(95%CI:6.9,10.3)per year during the period of 2000−2015.The age at diagnosis of patients with cervical cancer tended to be younger.In rural areas,the mean age at diagnosis decreased about 3.22 years from 2000 to 2015(𝛽=-0.33,P<0.001).Conclusions:China has a high burden of cervical cancer and important disparities among different regions.Es-pecially in the middle and western areas and rural areas,cervical cancer is a serious issue in women’s health,and prevention strategies need to be enhanced.Prevention and control strategies need to be enhanced and imple-mented with reference to local status,such as human papillomavirus(HPV)vaccination and screening programs.展开更多
Background:Lung cancer has been the leading cause of cancer-related deaths worldwide for many years.This study aimed to investigate the global patterns and trends of lung cancer.Methods:Lung cancer incidence and morta...Background:Lung cancer has been the leading cause of cancer-related deaths worldwide for many years.This study aimed to investigate the global patterns and trends of lung cancer.Methods:Lung cancer incidence and mortality were derived from the GLOBOCAN 2020 database.Continuous data from Cancer Incidence in Five Continents Time Trends were used to analyze the temporal trends from 2000 to 2012 using Joinpoint regression,and average annual percent changes were calculated.The association between the Human Development Index and lung cancer incidence and mortality was assessed by linear regression.Results:An estimated 2.2 million new lung cancer cases and 1.8 million lung cancer-related deaths occurred in 2020.The age-standardized incidence rate(ASIR)ranged from 36.8 per 100,000 in Demark to 5.9 per 100,000 in Mexico.The age-standardized mortality rate(ASMR)varied from 32.8 per 100,000 in Poland to 4.9 per 100,000 in Mexico.Both ASIR and ASMR were approximately twice higher in men than in women.The ASIR of lung cancer showed a downward trend in the United States of America(USA)between 2000 and 2012,and was more prominent in men.The age-specific incidence rates of lung cancer for ages of 50 to 59 years showed an upward trend in China for both men and women.Conclusions:The burden of lung cancer is still unsatisfactory,especially in developing countries like China.Considering the effectiveness of tobacco control and screening in developed countries,such as the USA,there is a need to strengthen health education,accelerate the establishment of tobacco control policies and regulations,and improve early cancer screening awareness to reduce the future burden of lung cancer.展开更多
Background:Given the recent updates in cancer burden estimates by GLOBOCAN 2022,this study was undertaken to provide pertinent perspectives within the context of the Human Development Index(HDI)and major world economi...Background:Given the recent updates in cancer burden estimates by GLOBOCAN 2022,this study was undertaken to provide pertinent perspectives within the context of the Human Development Index(HDI)and major world economies.Methods:Datasets sourced from GLOBOCAN encompassed cancer cases and deaths across all cancer types in 2022,alongside projections up to 2050.Cancer incidences and deaths of the top 10 cancers within China and four distinct HDI-classified regions were compared using descriptive analyses.Age-standardized incidence rates(ASIRs)and mortality rates(ASMRs)worldwide for the most prevalent cancers in 2022 across ten largest economies and four-tier HDIs were examined.The top five cancer types concerning both incidence and mortality in China were delineated by sex and age group.Results:In males,prostate cancer predominated in countries with low,high(except China),and very high HDI.Prostate and liver cancers were prominent causes of death in countries with low HDI.In females,breast and cervical cancers predominated in countries with low-to-medium HDI.Lung and colorectal cancer incidence and deaths increased with high HDI for both sexes.ASIRs and ASMRs for breast,prostate,lung,and colorectal cancers in the top 10 economies were higher than the global average.However,liver,stomach,and cervical cancers in most Western countries exhibited lower rates.In China,hematologic malignancies(43%)were prevalent among children aged 0-14 years,whereas thyroid cancer led among adolescents and young adults aged 15-39 years.Regarding incidence and mortality,lung cancer predominated for individuals over 40 years,except for females aged 40-59 years,in whom breast cancer predominated.Projected trends indicated substantial increases in new cancer cases(76.6%)and deaths(89.7%)over the next three decades.Conclusions:Infection-and poverty-related cancer burdens are offset by increased prostate,breast,colorectal,and lung cancer incidence associated with rapid societal and economic transitions.Cancer incidence and mortality patterns in China feature characteristics of developed and developing countries,necessitating tailored,evidence-based,and comprehensive strategies for effective cancer prevention and control.展开更多
背景结直肠癌已成为上海市嘉定区发病率排名第三的恶性肿瘤,其疾病负担仍在加重。目的分析2003—2019年上海市嘉定区结直肠癌流行趋势,为结直肠癌防治提供科学依据。方法基于2003—2019年上海市嘉定区肿瘤登记资料,计算粗发病率、粗死...背景结直肠癌已成为上海市嘉定区发病率排名第三的恶性肿瘤,其疾病负担仍在加重。目的分析2003—2019年上海市嘉定区结直肠癌流行趋势,为结直肠癌防治提供科学依据。方法基于2003—2019年上海市嘉定区肿瘤登记资料,计算粗发病率、粗死亡率、标化发病率、标化死亡率等统计指标(以2010年中国标准人口构成进行标化调整),利用Joinpoint Regression Program 4.9.1.0软件分析发病率和死亡率的变化趋势。结果2003—2019年上海市嘉定区结直肠癌新发病例5020例,粗发病率52.12/10万,标化发病率26.27/10万,死亡病例2419例,粗死亡率25.12/10万,标化死亡率11.16/10万,男性的粗发病率和粗死亡率均高于女性(P<0.05);总人群标化发病率总体呈现上升趋势(APC=2.63%,P<0.05),其中男性标化发病率呈上升趋势(APC=3.48%,P<0.05),女性标化发病率无明显变化趋势(APC=1.39%,P=0.119),均未发现转折点;总人群标化死亡率无明显变化趋势(APC=-0.49%,P=0.250),其中男性标化死亡率无明显变化趋势(APC=0.34%,P=0.545),女性标化死亡率呈现下降趋势(APC=-1.94%,P<0.05)。结论2003—2019年上海市嘉定区结直肠癌总体发病率总体仍有上升,其中男性呈上升趋势,女性无明显变化趋势;总体死亡率无明显变化趋势,其中男性无明显变化,女性呈下降趋势,应继续加强结直肠癌的防控工作,重点关注男性人群。展开更多
背景与目的:恶性肿瘤严重威胁着居民健康,已成为重大的公共卫生问题。本研究旨在描述和分析2015年上海市恶性肿瘤流行特征。方法:根据上海市恶性肿瘤病例报告登记系统收集的恶性肿瘤发病和死亡资料,按地区、性别分层,分别计算恶性肿瘤...背景与目的:恶性肿瘤严重威胁着居民健康,已成为重大的公共卫生问题。本研究旨在描述和分析2015年上海市恶性肿瘤流行特征。方法:根据上海市恶性肿瘤病例报告登记系统收集的恶性肿瘤发病和死亡资料,按地区、性别分层,分别计算恶性肿瘤发病与死亡粗率、标化率、前10位恶性肿瘤发病与死亡顺位和构成等,并应用Joinpoint统计软件分析2002—2015年上海市肺癌发病和死亡趋势,估算总体和分阶段的年度变化百分比(annual percent change,APC)。采用Segi’s世界标准人口年龄构成计算标化率。结果:2015年上海市共报告恶性肿瘤新发病例71 610例,死亡病例38 445例。病理学诊断比例(percentage of morphologically verified cases,MV%)为78.42%,只有死亡医学证明书比例(percentage of death certifications only,DCO%)为0.21%,死亡发病比(mortality to incidence ratio,M/I)为0.55。上海市恶性肿瘤粗发病率为497.33/10万,标化发病率为228.82/10万,男性标化发病率低于女性,市区低于郊区。恶性肿瘤发病在40岁以后快速上升,在80～84岁年龄组达到高峰。全市发病前10位恶性肿瘤依次为肺癌、结直肠癌、甲状腺癌、胃癌、乳腺癌、肝癌、前列腺癌、胰腺癌、脑和中枢神经系统肿瘤以及膀胱癌,前10位恶性肿瘤占全部恶性肿瘤发病的76.59%。全市恶性肿瘤粗死亡率为267.00/10万,标化死亡率为95.99/10万,男性标化死亡率高于女性,市区和郊区基本持平。死亡率在45岁以后快速上升,在≥85岁年龄组达到高峰。死亡前10位恶性肿瘤依次为肺癌、结直肠癌、胃癌、肝癌、胰腺癌、乳腺癌、食管癌、胆囊癌、前列腺癌以及脑和中枢神经系统肿瘤,前10位恶性肿瘤占全部恶性肿瘤死亡的78.07%。截至2016年12月31日,上海市共有399 027例现患肿瘤病例,现患率为2.77%。市区现患率为3.07%,郊区为2.55%。乳腺癌是现患病例中最常见的恶性肿瘤,占15.33%。现患病例生存达5年的占50.90%。肺癌是上海市发病和死亡均位居第1位的恶性肿瘤。Joinpoint趋势分析显示,2011年男性和女性肺癌发病率均出现拐点。男性肺癌发病率在2002—2011年期间显著下降,APC为-1.34%(P<0.001),自2011年起显著上升,APC为3.30%(P<0.001);女性肺癌发病率在2002—2011年期间无明显变化趋势,较为平稳,2011—2015年期间呈快速上升趋势,APC达15.25%(P<0.001)。与发病率变化不同,2002—2015年间上海市男性肺癌死亡率呈缓慢持续下降趋势,APC为-0.72%(P=0.03),女性无明显变化趋势。与2002年相比,2015年男性和女性肺癌诊断时期别为Ⅰ期的病例比例和腺癌比例均明显上升。男性肺癌诊断时期别Ⅰ期比例由2002年的3.96%上升到2015年的11.08%,女性由3.72%上升至23.57%。男性腺癌比例由2002年的15.81%上升到2015年的34.46%,女性由28.76%上升至66.08%。结论:肺癌、消化系统恶性肿瘤、甲状腺癌和女性乳腺癌仍是威胁上海市居民健康的主要癌种。乳腺癌是现患病例中最常见的恶性肿瘤。自2011年开始,男性和女性肺癌发病率显著上升,提示与低剂量螺旋CT广泛应用有一定关系,但需更多数据和研究支持。展开更多
基金funded by the Jing-jin-ji Special Projects for Basic Research Cooperation (No. J200017)the Sanming Project of the Medicine in Shenzhen (No. SZSM2019 11015)the National Natural Science Foundation of China (No. 82273721)。
文摘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.
文摘Objective:To estimate the incidence and mortality of cervical cancer in China based on the cancer registration data in 2015,collected by the National Central Cancer Registry(NCCR).Methods:There were 501 cancer registries that submitted data to the NCCR,whose data were the basis for estimating the incidence and mortality of cervical cancer in China in 2015.After evaluating the data quality,368 registries’data were accepted for the analysis and stratified by area(urban/rural)and age group.Combined with data on the national population in 2015,the nationwide incidence and mortality of cervical cancer were estimated.Cervical Cancer cases of 22 cancer registries were applied for temporal trends from 2000 to 2015.The Chinese population census in 2000 and Segi’s population were used to calculate age-standardized incidence and mortality rates.Results:An estimated 111,000 new cases were attributed to cervical cancer in China in 2015,accounting for 6.24%of all female new cancer cases in that year in China.The crude rate(CR)of incidence and age-standardized incidence rates by the China standard population(ASIRC)and by Segi’s world standard population(ASIRW)of cervical cancer were 16.56/100,000,11.78/100,000,and 10.86/100,000,respectively.The cumulative incidence rate from birth to 74 years old was 1.15%,whereas the calculation of incidence rates over the truncated age range of 35-64 years by Segi’s world standard population(T-ASIRW)was 27.66/100,000.The estimates of cervical cancer deaths were about 33,800 and 3.94%of all female cancer-related deaths in China in 2015,with a crude mortality rate of 5.04/100,000.The age-standardized mortality rates adjusted by the Chinese standard population(ASMRC)and by world Segi’s population(ASMRW)were 3.29/100,000 and 3.15/100,000,respectively,with a cumulative mortality rate(0-74 years old)of 0.35%.Both the incidence and mortality were higher in rural than in urban areas.The age-specific cervical cancer incidence significantly increased with age,particularly after age 25 years,and peaked at 50-54 years old,whereas age-specific mortality increased rapidly after 35 years old,peaking at 80-84 years old.The age-standardized incidence rates increased by about 8.6(95%CI:6.9,10.3)per year during the period of 2000−2015.The age at diagnosis of patients with cervical cancer tended to be younger.In rural areas,the mean age at diagnosis decreased about 3.22 years from 2000 to 2015(𝛽=-0.33,P<0.001).Conclusions:China has a high burden of cervical cancer and important disparities among different regions.Es-pecially in the middle and western areas and rural areas,cervical cancer is a serious issue in women’s health,and prevention strategies need to be enhanced.Prevention and control strategies need to be enhanced and imple-mented with reference to local status,such as human papillomavirus(HPV)vaccination and screening programs.
基金CAMS Innovation Fund for Medical Sciences(No.2021-I2M-1-012)
文摘Background:Lung cancer has been the leading cause of cancer-related deaths worldwide for many years.This study aimed to investigate the global patterns and trends of lung cancer.Methods:Lung cancer incidence and mortality were derived from the GLOBOCAN 2020 database.Continuous data from Cancer Incidence in Five Continents Time Trends were used to analyze the temporal trends from 2000 to 2012 using Joinpoint regression,and average annual percent changes were calculated.The association between the Human Development Index and lung cancer incidence and mortality was assessed by linear regression.Results:An estimated 2.2 million new lung cancer cases and 1.8 million lung cancer-related deaths occurred in 2020.The age-standardized incidence rate(ASIR)ranged from 36.8 per 100,000 in Demark to 5.9 per 100,000 in Mexico.The age-standardized mortality rate(ASMR)varied from 32.8 per 100,000 in Poland to 4.9 per 100,000 in Mexico.Both ASIR and ASMR were approximately twice higher in men than in women.The ASIR of lung cancer showed a downward trend in the United States of America(USA)between 2000 and 2012,and was more prominent in men.The age-specific incidence rates of lung cancer for ages of 50 to 59 years showed an upward trend in China for both men and women.Conclusions:The burden of lung cancer is still unsatisfactory,especially in developing countries like China.Considering the effectiveness of tobacco control and screening in developed countries,such as the USA,there is a need to strengthen health education,accelerate the establishment of tobacco control policies and regulations,and improve early cancer screening awareness to reduce the future burden of lung cancer.
文摘Background:Given the recent updates in cancer burden estimates by GLOBOCAN 2022,this study was undertaken to provide pertinent perspectives within the context of the Human Development Index(HDI)and major world economies.Methods:Datasets sourced from GLOBOCAN encompassed cancer cases and deaths across all cancer types in 2022,alongside projections up to 2050.Cancer incidences and deaths of the top 10 cancers within China and four distinct HDI-classified regions were compared using descriptive analyses.Age-standardized incidence rates(ASIRs)and mortality rates(ASMRs)worldwide for the most prevalent cancers in 2022 across ten largest economies and four-tier HDIs were examined.The top five cancer types concerning both incidence and mortality in China were delineated by sex and age group.Results:In males,prostate cancer predominated in countries with low,high(except China),and very high HDI.Prostate and liver cancers were prominent causes of death in countries with low HDI.In females,breast and cervical cancers predominated in countries with low-to-medium HDI.Lung and colorectal cancer incidence and deaths increased with high HDI for both sexes.ASIRs and ASMRs for breast,prostate,lung,and colorectal cancers in the top 10 economies were higher than the global average.However,liver,stomach,and cervical cancers in most Western countries exhibited lower rates.In China,hematologic malignancies(43%)were prevalent among children aged 0-14 years,whereas thyroid cancer led among adolescents and young adults aged 15-39 years.Regarding incidence and mortality,lung cancer predominated for individuals over 40 years,except for females aged 40-59 years,in whom breast cancer predominated.Projected trends indicated substantial increases in new cancer cases(76.6%)and deaths(89.7%)over the next three decades.Conclusions:Infection-and poverty-related cancer burdens are offset by increased prostate,breast,colorectal,and lung cancer incidence associated with rapid societal and economic transitions.Cancer incidence and mortality patterns in China feature characteristics of developed and developing countries,necessitating tailored,evidence-based,and comprehensive strategies for effective cancer prevention and control.
文摘背景结直肠癌已成为上海市嘉定区发病率排名第三的恶性肿瘤,其疾病负担仍在加重。目的分析2003—2019年上海市嘉定区结直肠癌流行趋势,为结直肠癌防治提供科学依据。方法基于2003—2019年上海市嘉定区肿瘤登记资料,计算粗发病率、粗死亡率、标化发病率、标化死亡率等统计指标(以2010年中国标准人口构成进行标化调整),利用Joinpoint Regression Program 4.9.1.0软件分析发病率和死亡率的变化趋势。结果2003—2019年上海市嘉定区结直肠癌新发病例5020例,粗发病率52.12/10万,标化发病率26.27/10万,死亡病例2419例,粗死亡率25.12/10万,标化死亡率11.16/10万,男性的粗发病率和粗死亡率均高于女性(P<0.05);总人群标化发病率总体呈现上升趋势(APC=2.63%,P<0.05),其中男性标化发病率呈上升趋势(APC=3.48%,P<0.05),女性标化发病率无明显变化趋势(APC=1.39%,P=0.119),均未发现转折点;总人群标化死亡率无明显变化趋势(APC=-0.49%,P=0.250),其中男性标化死亡率无明显变化趋势(APC=0.34%,P=0.545),女性标化死亡率呈现下降趋势(APC=-1.94%,P<0.05)。结论2003—2019年上海市嘉定区结直肠癌总体发病率总体仍有上升,其中男性呈上升趋势,女性无明显变化趋势;总体死亡率无明显变化趋势,其中男性无明显变化,女性呈下降趋势,应继续加强结直肠癌的防控工作,重点关注男性人群。
文摘背景与目的:恶性肿瘤严重威胁着居民健康,已成为重大的公共卫生问题。本研究旨在描述和分析2015年上海市恶性肿瘤流行特征。方法:根据上海市恶性肿瘤病例报告登记系统收集的恶性肿瘤发病和死亡资料,按地区、性别分层,分别计算恶性肿瘤发病与死亡粗率、标化率、前10位恶性肿瘤发病与死亡顺位和构成等,并应用Joinpoint统计软件分析2002—2015年上海市肺癌发病和死亡趋势,估算总体和分阶段的年度变化百分比(annual percent change,APC)。采用Segi’s世界标准人口年龄构成计算标化率。结果:2015年上海市共报告恶性肿瘤新发病例71 610例,死亡病例38 445例。病理学诊断比例(percentage of morphologically verified cases,MV%)为78.42%,只有死亡医学证明书比例(percentage of death certifications only,DCO%)为0.21%,死亡发病比(mortality to incidence ratio,M/I)为0.55。上海市恶性肿瘤粗发病率为497.33/10万,标化发病率为228.82/10万,男性标化发病率低于女性,市区低于郊区。恶性肿瘤发病在40岁以后快速上升,在80～84岁年龄组达到高峰。全市发病前10位恶性肿瘤依次为肺癌、结直肠癌、甲状腺癌、胃癌、乳腺癌、肝癌、前列腺癌、胰腺癌、脑和中枢神经系统肿瘤以及膀胱癌,前10位恶性肿瘤占全部恶性肿瘤发病的76.59%。全市恶性肿瘤粗死亡率为267.00/10万,标化死亡率为95.99/10万,男性标化死亡率高于女性,市区和郊区基本持平。死亡率在45岁以后快速上升,在≥85岁年龄组达到高峰。死亡前10位恶性肿瘤依次为肺癌、结直肠癌、胃癌、肝癌、胰腺癌、乳腺癌、食管癌、胆囊癌、前列腺癌以及脑和中枢神经系统肿瘤,前10位恶性肿瘤占全部恶性肿瘤死亡的78.07%。截至2016年12月31日,上海市共有399 027例现患肿瘤病例,现患率为2.77%。市区现患率为3.07%,郊区为2.55%。乳腺癌是现患病例中最常见的恶性肿瘤,占15.33%。现患病例生存达5年的占50.90%。肺癌是上海市发病和死亡均位居第1位的恶性肿瘤。Joinpoint趋势分析显示,2011年男性和女性肺癌发病率均出现拐点。男性肺癌发病率在2002—2011年期间显著下降,APC为-1.34%(P<0.001),自2011年起显著上升,APC为3.30%(P<0.001);女性肺癌发病率在2002—2011年期间无明显变化趋势,较为平稳,2011—2015年期间呈快速上升趋势,APC达15.25%(P<0.001)。与发病率变化不同,2002—2015年间上海市男性肺癌死亡率呈缓慢持续下降趋势,APC为-0.72%(P=0.03),女性无明显变化趋势。与2002年相比,2015年男性和女性肺癌诊断时期别为Ⅰ期的病例比例和腺癌比例均明显上升。男性肺癌诊断时期别Ⅰ期比例由2002年的3.96%上升到2015年的11.08%,女性由3.72%上升至23.57%。男性腺癌比例由2002年的15.81%上升到2015年的34.46%,女性由28.76%上升至66.08%。结论:肺癌、消化系统恶性肿瘤、甲状腺癌和女性乳腺癌仍是威胁上海市居民健康的主要癌种。乳腺癌是现患病例中最常见的恶性肿瘤。自2011年开始,男性和女性肺癌发病率显著上升,提示与低剂量螺旋CT广泛应用有一定关系,但需更多数据和研究支持。
