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2015年中国恶性肿瘤流行情况分析
郑荣寿
孙可欣
张思维
曾红梅
邹小农
陈茹
顾秀瑛
魏文强
赫捷
作者及单位信息
·
DOI： 10.3760/cma.j.issn.0253-3766.2019.01.005
Report of cancer epidemiology in China, 2015
Zheng Rongshou
Sun Kexin
Zhang Siwei
Zeng Hongmei
Zou Xiaonong
Chen Ru
Gu Xiuying
Wei Wenqiang
He Jie
Authors Info & Affiliations
Zheng Rongshou
Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Sun Kexin
Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Zhang Siwei
Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Zeng Hongmei
Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Zou Xiaonong
Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Chen Ru
Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Gu Xiuying
Cancer Research Institute, Cancer Hospital, Xinjiang Medical University, Urumqi 830011, China
Wei Wenqiang
Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
He Jie
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
·
DOI： 10.3760/cma.j.issn.0253-3766.2019.01.005
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摘要

目的汇总分析各省肿瘤登记处上报的2015年恶性肿瘤登记数据，估算全国2015年恶性肿瘤流行情况。

方法收集整理各省501个登记处上报的2015年肿瘤登记数据，通过数据质量的审核和评估，以符合标准的368个登记处数据为基础，按地区(城乡)、性别、年龄别及不同肿瘤的发病率和死亡率分层，结合全国人口数据，估算全国2015年恶性肿瘤发病、死亡数据。标准人口采用2000年全国人口普查数据和Segi′s世界标准人口。

结果纳入分析的368个登记处共覆盖人口309 553 499人(其中城市148 804 626人，农村160 748 873人)。病理诊断比例为69.34%，只有死亡证明书比例为2.09%，死亡发病比为0.61。据估计，全国2015年新发恶性肿瘤病例约392.9万例，全国恶性肿瘤发病率为285.83/10万(男性305.47/10万，女性265.21/10万)，中国人口标化率(简称中标率)为190.64/10万，世界人口标化率(简称世标率)为186.39/10万，累积率(0～74岁)为21.44%。城市地区发病率为304.96/10万，中标发病率为196.09/10万；农村地区发病率为261.40/10万，中标发病率为182.70/10万。全国2015年恶性肿瘤死亡病例约233.8万，死亡率为170.05/10万(男性210.10/10万，女性128.00/10万)，中标死亡率为106.72/10万，世标死亡率为105.84/10万，累积死亡率(0～74岁)为11.94%。城市地区死亡率为172.61/10万，中标死亡率为103.65/10万；农村地区恶性肿瘤死亡率为166.79/10万，中标死亡率为110.76/10万。中国常见的恶性肿瘤为肺癌、胃癌、结直肠癌、肝癌和女性乳腺癌等，前10位发病约占全部恶性肿瘤新发病例的76.70%。肺癌、肝癌、胃癌、食管癌和结直肠癌等是主要的肿瘤死因，前10位死亡约占全部恶性肿瘤死亡病例的83.00%。

结论中国癌症负担总体仍呈现持续上升趋势，癌症负担的城乡差异及男女性别差异明显，癌谱呈现发达国家癌谱与发展中国家癌谱共存的局面，癌症防控形势依然严峻。

肿瘤登记;恶性肿瘤;发病率;死亡率;中国
ABSTRACT

ObjectiveData from local cancer registries were pooled to estimate cancer incidence and mortality in China, 2015.

MethodsData submitted from 501 cancer registries were checked & evaluated according to the criteria of data quality control, and 368 registries′ data were qualified for the final analysis. Data were stratified by area (urban/rural), sex, age group and cancer sites, and combined with national population data to estimate cancer incidence and mortality in China, 2015. Chinese population census in 2000 and Segi′s population were used for age-standardized.

ResultsTotal population covered by 368 cancer registries were 309 553 499 (148 804 626 in urban and 160 748 873 in rural areas). The percentage of morphologically verified cases (MV) and the percentage of death certificate-only cases (DCO) accounted for 69.34% and 2.09%, respectively, and the mortality to incidence ratio was 0.61. About 3 929 000 new cancer cases were reported in 2015 and the crude incidence rate was 285.83 per 100 000 population (males and females were 305.47 and 265.21 per 100 000 population). Age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 190.64 and 186.39 per 100 000 population, respectively, with the cumulative incidence rate (0-74 age years old) of 21.44%. The cancer incidence and ASIRC were 304.96/100 000 and 196.09/100 000 in urban areas and 261.40/100 000 and 182.70/100 000 in rural areas, respectively. About 2 338 000 cancer deaths were reported in 2015 and the cancer mortality was 170.05/100 000 (210.10/100 000 in males and 128.00/100 000 in females). Age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 106.72/100 000 and 105.84/100 000, respectively, with the cumulative incidence rate (0-74 age years old) of 11.94%. The cancer mortality and ASMRC were 172.61/100 000 and 103.65/100 000 in urban areas and 166.79/100 000 and 110.76/100 000 in rural areas, respectively. The most common cancer cases including lung, gastric, colorectal, liver and female breast, the top 10 cancer incidence accounted for about 76.70% of all cancer new cases. The most common cancer deaths including lung, liver, gastric, esophageal and colorectal, the top 10 cancer deaths accounted for about 83.00% of all cancer deaths.

ConclusionsThe burden of cancer showed a continuous upward trend in China. Cancer prevention and control faces the problem of the disparity in different areas and different cancer burden between men and women. The cancer pattern in China presents the coexistence of the cancer patterns in developed and developing countries. The situation of cancer prevention and control is still serious in China.

Cancer registry;Neoplasm;Incidence;Mortality;China
Wei Wenqiang, Email: nc.defcaab.smacicqwiew
He Jie, Email: tendef.3ab62eijeh.forp
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引用本文

郑荣寿,孙可欣,张思维,等. 2015年中国恶性肿瘤流行情况分析[J]. 中华肿瘤杂志,2019,41(1)：19-28.

DOI:10.3760/cma.j.issn.0253-3766.2019.01.005

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恶性肿瘤已经成为严重威胁中国人群健康的主要公共卫生问题之一，根据最新的统计数据显示，恶性肿瘤死亡占居民全部死因的23.91% [ 1 ]，且近十几年来恶性肿瘤的发病死亡均呈持续上升态势 [ 2 ]，防控形势严峻。国家癌症中心是国家癌症预防和诊疗的全国性领导机构，其主要职责之一就是组织开展肿瘤登记等信息收集工作。肿瘤登记可以为国家癌症防控提供基础的科学数据支撑，是癌症防控重要的基础性工作。原国家卫生和计划生育委员会、中医药管理局联合下发的《肿瘤登记管理办法》 [ 3 ]对我国的肿瘤登记工作进行了明确部署，国家癌症中心肿瘤登记办公室负责制定全国肿瘤登记工作计划、实施方案、质量控制和评价标准，建立全国肿瘤登记信息系统和跨区域肿瘤登记数据交换制度，负责肿瘤登记数据收集、质量控制和统计分析，定期汇总和分析登记资料，发布全国肿瘤统计数据。本研究根据新上报的肿瘤登记处数据，估计全国2015年恶性肿瘤发病、死亡情况，并分析分城乡、性别主要癌种的流行现况。
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备注信息
A
魏文强，Email: nc.defcaab.smacicqwiew
B
赫捷，Email: tendef.3ab62eijeh.forp
C
本研究得到了全国各肿瘤登记处工作人员的协助
D
所有作者均申明不存在利益冲突
E
国家自然科学基金 (81602931)
国家重点研发计划 (2018YFC1311704)
中国医学科学院医学与健康科技创新工程 (2018－I2M－3－003)
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