最新中國和全球腫瘤發(fā)病率和死亡率解析(2013)

1、最新腫瘤發(fā)病率和死亡率解析中國&全球-2012中國腫瘤登記年報-Global Cancer Statistics 2011by IARCTang Jian 2013/3/12 MoticA. 中國腫瘤發(fā)病率和死亡率總體情況B. 中國腫瘤發(fā)病率和死亡率（按性別）C. 中國腫瘤發(fā)病率和死亡率（按地域）D. 中國腫瘤發(fā)病率和死亡率（按年齡）E. 中國排名前十腫瘤病種的發(fā)病率和死亡率F. 全球腫瘤發(fā)病率和死亡率具體情況目錄 CONTENTSMotic中國腫瘤發(fā)病率和死亡率總體情況總體腫瘤發(fā)病率和死亡率較高： 腫瘤發(fā)病率：每10萬人中有286人患癌；一生中有22%的概率患癌癥。 腫瘤死亡率：每1

2、0萬人有181人患癌死亡；一生中有13%的概率患癌死亡； 每分鐘就有6人被確診為癌癥，平均每5位癌癥患者有3人死亡。Motic中國腫瘤發(fā)病率和死亡率（按性別）相比女性，男性癌癥發(fā)病率和死亡率都高： 腫瘤發(fā)病率：男女之比1.3:1；腫瘤死亡率：男女之比1.65:1。 一生中，男性患癌癥概率為26%，女性19% 一生中，男性因患癌死亡概率為17%，女性為9% 患癌人群中，因患癌而死亡的概率，男性(71%)比女性(54%)高M(jìn)otic中國腫瘤發(fā)病率和死亡率（按地域）城市人口與農(nóng)村人口相比，癌癥發(fā)病率要略高，但一生中因患癌癥死亡率要低： 腫瘤發(fā)病率：城市與農(nóng)村之比1.2:1；腫瘤死亡率：城市與農(nóng)村之比

3、1.02:1 。 一生中，城市患癌癥概率為22.23%，農(nóng)村21.76%。 一生中，城市患癌死亡概率為12%，農(nóng)村為15%。 患癌人群中，因患癌而死亡的概率，城市人口(60%)比農(nóng)村人口(71%)低Motic中國腫瘤發(fā)病率和死亡率（按年齡）腫瘤發(fā)病率隨人群年齡逐漸上升，特別是50歲以上隨年齡增加而大幅上升 50歲以上占全部發(fā)病的80%以上；80-85歲最高。Motic中國腫瘤發(fā)病率和死亡率（按年齡）腫瘤死亡率隨人群年齡逐漸上升，特別是60歲以上隨年齡增加而大幅上升 60歲以上約占全部死亡的63%以上；85歲以上達(dá)到最高。Motic中國排名前十腫瘤病種的發(fā)病率和死亡率（總體情況）發(fā)病率與死亡率最

4、高的均是肺癌，排名前十病種的發(fā)病率占比76.39%。排名前十病種的死亡率占比84.27%.Motic中國排名前十腫瘤病種的發(fā)病率（按性別）男性發(fā)病率最高的是肺癌，其次為胃癌、肝癌。排名前十病種的發(fā)病率占比84.14%。女性發(fā)病率最高的是乳腺癌，其次為肺癌、結(jié)直腸癌。排名前十病種的發(fā)病率占比77.57%。Motic中國排名前十腫瘤病種的死亡率（按性別）男性死亡率最高的是肺癌，其次為肝癌、胃癌。排名前十病種的死亡率占比88.33%。女性死亡率最高的是肺癌，其次為胃癌、肝癌。排名前十病種的死亡率占比81.12%。Motic全球腫瘤發(fā)病率和死亡率具體情況MoticWorldwide1.1 : 11.2

5、6 : 1Total: 12,700,000Total: 7,600,000MoticDeveloped countriesMoticDeveloping countriesMoticMoticMoticMoticIt should also be noted that cancer tends to be diagnosed at later stages in many developing countries compared with developed countries and this, combined with reduced access to appropriate th

6、erapeutic facilities and drugs (Fig.3), has an adverse effect on survival.MoticMoticSelected CancersFemale Breast Cancer1MoticBreast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females worldwide, accounting for 23% (1.38 million) of the total new cancer ca

7、ses and 14% (458,400) of the total cancer deaths in 2008 (Fig. 2), About half the breast cancer cases and 60% of the deaths are estimated to occur in economically developing countries. MoticIn general, incidence rates are high in Western and Northern Europe, Australia/New Zealand, and North America;

8、 intermediate in South America, the Caribbean, and Northern Africa; and low in sub-Saharan Africa and Asia.MoticThe factors that contribute to the international variation in incidence rates largely stem from differences in reproductive and hormonal factors and the availability of early detection ser

9、vices.Reproductive factors that increase risk12345 long menstrual history oral contraceptives late age at first birth nulliparity recent use of postmenopausal hormone therapyMoticHow to reduce the risk of developing breast cancer? Maintaining a healthy body weight Increasing physical activity Minimi

10、zing alcohol intake Early detection strategies include the promotion of awareness of early signs and symptoms and screening by clinical breast examinationBest available strategiesMoticSelected CancersColorectal Cancer2MoticColorectal cancer is the 3rd most commonly diagnosed cancer in males and the

11、2nd in females, with over 1.2 million new cancer cases and 608,700 deaths estimated to have occurred in 2008.MoticThe highest incidence rates are found in Australia and New Zealand, Europe, and North America, whereas the lowest rates are found in Africa and South-Central Asia. Rates are substantiall

12、yhigher in males than in females.MoticTrends Risk FactorsRates continue to increase in countries with limited resources and health infrastructure, particularly in Eastern Europe and Eastern AsiaWhile decreasing in several Western countries, particularly in UnitedStates, Canada, and AustraliaSmokingP

13、hysical inactivityOverweight/ObesityRed and processed meat consumption Excessive alcohol consumption Population-based colorectal screening programs* According to a recent randomized trial in the United Kingdom, a one-time flexible sigmoidoscopy screening between 55 and 64 years of age reduced colore

14、ctal cancer incidence by 33% and mortality by 43%.MoticSelected CancersLung Cancer3MoticLung cancer was the most commonly diagnosed canceras well as the leading cause of cancer death in males in 2008 globally. Among females, it was the 4th most commonly diagnosed cancer and the 2nd leading cause of

15、cancer death. Lung cancer accounts for 13% (1.6 million) of the total cases and 18% (1.4 million) of the deaths in 2008.MoticIn males, the highest lung cancer incidence rates are in Eastern and Southern Europe, North America,and Eastern Asia, while rates are low in sub-Saharan Africa. In females, th

16、e highest lung cancer incidence rates are found in North America, Northern Europe, and Australia/New Zealand.MoticSmoking accounts for 80% of the worldwide lung cancerburden in males and at least 50% of the burden in females.MoticMale lung cancer death rates are decreasing in most Western countries,

17、 including many European countries, North America, and Australia, where the tobacco epidemic peaked by the middle of the last century.In contrast, lung cancer rates are increasing in countries such as China and several other countries in Asia and Africa, where the epidemic has been established more

18、recently and smoking prevalence continues to either increase or show signs of stability.Moticby applying proven tobacco control interventions that include raising the price of cigarettes* and other tobacco products, banning smoking in public places, the restriction of advertising of tobacco products

19、, counter advertising, and treating tobacco dependence.avoid the burden of lung cancerBest strategy* a 10% increase in cigarette prices has been shown to reduce cigarette consumption by 3% to 5%.MoticSelected CancersProstate Cancer4MoticProstate cancer is the 2nd most frequently diagnosed cancer and

20、 the 6th leading cause of cancer death in males, accounting for 14% (903,500) of the total new cancer cases and 6% (258,400) of the total cancer deaths in males in 2008。MoticIncidence rates vary by more than 25-foldworldwide largely because of the wide utilization of prostate-specific antigen (PSA)

21、testing. Death rates for prostate cancer have been decreasing in many developed countries, including Australia, Canada, the United Kingdom, the UnitedStates, Italy in part because of the improved treatment with curative intent.Moticthe only well-established risk factors Older age Race (black) Family

22、 historythere are no establishedpreventable risk factors for prostate cancer.MoticSelected CancersStomach Cancer5MoticA total of 989,600 new stomach cancer cases and 738,000 deaths are estimated to have occurred in 2008, accounting for 8% of the total cases and 10% of total deaths . Over 70% of new

23、cases and deaths occur in developing countries. Generally, stomach cancer rates are about twice as high in males as in females.MoticThe highest incidence rates are in Eastern Asia, Eastern Europe, and South America and the lowest rates are in North America and most parts of Africa.Regional variation

24、s in part reflect differences in dietary patterns, particularly in European countries, and the prevalence of Helicobacter pylori infection.Motic1234the increased use and availability of refrigeration including the increased availability of fresh fruits and vegetables, and a decreased reliance on sal

25、ted and preserved foods.Rates have decreased due to(western countries):reductions in chronic H. pylori infection in most parts of the world.reductions in smoking in some parts of the developed world.In Japan, mortality rates may have declined via the introduction of screening using photofluorography

26、.MoticSelected CancersLiver Cancer6MoticLiver cancer in men is the 5th most frequently diagnosed cancer worldwide but the 2nd most frequent cause of cancer death. In women, it is the 7th most commonly diagnosed cancer and the 6th leading cause of cancer death. An estimated 748,300 new liver cancer c

27、ases and 695,900 cancer deaths occurred worldwide in 2008.MoticHalf of these cases and deaths were estimated to occur in China. Globally, rates are more than twice as high in males as in females.MoticRisk factors accounting for liver cancer12345 chronic HBV/HCV infectionnonalcoholic fatty liver dise

28、aseobesityalcohol-related cirrhosis aflatoxin B1 (AFB) exposureMoticLiver cancer incidence rates are increasing inmany parts of the world including the United Statesand Central Europe, possibly due to the obesity epidemic and the rise in HCV infection through continued transmission by injection drug

29、 users.In contrast to the trend in the low-risk areas, ratesdecreased in some historically high-risk areas, possibly due to the HBV vaccine. Universal infant hepatitis vaccination programs in Taiwan reduced liver cancer incidence rates by about two-thirds in children and young adults.Moticintroduced

30、 the HBV vaccine into their nationalinfant immunization schedules(Fig. 10).Preventive strategies against HCV, include screening ofdonors blood for antibodies to HCV, institutingadequate infection control practices including the use of oral delivery of medicines where possible, and needle exchange pr

31、ograms among injection drug users.Crop substitution and improved grain storage practices have been shown to reduce contamination with AFB.avoid the burden of liver cancerBest strategyMoticMoticSelected CancersCervical Cancer7MoticCervical cancer is the 3rd most commonly diagnosed cancer and the 4th

32、leading cause of cancer death in females worldwide, accounting for 9% (529,800) of the total new cancer cases and 8% (275,100) of the total cancer deaths among females in 2008. More than 85% of these cases and deaths occur in developing countries. India, the 2nd most populous country in the world, a

33、ccounts for 27% (77,100) of the total cervical cancer deaths.MoticWorldwide, the highest incidence rates are in Eastern, Western, and Southern Africa, as well as South-Central Asia and South America. Rates are lowest in Western Asia, Australia/New Zealand, and North America. The disproportionately h

34、igh burden of cervical cancer in developing countries and elsewhere in medically underserved populations is largely due to a lack of screening that allows detection of precancerous and early stage cervical cancer.MoticThe most efficient and cost-effective screening techniques in low-resource countri

35、es visual Inspection acetic acid/Lugols iodine HPV DNA testingA recent clinical trial in rural India, a low-resource area, found that a singleround of HPV DNA testing was associated with about a 50% reduction in the risk of developing advanced cervical cancer and associated deaths.MoticThe expectati

36、ons that vaccines which primarily protect against the most common strains of HPV infections (HPV types 16 and 18), which cause about 70% of cervical cancers, may prevent cervical cancer worldwide are at present high.However, affordable pricing is the most critical factor to facilitate the introducti

37、on of HPV vaccines in low- and medium-resource countries in the short term.It is also extremely important that women continue to receive screening services because the current vaccines are being given to adolescent girls only, and even vaccinated girls should begin screening when they reach the reco

38、mmended screening age since the vaccines do not provide protection for the 30% of chronic infections by HPV types other than HPV 16, 18, 6 and 11 that cause cervical cancer.Dispute of HPVMoticSelected CancersEsophageal8MoticEsophageal cancer usually occurs as either squamous cell carcinoma in the mi

39、ddle or upper one-third of the esophagus, or as adenocarcinoma in the lower onethird or junction of the esophagus and stomach.MoticAn estimated 482,300 new esophageal cancer cases and 406,800 deaths occurred in 2008 worldwide. Incidence rates vary internationally by nearly 16-fold, with the highest

40、rates found in Southern and Eastern Africa and Eastern Asia and lowest rates observed in Western and Middle Africa and Central America in both males and females. Esophageal cancer is 3 to 4 times more common among males than females.MoticIn the highest risk area, stretching from northern Iran throug

41、h the central Asian republics to North-Central China, often referred to as theesophageal cancer Belt90% of cases are squamous cell carcinomas.Motic Major risk factors (for squamous cell carcinomas) Poor nutritional statusLow intake of fruits and vegetablesDrinking beverages at high TemperaturesSmoki

42、ng/excessive alcohol consumptionIn low-risk areas such as the United States and several Western countries, smoking and excessive alcohol consumption account for about 90% of the total cases of squamous cell carcinoma of the esophagus.Motic Major risk factors (for adenocarcinoma) SmokingOverweight/Ob

43、esityChronic gastroesophagealreflux diseaseBarretts esophagusMoticIncidence rates for adenocarcinoma of the esophagus have been increasing in several western countries, in part due to increases in the prevalence of known risk factors such as overweight and obesity. In contrast, rates for squamous ce

44、ll carcinoma of the esophagus have been steadily declining in these same countries because of long-term reductions in tobacco use and alcoholconsumption.MoticSelected CancersBladder9MoticAn estimated 386,300 new cases and 150,200 deaths from bladder cancer occurred in 2008 worldwide. The majority of

45、 bladder cancer occurs in males and there is a 14-fold variation in incidence internationally. The highest incidence rates are found in the countries of Europe, North America, and Northern Africa. Egyptian males have the highest mortalityrates, which is twice as high as the highest rates in Europe a

46、nd over 4 times higher than that in theUnited States. The lowest rates are found in thecountries of Melanesia and Middle Africa.MoticSmoking is the major risk factors in Western countries, whereas chronic infection with Schistosoma hematobium in developing countries, particularly in Africa and the M

47、iddle East, accounts for about 50% of the total burden.MoticSelected CancersLip and Oral Cavity10MoticAn estimated 263,900 new cases and 128,000 deaths from oral cavity cancer (including lip cancer)occurred in 2008 worldwide. Generally, the highest oral cavity cancer rates are found in Melanesia,South-Central Asia, and Central and Eastern Europe and the lowest