我國和全球腫瘤發(fā)病率和死亡率解析圖文講解

最新腫瘤發(fā)病率和死亡率解析中國&全球---《2023中國腫瘤登記年報》---《GlobalCancerStatistics2023》byIARCTangJian2023/3/12第1頁中國腫瘤發(fā)病率和死亡率總體狀況中國腫瘤發(fā)病率和死亡率（按性別）中國腫瘤發(fā)病率和死亡率（按地區(qū)）中國腫瘤發(fā)病率和死亡率（按年齡）中國排名前十腫瘤病種旳發(fā)病率和死亡率全球腫瘤發(fā)病率和死亡率具體狀況目錄

CONTENTS第2頁中國腫瘤發(fā)病率和死亡率總體狀況總體腫瘤發(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；畢生中有22%旳概率患癌癥。腫瘤死亡率：每10萬人有181人患癌死亡；畢生中有13%旳概率患癌死亡；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。第3頁中國腫瘤發(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。

畢生中，男性患癌癥概率為26%，女性19%畢生中，男性因患癌死亡概率為17%，女性為9%患癌人群中，因患癌而死亡旳概率，男性(71%)比女性(54%)高第4頁中國腫瘤發(fā)病率和死亡率（按地區(qū)）都市人口與農(nóng)村人口相比，癌癥發(fā)病率要略高，但畢生中因患癌癥死亡率要低：

腫瘤發(fā)病率：都市與農(nóng)村之比1.2:1；腫瘤死亡率：都市與農(nóng)村之比1.02:1。

畢生中，都市患癌癥概率為22.23%，農(nóng)村21.76%。畢生中，都市患癌死亡概率為12%，農(nóng)村為15%?；及┤巳褐校蚧及┒劳鰰A概率，都市人口(60%)比農(nóng)村人口(71%)低第5頁中國腫瘤發(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歲以上隨年齡增長而大幅上升

50歲以上占所有發(fā)病旳80%以上；80-85歲最高。第6頁中國腫瘤發(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歲以上隨年齡增長而大幅上升

60歲以上約占所有死亡旳63%以上；85歲以上達到最高。第7頁中國排名前十腫瘤病種旳發(fā)病率和死亡率（總體狀況）發(fā)病率與死亡率最高旳均是肺癌，排名前十病種旳發(fā)病率占比76.39%。排名前十病種旳死亡率占比84.27%.第8頁中國排名前十腫瘤病種旳發(fā)病率（按性別）男性發(fā)病率最高旳是肺癌，另一方面為胃癌、肝癌。排名前十病種旳發(fā)病率占比84.14%。女性發(fā)病率最高旳是乳腺癌，另一方面為肺癌、結(jié)直腸癌。排名前十病種旳發(fā)病率占比77.57%。第9頁中國排名前十腫瘤病種旳死亡率（按性別）男性死亡率最高旳是肺癌，另一方面為肝癌、胃癌。排名前十病種旳死亡率占比88.33%。女性死亡率最高旳是肺癌，另一方面為胃癌、肝癌。排名前十病種旳死亡率占比81.12%。第10頁全球腫瘤發(fā)病率和死亡率具體狀況第11頁Worldwide1.1:11.26:1Total:12,700,000Total:7,600,000第12頁Developedcountries第13頁Developingcountries第14頁第15頁第16頁第17頁Itshouldalsobenotedthatcancertendstobediagnosedatlaterstagesinmanydevelopingcountriescomparedwithdevelopedcountriesandthis,combinedwithreducedaccesstoappropriatetherapeuticfacilitiesanddrugs(Fig.3),hasanadverseeffectonsurvival.第18頁第19頁SelectedCancersFemaleBreastCancer[1]第20頁Breastcanceristhemostfrequentlydiagnosedcancerandtheleadingcauseofcancerdeathinfemalesworldwide,accountingfor23%(1.38million)ofthetotalnewcancercasesand14%(458,400)ofthetotalcancerdeathsin2023(Fig.2),Abouthalfthebreastcancercasesand60%ofthedeathsareestimatedtooccurineconomicallydevelopingcountries.第21頁Ingeneral,incidenceratesarehighinWesternandNorthernEurope,Australia/NewZealand,andNorthAmerica;intermediateinSouthAmerica,theCaribbean,andNorthernAfrica;andlowinsub-SaharanAfricaandAsia.第22頁Thefactorsthatcontributetotheinternationalvariationinincidencerateslargelystemfromdifferencesinreproductiveandhormonalfactorsandtheavailabilityofearlydetectionservices.第23頁Reproductivefactorsthatincreaserisk12345longmenstrualhistoryoralcontraceptiveslateageatfirstbirthnulliparityrecentuseofpostmenopausalhormonetherapy第24頁Howtoreducetheriskofdevelopingbreastcancer?MaintainingahealthybodyweightIncreasingphysicalactivityMinimizingalcoholintakeEarlydetectionstrategiesincludethepromotionofawarenessofearlysignsandsymptomsandscreeningbyclinicalbreastexaminationBestavailablestrategies第25頁SelectedCancersColorectalCancer[2]第26頁Colorectalcanceristhe3rdmostcommonlydiagnosedcancerinmalesandthe2ndinfemales,withover1.2millionnewcancercasesand608,700deathsestimatedtohaveoccurredin2023.第27頁ThehighestincidenceratesarefoundinAustraliaandNewZealand,Europe,andNorthAmerica,whereasthelowestratesarefoundinAfricaandSouth-CentralAsia.Ratesaresubstantiallyhigherinmalesthaninfemales.第28頁TrendsRiskFactorsRatescontinuetoincreaseincountrieswithlimitedresourcesandhealthinfrastructure,particularlyinEasternEuropeandEasternAsiaWhiledecreasinginseveralWesterncountries,particularlyinUnitedStates,Canada,andAustraliaSmokingPhysicalinactivityOverweight/ObesityRedandprocessedmeatconsumptionExcessivealcoholconsumptionPopulation-basedcolorectalscreeningprograms**AccordingtoarecentrandomizedtrialintheUnitedKingdom,aone-timeflexiblesigmoidoscopyscreeningbetween55and64yearsofagereducedcolorectalcancerincidenceby33%andmortalityby43%.第29頁SelectedCancersLungCancer[3]第30頁Lungcancerwasthemostcommonlydiagnosedcanceraswellastheleadingcauseofcancerdeathinmalesin2023globally.Amongfemales,itwasthe4thmostcommonlydiagnosedcancerandthe2ndleadingcauseofcancerdeath.Lungcanceraccountsfor13%(1.6million)ofthetotalcasesand18%(1.4million)ofthedeathsin2023.第31頁Inmales,thehighestlungcancerincidenceratesareinEasternandSouthernEurope,NorthAmerica,andEasternAsia,whileratesarelowinsub-SaharanAfrica.Infemales,thehighestlungcancerincidenceratesarefoundinNorthAmerica,NorthernEurope,andAustralia/NewZealand.第32頁Smokingaccountsfor80%oftheworldwidelungcancerburdeninmalesandatleast50%oftheburdeninfemales.第33頁MalelungcancerdeathratesaredecreasinginmostWesterncountries,includingmanyEuropeancountries,NorthAmerica,andAustralia,wherethetobaccoepidemicpeakedbythemiddleofthelastcentury.Incontrast,lungcancerratesareincreasingincountriessuchasChinaandseveralothercountriesinAsiaandAfrica,wheretheepidemichasbeenestablishedmorerecentlyandsmokingprevalencecontinuestoeitherincreaseorshowsignsofstability.第34頁byapplyingproventobaccocontrolinterventionsthatincluderaisingthepriceofcigarettes*andothertobaccoproducts,banningsmokinginpublicplaces,therestrictionofadvertisingoftobaccoproducts,counteradvertising,andtreatingtobaccodependence.avoidtheburdenoflungcancerBeststrategy*a10%increaseincigarettepriceshasbeenshowntoreducecigaretteconsumptionby3%to5%.第35頁SelectedCancersProstateCancer[4]第36頁Prostatecanceristhe2ndmostfrequentlydiagnosedcancerandthe6thleadingcauseofcancerdeathinmales,accountingfor14%(903,500)ofthetotalnewcancercasesand6%(258,400)ofthetotalcancerdeathsinmalesin2023。第37頁Incidenceratesvarybymorethan25-foldworldwidelargelybecauseofthewideutilizationofprostate-specificantigen(PSA)testing.Deathratesforprostatecancerhavebeendecreasinginmanydevelopedcountries,includingAustralia,Canada,theUnitedKingdom,theUnitedStates,Italyinpartbecauseoftheimprovedtreatmentwithcurativeintent.第38頁theonlywell-establishedriskfactorsOlderageRace(black)Familyhistorytherearenoestablishedpreventableriskfactorsforprostatecancer.第39頁SelectedCancersStomachCancer[5]第40頁Atotalof989,600newstomachcancercasesand738,000deathsareestimatedtohaveoccurredin2023,accountingfor8%ofthetotalcasesand10%oftotaldeaths.Over70%ofnewcasesanddeathsoccurindevelopingcountries.Generally,stomachcancerratesareabouttwiceashighinmalesasinfemales.第41頁ThehighestincidenceratesareinEasternAsia,EasternEurope,andSouthAmericaandthelowestratesareinNorthAmericaandmostpartsofAfrica.Regionalvariationsinpartreflectdifferencesindietarypatterns,particularlyinEuropeancountries,andtheprevalenceofHelicobacterpyloriinfection.第42頁1234theincreaseduseandavailabilityofrefrigerationincludingtheincreasedavailabilityoffreshfruitsandvegetables,andadecreasedrelianceonsaltedandpreservedfoods.Rateshavedecreaseddueto(westerncountries):reductionsinchronicH.pyloriinfection

inmostpartsoftheworld.reductionsinsmokinginsomepartsofthedevelopedworld.InJapan,mortalityratesmayhavedeclinedviatheintroductionofscreeningusingphotofluorography.第43頁SelectedCancersLiverCancer[6]第44頁Livercancerinmenisthe5thmostfrequentlydiagnosedcancerworldwidebutthe2ndmostfrequentcauseofcancerdeath.Inwomen,itisthe7thmostcommonlydiagnosedcancerandthe6thleadingcauseofcancerdeath.Anestimated748,300newlivercancercasesand695,900cancerdeathsoccurredworldwidein2023.第45頁HalfofthesecasesanddeathswereestimatedtooccurinChina.Globally,ratesaremorethantwiceashighinmalesasinfemales.第46頁Riskfactorsaccountingforlivercancer12345chronicHBV/HCVinfectionnonalcoholicfattyliverdiseaseobesityalcohol-relatedcirrhosisaflatoxinB1(AFB)exposure第47頁LivercancerincidenceratesareincreasinginmanypartsoftheworldincludingtheUnitedStatesandCentralEurope,possiblyduetotheobesityepidemicandtheriseinHCVinfectionthroughcontinuedtransmissionbyinjectiondrugusers.Incontrasttothetrendinthelow-riskareas,ratesdecreasedinsomehistoricallyhigh-riskareas,possiblyduetotheHBVvaccine.UniversalinfanthepatitisvaccinationprogramsinTaiwanreducedlivercancerincidenceratesbyabouttwo-thirdsinchildrenandyoungadults.第48頁introducedtheHBVvaccineintotheirnationalinfantimmunizationschedules(Fig.10).PreventivestrategiesagainstHCV,includescreeningofdonor’sbloodforantibodiestoHCV,institutingadequateinfectioncontrolpracticesincludingtheuseoforaldeliveryofmedicineswherepossible,andneedleexchangeprogramsamonginjectiondrugusers.CropsubstitutionandimprovedgrainstoragepracticeshavebeenshowntoreducecontaminationwithAFB.avoidtheburdenoflivercancerBeststrategy第49頁第50頁SelectedCancersCervicalCancer[7]第51頁Cervicalcanceristhe3rdmostcommonlydiagnosedcancerandthe4thleadingcauseofcancerdeathinfemalesworldwide,accountingfor9%(529,800)ofthetotalnewcancercasesand8%(275,100)ofthetotalcancerdeathsamongfemalesin2023.Morethan85%ofthesecasesanddeathsoccurindevelopingcountries.India,the2ndmostpopulouscountryintheworld,accountsfor27%(77,100)ofthetotalcervicalcancerdeaths.第52頁Worldwide,thehighestincidenceratesareinEastern,Western,andSouthernAfrica,aswellasSouth-CentralAsiaandSouthAmerica.RatesarelowestinWesternAsia,Australia/NewZealand,andNorthAmerica.Thedisproportionatelyhighburdenofcervicalcancerindevelopingcountriesandelsewhereinmedicallyunderservedpopulationsislargelyduetoalackofscreeningthatallowsdetectionofprecancerousandearlystagecervicalcancer.第53頁Themostefficientandcost-effectivescreeningtechniquesinlow-resourcecountries

visualInspection

aceticacid/Lugol’siodineHPVDNAtestingArecentclinicaltrialinruralIndia,alow-resourcearea,foundthatasingleroundofHPVDNAtestingwasassociatedwithabouta50%reductionintheriskofdevelopingadvancedcervicalcancerandassociateddeaths.第54頁TheexpectationsthatvaccineswhichprimarilyprotectagainstthemostcommonstrainsofHPVinfections(HPVtypes16and18),whichcauseabout70%ofcervicalcancers,maypreventcervicalcancerworldwideareatpresenthigh.However,affordablepricingisthemostcriticalfactortofacilitatetheintroductionofHPVvaccinesinlow-andmedium-resourcecountriesintheshortterm.Itisalsoextremelyimportantthatwomencontinuetoreceivescreeningservicesbecausethecurrentvaccinesarebeinggiventoadolescentgirlsonly,andevenvaccinatedgirlsshouldbeginscreeningwhentheyreachtherecommendedscreeningagesincethevaccinesdonotprovideprotectionforthe30%ofchronicinfectionsbyHPVtypesotherthanHPV16,18,6and11thatcausecervicalcancer.DisputeofHPV第55頁SelectedCancersEsophageal[8]第56頁Esophagealcancerusuallyoccursaseithersquamouscellcarcinomainthemiddleorupperone-thirdoftheesophagus,orasadenocarcinomaintheloweronethirdorjunctionoftheesophagusandstomach.第57頁Anestimated482,300newesophagealcancercasesand406,800deathsoccurredin2023worldwide.Incidenceratesvaryinternationallybynearly16-fold,withthehighestratesfoundinSouthernandEasternAfricaandEasternAsiaandlowestratesobservedinWesternandMiddleAfricaandCentralAmericainbothmalesandfemales.Esophagealcanceris3to4timesmorecommonamongmalesthanfemales.第58頁Inthehighestriskarea,stretchingfromnorthernIranthroughthecentralAsianrepublicstoNorth-CentralChina,oftenreferredtoasthe‘esophagealcancerBelt’90%ofcasesaresquamouscellcarcinomas.EsophagealCancerBelt第59頁Majorriskfactors

(forsquamouscellcarcinomas)

PoornutritionalstatusLowintakeoffruitsandvegetablesDrinkingbeveragesathighTemperaturesSmoking/excessivealcoholconsumptionInlow-riskareassuchastheUnitedStatesandseveralWesterncountries,smokingandexcessivealcoholconsumptionaccountforabout90%ofthetotalcasesofsquamouscellcarcinomaoftheesophagus.第60頁Majorriskfactors

(foradenocarcinoma)

SmokingOverweight/ObesityChronicgastroesophagealrefluxdiseaseBarrett’sesophagus第61頁Incidenceratesforadenocarcinomaoftheesophagushavebeenincreasinginseveralwesterncountries,inpartduetoincreasesintheprevalenceofknownriskfactorssuchasoverweightandobesity.Incontrast,ratesforsquamouscellcarcinomaoftheesophagushavebeensteadilydeclininginthesesamecountriesbecauseoflong-termreductionsintobaccouseandalcoholconsumption.第62頁SelectedCancersBladder[9]第63頁Anestimated386,300newcasesand150,200deathsfrombladdercanceroccurredin2023worldwide.Themajorityofbladdercanceroccursinmalesandthereisa14-foldvariationinincidenceinternationally.ThehighestincidenceratesarefoundinthecountriesofEurope,NorthAmerica,andNorthernAfrica.Egyptianmaleshavethehighestmortalityrates,whichistwiceashighasthehighestratesinEuropeandover4timeshigherthanthatintheUnitedStates.ThelowestratesarefoundinthecountriesofMelanesiaandMiddleAfrica.第64頁SmokingisthemajorriskfactorsinWesterncountries,whereaschronicinfectionwithSchistosomahematobiumindevelopingcountries,particularlyinAfricaandtheMiddleEast,accountsforabout50%ofthetotalburden.第65頁SelectedCancersLipandOralCavity[10]第66頁Anestimated263,900newcasesand128,000deathsfromoralcavitycancer(includinglipcancer)occurredin2023worldwide.Generally,thehighestoralcavitycancerratesarefoundinMelanesia,South-CentralAsia,andCentralandEastern