2005—2020年中国国家及分省疾病监测点的肿瘤死亡疾病负担数据解读

doi:10.16150/j.1671-2870.2024.04.004

摘要/Abstract

摘要：

2023年，《2005—2020年中国国家和分省肿瘤负担趋势:国家死亡监测点数据分析》发布，该文数据覆盖全国31个省市人群的23个特定部位肿瘤的死亡率和人均减寿年数。分析提示，2020年，我国因肿瘤死亡人数为239.78万，死亡率为170.80/10万；各肿瘤的死亡人数顺位前10位为肺癌（76.1万）、肝癌（36.77万）、胃癌（29.12万）、结直肠癌（18.24万）、食管癌（17.33万）、胰腺癌（10.04万）、乳腺癌（5.71万）、白血病（5.49万）、脑神经癌（5.42万）、子宫颈癌（4.48万），分别占因肿瘤死亡人数的百分比为32.0%、15.3%、12.1%、7.6%、7.2%、4.2%、2.4%、2.3%、2.3%、1.9%；死亡率分别为54.57/10万、26.19/10万、20.74/10万、13.00/10万、12.34/10万、7.15/10万、4.06/10万、3.91/10万、3.86/10万和3.19/10万。2020年，我国因肿瘤人均减寿年数（average years of life lost，AYLL）为23.60年，比2005年下降了3.74年，其中白血病导致的AYLL为37.35年，较2005年因白血病所致的AYLL 50.71年，降低了13.36年，但仍是导致寿命损失最多的肿瘤，前列腺癌为导致AYLL最少的肿瘤。我国肿瘤谱的构成出现正在向发达国家转变的可能。在发达国家高发的肺癌、乳腺癌和结直肠癌，在中国呈现疾病负担增加趋势。2020年肺癌、乳腺癌和结直肠癌的死亡率在该阶段都上升，较2005年分别上升78.98%，19.41%和47.56%。GLOBOCAN2022提示，2020年我国各肿瘤发病率顺位前10位的为肺癌（40.8/10万）、乳腺癌（33.0/10万）、甲状腺癌（24.6/10万）、肝癌（20.1/10万）、子宫颈癌（15.0/10万）、胃癌（13.8/10万）、前列腺癌（13.7/10万）、食管癌（9.7/10万）、子宫癌(8.7/10万)和卵巢癌（6.8/10万）。中国和美国发病率前10位中有5个癌种重合，其中导致死亡人数首位的均为肺癌。肿瘤疾病谱的改变，让已经获得证实的肿瘤预防和控制措施的推广实施显得更为紧迫。

关键词: 肿瘤, 死亡率, 肿瘤谱, 筛查

Abstract:

In December 2023, the Chinese Center for Disease Control and Prevention published National and subnational trends in cancer burden in China, 2005-2020: an analysis of national mortality surveillance data.on Lancet Public Health, covering the mortality rate and average years of life lost from 23 specific tumor sites in people in 31 provinces and cities across the country. The analysis suggests that in 2020, the number of deaths from cancer in China was 2.3978 million, with a mortality rate of 170.80/100 000. The top 10 tumor deaths cases are as follows: lung cancer 761,000, liver cancer 367,700, stomach cancer 291,200, colorectal cancer 182,400, esophageal cancer 173,300, pancreatic cancer 100,400, breast cancer 57,100, leukemia 54,900, cranial nerve cancer 54,200, cervical cancer 44,800, accounting for 32.0%, 15.3%, 12.1%, 7.6%, 7.2%, 4.2%, 2.4%, 2.3%, 2.3%, 1.9% of the total number of deaths due to tumors, respectively. The mortality rates were 54.57/100 000, 26.19/100 000, 20.74/100 000, 13.00/100 000, 12.34/100 000, 7.15/100 000, 4.06/100 000, 3.91/100 000, 3.86/100 000 and 3.19/100 000, respectively. In 2020, the average years of life lost (AYLL) due to cancer in China was 23.60 years, which was 3.74 years lower than that in 2015. Among them, leukemia caused an AYLL of 37.35 years, with a decrease of 13.36 years from the AYLL of 50.71 years caused by leukemia in 2005, but it was still the tumor that caused the most life loss. Prostate cancer was the tumor that caused the least AYLL. The composition of China’s cancer spectrum is changing to those in developed countries. Lung cancer, breast cancer and colorectal cancer, which are highly prevalent in developed countries, are showing an increasing disease burden trend in China. In 2020, the mortality rates of lung cancer, breast cancer and colorectal cancer all increased during this period, increasing by 78.98%, 19.41% and 47.56% respectively compared with those in 2005. GLOBOCAN2022 suggests that the top 10 cancer incidence rates in China in 2020 are lung cancer (40.8/100 000), breast cancer (33.0/100 000), thyroid cancer (24.6/100 000), liver cancer (20.1/100 000), cervical cancer (15.0/100 000), gastric cancer (13.8/100 000), prostate cancer (13.7/100 000), esophageal cancer (9.7/100 000), uterine cancer (8.7/100 000) and ovarian cancer (6.8/100 000). Five of the top 10 common cancer in China and the United States overlap, and lung cancer is the leading cause of death in both countries. Changes in the spectrum of tumor diseases have made the promotion and implementation of proven tumor prevention and control measures more urgent.

Key words: Cancer, Mortality rate, Cancer spectrum, Screening

中图分类号:

R73-31

章新, 郑莹. 2005—2020年中国国家及分省疾病监测点的肿瘤死亡疾病负担数据解读[J]. 诊断学理论与实践, 2024, 23(04): 371-377.

ZHANG Xin, ZHENG Ying. Interpretation of cancer death burden data from disease surveillance sites in China from 2005 to 2020[J]. Journal of Diagnostics Concepts & Practice, 2024, 23(04): 371-377.

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肿瘤	2020年			2005年			变化情况^*
肿瘤	全部人群（年）	男性（年）	女性（年）	全部人群（年）	男性（年）	女性（年）	全部人群（年）	男性（年）	女性（年）
全部肿瘤	23.60	23.78	23.27	27.34	27.78	26.50	-3.74	-4.00	-3.23
白血病	37.35	36.28	38.81	50.71	49.55	52.25	-13.36	-13.27	-13.44
脑神经癌	31.55	32.87	29.86	38.39	38.94	37.56	-6.83	-6.07	-7.70
乳腺癌	30.81	18.64	30.96	32.57	26.88	32.65	-1.75	-8.24	-1.69
子宫颈癌	30.30	-	30.30	31.66	-	31.66	-1.36	-	-1.36
卵巢癌	28.52	-	28.52	30.39	-	30.39	-1.87	-	-1.87
鼻咽癌	27.62	28.12	26.12	31.34	32.11	29.17	-3.72	-3.98	-3.05
肝癌	27.12	28.47	23.14	30.64	32.04	26.64	-3.52	-3.57	-3.50
其他肿瘤	26.65	26.95	26.32	30.90	30.53	31.24	-4.24	-3.58	-4.92
淋巴癌	25.41	25.91	24.41	31.85	32.27	31.04	-6.44	-6.36	-6.62
口腔癌	22.10	23.48	18.82	24.62	25.07	23.68	-2.52	-1.59	-4.86
喉癌	21.99	22.67	17.46	24.83	25.74	21.14	-2.84	-3.06	-3.69
肺癌	21.98	22.38	21.01	24.85	25.36	23.64	-2.87	-2.97	-2.63
多发性骨髓瘤	21.75	21.79	21.68	26.54	26.22	27.13	-4.79	-4.43	-5.44
胃癌	21.64	21.93	21.00	24.28	24.99	22.82	-2.64	-3.06	-1.82
胰腺癌	21.57	22.05	20.77	23.32	23.85	22.43	-1.75	-1.80	-1.66
结直肠癌	21.29	21.71	20.73	24.20	25.00	23.21	-2.90	-3.29	-2.48
食管癌	20.87	22.10	17.13	23.65	24.89	20.67	-2.78	-2.79	-3.54
肾癌	20.64	21.96	18.54	27.03	27.17	26.80	-6.39	-5.21	-8.26
胆囊癌	19.65	20.47	18.90	21.38	22.23	20.64	-1.73	-1.76	-1.74
甲状腺癌	18.79	19.78	18.15	21.28	23.08	20.11	-2.49	-3.30	-1.96
皮肤癌	17.22	18.57	15.80	22.39	23.32	21.27	-5.17	-4.75	-5.47
膀胱癌	16.58	16.89	15.25	19.67	19.97	18.69	-3.09	-3.07	-3.44
前列腺癌	15.71	15.71	-	17.56	17.56	-	-1.85	-1.85	-

发病率顺位	肿瘤类型	2020年国家死因监测系统			GLOBOCAN2022				变化情况^*
发病率顺位	肿瘤类型	死亡例数 (万)	死亡率 (/10万)	死亡例数占比(%)	肿瘤类型	死亡例数 (万)	死亡率 (/10万)	占肿瘤死亡例数(%)	死亡例数 (万)	死亡率 (/10万)	死亡例数占比(%)
	全部肿瘤	239.78	170.80	100.00	全部肿瘤	256.06	181.40	100.00	16.28	10.60	0.00
1	肺癌	76.61	54.57	32.00	肺癌	73.33	51.90	28.64	-3.28	-2.67	-3.36
2	肝癌	36.77	26.19	15.30	肝癌	31.65	22.40	12.36	-5.12	-3.79	-2.94
3	胃癌	29.12	20.74	12.10	胃癌	26.04	18.40	10.17	-3.08	-2.34	-1.93
4	结直肠癌	18.24	13.00	7.60	结直肠癌	24.00	17.00	9.37	5.76	4.00	1.77
5	食管癌	17.33	12.34	7.20	食管癌	18.75	13.30	7.32	1.42	0.96	0.12
6	胰腺癌	10.04	7.15	4.20	胰腺癌	10.63	7.50	4.15	0.59	0.35	-0.05
7	乳腺癌	5.71	4.06	2.40	乳腺癌	7.50	10.90	2.93	1.79	6.84	0.53
8	白血病	5.49	3.91	2.30	脑神经癌	5.66	4.00	2.21	-0.48	-0.31	-0.34
9	脑神经癌	5.42	3.86	2.30	子宫颈癌	5.57	8.10	2.18	0.24	0.14	-0.09
10	子宫颈癌	4.48	3.19	1.90	白血病	5.01	3.60	1.96	1.09	4.91	0.28