我國(guó)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(guó)&全球---《2023中國(guó)腫瘤登記年報(bào)》---《GlobalCancerStatistics2023》byIARCTangJian2023/3/12第1頁(yè)中國(guó)腫瘤發(fā)病率和死亡率總體狀況中國(guó)腫瘤發(fā)病率和死亡率（按性別）中國(guó)腫瘤發(fā)病率和死亡率（按地區(qū)）中國(guó)腫瘤發(fā)病率和死亡率（按年齡）中國(guó)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(yè)中國(guó)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(wàn)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(wàn)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(yè)中國(guó)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(yè)中國(guó)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(yè)中國(guó)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(zhǎng)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(yè)中國(guó)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(zhǎng)而大幅上升

60歲以上約占所有死亡旳63%以上；85歲以上達(dá)到最高。第7頁(yè)中國(guó)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(yè)中國(guó)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(yè)中國(guó)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(yè)全球腫瘤發(fā)病率和死亡率具體狀況第11頁(yè)Worldwide1.1:11.26:1Total:12,700,000Total:7,600,000第12頁(yè)Developedcountries第13頁(yè)Developingcountries第14頁(yè)第15頁(yè)第16頁(yè)第17頁(yè)Itshouldalsobenotedthatcancertendstobediagnosedatlaterstagesinmanydevelopingcountriescomparedwithdevelopedcountriesandthis,combinedwithreducedaccesstoappropriatetherapeuticfacilitiesanddrugs(Fig.3),hasanadverseeffectonsurvival.第18頁(yè)第19頁(yè)SelectedCancersFemaleBreastCancer[1]第20頁(yè)Breastcanceristhemostfrequentlydiagnosedcancerandtheleadingcauseofcancerdeathinfemalesworldwide,accountingfor23%(1.38million)ofthetotalnewcancercasesand14%(458,400)ofthetotalcancerdeathsin2023(Fig.2),Abouthalfthebreastcancercasesand60%ofthedeathsareestimatedtooccurineconomicallydevelopingcountries.第21頁(yè)Ingeneral,incidenceratesarehighinWesternandNorthernEurope,Australia/NewZealand,andNorthAmerica;intermediateinSouthAmerica,theCaribbean,andNorthernAfrica;andlowinsub-SaharanAfricaandAsia.第22頁(yè)Thefactorsthatcontributetotheinternationalvariationinincidencerateslargelystemfromdifferencesinreproductiveandhormonalfactorsandtheavailabilityofearlydetectionservices.第23頁(yè)Reproductivefactorsthatincreaserisk12345longmenstrualhistoryoralcontraceptiveslateageatfirstbirthnulliparityrecentuseofpostmenopausalhormonetherapy第24頁(yè)Howtoreducetheriskofdevelopingbreastcancer?MaintainingahealthybodyweightIncreasingphysicalactivityMinimizingalcoholintakeEarlydetectionstrategiesincludethepromotionofawarenessofearlysignsandsymptomsandscreeningbyclinicalbreastexaminationBestavailablestrategies第25頁(yè)SelectedCancersColorectalCancer[2]第26頁(yè)Colorectalcanceristhe3rdmostcommonlydiagnosedcancerinmalesandthe2ndinfemales,withover1.2millionnewcancercasesand608,700deathsestimatedtohaveoccurredin2023.第27頁(yè)ThehighestincidenceratesarefoundinAustraliaandNewZealand,Europe,andNorthAmerica,whereasthelowestratesarefoundinAfricaandSouth-CentralAsia.Ratesaresubstantiallyhigherinmalesthaninfemales.第28頁(yè)TrendsRiskFactorsRatescontinuetoincreaseincountrieswithlimitedresourcesandhealthinfrastructure,particularlyinEasternEuropeandEasternAsiaWhiledecreasinginseveralWesterncountries,particularlyinUnitedStates,Canada,andAustraliaSmokingPhysicalinactivityOverweight/ObesityRedandprocessedmeatconsumptionExcessivealcoholconsumptionPopulation-basedcolorectalscreeningprograms**AccordingtoarecentrandomizedtrialintheUnitedKingdom,aone-timeflexiblesigmoidoscopyscreeningbetween55and64yearsofagereducedcolorectalcancerincidenceby33%andmortalityby43%.第29頁(yè)SelectedCancersLungCancer[3]第30頁(yè)Lungcancerwasthemostcommonlydiagnosedcanceraswellastheleadingcauseofcancerdeathinmalesin2023globally.Amongfemales,itwasthe4thmostcommonlydiagnosedcancerandthe2ndleadingcauseofcancerdeath.Lungcanceraccountsfor13%(1.6million)ofthetotalcasesand18%(1.4million)ofthedeathsin2023.第31頁(yè)Inmales,thehighestlungcancerincidenceratesareinEasternandSouthernEurope,NorthAmerica,andEasternAsia,whileratesarelowinsub-SaharanAfrica.Infemales,thehighestlungcancerincidenceratesarefoundinNorthAmerica,NorthernEurope,andAustralia/NewZealand.第32頁(yè)Smokingaccountsfor80%oftheworldwidelungcancerburdeninmalesandatleast50%oftheburdeninfemales.第33頁(yè)MalelungcancerdeathratesaredecreasinginmostWesterncountries,includingmanyEuropeancountries,NorthAmerica,andAustralia,wherethetobaccoepidemicpeakedbythemiddleofthelastcentury.Incontrast,lungcancerratesareincreasingincountriessuchasChinaandseveralothercountriesinAsiaandAfrica,wheretheepidemichasbeenestablishedmorerecentlyandsmokingprevalencecontinuestoeitherincreaseorshowsignsofstability.第34頁(yè)byapplyingproventobaccocontrolinterventionsthatincluderaisingthepriceofcigarettes*andothertobaccoproducts,banningsmokinginpublicplaces,therestrictionofadvertisingoftobaccoproducts,counteradvertising,andtreatingtobaccodependence.avoidtheburdenoflungcancerBeststrategy*a10%increaseincigarettepriceshasbeenshowntoreducecigaretteconsumptionby3%to5%.第35頁(yè)SelectedCancersProstateCancer[4]第36頁(yè)P(yáng)rostatecanceristhe2ndmostfrequentlydiagnosedcancerandthe6thleadingcauseofcancerdeathinmales,accountingfor14%(903,500)ofthetotalnewcancercasesand6%(258,400)ofthetotalcancerdeathsinmalesin2023。第37頁(yè)Incidenceratesvarybymorethan25-foldworldwidelargelybecauseofthewideutilizationofprostate-specificantigen(PSA)testing.Deathratesforprostatecancerhavebeendecreasinginmanydevelopedcountries,includingAustralia,Canada,theUnitedKingdom,theUnitedStates,Italyinpartbecauseoftheimprovedtreatmentwithcurativeintent.第38頁(yè)theonlywell-establishedriskfactorsOlderageRace(black)Familyhistorytherearenoestablishedpreventableriskfactorsforprostatecancer.第39頁(yè)SelectedCancersStomachCancer[5]第40頁(yè)Atotalof989,600newstomachcancercasesand738,000deathsareestimatedtohaveoccurredin2023,accountingfor8%ofthetotalcasesand10%oftotaldeaths.Over70%ofnewcasesanddeathsoccurindevelopingcountries.Generally,stomachcancerratesareabouttwiceashighinmalesasinfemales.第41頁(yè)ThehighestincidenceratesareinEasternAsia,EasternEurope,andSouthAmericaandthelowestratesareinNorthAmericaandmostpartsofAfrica.Regionalvariationsinpartreflectdifferencesindietarypatterns,particularlyinEuropeancountries,andtheprevalenceofHelicobacterpyloriinfection.第42頁(yè)1234theincreaseduseandavailabilityofrefrigerationincludingtheincreasedavailabilityoffreshfruitsandvegetables,andadecreasedrelianceonsaltedandpreservedfoods.Rateshavedecreaseddueto(westerncountries):reductionsinchronicH.pyloriinfection

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

visualInspection

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

(forsquamouscellcarcinomas)

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

(foradenocarcinoma)

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