文章摘要
张玥,石菊芳,黄慧瑶,任建松,李霓,代敏.中国人群结直肠癌疾病负担分析[J].中华流行病学杂志,2015,36(7):709-714
中国人群结直肠癌疾病负担分析
Burden of colorectal cancer in China
投稿时间:2014-12-30  
DOI:10.3760/cma.j.issn.0254-6450.2015.07.010
中文关键词: 结直肠肿瘤;发病率;死亡率;疾病负担
英文关键词: Colorectal neoplasms;Incidence;Mortality;Burden of disease
基金项目:北京希望马拉松专项基金(LC2012YF44); 城市癌症早诊早治项目
作者单位E-mail
张玥 100021 北京协和医学院 中国医学科学院肿瘤医院全国肿瘤防治研究办公室  
石菊芳 100021 北京协和医学院 中国医学科学院肿瘤医院全国肿瘤防治研究办公室 shijf@cicams.ac.cn 
黄慧瑶 100021 北京协和医学院 中国医学科学院肿瘤医院全国肿瘤防治研究办公室  
任建松 100021 北京协和医学院 中国医学科学院肿瘤医院全国肿瘤防治研究办公室  
李霓 100021 北京协和医学院 中国医学科学院肿瘤医院全国肿瘤防治研究办公室  
代敏 100021 北京协和医学院 中国医学科学院肿瘤医院全国肿瘤防治研究办公室  
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中文摘要:
      目的 了解中国人群结直肠癌的发病与死亡情况。方法 从GLOBOCAN 2012、《2012中国肿瘤登记年报》、《五大洲癌症发病率》(CI5)、全国三次死因回顾调查和WHO Mortality Database 5个数据源中摘录中国结直肠癌的发病和/或死亡数据,分析中国人群结直肠癌的发病、死亡及其趋势。结果 GLOBOCAN 2012估计2012年中国男、女性结直肠癌发病率(世标率)分别为16.9/10万和11.6/10万,死亡率(世标率)分别为9.0/10万和6.1/10万。GLOBOCAN 2012对不同人类发展指数与结直肠癌疾病负担分析显示,人类发展指数越高,结直肠癌发病率与死亡率也越高,中国目前属高等发展水平,提示随着中国经济卫生的发展,未来结直肠癌负担可能越来越严重。CI5第4卷和GLOBOCAN 2012显示,中国人群结直肠癌发病率从50岁开始上升明显。《2012中国肿瘤登记年报》显示,2009年城市地区的结直肠癌发病率(世标率)(22.2/10万)和死亡率(世标率)(9.9/10万)约为农村地区发病率(世标率)(11.8/10万)和死亡率(世标率)(5.7/10万)的2倍。2009年结肠癌占全部结直肠肛门癌的构成比,男、女性分别为49.0%和54.2%,城市和农村地区分别为53.4%和41.7%。CI5第4~10卷数据显示:1973-2007年上海男性和女性结肠癌和直肠肛门癌均呈上升趋势,与1973-1977年相比,2003-2007年男性发病率分别增加138.8%和31.1%,女性则分别增加146.7%和49.1%。全国三次死因回顾调查显示,从1973-1975年至2004-2005年间结直肠癌死亡粗率上升77.9%。基于WHO Mortality Database数据的Joinpoint分析显示:1987-2000年中国结直肠癌死亡率平均年度变化百分比升高0.7%(P<0.05)。结论 中国人群结直肠癌疾病负担提示城市地区和男性人群应为防控重点。中国结直肠癌发病与死亡模式趋向发达国家,呈增长趋势,应尽早开展筛查等人群层面的防控工作。
英文摘要:
      Objective To understand the incidence and mortality of colorectal cancer in China. Methods The data from GLOBOCAN 2012, Chinese Cancer Registry Annual Report 2012, Cancer Incidence in Five Continents (CI5), the Three National Death Cause Surveys in China and WHO Mortality Database were used to learn about the incidence and mortality of colorectal cancer and related trends in China. Results It was estimated by GLOBOCAN 2012 that in 2012 the age-standardized incidence of colorectal cancer in China was 16.9 per 100 000 in males and 11.6 per 100 000 in females, and the age-standardized mortality was 9.0 per 100 000 in males and 6.1 per 100 000 in females. GLOBOCAN 2012 estimated that colorectal cancer incidence and mortality would increase with the level of human development index. China's human development level was high, suggesting that the burden of colorectal cancer would be more serious in China with the development of social economy. The data from CI5 Volume Ⅳ and GLOBOCAN 2012 indicated that the incidence of colorectal cancer began to increase obviously at age of 50 years in China. Chinese Cancer Registry Annual Report 2012 showed that the incidence and mortality of colorectal cancer in urban population were two times higher than those in rural population in 2009, the proportions of colon cancer among colorectal and anus cancers, which was 49.0% in males and 54.2% in females, 53.4% in urban population and 41.7% in rural population. CI5 Volumes Ⅳ-Ⅹ showed that colon cancer and rectum and anus cancer incidence in Shanghai for both males and females were increasing during the period 1973-2007. The percentage change in colon cancer and rectum and anus cancer incidence between 1973-1977 and 2003-2007 increased by 138.8% and 31.1% in males, 146.7% and 49.1% in females, respectively. The data from the Three National Death Cause Surveys showed that the crude mortality of colorectal cancer increased by 77.9% form mid 1970's (1973-1975) to mid 2000's (2004-2005). WHO Mortality Database showed that average annual percentage change(AAPC) of age-standardized colorectal cancer mortality increased by 0.7%(P<0.05) from 1987 to 2000. Conclusion More attention should be paid to the prevention and control of colorectal cancer in urban area and in male population in China. Similar to the western countries, the burden of colorectal cancer in China would continue to become serious if no population based prevention and control programs are conducted.
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