中国女性乳腺癌疾病负担分析

王乐; 张玥; 石菊芳; 代敏

Abstract

王乐,张玥,石菊芳,代敏.中国女性乳腺癌疾病负担分析[J].Chinese journal of Epidemiology,2016,37(7):970-976

中国女性乳腺癌疾病负担分析

Disease burden of famale breast cancer in China

Received:December 31, 2015

DOI：10.3760/cma.j.issn.0254-6450.2016.07.013

KeyWord: 乳腺肿瘤疾病负担发病率死亡率伤残调整生命年

English Key Word: Breast cancer Burden of disease Incidence Mortality Disability-adjusted life years

FundProject:国家自然科学基金（81402740）；教育部高等学校博士学科点专项科研基金（20131106120014）；国家重大公共卫生服务项目（城市癌症早诊早治项目）

Author Name	Affiliation	E-mail
Wang Le	Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China
Zhang Yue	Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
Shi Jufang	Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China	shijf@cicams.ac.cn
Dai Min	Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China

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Abstract:

目的分析我国女性乳腺癌疾病负担数据以系统了解其疾病负担情况。方法自《2012中国肿瘤登记年报》、全国三次死因回顾性调查、《全国疾病监测系统死因监测数据集2012》、《中国卫生统计年鉴》、GLOBOCAN 2012、Cancer Incidence in Five Continents、WHO死亡率数据库和全球疾病负担（GBD）2013国内外8个资料数据源，摘录中国女性乳腺癌发病、死亡和伤残调整生命年（DALY）等数据，分析乳腺癌疾病负担现况及发展趋势。结果全国三次死因回顾性调查数据显示，我国乳腺癌死亡粗率在1973-2005年间翻了1倍（城市和农村增幅分别为127.4%和75.2%）；其中Joinpoint分析显示，WHO死亡率数据库中1987-2000年我国乳腺癌死亡粗率平均年度变化百分比为3.1%（P<0.05）；《中国卫生统计年鉴》来源的2002-2013年城市地区乳腺癌死亡粗率年度变化百分比为2.7%（P<0.05），农村则无明显变化（P>0.05）；GLOBOCAN 2012估计2012年我国乳腺癌世标发病率与死亡率分别是22.1/10万和5.4/10万，其中发病率从40岁开始上升，至45～59岁达到峰值后趋于平缓；《2012中国肿瘤登记年报》数据显示，2009年我国城市地区乳腺癌发病率和死亡率分别为农村地区的2倍和1.5倍；GLOBOCAN 2012预测至2035年我国乳腺癌发病与死亡将分别达到25.2万例和7.6万例，其中65岁以上乳腺癌患者数量增幅更明显；GBD数据显示，2013年我国乳腺癌DALY为166.6万人年，占全球12.7%，较1990年增加56.7%，其中DALY率峰值年龄是50～59岁，伤残损失寿命年占DALY比重的全国水平为8.7%（分省份该数值范围为8.1%～9.0%）。结论我国女性因乳腺癌所致疾病负担日趋加重，尤其城市人群；建议深入开展乳腺癌DALY研究。

English Abstract:

Objective To analyze the data on burden of female breast cancer in China. Methods The data from Chinese Cancer Registry Annual Report 2012, three national death cause surveys in China, Disease Surveillance Points system (DSP), China Health Statistics Yearbook, GLOBOCAN 2012, Cancer Incidence in Five Continents (CI5), WHO Mortality Database and Global Burden of Disease (GBD) 2013 were used to extract the incidence, mortality and disability-adjusted life years (DALY) of female breast cancer and analyze related trends in China. Results The data from three national death cause surveys showed that the crude mortality of breast cancer doubled from year 1973-1975 to year 2004-2005, the increase was higher in urban area (127.4%) than in rural area (75.2%). WHO Mortality Database showed that average annual percentage change (AAPC) of breast cancer crude mortality increased by 3.1% (P<0.05) from 1987 to 2000, and China Health Statistics Yearbook showed that the AAPC in urban females increased by 2.7% from 2002 to 2013 (P<0.05), whereas the AAPC in rural females showed no significant change (P>0.05). It was estimated by GLOBOCAN 2012 that in 2012 the age-standardized incidence and age-standardized mortality of breast cancer in China was 22.1 per 100 000 and 5.4 per 100 000, respectively. The age-specific incidence began to increase obviously at age of 40 years and peaked at age 45-59 years (GLOBOCAN 2012). Chinese Cancer Registry Annual Report 2012 showed that breast cancer incidence and mortality were 2-fold and 1.5-fold higher in urban females than in rural females in 2009. It was estimated that the breast cancer case number and death number in females in China would increase to 251 600 and 75 900, respectively, more increose in age group≥65 years. Only GBD 2013 reported DALY, the DALY caused by breast cancer in China was 1 666.0 thousand in 2013, accounting for 12.7% of global DALY, and increased by 56.7% from 1990 (1 062.6 thousand), the peak age-specific DALY rate was at 50 to 59 years, and national average ratio of years lived with disability (YLD) was 8.7% (ranging from 8.1% to 9.0% at provincial level). Conclusions Burden of disease caused by female breast cancer is becoming increasingly severe in China, especially in urban areas. It is necessary to strengthen the population-based prevention and control programs and further studies may focus on DALY.

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