| 蔡林,朱称心,张兴龙,房怡,杨海燕,郭兰伟.全球肺癌流行数据解读[J].Chinese journal of Epidemiology,2024,45(4):585-590 |
| 全球肺癌流行数据解读 |
| Interpretation of global lung cancer statistics |
| Received:September 20, 2023 |
| DOI：10.3760/cma.j.cn112338-20230920-00172 |
| KeyWord: 肿瘤，肺 流行病学 癌症预防 |
| English Key Word: Neoplasm, lung Epidemiology Cancer prevention |
| FundProject:中国博士后科学基金（2023M731010）；河南省中青年卫生健康科技创新优秀人才培养项目（YXKC2022045） |
| Author Name | Affiliation | E-mail | | Cai Lin | The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Henan Office for Cancer Control and Research, Zhengzhou 450008, China
Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China | | | Zhu Chenxin | The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Henan Office for Cancer Control and Research, Zhengzhou 450008, China
Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China | | | Zhang Xinglong | The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Henan Office for Cancer Control and Research, Zhengzhou 450008, China
Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China | | | Fang Yi | The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Henan Office for Cancer Control and Research, Zhengzhou 450008, China
Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China | | | Yang Haiyan | Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China | | | Guo Lanwei | The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Henan Office for Cancer Control and Research, Zhengzhou 450008, China
Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China | guolanwei1019@126.com |
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| Abstract: |
| 肺癌仍然是全球癌症的主要死因之一，造成了严重的疾病负担。烟草暴露是肺癌主要的危险因素，20世纪60年代以来，全球逐步对烟草暴露采取控制措施，人群中烟草暴露水平也随之降低，全球肺癌的流行特征可能也随之发生变化。本研究通过全球肿瘤登记数据和相关研究报道的数据资料，分年龄、性别、地区、诊断分期、生存情况5个方面，对全球肺癌流行数据进行描述，以阐明目前全球肺癌的流行特征，为肺癌防控提供相应的科学依据，并通过癌症三级预防策略为肺癌防控提供相应的措施和建议。分析结果显示，肺癌在老年人群（≥65岁）中发病和死亡负担远高于劳动力人群（15~64岁）；男性肺癌年龄标化发病率高于女性，但总体上男性肺癌年龄标化发病率呈下降趋势，而女性肺癌年龄标化发病率呈上升趋势；在人类发展指数（HDI）高和非常高的地区肺癌发病和死亡负担远高于HDI低和非常低的地区；肺癌Ⅰ期诊断率最高的国家为日本（38.6%），其相应的标化5年净生存率也最高（32.9%），中国、日本等国肺癌的生存状况有所改善，但整体肺癌的生存状况仍然不容乐观。鉴于目前肺癌的流行特征，进一步加强烟草控制措施，降低女性肺癌特异性危险因素的暴露是肺癌一级预防的主要目标。推动高危人群行低剂量计算机断层扫描筛查，降低肺癌筛查的假阳性率及推动医疗制度改革和规范化诊疗分别为肺癌二级和三级预防的主要措施。 |
| English Abstract: |
| Lung cancer remains one of the leading cause of global cancer-related mortality, posing a significant burden of disease. Tobacco exposure stands as the foremost risk factor for lung cancer. Since the 1960, global efforts have gradually been implemented to control tobacco exposure, consequently reducing tobacco exposure levels within populations. This shift in exposure levels may have altered the epidemiological characteristics of lung cancer globally. This study aims to describe global lung cancer incidence data across five dimensions: age, gender, region, stage at diagnosis, and survival status, using global cancer registry data and relevant research findings. The objective is to elucidate the current epidemiological features of lung cancer worldwide, providing a scientific basis for lung cancer prevention and control. Furthermore, this study offers corresponding measures and recommendations for lung cancer prevention and control, aligning with the three-tiered cancer prevention strategy. Findings indicate that the incidence and mortality burden of lung cancer is significantly higher among the elderly population (aged 65 years and above) compared to the working-age population (aged 15-64 years). The aged-standardized incidence rate of lung cancer remains higher in males than in females, but the overall aged-standardized incidence rate of lung cancer in males shows a declining trend, while that in females shows an increasing trend. Regions with high and very high human development index (HDI) exhibit a substantially higher incidence and mortality burden of lung cancer compared to regions with low and very low HDI. Japan ranks highest in the diagnosis of stage Ⅰ lung cancer, with a diagnosis rate of 38.6%. Its age-standardized 5-year net survival rate is relatively high at 32.9%. Despite improvements in the survival status of lung cancer in certain countries like China and Japan, the overall prognosis for lung cancer remains pessimistic. Given the current epidemiological characteristics of lung cancer, reinforcing tobacco control measures and reducing female-specific lung cancer risk factors stand as significant goals for primary prevention. Promoting low-dose computed tomography screening for high-risk population, minimizing false-positive rates in lung cancer screening, and promoting medical system reforms and standardized treatment constitute principal measures for secondary and tertiary lung cancer prevention, respectively. |
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