中国人群肺癌疾病负担分析

郭兰伟; 蔡林; 朱称心; 张兴龙; 房怡; 杨海燕

Abstract

郭兰伟,蔡林,朱称心,张兴龙,房怡,杨海燕.中国人群肺癌疾病负担分析[J].Chinese journal of Epidemiology,2024,45(5):626-632

中国人群肺癌疾病负担分析

Analysis on disease burden of lung cancer in population in China

Received:October 18, 2023

DOI：10.3760/cma.j.cn112338-20231018-00233

KeyWord: 肿瘤，肺流行病学中国

English Key Word: Neoplasm, lung Epidemiology China

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
Guo Lanwei	Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Henan Office for Cancer Control and Research, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China	guolanwei1019@126.com
Cai Lin	Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Henan Office for Cancer Control and Research, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
Zhu Chenxin	Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Henan Office for Cancer Control and Research, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
Zhang Xinglong	Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Henan Office for Cancer Control and Research, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
Fang Yi	Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Henan Office for Cancer Control and Research, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 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

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Abstract:

目的分析中国肺癌的发病、死亡和生存现状及趋势。方法使用GLOBOCAN 2020、2019年全球疾病负担研究（GBD2019）数据库和CONCORD-3项目报告的数据对中国肺癌的发病、死亡、伤残调整寿命年（DALY）及生存现状和趋势进行描述，使用Joinpoint 5.0软件对1990-2019年中国肺癌年龄标化发病率（ASIR）和年龄标化死亡率（ASMR）进行趋势分析，采用Excel 2016软件进行数据管理，采用R 4.2.1软件中的ggplot2包绘制相关图形。结果 2020年中国肺癌新发病例数为815 563例，ASIR为34.8/10万，男性肺癌新发病例为539 181例，ASIR为47.8/10万；女性肺癌新发病例为276 382例，ASIR为22.8/10万；2020年肺癌死亡病例为714 699例，ASMR为30.2/10万；男性肺癌死亡病例471 546例，ASMR为41.8/10万，女性肺癌死亡病例243 153例，ASMR为19.7/10万；1990-2019年男性和女性肺癌ASIR和ASMR均呈上升趋势（P＜0.05），但在2010-2019年男性肺癌ASIR和ASMR呈下降趋势，年变化百分比（APC）分别为-0.17%（95%CI：-0.24%~-0.09%）和-0.69%（95%CI：-0.79%~-0.59%），女性肺癌ASIR和ASMR在2016-2019年均呈上升趋势，APC分别为3.33%（95%CI：2.73%~3.88%）和2.61%（95%CI：1.99%~3.28%）；2010-2014年中国肺癌5年净生存率为19.8%（95%CI：19.4%~20.2%）。结论中国肺癌的发病和死亡仍然处在较高水平，预后较差，肺癌的疾病负担将随着人口老龄化进一步加重。应采取肺癌防控的三级预防措施以应对不断加重的肺癌疾病负担；此外，应注意近年来女性肺癌ASIR和ASMR出现的上升趋势，进一步调查其危险因素，并采取相应预防措施遏制女性肺癌发病率的上升趋势。

English Abstract:

Objective To analyze the incidence, mortality, and survival status and trends of lung cancer in China. Methods The data of incidence, mortality, disability-adjusted life year (DALY), and survival status and trends of lung cancer in China were collected from GLOBOCAN 2020, Global Burden of Disease Study in 2019 (GBD2019) databases, and the CONCORD-3 project report. Joinpoint 5.0 software was used to analyze the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of lung cancer in China from 1990 to 2019. Data management was conducted by using Excel 2016, and relevant graphical representations were generated using the ggplot2 package in software R 4.2.1. Results In 2020, a total of 815 563 lung cancer cases were newly reported in China with the ASIR of 34.8/100 000, in which 539 181 cases were reported in men, with the ASIR of 47.8/100 000, and 276 382 cases were reported in women, with the ASIR of 22.8/100 000. A total of 714 699 lung cancer deaths were reported in 2020, with the ASMR of 30.2/100 000. Among these deaths, there were 471 546 deaths in men with the ASMR of 41.8/100 000, and 243 153 deaths in women with the ASMR of 19.7/100 000. From 1990 to 2019, the ASIR and ASMR of lung cancer in both men and women showed increasing trends (P＜0.05). However, from 2010 to 2019, the ASIR and ASMR of lung cancer in men showed decreasing trends, with annual percent of change (APC) of -0.17% (95%CI: -0.24% - -0.09%) and -0.69% (95%CI: -0.79% - -0.59%), respectively. The ASIR and ASMR of lung cancer in women showed increasing trends from 2016 to 2019, with APC of 3.33% (95%CI: 2.73% - 3.88%) and 2.61% (95%CI: 1.99% - 3.28%), respectively. The five-year net survival rate for lung cancer was 19.8% in China (95%CI:19.4% - 20.2%) from 2010 to 2014. Conclusions The morbidity and mortality of lung cancer in China remain at high levels, the prognosis of lung cancer was poor, and the disease burden of lung cancer would become more serious in the context of population aging, so three-level prevention of lung cancer should be implemented to address this problem. In addition, attention should be paid to the increasing trends of ASIR and ASMR of lung cancer in women in recent years. Further investigation of risk factors and targeted prevention are needed to curb the rising trend in the incidence of lung cancer in women.

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