全球女性乳腺癌流行情况研究

女性乳腺癌已成为全球女性中,发病和死亡均居首位的恶性肿瘤,严重危害女性生命健康.不同地区乳腺癌发病和死亡负担各不相同.乳腺癌发病呈现发达地区高,欠发达地区低;城市高于农村的特点.在发达地区,乳腺癌的发病年龄相对较晚,而欠发达地区乳腺癌的发病年龄较早.该文以最新数据就世界乳腺癌流行病学情况作一综述,以期为今后乳腺癌的防治策略提供病因依据和理论支持.     

乳腺癌当前流行趋势分析

乳腺癌自２０世纪７０年代末开始,其发病数一直位居女性肿瘤首位并且全球每年约以２％的速度递增。据有关资料分析,按此增长速度预计到２０１０年,全球乳腺癌的年新发病例数将有可能达到１４０万左右。本文搜集整理了近２０年乳腺癌的发病资料［１－４］,并根据最近有关乳腺癌的统计学报告［５,６］,拟就全球及我国乳腺癌当前流行趋势作一简要分析。１乳腺癌的发病趋势１.１全球乳腺癌发病现状 １９７５年全球乳腺癌年新病例数为５４．１２万,而到１９９０年则增至 ７９. ４８万（见表 １）, ２０年内发病数增加了 ４７％,同朗相比…     

中国女性乳腺癌发病死亡和生存状况

目的：通过对肿瘤登记数据的分析,了解中国女性乳腺癌的流行现况及生存状态。方法：根据全国肿瘤登记中心的数据资料,评估全国乳腺癌的流行情况,并分析乳腺癌长期变化趋势及生存状况。结果：2011年中国女性乳腺癌发病人数约24.9万,发病率37.86/ 10万,近10年发病呈上升趋势,年龄调整后上升减缓。每年死亡约6.0 万,死亡率9.21/ 10万,近10年乳腺癌死亡率呈上升趋势,年龄调整后上升幅度减缓。乳腺癌患者的1、3 和5 年观察生存率分别为90.5% 、80.0% 和72.7% ,5 年相对生存率为73.0%（95%CI 为0.712～0.749）。 结论：乳腺癌是威胁我国妇女健康的主要恶性肿瘤之一,疾病负担依然日益加重,应进一步加强乳腺癌的防治工作。     

北京市居民中肺癌流行趋势和特征

本文根据北京市肿瘤登记报告所积累的1977年-1987年癌症发病和死亡资料,对肺癌的流行趋势和特征进行了分析。分析结果表明:近十年来北京市肺癌居各种恶性肿瘤的首位,且有逐年上升的趋势;1985年一1987年北京市城区居民中男性肺癌世界标化发病率为40.1/10万,占男性全部癌瘤发病总数的20.8%,女性肺癌标化发病率为24.7/10万,占女性癌瘤总数的18.6%;肺癌标化发病率性比值(男:女)为1.56;城区与近郊区比较中发现近郊区中壮年龄组段明显高于城区;5年相对生存率男性为8.2%,女性为4.8%。综合肺癌的流行特征的分析,说明肺癌已成为北京当前以至今后一段时期内对居民健康威胁最大的卫生问题之一。文章最后针对肺癌Ⅰ级预防措施中所采取的治理大气污染问题进行了深入的分析与讨论。     

天津市女性乳腺癌发病率死亡率和生存率分析

目的：观察天津市乳腺癌发病率和死亡率的变化趋势,评价乳腺癌的防治效果。方法：用描述流行病学的方法研究天津市乳腺癌的流行情况。结果：1981－1997年间,天津市乳腺癌总发病率有增加的趋势（增加了39．7％）,年龄别发病率高峰有下降的趋势,死亡率有下降的趋势（下降了31．0％）。同时,通过对1970－1995年天津市肿瘤医院确诊的所有女性乳腺癌随访发现,天津市乳腺癌3,5年生存率均有不同程度的提高。结论：天津市乳腺癌发病率增长较快,但同时死亡率在下降,生存率在提高。     

新疆石河子市2010~2011年女性乳腺癌发病和死亡流行特征

[目的]了解2010~2011年石河子市女性乳腺癌发病与死亡流行特征,为乳腺癌的预防控制提供科学依据。[方法]根据石河子市肿瘤登记处2010~2011年女性乳腺癌发病及死亡资料,统计和分析粗发病率、粗死亡率、年龄别发病率、年龄别死亡率、中标率、世标率指标。[结果 ]2010~2011年石河子市女性乳腺癌新发病例209例,死亡病例64例。乳腺癌发病率为36.61/10万,中标率为19.11/10万,世标率为24.35/10万。乳腺癌死亡率为11.21/10万,中标率为5.72/10万,世标率为7.43/10万。石河子市女性乳腺癌发病从35岁开始,发病率最高峰为50~岁年龄组,死亡率最高峰为60~岁年龄组。[结论 ]石河子市女性乳腺癌死亡率较高,应加强35~54岁女性乳腺癌筛查,有效降低石河子市乳腺癌流行水平。     

淮安市女性乳腺癌发病和死亡分析

目的分析淮安市2009-2011年女性乳腺癌发病与死亡的流行特征,为乳腺癌的防治工作提供依据。方法利用淮安市恶性肿瘤登记报告工作收集淮安市2009-2011年女性乳腺癌的发病和死亡数据,分年龄、地区(城市和农村)分析淮安市乳腺癌流行病学特征。结果淮安地区2009-2011年乳腺癌发病共1 225例,粗发病率16.01/10万,城市20.22/10万,农村11.77/10万;标化发病率为13.19/10万,城市16.33/10万,农村10.03/10万。乳腺癌死亡共415例,粗死亡率为5.43/10万,城市6.66/10/10万,农村4.18/10万;标化死亡率为4.23/10万,城市5.15/10万,农村3.25/10万。发病死亡均为城市高于农村。2009-2011年发病(χ2=94.57,P<0.001)和死亡(χ2=8.66,P<0.001)均呈现逐年增加趋势。分年龄组分析,乳腺癌发病呈单峰分布,高峰在55~岁年龄组;死亡则呈双峰分布,高峰分别在55~岁年龄组及80~岁年龄组,最高峰在55~岁年龄组。结论淮安区城市乳腺癌发病和死亡均高于农村,并呈现逐年上升趋势,发病和死亡最高峰均在55~岁年龄组,严重威胁淮安地区中老年女性的生命健康。     

肝癌流行现况和趋势分析

摘 要：近年来,全球大部分国家和地区的肝癌发病率呈现上升趋势,但也有资料显示部分国家和地区在过去的数十年中肝癌发病率总趋势呈下降趋势。亚洲国家过去数十年肝癌死亡率总的趋势似有下降。该文主要结合GLOBOCAN2018及《中国肿瘤登记年报》等资料及相关文献,对肝癌流行情况及变化趋势进行分析。     

江苏省连云港市2007~2013年女性乳腺癌流行状况分析

摘 要：［目的］ 分析连云港市2007~2013年女性乳腺癌的发病情况及流行特点。［方法］ 利用“连云港市恶性肿瘤登记系统”和“连云港市死因登记系统”提取2007~2013年连云港市女性乳腺癌发病和死亡资料,计算女性乳腺癌的发病（死亡）率、标化率、变化百分比( percent change,PC)和年度变化百分比( annual percent change,APC)等指标。［结果］ 女性乳腺癌是连云港市女性第2位高发恶性肿瘤,2007~2013年连云港市女性乳腺癌的年均粗发病率为26.00/10万,标化发病率为19.61/10万,35~64岁截缩发病率为64.56/10万,0~74岁累积发病率为2.61%;2007~2013年连云港市女性乳腺癌发病率呈现明显上升趋势（t=4.98,P=0.0042）;发病高峰年龄为55~岁,40~岁和45~岁年龄组发病率随时间变化呈现上升趋势（t=2.87,P=0.035;t=4.43,P=0.0069）,而85岁以上年龄组发病率随时间变化呈现明显下降趋势（t=-2.89,P=0.0446）;城市地区发病率显著性高于农村地区（P<0.001）。2007~2013年连云港市女性乳腺癌年均粗死亡率为7.94/10万,标化死亡率为6.00/10万,35~64岁截缩死亡率为17.96/10万,0~74岁累积死亡率为0.84%;2007~2013年连云港市女性乳腺癌死亡率无明显变化趋势（t=-0.89,P=0.4119）;死亡高峰年龄为55~岁;65~岁组死亡率随时间变化呈现明显上升趋势（t=3.80,P=0.0127）。［结论］ 2007~2013年连云港市女乳腺癌发病率呈明显上升趋势,城市地区发病率显著高于农村;但死亡率无明显变化趋势。     

上海市闵行区女性乳腺癌发病流行趋势分析

[目的]描述上海市闵行区乳腺癌的发病流行现况,分析乳腺癌的时间趋势,为预防控制工作提供依据。[方法]采用上海市肿瘤登记报告和随访管理系统收集的乳腺癌发病资料,以及年度变化百分比对上海市闵行区1993～2006年女性乳腺癌发病的时间趋势进行分析。[结果]2002～2006年,闵行全区共新诊断乳腺癌1030例,总发病粗率为54.77/10万,世标率为32.71/10万。乳腺癌是闵行区女性发病第一位的恶性肿瘤,占所有恶性肿瘤发病的17.38%。2002～2006年新发乳腺癌病例早期率为23.20%。乳腺癌发病率随年龄增加逐渐增加,35岁后进入加速增长期,50～55岁为发病高峰,随后发病率逐渐下降。1993～2006年闵行区乳腺癌粗发病率、标化发病率分别以年均变化率（APC）7.53%、3.56%的速度快速上升。城区女性乳腺癌发病呈快速上升趋势,而农村女性则上升不明显。[结论]闵行区女性乳腺癌发病处于发达国家和发展中国家水平之间,乳腺癌早发现工作亟待加强,35岁以上女性乳腺癌早发现工作作为重点。     

北京城区女性乳腺癌发病死亡和生存情况20年监测分析

目的 探讨北京城区乳腺癌发病率、死亡率及生存率的变化特点,为乳腺癌的预防与控制提供依据。方法 利用1982-2001年北京城区肿瘤登记报告资料,并结合1982年1月1日至1983年12月30日和1987年1月1日至1988年12月30日两个时期新发病例的随访资料,对北京城区女性乳腺癌的发病率、死亡率、生存率进行比较分析。结果 1982-2001年北京城区女性乳腺癌发病率及世界标准人口标化率呈逐年上升趋势,平均每年递增4．6％和4．9％。其流行特征：（1）年龄别发病率呈现一条由低到高的双峰曲线;（2）20年间各年龄组发病率均呈增高趋势;（3）35～64岁截缩发病率高达95．3／10万;（4）1982-1983年和1987-1988年两个时期相比,5年观察生存率（OSR）从62．0％上升到68．7％,相对生存率（RSR）由66．3％增长到74．2％;（5）20年间,死亡率一直在8／10万～10／10万的水平上波动。结论 北京城区女性乳腺癌发病率呈逐年上升的流行趋势,死亡率呈平稳状态,5年生存率在不断提高。北京市乳腺癌的二级预防是有效果的。     

北京、上海、林州和启东地区女性乳腺癌发病及死亡的时间趋势

目的:分析1988-2007年北京、上海、林州和启东地区女性乳腺癌发病和死亡的时间趋势.方法:收集北京、上海、林州和启东4个历史资料比较完整的肿瘤登记处1988-2007年女性乳腺癌发病、死亡和相应的人口数据,进行数据汇总和时间趋势分析.结果:1988-2007年北京、上海、林州和启东地区女性乳腺癌标化发病率(采用1982年中国标准人口构成计算)年平均增长百分比分别为2.49％、2.55％、7.04％和4.16％;标化死亡率年平均增长百分比除林州增长4.10％外,北京、上海和启东地区的变化差异不显著.结论:1988-2007年,北京和上海这2个城市与林州和启东这2个农村地区相比,女性乳腺癌发病率和死亡率变化显著;4个地区的女性乳腺癌发病率均呈明显上升趋势,农村地区上升更快:林州地区女性乳腺癌死亡率有上升趋势,其他3个地区的女性乳腺癌死亡率均无明显变化.     

Characteristics of mortality rates from breast and ovarian cancer in Japan

Objective: Breast and ovarian cancer is rare in Japan compared with other developed countries but their mortality rates are increasing. It is necessary to examine the experience of Japan as a guide to further prevent breast and ovarian cancer in our country.Methods: We conducted an epidemiological study of breast and ovarian cancer in the past 50 years to investigate the trends and characteristics of the mortality rates in Japan. The numbers of age-specific death from breast and ovarian cancer and the population of 5-year groups were obtained from the Vital Statistics of Japan. The truncated age specific mortality rates were calculated according to the patterns of age specific mortality rates from both cancers. Age adjustments were made to the standard world population. Results: In the past 50 years, mortality ratesof breast and ovarian cancer increased about 2 or 6 fold,respectively. This increase was most marked over 50 years old. The death pattern of breast cancer was same as that of ovarian cancer, but that of ovarian cancer changed greatly with time. The birth cohort study had some interesting findings. Common to breast and ovarian cancer, the later the year of birth, the higher the mortality rates from both malignancies in later life.Conclusion: The increase of the yearly mortality rates from breast and ovarian cancer might be due to changesin lifestyle and environmental factors. We are very concerned about dietary practices. Further investigation is needed to clarify the possible causes of animal food.     

Current trends in colorectal cancer: site, incidence, mortality and survival in England and Wales

The objective was to examine trends in colorectal cancer (CRC) incidence and mortality in England and Wales over the last 30 years. Age-standardized incidence, mortality and survival rates for CRC, based on data from the National Cancer Intelligence Centre at the Office for National Statistics, were calculated and trends assessed.Between 1971 and 1997 the total number of cases of CRC increased by 42%, from 20 400 to 28 900. The site distribution of CRC between 1971 and 1994 was: rectum 38%, sigmoid 29%, caecum 15%, transverse colon and flexures 10%, ascending colon 5%, and descending colon 3%. Between 1971 and 1997 the direct age- standardized incidence increased by 20% in males and by 5% in females. The direct age-standardized mortality fell by 24% in males and by 37% in females. Age-standardized relative 5–year survival in adults improved from 22%–27% for patients diagnosed during 1971–1975 to over 40% for those diagnosed during the period 1991–1993.In conclusion, the incidence of CRC in England and Wales has been steadily rising. It is more common in males and has increased more rapidly in males than in females. The reasons for these trends remain unclear. Five-year survival has improved substantially, but rates are still below those in comparable countries elsewhere in Europe and in the USA.     

关于乳腺癌中美现状的对比与分析

乳腺癌发病率在全球地区呈现错综变化的发展趋势。从发病率的增长速率和死亡率来看:以中国为代表的发展中国家呈现出上升的趋势,而在以美国为代表的高度发达国家,则呈现出整体下降的趋势。该文旨在通过比较中美在乳腺癌方面的研究,对比中美两国在发病率、死亡率、存活率和治疗方案上的区别。虽然中国的乳腺癌确诊人数绝对值较高,且在全球中占比较大,但其在本国的构成比例低于美国;且从死亡率上讲,中国乳腺癌患者无论本国的死亡率还是标化死亡率,均低于美国。目前中国还没有建立标准的乳腺癌筛查程序,尽管中国女性诊断出乳腺癌的平均年龄比美国女性大约早10年,但是中国女性确诊时的肿瘤阶段更晚期,且肿瘤的直径更大。这使得两国的诊疗倾向性有着明显的差别。因此,在当前中国女性乳腺癌新发病例数及乳腺癌死亡病例数居高不下的情况下,为有效缓解乳腺癌带来的公共卫生负担,美国在乳腺肿瘤防治方面的经验和成果仍然有值得中国借鉴之处。     

Family history of breast cancer and all-cause mortality after breast cancer diagnosis in the Breast Cancer Family Registry

Although having a family history of breast cancer is a well established breast cancer risk factor, it is not known whether it influences mortality after breast cancer diagnosis. We studied 4,153 women with first primary incident invasive breast cancer diagnosed between 1991 and 2000, and enrolled in the Breast Cancer Family Registry through population-based sampling in Northern California, USA; Ontario, Canada; and Melbourne and Sydney, Australia. Cases were oversampled for younger age at diagnosis and/or family history of breast cancer. Carriers of germline mutations in BRCA1 or BRCA2 were excluded. Cases and their relatives completed structured questionnaires assessing breast cancer risk factors and family history of cancer. Cases were followed for a median of 6.5 years, during which 725 deaths occurred. Cox proportional hazards regression was used to evaluate associations between family history of breast cancer at the time of diagnosis and risk of all-cause mortality after breast cancer diagnosis, adjusting for established prognostic factors. The hazard ratios for all-cause mortality were 0.98 (95% confidence interval [CI] = 0.84–1.15) for having at least one first- or second-degree relative with breast cancer, and 0.85 (95% CI = 0.70–1.02) for having at least one first-degree relative with breast cancer, compared with having no such family history. Estimates did not vary appreciably when stratified by case or tumor characteristics. In conclusion, family history of breast cancer is not associated with all-cause mortality after breast cancer diagnosis for women without a known germline mutation in BRCA1 or BRCA2. Therefore, clinical management should not depend on family history of breast cancer.     

The impact of diabetes on survival following breast cancer

PURPOSE: It has been suggested that type 2 diabetes may affect breast cancer prognosis, possibly due to increased diabetes-related comorbidity, or direct effects of insulin resistance and/or hyperinsulinemia. The purpose of this study was to examine the impact of diabetes on survival following breast cancer. METHODS: Using population-based health databases from Ontario, Canada, this retrospective cohort study compared deaths between women with breast cancer aged 55-79 years with diabetes and without diabetes. Women were followed for all cause mortality from breast cancer diagnosis until March 31st 2006. RESULTS: Of the 6,107 women with breast cancer, 1,011 had diabetes and 5,096 did not have diabetes. Women with diabetes were slightly older, were more likely to reside in a lower income neighborhood, and had greater comorbidity compared to women without diabetes. After a mean follow-up of 5.0 years and adjustment for age, prior mammograms and other covariates, mortality following breast cancer was significantly higher among women with versus without diabetes (hazard ratio, HR 1.39, 95% confidence interval, CI 1.22-1.59, P < 0.0001). The effect of diabetes on mortality was comparable to that seen in women with diabetes without breast cancer over a 7-year follow-up. CONCLUSION: This study found that diabetes was associated with a close to 40% increase in mortality within the first 5 years following breast cancer, which was similar to that seen in women with diabetes without breast cancer. These findings suggest that early survival following breast cancer is reduced in women with diabetes, possibly due to diabetes-related causes.     

Epidemiological characteristics of ovarian cancer in Korea

Objective

This study was conducted to examine recent trends in ovarian cancer incidence and mortality and secular trends in demographic factors in Korea.

Methods

With the data from Korea Central Cancer Registry, International Agency for Research on Cancer, Korean Death Registry, and World Health Organization''s Statistical Information System, we calculated age-standardized incidence and mortality rates for ovarian cancer. Also we estimated future incidence of ovarian and cervical cancer using linear regression model. To assess the demographic trend, data from national surveys in Korea or results from published papers were searched.

Results

Ovarian cancer incidence rate was similar to that in women worldwide but lower than those in Western countries, and the trend has been increased steadily. Ovarian cancer-related mortality rates have been increasing in Korea, even though those in western and some Asian countries, such as China, have been decreasing. Age-specific incidence rate and mortality rate showed steep increases with advancing age. The incidence rate of ovarian cancer was estimated to surpass that of uterine cervix cancer in 2015. Korea showed rapid changes in nutritional, reproductive, and anthropometric factors.

Conclusion

These recent trends in ovarian cancer incidence and mortality may be partly attributed to gradual westernizing of life styles and to changes in socio-demographic behavior factors. In particular, the increasing trend in ovarian cancer mortality in Korea may be attributed to a real rise in mortality as well as, in part, a decline in misclassification bias related to an increase in the proportion of deaths confirmed by physician diagnosis.     

女性乳腺癌流行病学趋势及危险因素研究进展

乳腺癌是全球女性最常见的癌症,也是女性癌症死亡的主要原因.2018年全球新确诊女性乳腺癌病例约209万,死亡人数约63万.世界各地区乳腺癌发病率各不相同,但均呈上升趋势.虽然中国女性乳腺癌发病率(36.1/105)和死亡率(8.8/105)在世界范围内相对较低,但是中国女性乳腺癌发病人数及死亡人数均居世界首位,而且近年...