中国肺癌死亡趋势分析及发病、死亡的估计与预测

背景与目的利用我国现有相对较完善的肺癌发病死亡资料，描述中国肺癌死亡趋势，并估计和预测2000年及2005年的肺癌发病与死亡状况，以期对我国肺癌临床、基础研究及防治策略制定提供依据及参学。方法利用Joinpoint模型对卫生部上报WHO的中国1987～1999年肺癌死亡数据进行趋势分析。结合我国1990～1992年第一次全死因调查结果及我国人选《五大洲癌症发病率》第八卷中肿瘤登记处的肺癌发病死亡数据。采用埘数线性模型（基于Poisson分布）。估计并预测2000年及2005年中国肺癌的发病、死亡状况。结果我国肺癌年龄调整死亡率总体呈上升趋势，尤以农村明显（男性年均上升2．7％。女性上升3．6％．均有统计学意义）且各午龄段（15岁以上）均呈不同程度上升趋势。自2000年至2005年，我国肺癌的死亡人数将增加10．1万（自2000年的32．7万增至2005年的42．8万），发病人数将增加11．6万（自2000年的38．1万增至2005午的49．7万）。结论由于肺癌危险因素变化及人口增长、老龄化的双重作用，肺癌已成为中国近年来最常见、增幅最大的恶性肿瘤之一，其预防与控制将成为未来中国肿瘤控制计划制定和实施的重点之一。而控制烟草无疑成为其关键。     

Breast cancer in South-Eastern European countries since 2000: Rising incidence and decreasing mortality at young and middle ages

BackgroundMarked variations exist in the incidence and mortality trends of major cancers in South-Eastern European (SEE) countries which have now been detailed by age for breast cancer (BC) to seek clues for improvement.MethodsWe brought together and analysed data from 14 cancer registries (CRs), situated in SEE countries or directly adjacent. Age-standardised rate at world standard (ASRw) and truncated incidence and mortality rates during 2000–2010 by year, and for four age groups, were calculated. Average annual percentage change of rates was estimated using Joinpoint regression.ResultsAnnual incidence rates increased significantly in countries and age groups, by 2–4% (15–39 years), 2–5% (40–49), 1–4% (50–69) and 1–6% (at 70+). Mortality rates decreased significantly in all age-groups in most countries, but increased up to 5% annually above age 55 in Ukraine, Serbia, Moldova and Cyprus. The BC data quality was evaluated by internationally agreed indicators which appeared suboptimal for Moldova, Bosnia and Herzegovina and Romania.ConclusionThe observed variations of incidence trends reflect the influence of risk factors, as well as levels of early detection activities (screening). While mortality rates were mostly decreasing, probably due to improved cancer care and introduction of more effective systemic treatment regimens, the worrying increasing mortality trends in the 55-plus age groups in some countries have to be addressed by health professionals and policymakers. In order to assess and monitor the effects of cancer control activities in the region, the CRs need substantial investments.     

中国膀胱癌流行现状与趋势分析

目的分析2015年中国膀胱癌发病与死亡情况以及1998—2015年的时间变化趋势。方法收集整理全国501个登记处上报国家癌症中心的2015年肿瘤登记数据,经审核质控后统计膀胱癌性别、年龄别、地区别和合计粗发病率、粗死亡率、年龄标化率等指标,并汇总1998—2015年间中国肿瘤登记膀胱癌世标发病率和世标死亡率,采用对数线性模型拟合年度变化百分比(APC)或平均年度变化百分比(AAPC)。结果膀胱癌居中国恶性肿瘤发病谱第13位,粗发病率为5.80/10万,中标发病率为3.60/10万,世标发病率为3.57/10万;粗死亡率为2.37/10万,中标死亡率为1.31/10万,世标死亡率为1.32/10万。男性膀胱癌居恶性肿瘤发病谱第7位,发病率为女性的3.8倍,男性死亡率为女性的4.0倍。城市地区发病率为农村的1.4倍,西部地区发病率和中部地区相近,均低于东部地区,死亡率的地区分布特征与发病率相似。膀胱癌的年龄别发病率和死亡率分别在45岁和55岁组快速上升,在80~84岁组和85岁组到达高峰。时间趋势分析显示,中国膀胱癌发病率在2007年出现下降拐点,1998—2007年世标发病率呈上升趋势(APC=2.58,P<0.001),2007—2015年呈下降趋势(APC=-3.82,P<0.001)。膀胱癌世标死亡率呈持续下降趋势,速度有所减缓,1998—2003年和2003—2015年的年平均下降速度分别为3.65%(P=0.002)和1.42%(P<0.001)。结论膀胱癌是威胁中国居民健康的主要恶性肿瘤之一,存在明显的性别、地区和年龄流行差异。中国膀胱癌发病率和死亡率呈下降趋势,仍需进一步加强烟草控制,倡导中老年患者树立早诊早治意识。     

2016年广西肿瘤登记地区恶性肿瘤发病和死亡分析

目的 分析2016年广西肿瘤登记地区恶性肿瘤发病和死亡情况。 方法 对2016年广西31个肿瘤登记处的肿瘤登记数据进行分析,按城乡、性别、年龄别对数据进行分层,分别计算恶性肿瘤发病和死亡的粗率、标化率、累积率（0～74岁）和前10位恶性肿瘤构成。人口标准化率采用2000年全国普查标准人口年龄构成和Segi's 世界标准人口年龄构成计算。 结果 纳入分析的31个登记处共覆盖人口11 628 368人（其中城市6 698 487人,农村4 929 881人）,恶性肿瘤新发病例28 140例,发病粗率、中标率、世标率和累积率（0～74岁）分别为241.99/10万、196.89/10万、192.26/10万、21.90%;无论是中标率还是世标率,男性均高于女性,城市地区均高于农村地区。恶性肿瘤发病在40岁以后快速上升,在80岁年龄组时达到高峰。发病前10位恶性肿瘤依次为肝癌、肺癌、乳腺癌、结直肠癌、宫颈癌、胃癌、鼻咽癌、前列腺癌、子宫肿瘤和脑瘤,占全部恶性肿瘤发病的75.65%。恶性肿瘤死亡病例17 647例,死亡粗率、中标率、世标率和累积率（0～74岁）分别为151.76/10万、119.05/10万、117.31/10万、13.27%;无论中标率还是世标率,男性均高于女性,城市地区均低于农村地区。恶性肿瘤死亡在40岁以后快速上升,在85岁年龄组时达到高峰。死亡前10位恶性肿瘤依次为肝癌、肺癌、结直肠癌、胃癌、乳腺癌、鼻咽癌、宫颈癌、食管癌、前列腺癌和白血病,占全部恶性肿瘤死亡的81.74%。结论  2016年广西肿瘤登记地区恶性肿瘤发病率和死亡率略高于2015年,肝癌、肺癌、结直肠癌、乳腺癌和鼻咽癌是重点防控的癌种。     

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.     

Estimates of cancer incidence and mortality in China, 2013

Introduction:Population-based cancer registration data are collected by the National Central Cancer Registry in China every year.Cancer incident cases and cancer deaths in 2013 were analyzed.Methods:Through the procedure of quality control,reported data from 255 registries were accepted to establish the national database for cancer estimates.Incidences and mortalities were calculated with stratification by area (urban/ rural),sex (male/female),age group (0,1-4,5-9,10-14...80-84,and 85-year-old and above),and cancer site.The structure of Segi's population was used for the calculation of age-standardized rates (ASR).Top 10 most common cancers and leading causes of cancer deaths were listed.Results:In 2013,3,682,200 new cancer cases and 2,229,300 cancer deaths were estimated in China based on the pooled data from 255 cancer registries,covering 16.6S％ of the national population.The incidence was 270.59/100,000,with an ASR of 186.15/100,000;the mortality was 166.83/100,000,with an ASR of 108.94/100,000.The top 10 most common cancer sites were the lung,stomach,liver,colorectum,female breast,esophagus,thyroid,cervix,brain,and pancreas.The ten leading causes of cancer deaths were lung cancer,liver cancer,gastric cancer,esophageal cancer,colorectal cancer,pancreatic cancer,female breast cancer,brain tumor,leukemia,and lymphoma.Conclusions:Cancer leaves serious disease burden in China with high incidence and mortality.Lung cancer was the most common cancer and the leading cause of cancer death in China.Efficient control strategy is needed,especially for major cancers.     

2012年福建省肿瘤登记地区恶性肿瘤发病和死亡分析

目的 分析2012年福建省恶性肿瘤发病与死亡状况,为福建省肿瘤防治提供科学依据。方法 根据中国肿瘤登记中心制定的审核和评价方法,对2012年福建省9个肿瘤登记处的数据进行评价,将符合要求的7个登记处数据合并分析。结果 2012年福建省肿瘤登记地区恶性肿瘤发病率为251.44/10万(男性308.44/10万,女性193.03/10万),世标发病率为201.11/10万,中标发病率为205.15/10万,累计率(0~74岁)为23.51%;恶性肿瘤死亡率为161.85/10万(男性220.87/10万,女性101.37/10万),世标死亡率为127.70/10万,中标死亡率为128.54/10万,累积率(0~74岁)为15.04%。恶性肿瘤年龄别发病率和死亡率均随着年龄的增长而上升,分别在75~岁年龄组和80~岁年龄组达到高峰。居恶性肿瘤发病前5位的依次是肺癌、胃癌、肝癌、食管癌和乳腺癌,居恶性肿瘤死亡前5位的依次是肺癌、肝癌、胃癌、食管癌和结直肠癌。结论 消化系统肿瘤、肺癌、女性乳腺癌是福建省肿瘤登记地区最主要的恶性肿瘤,应作为肿瘤防治工作的重点。     

Recent trends in cancer survival across Europe between 2000 and 2004: a model-based period analysis from 12 cancer registries

BackgroundMonitoring population-based cancer survival is an essential component in the evaluation of cancer control, but subject to an inherent delay in the reporting of the most recent survival estimates with traditional techniques of analysis.MethodsWe examined survival trends between the years 2000 and 2004 for 20 common cancers based on follow-up data from 12 cancer registries from diverse areas of Europe using model-based period analysis techniques.ResultsBetween 2000 and 2004, marked rises were seen in 5-year relative survival amongst patients with prostate, breast and colorectal cancer, which were statistically significant in 10, 8 and 7 of the 12 participating cancer registries, respectively. For cancer sites amenable to effective early detection and treatment, major geographical differences in patient prognosis still persisted, with a lower survival generally observed in Eastern European countries.ConclusionModel-based period analysis enables the timely monitoring of recent trends in population-based cancer survival. For colorectal and breast cancers, the identified rises in survival are probably (at least partly) explained by the improvements in clinical care and the management of the disease. Nevertheless, persisting geographic differences do point to the potential for a further reduction in the burden of cancer throughout Europe, towards which improvements in diverse areas of care, including secondary prevention, access to advances in treatment as well as subspecialisation and regionalisation of oncologic care may all contribute.     

2016年上海市恶性肿瘤发病和死亡情况与2002—2016年的变化趋势分析

背景与目的：上海市疾病预防控制中心每年更新上海市恶性肿瘤发病和死亡及其趋势的统计资料。分析2016年上海市恶性肿瘤发病和死亡的基本情况及其2002—2016年的变化趋势。方法：采用上海市疾病预防控制中心建立的人群基础肿瘤登记管理系统和死因登记系统收集的2002—2016年恶性肿瘤发病和死亡资料,按诊断或死亡年份、性别和年龄组分层分析,计算数量、构成比、粗率、年龄别率、年龄标准化率（标化率）等指标,同时计算不同分组的主要癌症类型的数量、构成比和率值。按性别划分的所有恶性肿瘤和各主要癌症类型的发病和死亡标化率采用Joinpoint回归模型计算年度变化百分比（annual percent change,APC）分析变化趋势。应用Segi’s 1960年世界标准人口计算发病和死亡的标化率。结果：2016年上海市恶性肿瘤新发病例和死亡人数分别为74 422例和37 010人,粗发病率为513.94/10万,标化发病率为231.58/10万,女性的标化发病率高于男性。粗死亡率为255.58/10万,标化死亡率为90.01/10万,男性的标化死亡率高于女性。年龄别发病和死亡的数量和率值随着年龄的增长而增加,年龄别发病的数量和率值分别在60~64岁组和80~84岁组达到高峰,年龄别死亡的数量和率值分别在80~84岁组和85岁及以上组达到高峰。按发病例数排序,前10位常见癌症类型的部位依次为肺、结直肠、甲状腺、胃、乳腺、肝脏、前列腺、胰腺、脑和中枢神经系统、膀胱。按死亡人数排序,前10位依次为肺、结直肠、胃、肝、胰腺、乳腺、胆囊、食管、前列腺和淋巴系统。按性别划分的发病和死亡的前10位常见癌症类型与按常见组合年龄段划分的前5位常见癌症类型差异较大。总体上,男性的标化发病率在2002—2009年维持稳定状态,在2009—2016年以年均1.16%的增速上升,女性的标化发病率在2002—2009年维持稳定状态,在2009—2016年以年均4.48%的增速上升。2002—2016年,男性的标化死亡率以年均1.35%的减速下降,女性的标化死亡率以年均1.31%的减速下降。不同性别和癌症类型的变化趋势各不相同。结论：尽管男性和女性的标化发病率略有上升,但是对应的标化死亡率正在下降。按性别或年龄分层的总体和常见癌症类型的现况和趋势反映了上海户籍人口在癌症危险因素、筛查技术应用和诊疗水平等方面的变化。以人群为基础的癌症发病和死亡资料可用于减少癌症负担。     

Recent trends in incidence of five common cancers in 26 European countries since 1988: Analysis of the European Cancer Observatory

BackgroundIndividual country- and cancer site-specific studies suggest that the age-adjusted incidence of many common cancers has increased in European populations over the past two decades. To quantify the extent of these trends and the recent burden of cancer, here we present a comprehensive overview of trends in population-based incidence of the five common cancers across Europe derived from a new web-based portal of the European cancer registries.MethodsData on incidence for cancers of the colon and rectum, prostate, breast, corpus uteri and stomach diagnosed from 1988 to 2008 were obtained from the European Cancer Observatory for cancer registries from 26 countries. Annual age-standardised incidence rates and average annual percentage changes were calculated.ResultsIncidence of four common cancers in eastern and central European countries (prostate, postmenopausal breast, corpus uteri and colorectum) started to approach levels in northern and western Europe, where rates were already high in the past but levelled off in some countries in recent years. Decreases in stomach cancer incidence were seen in all countries.DiscussionIncreasing trends in incidence of the most common cancers, except stomach cancer, are bad news to public health but can largely be explained by well-known changes in society in the past decades. Thus, current and future efforts in primary cancer prevention should not only remain focussed on the further reduction of smoking but engage in the long-term efforts to retain healthy lifestyles, especially avoiding excess weight through balanced diets and regular physical exercise.     

Cancer incidence and mortality in China, 2007

Objective:Cancer incidence and mortality data collected from population-based cancer registries were analyzed to present the overall cancer statistics in Chinese registration areas by age,sex and geographic area in 2007.Methods:In 2010,48 cancer registries reported cancer incidence and mortality data of 2007 to National Central Cancer Registry of China.Of them,38 registries’ data met the national criteria.Incidence and mortality were calculated by cancer sites,age,gender,and area.Age-standardized rates were described by China and World population.Results:The crude incidence rate for all cancers was 276.16/100,000(305.22/100,000 for male and 246.46/100,000 for female;284.71/100,000 in urban and 251.07/100,000 in rural).Age-standardized incidence rates by China and World population were 145.39/100,000 and 189.46/100,000 respectively.The crude mortality rate for all cancers was 177.09/100,000(219.15/100,000 for male and 134.10/100,000 for female;173.55/100,000 in urban and 187.49/100,000 in rural).Age-standardized mortality rates by China and World population were 86.06/100,000 and 116.46/100,000,respectively.The top 10 most frequently common cancer sites were the lung,stomach,colon and rectum,liver,breast,esophagus,pancreas,bladder,brain and lymphoma,accounting for 76.12% of the total cancer cases.The top 10 causes of cancer death were cancers of the lung,liver,stomach,esophagus,colon and rectum,pancreas,breast,leukemia,brain and lymphoma,accounting for 84.37% of the total cancer deaths.Conclusion: Cancer remains a major disease threatening people’s health in China. Prevention and control should be enhanced, especially for the main cancers.     

浙江省4个肿瘤登记地区2005年恶性肿瘤发病与死亡

目的 探讨浙江省4个肿瘤登记地区人群恶性肿瘤发病与死亡的流行特征.方法 资料来源于浙江省四个肿瘤登记地区上报的2005年肿瘤发病与死亡资料,根据<中国肿瘤登记工作指导手册>以及国际癌症研究中心和国际癌症登记协会推荐的肿瘤登记原则和方法 ,进行资料的分类、审核和分析.结果 2005年浙江省4个肿瘤登记地区共报告新发病例数为19 689例,恶性肿瘤粗发病率为268.22/10万,发病世调率为189.06/10万;死亡病例为1 1 461例,粗死亡率为156.13/10万,死亡世调率为102.64/10万.肺癌、胃癌、肝癌、乳腺癌、直肠癌、结肠癌、食管癌、脑肿瘤、白血病和胰腺癌均排在发病与死亡的前10位之内.结论 肺癌、消化系统恶性肿瘤、乳腺癌、脑肿瘤和白血病应作为浙江省4个肿瘤登记地区肿瘤防治工作的重点,尤其应该加强对大肠癌、乳腺癌和胰腺癌的防治研究.     

2013年广西肿瘤登记地区鼻咽癌发病和死亡分析

目的 根据2016年广西肿瘤登记地区上报的鼻咽癌登记资料,评估2013年广西鼻咽癌的发病和死亡情况。方法 根据全国肿瘤登记中心制定的审核方法和评价标准,对全区8个肿瘤登记地区上报的2013年肿瘤登记数据进行评价,其中6个登记地区的数据符合入选标准。将入选的6个登记地区的发病、死亡和人口数据进行汇总,按地区（城乡）、性别、年龄别和地域分层,评估广西鼻咽癌发病、死亡情况。人口标准化率计算根据全国2000年人口普查的人口结构和Segi's世界人口结构。结果 入选的6个肿瘤登记地区（其中地级以上城市2个,县及县级市4个）覆盖人口5 196 871人,其中城市1 933 143人,农村3 263 728人;鼻咽癌病理学诊断比例（MV%）为66.72%,只有死亡医学证明书比例（DCO%）为1.40%,死亡/发病比（M/I）为0.47。共报告新发鼻咽癌病例643例,死亡病例303例;粗发病率为12.37 /10 万（男性16.96/10万,女性7.41/10 万）,中标发病率为11.16/10 万,世标发病率为10.49/10 万,累积发病率（0~74 岁）为1.13%。城市地区粗发病率为9.10/10 万,中标发病率为7.52/10 万;农村地区粗发病率为14.31/10 万,中标发病率为13.67/10 万。鼻咽癌粗死亡率为5.83 /10 万（男性8.37/10万,女性3.08/10 万）,中标死亡率为5.16/10 万,世标死亡率为5.01/10 万,累积死亡率（0~74 岁）为0.56%;城市地区粗死亡率为4.09/10 万,中标死亡率为3.35/10 万;农村地区粗死亡率为6.86/10 万,中标死亡率为6.39/10 万。结论 2013年广西肿瘤登记地区鼻咽癌发病和死亡均高于全国平均水平,无论是发病或死亡均存在明显的年龄、性别、城乡和地域差异,30岁以后各年龄组是高发阶段,男性高于女性,农村高于城市,东部地区高于中南部和中北部地区,30岁以上男性是重点防治人群。     

The incidence and mortality of major cancers in China, 2012

Background: The National Central Cancer Registry (NCCR) collected population-based cancer registration data in 2012 from local registries and estimated the cancer incidence and mortality in China. Methods: In the middle of 2015, 261 cancer registries submitted reports on new cancer cases and deaths occurred in 2012. Qualiifed data from 193 registries were used for analysis after evaluation. Crude rates, number of cases, and age-standardized rates stratiifed by area (urban/rural), sex, age group, and cancer type were calculated according to the national population in 2012. Results: The covered population were 198,060,406 from 193 qualiifed cancer registries (74 urban and 119 rural reg-istries). The major indicators of quality control, percentage of cases morphologically veriifed (MV%), death certiifcate-only cases (DCO%), and the mortality to incidence (M/I) ratio, were 69.13%, 2.38%, and 0.62, respectively. It was esti-mated that there were 3,586,200 new cancer cases and 2,186,600 cancer deaths in 2012 in China with an incidence of 264.85/100,000 [age-standardized rate of incidence by the Chinese standard population (ASRIC) of 191.89/100,000] and a mortality of 161.49/100,000 [age-standardized rate of mortality by the Chinese standard population (ASRMC) of 112.34/100,000]. The ten most common cancer sites were the lung, stomach, liver, colorectum, esophagus, female breast, thyroid, cervix, brain, and pancreas, accounting for approximately 77.4%of all new cancer cases. The ten lead-ing causes of cancer death were lung cancer, liver cancer, gastric cancer, esophageal cancer, colorectal cancer, pancre-atic cancer, female breast cancer, brain tumor, leukemia, and lymphoma, accounting for 84.5%of all cancer deaths. Conclusions: Continuous cancer registry data provides basic information in cancer control programs. The cancer burden in China is gradually increasing, both in urban and rural areas, in males and females. Effcient cancer preven-tion and control, such as health education, tobacco control, and cancer screening, should be paid attention by the health sector and the whole society of China.     

Report of incidence and mortality in China Cancer Registries, 2008

Objective: Annual cancer incidence and mortality in 2008 were provided by National Central Cancer Registry in China, which data were collected from population‐based cancer registries in 2011. Methods: There were 56 registries submitted their data in 2008. After checking and evaluating the data quality, total 41 registries’ data were accepted and pooled for analysis. Incidence and mortality rates by area (urban or rural areas) were assessed, as well as the age‐ and sex‐specific rates, age‐standardized rates, proportions and cumulative rate. Results: The coverage population of the 41 registries was 66,138,784 with 52,158,495 in urban areas and 13,980,289 in rural areas. There were 197,833 new cancer cases and 122,136 deaths in cancer with mortality to incidence ratio of 0.62. The morphological verified rate was 69.33%, and 2.23% of cases were identified by death certificate only. The crude cancer incidence rate in all areas was 299.12/100,000 (330.16/100,000 in male and 267.56/100,000 in female) and the age‐standardized incidence rates by Chinese standard population (ASIRC) and world standard population (ASIRW) were 148.75/100,000 and 194.99/100,000, respectively. The cumulative incidence rate (0-74 years old) was of 22.27%. The crude incidence rate in urban areas was higher than that in rural areas. However, after adjusted by age, the incidence rate in urban was lower than that in rural. The crude cancer mortality was 184.67/100,000 (228.14/100,000 in male and 140.48/100,000 in female), and the age‐standardized mortality rates by Chinese standard population (ASMRC) and by world population were 84.36/100,000 and 114.32/100,000, respectively. The cumulative mortality rate (0-74 years old) was of 12.89%. Age‐adjusted mortality rates in urban areas were lower than that in rural areas. The most common cancer sites were lung, stomach, colon‐rectum, liver, esophagus, pancreas, brain, lymphoma, breast and cervix which accounted for 75% of all cancer incidence. Lung cancer was the leading cause of cancer death, followed by gastric cancer, liver cancer, esophageal cancer, colorectal cancer and pancreas cancer, which accounted for 80% of all cancer deaths. The cancer spectrum varied by areas and sex in rural areas, cancers from digestive system were more common, such as esophageal cancer, gastric cancer and liver cancer, while incidence rates of lung cancer and colorectal cancer were much higher in urban areas. In addition, breast cancer was the most common cancer in urban women followed by liver cancer, gastric cancer and colorectal cancer. Conclusion: Lung cancer, gastric cancer, colorectal cancer, liver cancer, esophageal cancer and female breast cancer contributed to the increased incidence of cancer, which should be paid more attention to in further national cancer prevention and control program. Different cancer control strategies should be carried out due to the varied cancer spectrum in different groups.     

Adrenocortical carcinoma: A population-based study on incidence and survival in the Netherlands since 1993

BackgroundThe reported annual incidence of adrenocortical carcinoma (ACC) is 0.5–2.0 cases per million individuals. Updated population-based studies on incidence are lacking. The aim of this nationwide survey was to describe the incidence and survival rates of ACC in the Netherlands. Secondary objectives were to evaluate changes in both survival rates and the number of patients undergoing surgery.MethodsAll ACC patients registered in the Netherlands Cancer Registry (NCR) between 1993 and 2010 were included. Data on demographics, stage of disease, primary treatment modality and survival were evaluated.ResultsIncluded were 359 patients, 196 of whom were female (55%). Median age at diagnosis was 56 years (range 1–91). The 5-year age-standardised incidence rate decreased from 1.3 to 1.0 per one million person-years. Median survival for patients with stage I–II, stage III and stage IV disease was 159 months (95% confidence interval (CI) 93–225 months), 26 months (95% CI: 4–48 months) and 5 months (95% CI: 2–7 months), respectively (P < 0.001). Improvement in survival was not observed, as reflected by the lack of association between survival and time of diagnosis. The percentage of patients receiving treatment within 6 months after diagnosis increased significantly from 76% in 1993–1998 to 88% in 2005–2010 (P = 0.047), mainly due to an increase in surgery for stage III–IV patients.ConclusionThese nationwide data provide an up-to-date survey of the epidemiology of ACC in the Netherlands. A trend towards a decreasing overall incidence rate was observed. Survival rates did not change during this period despite an increased number of surgical procedures.     

2014年山西省肿瘤登记地区恶性肿瘤发病与死亡分析

目的探讨2014年山西省肿瘤登记地区恶性肿瘤发病与死亡情况。方法收集2014年全省12个肿瘤登记地区的数据资料,分析不同地区、不同年龄和性别的恶性肿瘤发病率与死亡率特点,同时与全国数据进行比较。结果2014年山西省肿瘤登记地区新发恶性肿瘤11703例(男性6559例,女性5144例),发病率为221.21/10万,中国人口标化发病率为163.91/10万,世界人口标化发病率为163.25/10万;城市地区发病率、中国人口标化发病率分别为247.02/10万、171.35/10万,农村地区分别为205.98/10万、159.03/10万。男性常见恶性肿瘤发病以胃癌、肺癌、食管癌、肝癌、结直肠癌为主,女性以乳腺癌、子宫颈癌、肺癌、食管癌、胃癌为主。恶性肿瘤死亡病例7283例(男性4548例,女性2735例),恶性肿瘤死亡率为137.66/10万,中国人口标化死亡率为99.67/10万,世界人口标化死亡率为100.11/10万;城市地区死亡率、中国人口标化死亡率分别为141.03/10万、92.84/10万,农村地区分别为135.68/10万、103.69/10万。男性常见恶性肿瘤死亡以肺癌、胃癌、肝癌、食管癌、结直肠癌为主,女性以肺癌、胃癌、肝癌、食管癌、子宫颈癌为主。结论山西省肿瘤登记地区恶性肿瘤发病与死亡均以肺癌、上消化道恶性肿瘤和女性子宫颈癌为主,胃癌、子宫颈癌的发病率较高。     

2014年上海市恶性肿瘤发病和死亡特征分析

背景与目的：恶性肿瘤已成为严重威胁上海市居民健康的重大公共卫生问题。该研究旨在描述和分析2014年上海市恶性肿瘤发病与死亡情况。方法：根据上海市恶性肿瘤病例报告登记系统收集的恶性肿瘤发病资料,按地区、性别分层,分别计算恶性肿瘤发病与死亡粗率、标化率、前10位恶性肿瘤发病与死亡顺位和构成等,应用Joinpoint统计软件分析2002—2014年上海市恶性肿瘤发病和死亡趋势,估算总体和分阶段的年度变化百分比（annual percentage change,APC）。采用Segi’s世界标准人口年龄构成计算标化率。结果：2014年上海市共报告恶性肿瘤新发病例68 541例,死亡病例37 242例。病理学诊断比例为79.49%,只有死亡医学证明书比例为0.04%,死亡发病比为0.54。上海市恶性肿瘤粗发病率为477.79/10万,标化发病率为223.57/10万,男性标化发病率低于女性,市区低于郊区。恶性肿瘤发病在40岁以后快速上升,在80~84岁年龄组达到高峰。全市发病前10位恶性肿瘤依次为肺癌、结直肠癌、甲状腺癌、胃癌、乳腺癌、肝癌、前列腺癌、胰腺癌、脑和中枢神经系统肿瘤以及膀胱癌,前10位恶性肿瘤占全部恶性肿瘤发病的75.89%。全市恶性肿瘤粗死亡率为259.61/10万,标化死亡率为95.73/10万,男性标化死亡率高于女性,市区和郊区基本持平。死亡率在45岁以后快速上升,在≥85岁年龄组达到高峰。死亡前10位恶性肿瘤依次为肺癌、结直肠癌、胃癌、肝癌、胰腺癌、乳腺癌、食管癌、胆囊癌、前列腺癌以及脑和中枢神经系统肿瘤,前10位恶性肿瘤占全部恶性肿瘤死亡的78.12%。2002—2014年,上海市女性所有部位的恶性肿瘤标化发病率呈明显上升趋势（APC为2.17%,P<0.001）,男性标化发病率则较为稳定。男性和女性所有部位的恶性肿瘤标化死亡率均呈明显下降趋势（APC分别为-0.82%和-0.76%,P<0.05）。结论：肺癌、消化系统恶性肿瘤、甲状腺癌和女性乳腺癌是威胁上海市居民健康的主要恶性肿瘤,仍是肿瘤防治工作的重点。同时,2002—2014年女性恶性肿瘤发病率有上升趋势,男性和女性恶性肿瘤死亡率均持续下降。