2020年全球及中国结直肠癌流行状况分析

目的 根据国际癌症研究机构发布的2020全球癌症数据，结合性别、年龄、人类发展指数（HDI）等特征分析2020年全球及中国结直肠癌发病和死亡情况，比对中国和全球结直肠癌数据，为探讨中国结直肠癌防治策略提供科学依据。方法 全球各国结直肠癌数据来源于GLOBOCAN 2020数据库，HDI根据联合国开发计划署公布的数据进行整理。将癌症数据进行年龄、性别、HDI分层，描述全球及中国结直肠癌流行病现状。使用Pearson相关性评估标化发病率（SIR）、标化死亡率（SMR）及死亡发病比（M/I）与HDI之间的相关性。结果 2020年全球结直肠癌发病数（193.2万）在各癌种中位于第三位，SIR（19.5/10万）位于第四位；全球结直肠癌死亡数（93.5万）位于第二位，SMR（9.0/10万）位于第三位。2020年中国结直肠癌发病数（55.5万）在各癌种中位于第二位，占全球结直肠癌发病数的28.8%，SIR（23.9/10万）位于第三位；中国结直肠癌死亡数（28.6万）在各癌种位于第五位，占全球结直肠癌死亡数的30.6%，SMR（12.0/10万）位于第五位。全球结直肠癌发病数、死亡数、SIR、SMR男性均高于女性。SIR、SMR与HDI水平呈现著正相关（SIR：r=0.795，P<0.001；SMR：r=0.804，P<0.001），死亡发病比与HDI水平呈显著负相关（r=-0.843,P<0.001）。全球及中国结直肠癌发病数、死亡数、SIR、SMR随年龄增加呈现逐渐上升趋势，40~44年龄组之后均迅速增长。结论 全球及中国结直肠癌疾病负担严重，流行情况在不同HDI水平国家、性别之间、年龄别之间呈现差异。分析和探讨结直肠癌流行病现状特点，了解结直肠癌流行的影响因素，可为进一步采取有效精准防控措施提供理论依据和数据支撑。

Analysis of the epidemic situation of colorectal cancer in the world and China in 2020

Objective Based on the global cancer data released by the International Agency for Research on Cancer (IARC) in 2020, the incidence and mortality situation of colorectal cancer in the world and China in 2020 were analyzed in combination with gender, age, human development index (HDI) and other characteristics, and the data of colorectal cancer in the world and China were compared ,providing scientific basis for discussing the prevention and treatment strategies of colorectal cancer in China.Methods Global colorectal cancer data for 2020 were collected from GLOBOCAN 2020 database, and the HDI collated from data published by the United Nations Development Programme.Cancer data were stratified by age, sex, and HDI to describe the current situation of colorectal cancer epidemic in the world and China. Pearson correlation was used to evaluate the correlation between standardized incidence rates(SIR) ,standardized mortality rates(SMR) , the mortality to incidence ratio(M/I) and HDI.Results In 2020,the incident cases of colorectal cancer (1,932,000) worldwide ranked second among all cancer types and SIR(19.5/100 000) ranked fourth .The deaths of colorectal cancer(935,000) worldwide ranked second among all cancer types and SMR (9.0/100 000)ranked third .In 2020,the incident cases of colorectal cancer(555,000) in China ranked second in all cancer types ,accounting for 28.8% of the global incident cases of colorectal cancer,and SIR(23.9/100,000) ranked third .The deaths of colorectal cancer (286,000) in China ranked fifth in all cancer types,accounting for 30.6% of the global incident deaths of colorectal cancer ,and SMR (12.0/100,000) ranked fifth.The incident cases, deaths, SIR and SMR of colorectal cancer were higher in males than females worldwide.There were significant positive correlation between SIR and SMR and HDI level ( SIR:r =0.795, P<0.001; SMR : r=0.804,P<0.001),and there was a significant negative correlation between M/I and HDI level (r=-0.843,P<0.001).The incident cases, deaths,SIR and SMR of colorectal cancer in the word and China increased with age, and increased rapidly after age group of 40 to 44.Conclusion The disease burden of CRC is serious in global and China and the epidemic situation of colorectal cancer is different in different HDI countries, gender and age groups. To analyze and discuss the current situation and characteristics of colorectal cancer epidemic and understand the influencing factors of colorectal cancer epidemic can provide the oretical basis and data support for further effective and precise prevention and control measures.