2022年中国人群恶性肿瘤发病与死亡年龄特征分析

摘 要：［目的］ 分析2022年中国人群恶性肿瘤发病和死亡负担的年龄分布特征。［方法］ 整理2010—2018年连续开展监测的106个肿瘤登记处数据，按城乡和性别分层，采用年龄-时期-队列模型计算恶性肿瘤的发病率和死亡率并拟合变化趋势。同时根据全国700个提交2018年度数据且质量良好的肿瘤登记处数据，结合全国人口数据估算2022年全国恶性肿瘤发病和死亡数据及其年龄分布特征。［结果］ 2022年全国恶性肿瘤新发病例约482.47万例，死亡病例约257.42万例。其中60岁及以上老年人群的病例数分别占全国恶性肿瘤新发病例和死亡病例总数的60%和76%左右。恶性肿瘤的发病率和死亡率均随年龄增长而增高，分别在80~84岁组和85岁及以上年龄组达到最高峰。不同类型恶性肿瘤发病的年龄特征分析结果显示，男性与女性在40岁之前均是甲状腺癌发病率最高，40岁以后肺癌和消化道恶性肿瘤发病率显著上升。乳腺癌是45~59岁女性发病率最高的恶性肿瘤类型，60岁后发病率逐渐下降。50岁之前男性肝癌死亡率最高，女性乳腺癌死亡率最高。50岁之后在男性和女性中肺癌均是死亡率最高的类型，消化道恶性肿瘤也成为主要恶性肿瘤死亡类型。［结论］ 不同类型恶性肿瘤的发病和死亡负担具有不同的年龄分布特征，老年人群负担沉重。应根据年龄分布特征，确定不同恶性肿瘤的高危人群，开展预防、筛查和诊疗等综合防控措施。

Age Distribution of Cancer Incidence and Mortality in China in 2022

Abstract：［Purpose］ To analyze the age distribution characteristics of cancer incidence and mortality in Chinese population in 2022. ［Methods］ Data from 106 cancer registries that conducted continuous surveillance from 2010 to 2018 were analyzed. The data was stratified by urban and rural areas， sex， and age. An age-period-cohort model was used to fit the incidence and mortality rates of cancers and to determine the time trend of the change. Using high-quality data from 700 cancer registries across China for 2018， along with demographic data， we estimated the national incidence and mortality rates for cancers in 2022， including the age distribution characteristics. ［Results］ In 2022, there were an estimated 4 824 700 new cancer cases and 2 574 200 cancer deaths in China. The elderly population aged 60 years old and above accounted for about 60% and 76% of all cancer cases and deaths, respectively. The incidence and mortality rates of cancers increased with age, peaking in the 80~84 and 85+ age groups, respectively. According to the characteristics of the age distribution by cancer type, thyroid cancer had the highest incidence rate before the age of 40 for both men and women. After the age of 40, there was a significant increase in the incidence rate of lung cancer and gastrointestinal cancer. In women, breast cancer had the highest incidence rate in the age group of 45~59 years old, but the incidence rate decreased after age of 60. In men under 50, liver cancer had the highest mortality rate, while in women under 50, breast cancer had the highest mortality rate. After the age of 50, lung cancer had the highest mortality rate in both sexes. Gastrointestinal cancer also became a common cause of cancer death. ［Conclusion］ The age distribution of cancer cases and deaths varies by cancer types, with a significant burden on the elderly in China. Identifying these age distribution characteristics can help determine high-risk groups for different types of cancer and guide the implementation of a comprehensive prevention and control strategy in China, including prevention, screening, diagnosis, and treatment.