中国和全球肿瘤发病率和死亡率解析.pptx

最新肿瘤发病率和死亡率解析中国&全球-2012中国肿瘤登记年报-Global Cancer Statistics 2011by IARCTang Jian 2013/3/12 MoticA.中国肿瘤发病率和死亡率总体情况B.中国肿瘤发病率和死亡率（按性别）C.中国肿瘤发病率和死亡率（按地域）D.中国肿瘤发病率和死亡率（按年龄）E.中国排名前十肿瘤病种的发病率和死亡率F.全球肿瘤发病率和死亡率具体情况目录CONTENTSMotic中国肿瘤发病率和死亡率总体情况总体肿瘤发病率和死亡率较高：肿瘤发病率：每10万人中有286人患癌；一生中有22%的概率患癌症。肿瘤死亡率：每10万人有181人患癌死亡；一生中有13%的概率患癌死亡；每分钟就有6人被确诊为癌症，平均每5位癌症患者有3人死亡。Motic中国肿瘤发病率和死亡率（按性别）相比女性，男性癌症发病率和死亡率都高：肿瘤发病率：男女之比1.3:1；肿瘤死亡率：男女之比1.65:1。一生中，男性患癌症概率为26%，女性19%一生中，男性因患癌死亡概率为17%，女性为9%患癌人群中，因患癌而死亡的概率，男性(71%)比女性(54%)高Motic中国肿瘤发病率和死亡率（按地域）城市人口与农村人口相比，癌症发病率要略高，但一生中因患癌症死亡率要低：肿瘤发病率：城市与农村之比1.2:1；肿瘤死亡率：城市与农村之比1.02:1。一生中，城市患癌症概率为22.23%，农村21.76%。一生中，城市患癌死亡概率为12%，农村为15%。患癌人群中，因患癌而死亡的概率，城市人口(60%)比农村人口(71%)低Motic中国肿瘤发病率和死亡率（按年龄）肿瘤发病率随人群年龄逐渐上升，特别是50岁以上随年龄增加而大幅上升 50岁以上占全部发病的80%以上；80-85岁最高。Motic中国肿瘤发病率和死亡率（按年龄）肿瘤死亡率随人群年龄逐渐上升，特别是60岁以上随年龄增加而大幅上升 60岁以上约占全部死亡的63%以上；85岁以上达到最高。Motic中国排名前十肿瘤病种的发病率和死亡率（总体情况）发病率与死亡率最高的均是肺癌，排名前十病种的发病率占比76.39%。排名前十病种的死亡率占比84.27%.Motic中国排名前十肿瘤病种的发病率（按性别）男性发病率最高的是肺癌，其次为胃癌、肝癌。排名前十病种的发病率占比84.14%。女性发病率最高的是乳腺癌，其次为肺癌、结直肠癌。排名前十病种的发病率占比77.57%。Motic中国排名前十肿瘤病种的死亡率（按性别）男性死亡率最高的是肺癌，其次为肝癌、胃癌。排名前十病种的死亡率占比88.33%。女性死亡率最高的是肺癌，其次为胃癌、肝癌。排名前十病种的死亡率占比81.12%。Motic全球肿瘤发病率和死亡率具体情况MoticWorldwide1.1 :11.26 :1Total:12,700,000Total:7,600,000MoticDeveloped countriesMoticDeveloping countriesMoticMoticMoticIt should also be noted that cancer tends to be diagnosed at later stages in many developing countries compared with developed countries and this,combined with reduced access to appropriate therapeutic facilities and drugs(Fig.3),has an adverse effect on survival.MoticMoticSelectedCancersFemaleBreastCancer1MoticBreast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females worldwide,accounting for 23%(1.38 million)of the total new cancer cases and 14%(458,400)of the total cancer deaths in 2008(Fig.2),About half the breast cancer cases and 60%of the deaths are estimated to occur in economically developing countries.MoticIn general,incidence rates are high in Western and Northern Europe,Australia/New Zealand,and North America;intermediate in South America,the Caribbean,and Northern Africa;and low in sub-Saharan Africa and Asia.MoticThe factors that contribute to the international variation in incidence rates largely stem from differences in reproductive and hormonal factors and the availability of early detection services.Reproductive factors that increase risk12345long menstrual historyoral contraceptiveslate age at first birthnulliparityrecent use of postmenopausal hormone therapyMoticHowtoreducetheriskofdevelopingbreastcancer?Maintaining a healthy body weightIncreasing physical activity Minimizing alcohol intake Early detection strategies include the promotion of awareness of early signs and symptoms and screening by clinical breast examinationBest available strategiesMoticSelectedCancersColorectal Cancer2MoticColorectal cancer is the 3rd most commonly diagnosed cancer in males and the 2nd in females,with over 1.2 million new cancer cases and 608,700 deaths estimated to have occurred in 2008.MoticThe highest incidence rates are found in Australia and New Zealand,Europe,and North America,whereas the lowest rates are found in Africa and South-Central Asia.Rates are substantiallyhigher in males than in females.MoticTrendsRiskFactorsRates continue to increase in countries with limited resources and health infrastructure,particularly in Eastern Europe and Eastern AsiaWhile decreasing in several Western countries,particularly in UnitedStates,Canada,and AustraliaSmokingPhysical inactivityOverweight/ObesityRed and processed meat consumption Excessive alcohol consumption Population-based colorectal screening programs*According to a recent randomized trial in the United Kingdom,a one-time flexible sigmoidoscopy screening between 55 and 64 years of age reduced colorectal cancer incidence by 33%and mortality by 43%.MoticSelectedCancersLung Cancer3MoticLung cancer was the most commonly diagnosed canceras well as the leading cause of cancer death in males in 2008 globally.Among females,it was the 4th most commonly diagnosed cancer and the 2nd leading cause of cancer death.Lung cancer accounts for 13%(1.6 million)of the total cases and 18%(1.4 million)of the deaths in 2008.MoticIn males,the highest lung cancer incidence rates are in Eastern and Southern Europe,North America,and Eastern Asia,while rates are low in sub-Saharan Africa.In females,the highest lung cancer incidence rates are found in North America,Northern Europe,and Australia/New Zealand.MoticSmoking accounts for 80%of the worldwide lung cancerburden in males and at least 50%of the burden in females.MoticMale lung cancer death rates are decreasing in most Western countries,including many European countries,North America,and Australia,where the tobacco epidemic peaked by the middle of the last century.In contrast,lung cancer rates are increasing in countries such as China and several other countries in Asia and Africa,where the epidemic has been established more recently and smoking prevalence continues to either increase or show signs of stability.Moticbyapplyingproventobaccocontrolinterventionsthatincluderaisingthepriceofcigarettes*andothertobaccoproducts,banningsmokinginpublicplaces,therestrictionofadvertisingoftobaccoproducts,counteradvertising,andtreatingtobaccodependence.avoid the burden of lung cancerBeststrategy*a 10%increase in cigarette prices has been shown to reduce cigarette consumption by 3%to 5%.MoticSelectedCancersProstate Cancer4MoticProstate cancer is the 2nd most frequently diagnosed cancer and the 6th leading cause of cancer death in males,accounting for 14%(903,500)of the total new cancer cases and 6%(258,400)of the total cancer deaths in males in 2008。MoticIncidence rates vary by more than 25-foldworldwide largely because of the wide utilization of prostate-specific antigen(PSA)testing.Death rates for prostate cancer have been decreasing in many developed countries,including Australia,Canada,the United Kingdom,the UnitedStates,Italy in part because of the improved treatment with curative intent.Motictheonlywell-establishedriskfactors Older age Race(black)Family historythere are no establishedpreventable risk factors for prostate cancer.MoticSelectedCancersStomach Cancer5MoticA total of 989,600 new stomach cancer cases and 738,000 deaths are estimated to have occurred in 2008,accounting for 8%of the total cases and 10%of total deaths.Over 70%of new cases and deaths occur in developing countries.Generally,stomach cancer rates are about twice as high in males as in females.MoticThe highest incidence rates are in Eastern Asia,Eastern Europe,and South America and the lowest rates are in North America and most parts of Africa.Regional variations in part reflect differences in dietary patterns,particularly in European countries,and the prevalence of Helicobacter pylori infection.Motic1234the increased use and availability of refrigeration including the increased availability of fresh fruits and vegetables,and a decreased reliance on salted and preserved foods.Rateshavedecreaseddueto(westerncountries):reductions in chronic H.pylori infection in most parts of the world.reductions in smoking in some parts of the developed world.In Japan,mortality rates may have declined via the introduction of screening using photofluorography.MoticSelectedCancersLiver Cancer6MoticLiver cancer in men is the 5th most frequently diagnosed cancer worldwide but the 2nd most frequent cause of cancer death.In women,it is the 7th most commonly diagnosed cancer and the 6th leading cause of cancer death.An estimated 748,300 new liver cancer cases and 695,900 cancer deaths occurred worldwide in 2008.MoticHalf of these cases and deaths were estimated to occur in China.Globally,rates are more than twice as high in males as in females.MoticRisk factors accounting for liver cancer12345 chronic HBV/HCV infectionnonalcoholic fatty liver diseaseobesityalcohol-related cirrhosis aflatoxin B1 (AFB)exposureMoticLiver cancer incidence rates are increasing inmany parts of the world including the United Statesand Central Europe,possibly due to the obesity epidemic and the rise in HCV infection through continued transmission by injection drug users.In contrast to the trend in the low-risk areas,ratesdecreased in some historically high-risk areas,possibly due to the HBV vaccine.Universal infant hepatitis vaccination programs in Taiwan reduced liver cancer incidence rates by about two-thirds in children and young adults.Moticintroduced the HBV vaccine into their nationalinfant immunization schedules(Fig.10).Preventive strategies against HCV,include screening ofdonors blood for antibodies to HCV,institutingadequate infection control practices including the use of oral delivery of medicines where possible,and needle exchange programs among injection drug users.Crop substitution and improved grain storage practices have been shown to reduce contamination with AFB.avoid the burden of liver cancerBeststrategyMoticMoticSelectedCancersCervical Cancer7MoticCervical cancer is the 3rd most commonly diagnosed cancer and the 4th leading cause of cancer death in females worldwide,accounting for 9%(529,800)of the total new cancer cases and 8%(275,100)of the total cancer deaths among females in 2008.More than 85%of these cases and deaths occur in developing countries.India,the 2nd most populous country in the world,accounts for 27%(77,100)of the total cervical cancer deaths.MoticWorldwide,the highest incidence rates are in Eastern,Western,and Southern Africa,as well as South-Central Asia and South America.Rates are lowest in Western Asia,Australia/New Zealand,and North America.The disproportionately high burden of cervical cancer in developing countries and elsewhere in medically underserved populations is largely due to a lack of screening that allows detection of precancerous and early stage cervical cancer.MoticThemostefficientandcost-effectivescreeningtechniquesinlow-resourcecountries visual Inspection acetic acid/Lugols iodine HPV DNA testingA recent clinical trial in rural India,a low-resource area,found that a singleround of HPV DNA testing was associated with about a 50%reduction in the risk of developing advanced cervical cancer and associated deaths.MoticThe expectations that vaccines which primarily protect against the most common strains of HPV infections(HPV types 16 and 18),which cause about 70%of cervical cancers,may prevent cervical cancer worldwide are at present high.However,affordable pricing is the most critical factor to facilitate the introduction of HPV vaccines in low-and medium-resource countries in the short term.It is also extremely important that women continue to receive screening services because the current vaccines are being given to adolescent girls only,and even vaccinated girls should begin screening when they reach the recommended screening age since the vaccines do not provide protection for the 30%of chronic infections by HPV types other than HPV 16,18,6 and 11 that cause cervical cancer.Dispute of HPVMoticSelectedCancersEsophageal8MoticEsophageal cancer usually occurs as either squamous cell carcinoma in the middle or upper one-third of the esophagus,or as adenocarcinoma in the lower onethird or junction of the esophagus and stomach.MoticAn estimated 482,300 new esophageal cancer cases and 406,800 deaths occurred in 2008 worldwide.Incidence rates vary internationally by nearly 16-fold,with the highest rates found in Southern and Eastern Africa and Eastern Asia and lowest rates observed in Western and Middle Africa and Central America in both males and females.Esophageal cancer is 3 to 4 times more common among males than females.MoticIn the highest risk area,stretching from northern Iran through the central Asian republics to North-Central China,often referred to as theesophageal cancer Belt90%of cases are squamous cell carcinomas.MoticMajorriskfactors(forsquamouscellcarcinomas)PoornutritionalstatusLow intake of fruits and vegetablesDrinking beverages at high TemperaturesSmoking/excessive alcohol consumptionIn low-risk areas such as the United States and several Western countries,smoking and excessive alcohol consumption account for about 90%of the total cases of squamous cell carcinoma of the esophagus.MoticMajorriskfactors(foradenocarcinoma)SmokingOverweight/ObesityChronic gastroesophagealreflux diseaseBarretts esophagusMoticIncidence rates for adenocarcinoma of the esophagus have been increasing in several western countries,in part due to increases in the prevalence of known risk factors such as overweight and obesity.In contrast,rates for squamous cell carcinoma of the esophagus have been steadily declining in these same countries because of long-term reductions in tobacco use and alcoholconsumption.MoticSelectedCancersBladder9MoticAn estimated 386,300 new cases and 150,200 deaths from bladder cancer occurred in 2008 worldwide.The majority of bladder cancer occurs in males and there is a 14-fold variation in incidence internationally.The highest incidence rates are found in the countries of Europe,North America,and Northern Africa.Egyptian males have the highest mortalityrates,which is twice as high as the highest rates in Europe and over 4 times higher than that in theUnited States.The lowest rates are found in thecountries of Melanesia and Middle Africa.MoticSmoking is the major risk factors in Western countries,whereas chronic infection with Schistosoma hematobium in developing countries,particularly in Africa and the Middle East,accounts for about 50%of the total burden.MoticSelectedCancersLip and Oral Cavity10MoticAn estimated 263,900 new cases and 128,000 deaths from oral cavity cancer(including lip cancer)occurred in 2008 worldwide.Generally,the highest oral cavity cancer rates are found in Melanesia,South-Central Asia,and Central and Eastern Europe and the lowest in Africa,Central America,and Eastern Asia for both males and females.Motic1234Major risk factorsSmokingAlcohol useSmokeless tobacco/Betel quidHPV infectionssmoking accounts for 42%of deathsheavy alcohol consumptionfor 16%of the deathsHaving synergistic effectsMoticConclusion1TheglobalburdenofcancerThe global burden of cancer continues to increase largely because of the aging and growth of the world population and an increasing adoption of cancer-causing behaviors,particularly smoking,within economically developing countries.MoticConclusion2Disproportionate cancer burden Female breast,lung,and colorectal cancers are occurring in high frequencies in many economically developing countries,in addition to the disproportionately high burden of cancers related to infections.MoticConclusion3CancerpreventionA significant proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge,and by implementing programs for tobacco control,vaccination(for liver and cervical cancers),and early detection and treatment,as well as public health campaigns promoting physica