2023年美国癌症数据解读及对中国癌症防治的启示

doi:10.19401/j.cnki.1007-3639.2023.02.004

中国癌症杂志 ›› 2023, Vol. 33 ›› Issue (2): 117-125.doi: 10.19401/j.cnki.1007-3639.2023.02.004

2023年美国癌症数据解读及对中国癌症防治的启示

周昌明¹^,²(), 王泽洲¹^,², 郑莹¹^,²()

1.复旦大学附属肿瘤医院肿瘤预防部，复旦大学上海医学院肿瘤学系，上海 200032
2.上海肿瘤疾病人工智能工程技术研究中心，上海 200032

收稿日期:2023-02-02 修回日期:2023-02-14 出版日期:2023-02-28 发布日期:2023-03-22
通信作者: 郑莹（ORCID: 0000-0002-6408-8510），主任医师，复旦大学附属肿瘤医院肿瘤预防部主任。
作者简介:周昌明（ORCID: 0000-0001-7863-428X），博士。
郑莹，复旦大学附属肿瘤医院肿瘤预防部主任，主任医师，教授，硕士研究生导师，毕业于上海医科大学，医学硕士。长期从事肿瘤预防控制工作，涵盖肿瘤登记和监测、常见肿瘤社区防治干预、肿瘤筛查和早发现及肿瘤防治的健康教育和科普。开展肿瘤病因和预后研究，建立起了以人群为基础的乳腺癌患者队列和大肠癌筛查人群队列。指导健康人和癌症患者建立健康的生活方式，执笔的《中国乳腺癌患者生活方式指南》是我国第一个癌症患者预防指南。曾经担任上海市重点公共卫生项目《社区居民大肠癌筛查项目》的技术负责人，组织编写和发布上海市抗癌协会《居民常见恶性肿瘤筛查和预防推荐》，为医疗机构和个人的癌症早发现和筛查提供指导。共发表学术论文100余篇，其中第一作者或通讯作者的文章90余篇，主编和参编20余部专著，获中华预防医学科技奖2项，上海市科技进步奖1项，上海医学科技奖1项，上海抗癌科技奖1项。主要学术兼职：上海市抗癌协会常务理事，上海市抗癌协会癌症预防与筛查专业委员会主任委员，中国抗癌协会乳腺癌专业委员会康复学组组长，中国临床肿瘤学会（CSCO）肿瘤大数据专家委员会常务委员，中国抗癌协会多原发和不明原因肿瘤专业委员会常务委员，中国抗癌协会乳腺癌专委会、科普专委会、肿瘤流行病学专委会、筛查和早诊早治专委会委员，中国控制吸烟协会控烟与肺癌防治专业委员会常务委员。
基金资助:
上海市老龄化和妇儿健康研究专项(2020YJZX0206);中国癌症基金会科研项目(NH2018001)

Interpretation of US cancer statistics 2023 and its implications for cancer prevention and treatment in China

ZHOU Changming¹^,²(), WANG Zezhou¹^,², ZHENG Ying¹^,²()

1. Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
2. Shanghai Engineering Research Center of Artificial Intelligence Technology for Tumor Diseases, Shanghai 200032, China

Received:2023-02-02 Revised:2023-02-14 Published:2023-02-28 Online:2023-03-22
Contact: ZHENG Ying

摘要/Abstract

摘要：

美国癌症协会发表的美国癌症统计数据预计2023年美国全年新发恶性肿瘤病例1 958 310例，死亡609 820例。美国的癌症死亡率在1991年达到峰值后持续加速下降，治疗的进步使得患者生存得到改善，减少吸烟人数、普及癌症筛查是其主要原因；2020年COVID-19大流行造成350 831人死亡，位列2020年死因第3位，同时造成包括癌症在内的其他多种死因显著增加，但疫情对癌症死亡的影响尚未被纳入评估。通过对2020年GLOBOCAN数据库中中国和美国数据进行对比分析发现，尽管中美癌症发病和死亡存在较大差异，但是美国癌症防治的经验值得中国借鉴，我们应努力提高肿瘤诊治规范化程度、提升医疗服务资源可及性以提升患者生存率，优化筛查模式、提升筛查效率，癌症筛查覆盖率，同时进一步提高HPV疫苗接种率将有效地降低癌症死亡。

关键词: 癌症, 统计, 死亡率, 筛查, HPV疫苗

Abstract:

In the year 2023, 1 958 310 new cancer cases and 609 820 cancer deaths are projected to occur in the United States, estimated by Cancer Statistics, published by American Cancer Society. An accelerated decline in mortality rate of cancer continues since it reached the peak in 1991. The treatment advance brought survival benefit to patients which mainly contribute to the decline along with tobacco control and screening. COVID-19 pandemic caused 350 831 mortality and ranked 3rd in cause of death in 2020, and the mortality had a significant increase in multiple causes of death including cancer. By comparing the data of China and the United States released by GLOBOCAN database in 2020, it is found that, although the influence of the pandemic on cancer has not been evaluated. Although the incidence and mortality of cancer differ between US and China, the experiences are worth learning. Improving the standardization of diagnosis and treatment, enhancing the accessibility of cancer health care, upgrading the coverage of screening and increasing the human papillomavirus (HPV) vaccination rate are proven to be effective ways to reduce the mortality of cancer.

Key words: Cancer, Statistics, Mortality rate, Screening, HPV vaccination

中图分类号:

R737.9

周昌明, 王泽洲, 郑莹. 2023年美国癌症数据解读及对中国癌症防治的启示[J]. 中国癌症杂志, 2023, 33(2): 117-125.

ZHOU Changming, WANG Zezhou, ZHENG Ying. Interpretation of US cancer statistics 2023 and its implications for cancer prevention and treatment in China[J]. China Oncology, 2023, 33(2): 117-125.

图/表 3

表1

表2

表3

参考文献 30

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Rank	Cause of death	2018		2019		2020		Increased number
Rank	Cause of death	Number	Rate (1/10⁵)	Number	Rate (1/10⁵)	Number	Rate (1/10⁵)	2019 vs 2018	2020 vs 2018
-	Total	2 839 205	724.6	2 854 838	715.7	3 383 729	835.2	15 633	528 891
1	Heart disease	655 381	163.8	659 041	161.6	696 962	168.2	3 660	37 921
2	Cancer	599 274	149.2	599 601	146.0	602 350	143.8	327	2 749
3	COVID-19	0	-	0	-	350 831	85.0	0	350 831
4	Accident	167 127	48.0	173 040	49.2	200 955	57.5	5 913	27 915
5	Cerebrovascular disease	147 810	37.2	150 005	37.0	160 264	38.9	2 195	10 259
6	Chronic lower respiratory disease	159 486	39.8	156 979	38.2	152 657	36.4	-2 507	-4 322
7	Alzheimer’s disease	122 019	30.6	121 499	29.9	134 242	32.6	-520	12 743
8	Diabetes	84 946	21.4	87 647	21.6	102 188	24.8	2 701	14 541
9	Influenza and pneumonia	59 120	14.9	49 783	12.3	53 544	13.1	-9 337	3 761
10	Nephropathy	51 386	12.9	51 565	12.7	52 547	12.7	179	982

Type	China				US				ASMR ratio (China vs US)
	Incidence
	Rank	Number	Crude rate (1/10⁵)	ASMR (1/10⁵)	Rank	Number	Crude rate (1/10⁵)	ASMR (1/10⁵)
Total	-	2 464 015	332.1	224.3	-	890 450	543.7	308.7	0.7
Lung cancer	1	539 181	72.7	47.8	2	116 335	71.0	36.3	1.3
Gastric cancer	2	331 629	44.7	29.5	13	15 944	9.7	5.3	5.6
Colorectal cancer	3	319 486	43.1	28.6	3	116 335	71.0	36.3	0.8
Liver cancer	4	302 598	40.8	27.6	10	29 713	18.1	10.4	2.7
Esophageal cancer	5	223 044	30.1	19.7	14	14 384	8.8	4.8	4.1
Prostate cancer	6	115 426	15.6	10.2	1	209 512	127.9	72.0	0.1
Pancreatic cancer	7	70 383	9.5	6.3	9	29 856	18.2	9.5	0.7
Bladder cancer	8	66 242	8.9	5.9	4	61 795	37.7	18.3	0.3
Thyroid cancer	9	53 389	7.2	5.4	15	14 351	8.8	6.1	0.9
Non-Hodgkin’s lymphoma	10	50 125	6.8	4.8	7	40 733	24.9	14.3	0.3
Type	China				US				ASMR ratio (China vs US)
	Mortality
	Rank	Number	Crude rate (1/10⁵)	ASMR (1/10⁵)	Rank	Number	Crude rate (1/10⁵)	ASMR (1/10⁵)
Total	-	1 814 325	244.5	163.3	-	318 594	194.5	97.1	1.7
Lung cancer	1	471 546	63.6	41.8	1	73 009	44.6	21.9	1.9
Liver cancer	2	288 127	38.8	26.1	5	20 575	12.6	6.8	3.8
Gastric cancer	3	256 512	34.6	22.8	13	6 847	4.2	2.2	10.4
Esophageal cancer	4	206 780	27.9	18.3	8	13 035	8.0	4.2	4.4
Colorectal cancer	5	164 959	22.2	14.8	3	28 899	17.6	9.4	1.6
Pancreatic cancer	6	67 882	9.1	6.0	4	24 933	15.2	7.7	0.8
Prostate cancer	7	51 094	6.9	4.6	2	32 438	19.8	8.2	0.6
Leukemia	8	35 664	4.8	3.8	6	13 859	8.5	4.1	0.9
CNA	9	33 658	4.5	3.3	10	10 230	6.2	3.8	0.9
Non-Hodgkin’s lymphoma	10	29 721	4.0	2.8	9	12 075	7.4	3.5	0.8

Type	China				US				ASMR ratio (China vs US)
	Incidence
	Rank	Number	Crude rate (1/10⁵)	ASMR (1/10⁵)	Rank	Number	Crude rate (1/10⁵)	ASMR (1/10⁵)
Total	-	2 082 385	295.2	187.3	-	866 471	518.2	290.4	0.6
Breast cancer	1	416 371	59.0	39.1	1	253 465	151.6	90.3	0.4
Lung cancer	2	276 382	39.2	22.8	2	111 540	66.7	30.4	0.8
Colorectal cancer	3	235 991	33.5	19.5	3	73 354	43.9	22.9	0.9
Thyroid cancer	4	167 704	23.8	17.5	6	38 561	23.1	17.4	1.0
Gastric cancer	5	146 879	20.8	12.3	17	10 315	6.2	3.1	4.0
Cervical cancer	6	109 741	15.6	10.7	14	13 545	8.1	6.2	1.7
Liver cancer	7	107 440	15.2	9.0	15	12 571	7.5	3.7	2.4
Esophageal cancer	8	101 378	14.4	8.2	20	3 925	2.3	1.1	7.5
Cervical cancer	9	81 964	11.6	7.6	11	23 820	14.2	8.1	0.9
Pancreatic cancer	10	55 342	7.8	5.3	8	26 798	16.0	7.0	0.8
Type	China				US				ASMR ratio (China vs US)
	Mortality
	Rank	Number	Crude rate (1/10⁵)	ASMR (1/10⁵)	Rank	Number	Crude rate (1/10⁵)	ASMR (1/10⁵)
Total	-	1 178 275	167.0	97.7	-	289 042	172.9	76.6	1.3
Lung cancer	1	243 153	34.5	19.7	1	65 216	39.0	16.4	1.2
Colorectal cancer	2	121 203	17.2	9.4	3	25 544	15.3	6.7	1.4
Gastric cancer	3	117 277	16.6	9.5	15	4 566	2.7	1.3	7.3
Breast cancer	4	117 174	16.6	10.0	2	42 617	25.5	12.4	0.8
Liver cancer	5	103 025	14.6	8.6	7	10 503	6.3	2.8	3.1
Esophageal cancer	6	94 355	13.4	7.4	16	3 174	1.9	0.8	9.0
Cervical cancer	7	59 060	8.4	5.3	12	5 706	3.4	2.1	2.5
Pancreatic cancer	8	53 971	7.7	4.2	4	22 750	13.6	5.6	0.8
Ovary cancer	9	37 519	5.3	3.3	5	14 359	8.6	4.0	0.8
CNS	10	31 546	4.5	3.0	10	7 903	4.7	2.6	1.2

2023年美国癌症数据解读及对中国癌症防治的启示

Interpretation of US cancer statistics 2023 and its implications for cancer prevention and treatment in China

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