中國和全球腫瘤發(fā)病率和死亡率解析培訓(xùn)課件

1、中國和全球腫瘤發(fā)病率和死亡率解析中國和全球腫瘤發(fā)病率和死亡率解析中國腫瘤發(fā)病率和死亡率總體情況中國腫瘤發(fā)病率和死亡率（按性別）中國腫瘤發(fā)病率和死亡率（按地域）中國腫瘤發(fā)病率和死亡率（按年齡）中國排名前十腫瘤病種的發(fā)病率和死亡率全球腫瘤發(fā)病率和死亡率具體情況目錄 CONTENTS2中國和全球腫瘤發(fā)病率和死亡率解析中國腫瘤發(fā)病率和死亡率總體情況目錄 CONTENTS2中國中國腫瘤發(fā)病率和死亡率總體情況總體腫瘤發(fā)病率和死亡率較高： 腫瘤發(fā)病率：每10萬人中有286人患癌；一生中有22%的概率患癌癥。 腫瘤死亡率：每10萬人有181人患癌死亡；一生中有13%的概率患癌死亡； 每分鐘就有6人被確診為癌癥

2、，平均每5位癌癥患者有3人死亡。3中國和全球腫瘤發(fā)病率和死亡率解析中國腫瘤發(fā)病率和死亡率總體情況總體腫瘤發(fā)病率和死亡率較高： 中國腫瘤發(fā)病率和死亡率（按性別）相比女性，男性癌癥發(fā)病率和死亡率都高： 腫瘤發(fā)病率：男女之比1.3:1；腫瘤死亡率：男女之比1.65:1。 一生中，男性患癌癥概率為26%，女性19% 一生中，男性因患癌死亡概率為17%，女性為9% 患癌人群中，因患癌而死亡的概率，男性(71%)比女性(54%)高4中國和全球腫瘤發(fā)病率和死亡率解析中國腫瘤發(fā)病率和死亡率（按性別）相比女性，男性癌癥發(fā)病率和死中國腫瘤發(fā)病率和死亡率（按地域）城市人口與農(nóng)村人口相比，癌癥發(fā)病率要略高，但一生中因

3、患癌癥死亡率要低： 腫瘤發(fā)病率：城市與農(nóng)村之比1.2:1；腫瘤死亡率：城市與農(nóng)村之比1.02:1 。 一生中，城市患癌癥概率為22.23%，農(nóng)村21.76%。 一生中，城市患癌死亡概率為12%，農(nóng)村為15%。 患癌人群中，因患癌而死亡的概率，城市人口(60%)比農(nóng)村人口(71%)低5中國和全球腫瘤發(fā)病率和死亡率解析中國腫瘤發(fā)病率和死亡率（按地域）城市人口與農(nóng)村人口相比，癌癥中國腫瘤發(fā)病率和死亡率（按年齡）腫瘤發(fā)病率隨人群年齡逐漸上升，特別是50歲以上隨年齡增加而大幅上升 50歲以上占全部發(fā)病的80%以上；80-85歲最高。6中國和全球腫瘤發(fā)病率和死亡率解析中國腫瘤發(fā)病率和死亡率（按年齡）腫瘤發(fā)

4、病率隨人群年齡逐漸上升中國腫瘤發(fā)病率和死亡率（按年齡）腫瘤死亡率隨人群年齡逐漸上升，特別是60歲以上隨年齡增加而大幅上升 60歲以上約占全部死亡的63%以上；85歲以上達到最高。7中國和全球腫瘤發(fā)病率和死亡率解析中國腫瘤發(fā)病率和死亡率（按年齡）腫瘤死亡率隨人群年齡逐漸上升中國排名前十腫瘤病種的發(fā)病率和死亡率（總體情況）發(fā)病率與死亡率最高的均是肺癌，排名前十病種的發(fā)病率占比76.39%。排名前十病種的死亡率占比84.27%.8中國和全球腫瘤發(fā)病率和死亡率解析中國排名前十腫瘤病種的發(fā)病率和死亡率（總體情況）發(fā)病率與死亡中國排名前十腫瘤病種的發(fā)病率（按性別）男性發(fā)病率最高的是肺癌，其次為胃癌、肝癌。

5、排名前十病種的發(fā)病率占比84.14%。女性發(fā)病率最高的是乳腺癌，其次為肺癌、結(jié)直腸癌。排名前十病種的發(fā)病率占比77.57%。9中國和全球腫瘤發(fā)病率和死亡率解析中國排名前十腫瘤病種的發(fā)病率（按性別）男性發(fā)病率最高的是肺癌中國排名前十腫瘤病種的死亡率（按性別）男性死亡率最高的是肺癌，其次為肝癌、胃癌。排名前十病種的死亡率占比88.33%。女性死亡率最高的是肺癌，其次為胃癌、肝癌。排名前十病種的死亡率占比81.12%。10中國和全球腫瘤發(fā)病率和死亡率解析中國排名前十腫瘤病種的死亡率（按性別）男性死亡率最高的是肺癌全球腫瘤發(fā)病率和死亡率具體情況11中國和全球腫瘤發(fā)病率和死亡率解析全球腫瘤發(fā)病率和死亡率

6、具體情況11中國和全球腫瘤發(fā)病率和死亡Worldwide1.1 : 11.26 : 1Total: 12,700,000Total: 7,600,00012中國和全球腫瘤發(fā)病率和死亡率解析Worldwide1.1 : 11.26 : 1ToDeveloped countries13中國和全球腫瘤發(fā)病率和死亡率解析Developed countries13中國和全球腫瘤發(fā)病Developing countries14中國和全球腫瘤發(fā)病率和死亡率解析Developing countries14中國和全球腫瘤發(fā)15中國和全球腫瘤發(fā)病率和死亡率解析15中國和全球腫瘤發(fā)病率和死亡率解析16中國和全球腫瘤

7、發(fā)病率和死亡率解析16中國和全球腫瘤發(fā)病率和死亡率解析17中國和全球腫瘤發(fā)病率和死亡率解析17中國和全球腫瘤發(fā)病率和死亡率解析It 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

8、an adverse effect on survival.18中國和全球腫瘤發(fā)病率和死亡率解析It should also be noted that c19中國和全球腫瘤發(fā)病率和死亡率解析19中國和全球腫瘤發(fā)病率和死亡率解析Selected CancersFemale Breast Cancer120中國和全球腫瘤發(fā)病率和死亡率解析Selected Cancers120中國和全球腫瘤發(fā)病Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females

9、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. 21中國和全球腫瘤發(fā)病率和死亡率解析Breast cancer is the most

10、freqIn 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.22中國和全球腫瘤發(fā)病率和死亡率解析In general, incidence rates arThe factors that contribute to

11、the international variation in incidence rates largely stem from differences in reproductive and hormonal factors and the availability of early detection services.23中國和全球腫瘤發(fā)病率和死亡率解析The factors that contribute toReproductive factors that increase risk12345long menstrual historyoral contraceptiveslate

12、 age at first birthnulliparityrecent use of postmenopausal hormone therapy24中國和全球腫瘤發(fā)病率和死亡率解析Reproductive factors that incrHow to reduce the risk of developing breast cancer?Maintaining a healthy body weightIncreasing physical activity Minimizing alcohol intake Early detection strategies include the

13、promotion of awareness of early signs and symptoms and screening by clinical breast examinationBest available strategies25中國和全球腫瘤發(fā)病率和死亡率解析How to reduce the risk of deveSelected CancersColorectal Cancer226中國和全球腫瘤發(fā)病率和死亡率解析Selected Cancers226中國和全球腫瘤發(fā)病Colorectal cancer is the 3rd most commonly diagnosed

14、 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 2008.27中國和全球腫瘤發(fā)病率和死亡率解析Colorectal cancer is the 3rd mThe highest incidence rates are found in Australia and New Zealand, Europe, and North America, whereas the lowest rate

15、s are found in Africa and South-Central Asia. Rates are substantiallyhigher in males than in females.28中國和全球腫瘤發(fā)病率和死亡率解析The highest incidence rates arTrends Risk FactorsRates continue to increase in countries with limited resources and health infrastructure, particularly in Eastern Europe and Eastern

16、 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 i

17、n 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%.29中國和全球腫瘤發(fā)病率和死亡率解析Trends Selected CancersLung Cancer330中國和全球腫瘤發(fā)病率和死亡率解析Selected Cancers330中國和全球腫瘤發(fā)病Lung cancer was the most commonly diagno

18、sed 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 2008.31中國和全球腫

19、瘤發(fā)病率和死亡率解析Lung cancer was the most commoIn 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, an

20、d Australia/New Zealand.32中國和全球腫瘤發(fā)病率和死亡率解析In males, the highest lung canSmoking accounts for 80% of the worldwide lung cancerburden in males and at least 50% of the burden in females.33中國和全球腫瘤發(fā)病率和死亡率解析Smoking accounts for 80% of thMale lung cancer death rates are decreasing in most Western countries

21、, 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

22、 recently and smoking prevalence continues to either increase or show signs of stability.34中國和全球腫瘤發(fā)病率和死亡率解析Male lung cancer death rates aby applying proven tobacco control interventions that include raising the price of cigarettes* and other tobacco products, banning smoking in public places, the re

23、striction of advertising of tobacco products, counter advertising, and treating tobacco dependence.avoid the burden of lung cancerBest strategy* a 10% increase in cigarette prices has been shown to reduce cigarette consumption by 3% to 5%.35中國和全球腫瘤發(fā)病率和死亡率解析by applying proven tobacco conSelected Canc

24、ersProstate Cancer436中國和全球腫瘤發(fā)病率和死亡率解析Selected Cancers436中國和全球腫瘤發(fā)病Prostate 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。37中

25、國和全球腫瘤發(fā)病率和死亡率解析Prostate cancer is the 2nd mosIncidence 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 Unite

26、d Kingdom, the UnitedStates, Italy in part because of the improved treatment with curative intent.38中國和全球腫瘤發(fā)病率和死亡率解析Incidence rates vary by more tthe only well-established risk factors Older age Race (black) Family historythere are no establishedpreventable risk factors for prostate cancer.39中國和全球腫瘤

27、發(fā)病率和死亡率解析the only well-established riskSelected CancersStomach Cancer540中國和全球腫瘤發(fā)病率和死亡率解析Selected Cancers540中國和全球腫瘤發(fā)病A 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 ca

28、ses and deaths occur in developing countries. Generally, stomach cancer rates are about twice as high in males as in females.41中國和全球腫瘤發(fā)病率和死亡率解析A total of 989,600 new stomachThe highest incidence rates are in Eastern Asia, Eastern Europe, and South America and the lowest rates are in North America an

29、d most parts of Africa.Regional variations in part reflect differences in dietary patterns, particularly in European countries, and the prevalence of Helicobacter pylori infection.42中國和全球腫瘤發(fā)病率和死亡率解析The highest incidence rates ar1234the increased use and availability of refrigeration including the in

30、creased availability of fresh fruits and vegetables, and a decreased reliance on salted and preserved foods.Rates have decreased due to(western countries):reductions in chronic H. pylori infection in most parts of the world.reductions in smoking in some parts of the developed world.In Japan, mortali

31、ty rates may have declined via the introduction of screening using photofluorography.43中國和全球腫瘤發(fā)病率和死亡率解析1234the increased use and avaiSelected CancersLiver Cancer644中國和全球腫瘤發(fā)病率和死亡率解析Selected Cancers644中國和全球腫瘤發(fā)病Liver cancer in men is the 5th most frequently diagnosed cancer worldwide but the 2nd most f

32、requent 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 2008.45中國和全球腫瘤發(fā)病率和死亡率解析Liver cancer in men is the 5thHalf of these cases and de

33、aths were estimated to occur in China. Globally, rates are more than twice as high in males as in females.46中國和全球腫瘤發(fā)病率和死亡率解析Half of these cases and deathsRisk factors accounting for liver cancer12345 chronic HBV/HCV infectionnonalcoholic fatty liver diseaseobesityalcohol-related cirrhosis aflatoxin

34、B1 (AFB) exposure47中國和全球腫瘤發(fā)病率和死亡率解析Risk factors accounting for liLiver 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 us

35、ers.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.48中國和全球腫瘤發(fā)病率和死亡率解析

36、Liver cancer incidence rates aintroduced 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 medicine

37、s 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 cancerBest strategy49中國和全球腫瘤發(fā)病率和死亡率解析introduced the HBV vaccine int50中國和全球腫瘤發(fā)病率和死亡率解析50中國和全球腫瘤發(fā)病

38、率和死亡率解析Selected CancersCervical Cancer751中國和全球腫瘤發(fā)病率和死亡率解析Selected Cancers751中國和全球腫瘤發(fā)病Cervical 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 cance

39、r 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.52中國和全球腫瘤發(fā)病率和死亡率解析Cervical cancer is the 3rd mosWorldwide, the highest incidence rat

40、es 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 populatio

41、ns is largely due to a lack of screening that allows detection of precancerous and early stage cervical cancer.53中國和全球腫瘤發(fā)病率和死亡率解析Worldwide, the highest incidenThe most efficient and cost-effective screening techniques in low-resource countries visual Inspection acetic acid/Lugols iodine HPV DNA test

42、ingA 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.54中國和全球腫瘤發(fā)病率和死亡率解析The most efficient and cost-efThe expectations that vaccine

43、s 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 vaccin

44、es 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 screenin

45、g 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 HPV55中國和全球腫瘤發(fā)病率和死亡率解析The expectations that vaccines中國和全球腫瘤發(fā)病率和死亡率解析培訓(xùn)課件Esophageal cancer usually occurs as either squamous cell carc

46、inoma in the middle or upper one-third of the esophagus, or as adenocarcinoma in the lower onethird or junction of the esophagus and stomach.57中國和全球腫瘤發(fā)病率和死亡率解析Esophageal cancer usually occuAn estimated 482,300 new esophageal cancer cases and 406,800 deaths occurred in 2008 worldwide. Incidence rates

47、 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.58中國和全球腫瘤

48、發(fā)病率和死亡率解析An estimated 482,300 new esophIn 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.Esophageal Cancer Belt59中國和全球腫瘤發(fā)病率和死亡率解析In the highest ri

49、sk area, stre Major risk factors (for squamous cell carcinomas) Poor nutritional statusLow 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 alcoh

50、ol consumption account for about 90% of the total cases of squamous cell carcinoma of the esophagus.60中國和全球腫瘤發(fā)病率和死亡率解析 Major risk factors (for sq Major risk factors (for adenocarcinoma) SmokingOverweight/ObesityChronic gastroesophagealreflux diseaseBarretts esophagus61中國和全球腫瘤發(fā)病率和死亡率解析 Major risk fac

51、tors (Incidence 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 i

52、n these same countries because of long-term reductions in tobacco use and alcoholconsumption.62中國和全球腫瘤發(fā)病率和死亡率解析Incidence rates for adenocarciSelected CancersBladder963中國和全球腫瘤發(fā)病率和死亡率解析Selected Cancers963中國和全球腫瘤發(fā)病An estimated 386,300 new cases and 150,200 deaths from bladder cancer occurred in 2008 wo

53、rldwide. 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 h

54、ighest 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.64中國和全球腫瘤發(fā)病率和死亡率解析An estimated 386,300 new casesSmoking is the major risk factors in Western countries, whereas chronic infection with Schistosoma h

55、ematobium in developing countries, particularly in Africa and the Middle East, accounts for about 50% of the total burden.65中國和全球腫瘤發(fā)病率和死亡率解析Smoking is the major risk factSelected CancersLip and Oral Cavity1066中國和全球腫瘤發(fā)病率和死亡率解析Selected Cancers1066中國和全球腫瘤發(fā)An 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 Amer