中國前列腺癌的發(fā)病情況

中國前列腺癌的發(fā)病情況2中國前列腺癌的發(fā)病情況PCincidenceindifferentareaofChinainthreetimeperiods2008Shanghai21/100,000Beijing14/100,000PCIncidenceinDifferentCitiesandAreas0.02.04.06.08.010.012.014.01988-19921993-19971998-2002YearsIncidence(1/10萬)北京市天津市上海市武漢市哈爾濱市磁縣啟東市嘉善縣扶綏縣長樂市林州市3中國前列腺癌的發(fā)病情況ProstateCancerIncidenceinChina0.001.002.003.004.005.006.00198819891990199119921993199419951996199719981999200020012002YearsIncidence(1/10萬)Incidenceadjusted4中國前列腺癌的發(fā)病情況中國前列腺癌的發(fā)病趨勢LM,etcChinJUrol;2009,20(6):368-370(per100,000)57.7%41.1%中國前列腺癌發(fā)病率逐年上升5中國前列腺癌的發(fā)病情況中國前列腺癌的發(fā)病率數(shù)據(jù)

（全國腫瘤登記，2005年）全國腫瘤登記地區(qū)2005年前列腺癌發(fā)病率為8.19/10萬，中國標化率為3.90/10萬。居男性所有惡性腫瘤第七位。2008中國腫瘤登記年報（ChineseCancerRegistryAnnualReport）-中國腫瘤登記地區(qū)2005年發(fā)病死亡.軍事醫(yī)學科學出版社，2009-9-16中國前列腺癌的發(fā)病情況上海2005年腫瘤統(tǒng)計資料男性

11,195女性

9,55420% 乳腺11% 肺、支氣管9% 結腸9% 胃5% 直腸5% 肝4% 卵巢 3% 中樞神經(jīng)系統(tǒng)3% 子宮體3% 胰腺肺、支氣管 21%胃 14%肝 10%結腸 8%前列腺 5%直腸 5%膀胱 4%胰腺 4% 食道 4%腎 3%上海市疾病預防控制中心7中國前列腺癌的發(fā)病情況上海前列腺癌標化發(fā)病率趨勢上海市疾病預防控制中心8中國前列腺癌的發(fā)病情況2003年全國各大城市的

前列腺癌發(fā)病率張思維,中國部分市縣2003年惡性腫瘤發(fā)病年度報告.中國腫瘤,2007,16(7).

一線城市發(fā)病率較高9中國前列腺癌的發(fā)病情況PCIncidenceinDifferentCountriesandAreas1993-19972000-201010中國前列腺癌的發(fā)病情況Theaveragelifespanincreasesto＞70yrsformale＞74yrsforfemale.

Thediagnostictechnologyimproved

PSA,BiopsytechniqueimprovedWesternizedfood.

ReasonsofPCIncidenceIncreased11中國前列腺癌的發(fā)病情況TypicalChineseDietLowanimalmeat,ParticularredmeatLowfat,particularmeatoriginHighsoyproductsHighvegetablesHighcarbohydrateHighfiberTeaasthemostcommondrink

12中國前列腺癌的發(fā)病情況PCandDietStrongcorrelationbetweenfatconsumptionandmorbidityandmortalityofPC.American,30%-40%ofcaloriesfromfat.Meatsaremainsourcesofdietaryfat.Chinese,only11.5%ofcaloriesfromfat5.3%ofdietaryfatfrommeats.MoreandmoremeatandfatconsumptioninChina13中國前列腺癌的發(fā)病情況ChangesofFoodConsumptioninChina

(1952v1997)02468101214GRAINCOOKINGOILREDMEATAQUATICFOODPOULTRYEGGS1952199714中國前列腺癌的發(fā)病情況PCDiagnosisinChina15中國前列腺癌的發(fā)病情況PSAng/mL PPVforcancer

0-1

2.8-5%

1-2.5

10.5-14%

2.5-4

22-30%

4-10

41%

>10

69%PSAvalueandriskofCaP＜4ng/ml18.1%PositiveDRE4-10ng/ml11.6%f/tPSA＞0.164-10ng/ml17.4%f/tPSA＜0.1610.1-20ng/ml26.2%＞20ng/ml61.7%DatafromEAUDatafromChina16中國前列腺癌的發(fā)病情況MoreandmoreearlystagePChavebeendetectedPCstagechanges17中國前列腺癌的發(fā)病情況024681012141618201981-19901991-20002001-2006No-PSAwithPSAPSAscreeningAveragenumberofRPperyearPCinasingleinstituteNewcases18中國前列腺癌的發(fā)病情況CUAGuidelineforPCPublishedin2006updatedin2007,2009GuidelineTraininginAlloverChinaToimprove:EarlydiagnosisReasonabletreatmentselectionsUnifytheopinions19中國前列腺癌的發(fā)病情況CUAGuidelineforPCRecommendation:PSAtestandDREforthosewhoare＞50yearsoldandseedoctorsforLUTSorotherurinarysymptoms.PCscreeninginChina

Impossibleforwholemalepopulation20中國前列腺癌的發(fā)病情況CUAGuidelineforPCBiopsyIndications:

PositiveDRE

PositiveUltrasoundorMRI

PSA＞10ng/ml

PSA4～10ng/mlwithf/tPSA＜1.6orPSAD＞0.1521中國前列腺癌的發(fā)病情況PCtreatmentinChina22中國前列腺癌的發(fā)病情況1980s:＜20%PCreceivedRP(localized)60-70%PCwithadvancedormetastasisdiseases2000s:20-40%PCundergoRP(localized)Around50%PCwithadvancedormetastasisdiseasesMorethan50%receivehormonaltherapyChangesofPCtreatmentoptionsPercentageofearlyPCisstilllow.PSAtestonlyforthosewhoareolderthan50yearsandseedoctorsforLUTSorotherurinarysymptoms.23中國前列腺癌的發(fā)病情況HormonalTherapy(＞50%):Inruralarea:＞80%surgicalcastrationInurbanarea:＞80%medicalcastrationRadicalProstatectomy(20～40%):Inruralarea: