2021年湖南省肿瘤登记地区恶性肿瘤发病与死亡特征及2017—2021年变化趋势分析★

Cancer incidence and mortality in 2021 and its trend from 2017 to 2021 in Hunan cancer registration area★

摘要:

目的 估算湖南省肿瘤登记地区2021年恶性肿瘤的发病与死亡状况和2017—2021年的趋势变化。方法 依据2021年湖南省78个肿瘤登记地区上报的恶性肿瘤发病与死亡资料，按照城乡、男女性别分层计算湖南省恶性肿瘤的粗发病率、粗死亡率、中国人口标准化率（中标率）、世界人口标准化率（世标率）、年龄别率、0~74岁累积率等。中标率采用2000年全国人口普查的标准人口构成进行计算，世标率采用Segi's世界标准人口构成进行估算。结果 2021年湖南省肿瘤登记地区恶性肿瘤粗发病率330.05/10万，女性粗发病率314.07/10万，男性粗发病率345.12/10万，世标率199.10/10万，中标率205.10/10万，0~74岁累积率22.46%；农村地区恶性肿瘤粗发病率313.23/10万，女性粗发病率300.18/10万，男性粗发病率325.28/10万，世标率191.08/10万，中标率196.92/10万，0~74岁累积率21.64%；城市地区恶性肿瘤粗发病率382.14/10万，女性粗发病率355.18/10万，男性粗发病率409.36/10万，世标率222.91/10万，中标率229.40/10万，0~74岁累积率24.88 %。男性恶性肿瘤发病率排名前五位的依次是：肺癌、肝癌、结直肠肛门癌、胃癌、口腔癌；女性恶性肿瘤发病率排名前五位的依次是：乳腺癌、肺癌、子宫颈癌、甲状腺癌、结直肠癌。2021年湖南省肿瘤登记地区恶性肿瘤粗死亡率180.10/10万，中标率96.89/10万，世标率95.90/10万，0~74岁累积率11.16%，男性粗死亡率227.84/10万，女性粗死亡率129.50/10万；城市地区恶性肿瘤粗死亡率204.48/10万，中标率105.27/10万，世标率104.76/10万，0~74岁累积率11.72%，男性粗死亡率265.40/10万，女性粗死亡率144.14/10万；农村地区恶性肿瘤粗死亡率172.23/10万，中标率94.14/10万，世标率92.99/10万，0~74岁累积率10.97%，男性粗死亡率216.24/10万，女性粗死亡率124.55/10万。恶性肿瘤死亡率排名前五位的依次是：肺癌、肝癌、结直肠癌、胃癌、子宫颈癌。2017—2021年湖南省肿瘤登记地区恶性肿瘤死亡率、35~64岁截缩死亡率趋势变化有统计学意义（P<0.05），前者呈上升趋势，平均每年上升约4.3%，后者呈下降趋势，平均每年下降约3.3%。结论 湖南省发病率和死亡率较高的癌种为肺癌、女性乳腺癌、结直肠癌、子宫颈癌、肝癌、胃癌，应重点防范。除此之外，甲状腺癌上升到女性发病率的第四位，口腔癌位列男性发病率第五位，也应予以关注。

Abstract:

Objective To estimate the cancer incidence and mortality rates in Hunan cancer registration area in 2021and its trends from 2017 to 2021.Methods The data of cancer new cases and deaths were collected from 78 cancer registries in Hunan Province. After the data were stratified by area and gender, the crude incidence and mortality rate, age-standardized rate, age-specific rate, cumulative rate (0-74 years old) were calculated. Age-standardized rates were adjusted by Chinese standard population in 2000 and Segi's population (ASR China and ASR world).Results The crude cancer incidence rate in Hunan cancer registration area in 2021 was 330.05/10⁵ (males: 345.12/10?; females: 314.07/10?). The ASR China and ASR world were 205.10/10⁵ and 199.10/10⁵, respectively, with the cumulative incidence rate (0-74 years old) of 22.46%. In urban areas, the crude cancer incidence rate, ASR China, ASR world and the cumulative incidence rate (0-74 years old) were 382.14/10⁵, 229.40/10⁵, 222.91/10⁵ and 24.88%, respectively. The crude incidence rate in urban areas was 409.36/10⁵ in males and 355.18/10⁵ in females. In rural areas, the crude cancer incidence rate, ASR China, ASR world, and the cumulative incidence rate (0-74 years old) were 313.23/10⁵, 196.92/10⁵, 191.08/10⁵ and 21.64%, respectively. The crude incidence rate in rural areas was 325.28/10⁵ in males and 300.18/10⁵ in females. The 5 most common cancers in males were lung cancer, liver cancer,colorectal cancer, gastric cancer and oral cancer, while those in females were breast cancer, lung cancer, cervical cancer, thyroid cancer and colorectal cancer. The crude cancer mortality rate in Hunan cancer registration areas in 2021 was 180.10/10⁵. The ASR China and ASR world were 96.89/10⁵ and 95.90/10⁵,respectively, with the cumulative mortality rate (0-74 years old) of 11.16%. The crude mortality rate was 227.84/10⁵ in male and 129.50/10⁵ in female. In urban areas, the crude mortality rate, the ASR China and ASR world and the cumulative mortality rate (0-74 years old) were 204.48/10⁵, 105.27/10⁵, 104.76/10⁵ and 11.72%, respectively. The crude mortality rate in urban areas was 265.40/10⁵ in males and 144.14/10⁵ in females. In rural areas, the crude cancer mortality rate, ASR China and ASR world and the cumulative mortality rate (0-74 years old) were 172.23/10⁵, 94.14/10⁵, 92.99/10⁵ and 10.97%, respectively. The crude cancer mortality rate in rural areas was 216.24/10⁵ in males and 124.55/10⁵ in females. The 5 cancers with highest mortality in Hunan cancer registration areas were lung cancer, liver cancer, colorectal cancer, gastric cancer, and cervical cancer. The crude cancer mortality rate and the truncated mortality rate (35-64 years old) of cancer from 2017 to 2021 showed trend changes are statistically significant (P<0.05). The former shows an upward trend, with an average annual increase of 4.3%. The latter exhibits a downward trend, with an average annual decrease of 3.3%.Conclusion In Hunan Province, the cancer types with higher incidence and mortality rates include lung cancer, female breast cancer, colorectal cancer, cervical cancer, liver cancer, and gastric cancer, which should be the focus of prevention efforts. In addition to these, thyroid cancer has risen to the fourth place in the incidence rate among women, and oral cancer ranks fifth in the incidence rate among men, which also warrant attention.