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Cancer Statistics, 2021.
文献信息
| DOI | 10.3322/caac.21654 |
|---|---|
| PMID | 33433946 |
| 期刊 | CA: a cancer journal for clinicians |
| 影响因子 | 232.4 |
| JCR 分区 | Q1 |
| 发表年份 | 2021 |
| 被引次数 | 9449 |
| 关键词 | 癌症病例,癌症统计,死亡率,发病率,死亡率 |
| 文献类型 | Journal Article, Research Support, Non-U.S. Gov't |
| ISSN | 0007-9235 |
| 页码 | 7-33 |
| 期号 | 71(1) |
| 作者 | Rebecca L Siegel, Kimberly D Miller, Hannah E Fuchs, Ahmedin Jemal |
一句话小结
根据美国癌症协会的数据,预计2021年美国将有约190万新癌症病例和60万癌症死亡病例,自1991年癌症死亡率已连续下降31%。这一趋势主要归因于吸烟率降低和早期检测与治疗的改善,尽管前列腺癌、乳腺癌和结直肠癌的死亡率下降速度放缓,但肺癌死亡率的下降加速,反映了治疗效果的显著提升。
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摘要
每年,美国癌症协会估计美国的新癌症病例和死亡人数,并汇编关于基于人群的癌症发生的最新数据。发病率数据(截至2017年)由监测、流行病学和最终结果项目、国家癌症登记计划以及北美中央癌症登记协会收集;死亡率数据(截至2018年)由国家健康统计中心收集。预计到2021年,美国将发生1,898,160例新癌症病例和608,570例癌症死亡病例。在20世纪的大部分时间里,癌症死亡率持续上升,但自1991年达到峰值以来,到2018年,癌症死亡率已连续下降,总下降幅度为31%,这主要得益于吸烟率的降低以及早期检测和治疗的改善。这意味着比如果峰值持续存在,癌症死亡人数将减少320万。前四种主要癌症的长期死亡率下降已停止,前列腺癌的下降停滞,乳腺癌和结直肠癌的下降速度减缓,但肺癌的下降速度加快,从2014年到2018年,肺癌几乎占总死亡率下降的一半。肺癌死亡率的年下降速度在2009年至2013年间为3.1%,而在2014年至2018年间则加倍至5.5%;女性则从1.8%上升到4.4%;总体上,从2.4%上升到5%。这一趋势与发病率的稳定下降(2.2%-2.3%)相对应,但非小细胞肺癌(NSCLC)的生存率迅速提高。例如,2009年至2010年间被诊断的非小细胞肺癌患者的两年相对生存率从34%提高到2015年至2016年的42%,每个诊断阶段的绝对生存率均增加了5%至6%;小细胞肺癌的生存率则维持在14%至15%。治疗的改善加速了对肺癌的进展,并推动了整体癌症死亡率的创纪录下降,尽管其他常见癌症的下降势头减缓。
英文摘要
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence. Incidence data (through 2017) were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2018) were collected by the National Center for Health Statistics. In 2021, 1,898,160 new cancer cases and 608,570 cancer deaths are projected to occur in the United States. After increasing for most of the 20th century, the cancer death rate has fallen continuously from its peak in 1991 through 2018, for a total decline of 31%, because of reductions in smoking and improvements in early detection and treatment. This translates to 3.2 million fewer cancer deaths than would have occurred if peak rates had persisted. Long-term declines in mortality for the 4 leading cancers have halted for prostate cancer and slowed for breast and colorectal cancers, but accelerated for lung cancer, which accounted for almost one-half of the total mortality decline from 2014 to 2018. The pace of the annual decline in lung cancer mortality doubled from 3.1% during 2009 through 2013 to 5.5% during 2014 through 2018 in men, from 1.8% to 4.4% in women, and from 2.4% to 5% overall. This trend coincides with steady declines in incidence (2.2%-2.3%) but rapid gains in survival specifically for nonsmall cell lung cancer (NSCLC). For example, NSCLC 2-year relative survival increased from 34% for persons diagnosed during 2009 through 2010 to 42% during 2015 through 2016, including absolute increases of 5% to 6% for every stage of diagnosis; survival for small cell lung cancer remained at 14% to 15%. Improved treatment accelerated progress against lung cancer and drove a record drop in overall cancer mortality, despite slowing momentum for other common cancers.
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主要研究问题
- 在癌症统计数据中,哪些因素导致了肺癌死亡率的显著下降?
- 除了肺癌外,其他主要癌症的死亡率变化趋势如何?
- 早期检测和治疗的进步在不同类型癌症中的具体影响是什么?
- 对于前列腺癌、乳腺癌和结直肠癌,死亡率停滞的原因可能是什么?
- 在未来的癌症统计中,如何预测不同类型癌症的发生率和死亡率变化?
核心洞察
研究背景和目的
本研究由美国癌症学会发起,每年对美国的新癌症病例和死亡人数进行统计和估算。其主要目的是通过收集和分析最新的癌症发生数据,揭示癌症流行趋势,为公共健康策略和癌症预防、早期发现及治疗提供依据。主要方法和发现
研究使用了来自多个权威机构的数据,包括监测、流行病学和最终结果项目(SEER)、国家癌症登记项目及北美中心癌症登记协会。2021年预计在美国将发生1,898,160例新癌症病例和608,570例癌症死亡。自1991年癌症死亡率达到峰值以来,死亡率持续下降,至2018年总下降幅度达到31%。这一下降主要归因于吸烟率的降低及早期检测和治疗的改进。尽管四种主要癌症的死亡率长期下降但已停滞,前列腺癌的死亡率停止下降,乳腺癌和结直肠癌的下降速度减缓,而肺癌的死亡率下降加速,从2014年至2018年几乎占到总体死亡下降的一半。肺癌死亡率的年均下降速度在不同性别上均有显著提升,男性从3.1%提升至5.5%,女性从1.8%提升至4.4%。此外,非小细胞肺癌(NSCLC)的两年相对生存率从2009-2010年的34%提升至2015-2016年的42%。核心结论
研究表明,尽管肺癌的死亡率下降速度加快且生存率显著提高,但其他常见癌症的死亡率下降势头减缓。同时,改善的治疗手段推动了肺癌的早期诊断和治疗效果,显著降低了整体癌症死亡率,反映了公共健康措施在癌症控制中的重要性。研究意义和影响
本研究不仅提供了关于美国癌症流行现状的详尽数据,也为未来的癌症防治策略提供了重要参考。通过识别不同癌症的趋势及其背后的驱动因素,研究强调了提高公众健康意识和加强早期检测、治疗的重要性。同时,肺癌的成功治疗案例为其他癌症的管理提供了可借鉴的模式,鼓励科研和临床实践的进一步创新。
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