5、消化系统肿瘤消化系统肿瘤 (1).pdf
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1、CA CANCER J CLIN 2021;0:1411VOLUME 0|NUMBER 0|MONTH 2021Abstract:This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer.Worldwide,an estimated 19.3 million new cancer
2、cases(18.1 million excluding nonmelanoma skin cancer)and almost 10.0 million cancer deaths(9.9 million excluding nonmelanoma skin cancer)occurred in 2020.Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer,with an estimated 2.3 million new cases(11.7%),followed by lu
3、ng(11.4%),colorectal(10.0%),prostate(7.3%),and stomach(5.6%)cancers.Lung can-cer remained the leading cause of cancer death,with an estimated 1.8 million deaths(18%),followed by colorectal(9.4%),liver(8.3%),stomach(7.7%),and female breast(6.9%)cancers.Overall incidence was from 2-fold to 3-fold high
4、er in transitioned ver-sus transitioning countries for both sexes,whereas mortality varied 2-fold for men and little for women.Death rates for female breast and cervical cancers,however,were considerably higher in transitioning versus transitioned countries(15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 p
5、er 100,000,respectively).The global cancer burden is expected to be 28.4 million cases in 2040,a 47%rise from 2020,with a larger increase in transitioning(64%to 95%)versus transitioned(32%to 56%)countries due to demographic changes,although this may be further exacerbated by increasing risk factors
6、associated with globalization and a growing economy.Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.CA Cancer J Clin 2021;0:1-41.2021 American Cancer Societ
7、y.Keywords:burden,cancer,epidemiology,incidence,mortalityIntroductionCancer ranks as a leading cause of death and an important barrier to increasing life expectancy in every country of the world.1 According to estimates from the World Health Organization(WHO)in 2019,2 cancer is the first or second l
8、eading cause of death before the age of 70 years in 112 of 183 countries and ranks third or fourth in a further 23 countries(Fig.1).Cancers rising prominence as a leading cause of death partly reflects marked declines in mortality rates of stroke and coronary heart disease,relative to cancer,in many
9、 countries.1Overall,the burden of cancer incidence and mortality is rapidly growing world-wide;this reflects both aging and growth of the population as well as changes in the prevalence and distribution of the main risk factors for cancer,several of which are associated with socioeconomic developmen
10、t.3,4 The extent to which the position of cancer as a cause of premature death reflects national levels of social and economic development can be seen by comparing the maps in Figure 1 and Figure 2A,the latter depicting the 4-tier Human Development Index(HDI)based on the United Nations 2019 Human De
11、velopment Report.5In this article,we examine the cancer burden worldwide in 2020 based on the GLOBOCAN estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer.6 The estimates provided herein do Global Cancer Statistics 2020:GLOBOCAN Estimates of Incide
12、nce and Mortality Worldwide for 36 Cancers in 185 CountriesHyuna Sung,PhD1;Jacques Ferlay,MSc,ME2;Rebecca L.Siegel,MPH1;Mathieu Laversanne,MSc2;Isabelle Soerjomataram,MD,MSc,PhD2;Ahmedin Jemal,DMV,PhD1;Freddie Bray,BSc,MSc,PhD21 Surveillance and Health Equity Science,American Cancer Society,Atlanta,
13、Georgia;2 Section of Cancer Surveillance,International Agency for Research on Cancer,Lyon,France.Additional supporting information may be found online in the Supporting Information section at the end of the article.Corresponding Author:Freddie Bray,BSc,MSc,PhD,Section of Cancer Surveillance,Internat
14、ional Agency for Research on Cancer,150,cours Albert Thomas,F-69372 Lyon Cedex 08,France(brayfiarc.fr).DISCLOSURES:Hyuna Sung,Rebecca L.Siegel,and Ahmedin Jemal are employed by the American Cancer Society,which receives grants from private and corporate foundations,including foundations associated w
15、ith companies in the health sector for research outside of the submitted work.They are not funded by or key personnel for any of these grants,and their salary is solely funded through American Cancer Society funds.The remaining authors report no conflicts of interest.Where authors are identified as
16、personnel of the International Agency for Research on Cancer/World Health Organization,the authors alone are responsible for the views expressed in this article,and they do not necessarily represent the decisions,policy,or views of the International Agency for Research on Cancer/World Health Organiz
17、ation.doi:10.3322/caac.21660.Available online at Global Cancer Statistics 20202CA:A Cancer Journal for Cliniciansnot reflect the impact of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the virus responsible for coronavirus disease 2019(COVID-19),7,8 as they are based on extrapolations
18、of cancer data collected in earlier years be-fore the pandemic.Although the full extent of the impact of the COVID-19 pandemic in different world regions is cur-rently unknown,delays in diagnosis and treatment associ-ated with the concerns of individuals,health system closures,including suspension o
19、f screening programs,and reduced availability of and access to care are expected to cause a short-term decline in cancer incidence followed by increases in advanced-stage diagnoses and cancer mortality in some settings.9-13As with previous reports,14-17 the primary focus is on a description of the c
20、ancer incidence and mortality at the global level and an assessment of the geographic variabil-ity observed across 20 predefined world regions(Fig.2B).We describe the magnitude and distribution of the disease overall and for the major cancer types in 2020,commenting briefly on the associated risk fa
21、ctors and prospects for pre-vention of the major cancers observed worldwide,and end-ing with a prediction of the magnitude of the disease in 2040 on the basis of global demographic projections.Data Sources and MethodsThe sources and methods used in compiling the GLOBOCAN estimates for 2020 are descr
22、ibed online at the Global Cancer Observatory(GCO)(gco.iarc.fr).18 The GCO website includes facilities for the tabulation and graphic visualization of the GLOBOCAN database for 185 countries and 36 cancers(as well as all cancers combined),by age and sex.The profile of cancer,globally and by world reg
23、ion,is built up using the best available sources of can-cer incidence and mortality data within a given country.Therefore,the validity of the national estimates depends on the degree of representativeness and quality of the source in-formation.The methods used to compile the 2020 estimates are large
24、ly based on those developed previously,with an em-phasis on the use of short-term predictions and the use of modelled mortality-to-incidence ratios,where applicable.19 The estimates are available in the GCO for 36 cancer types,based on codes from the International Statistical Classification of Disea
25、ses and Related Health Problems 10th Revision(ICD-10),including nonmelanoma skin cancer(NMSC)(C44,excluding basal cell carcinomas for incidence).19 Together with all cancers combined,cancer-specific estimates are provided for 185 countries or territo-ries worldwide by sex and by 18 age groups(ages 0
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