Cancer Statistics, 2017
Cancer Statistics, 2017
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DOI：
10.3322/caac.21772
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发表时间：
2017-01-01
影响因子：
254.7
通讯作者：
Jemal, Ahmedin
中科院分区：
文献类型：
--
作者：
Siegel, Rebecca L.;Miller, Kimberly D.;Jemal, Ahmedin
结直肠癌(CRC)是美国癌症死亡的第二大常见原因。每三年，美国癌症协会都会根据人口癌症登记的发病率和国家卫生统计中心的死亡率提供最新的CRC统计数据。到2023年，约有153,020人将被诊断患有结直肠癌，52,550人将死于这种疾病，其中19,550人将死于50岁以下的人，3750人将死于此病。CRC发病率从本世纪头十年的每年3%-4%下降到2011-2019年的每年1%，部分原因是自20世纪90年代中期以来，55岁以下的人口以每年1%-2%的速度增长。因此，55岁以下人群中的病例比例从1995年的11%增加到2019年的20%。自2010年左右以来，65岁以下人群中地区性疾病的发病率每年增加约2%-3%，远期疾病的发病率每年增加0.5%-3%，扭转了1995至2005年间向早期诊断的整体转变。例如，2019年所有新病例中有60%是晚期病例，而在2000年代中期和1995年，在广泛筛查之前，这一比例分别为52%和57%。也有向左侧肿瘤转移的趋势，直肠癌的比例从1995年的27%上升到2019年的31%。从2011年到2020年，CRC死亡率总体上每年下降2%，但在50岁以下的个人和65岁以下的美洲原住民中，死亡率每年上升0.5%-3%。总而言之，尽管总体上持续下降，但结直肠癌正在迅速转向年轻、更晚期和左半结肠/直肠的诊断。通过揭示1950年以来出生的几代人发病率上升的原因，并在所有人口，特别是美洲原住民中增加获得高质量筛查和治疗的机会，可以加快抗击CRC的进展。美国癌症协会每年估计本年度美国将发生的新癌症病例和死亡人数，并汇编关于癌症发病率、死亡率和存活率的最新数据。发病率数据由监测、流行病学和最终结果计划、国家癌症登记计划和北美中央癌症登记协会收集。死亡率数据由国家卫生统计中心收集。2017年，美国预计将新增1,688,780例癌症病例和600,920例癌症死亡病例。所有地点加在一起，男性的癌症发病率比女性高20%，而癌症死亡率则高出40%。然而，癌症类型不同，性别差异也不同。例如，女性的甲状腺癌发病率是男性的3倍(每10万人中有21人对7人)，尽管死亡率相同(每10万人中有0.5人死亡)，这在很大程度上反映了诊断流行中的性别差异。在过去十年的现有数据中，女性的总体癌症发病率(2004-2013年)保持稳定，男性的癌症发病率每年下降约2%，而男性和女性的癌症死亡率(2005-2014年)每年下降约1.5%。从1991年到2014年，总体癌症死亡率下降了25%，也就是说，如果死亡率保持在峰值，癌症死亡人数将比预期的少约2143,200人。尽管2014年黑人的癌症死亡率比白人高出15%，但《患者保护和平价医疗法案》增加了获得医疗服务的机会，可能会加速缩小种族差距；从2010年到2015年，没有保险的黑人比例减半，从21%降至11%，西班牙裔也是如此(31%至16%)。传统上服务不足的美国人覆盖面的扩大将促进现有癌症控制知识在人口的各个部分得到更广泛的应用。《加州癌症杂志》2017年；67：7-30。(C)2017年美国癌症协会。
Colorectal cancer (CRC) is the second most common cause of cancer death in the United States. Every 3 years, the American Cancer Society provides an update of CRC statistics based on incidence from population-based cancer registries and mortality from the National Center for Health Statistics. In 2023, approximately 153,020 individuals will be diagnosed with CRC and 52,550 will die from the disease, including 19,550 cases and 3750 deaths in individuals younger than 50 years. The decline in CRC incidence slowed from 3%-4% annually during the 2000s to 1% annually during 2011-2019, driven partly by an increase in individuals younger than 55 years of 1%-2% annually since the mid-1990s. Consequently, the proportion of cases among those younger than 55 years increased from 11% in 1995 to 20% in 2019. Incidence since circa 2010 increased in those younger than 65 years for regional-stage disease by about 2%-3% annually and for distant-stage disease by 0.5%-3% annually, reversing the overall shift to earlier stage diagnosis that occurred during 1995 through 2005. For example, 60% of all new cases were advanced in 2019 versus 52% in the mid-2000s and 57% in 1995, before widespread screening. There is also a shift to left-sided tumors, with the proportion of rectal cancer increasing from 27% in 1995 to 31% in 2019. CRC mortality declined by 2% annually from 2011-2020 overall but increased by 0.5%-3% annually in individuals younger than 50 years and in Native Americans younger than 65 years. In summary, despite continued overall declines, CRC is rapidly shifting to diagnosis at a younger age, at a more advanced stage, and in the left colon/rectum. Progress against CRC could be accelerated by uncovering the etiology of rising incidence in generations born since 1950 and increasing access to high-quality screening and treatment among all populations, especially Native Americans.Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data 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 were collected by the National Center for Health Statistics. In 2017, 1,688,780 new cancer cases and 600,920 cancer deaths are projected to occur in the United States. For all sites combined, the cancer incidence rate is 20% higher in men than in women, while the cancer death rate is 40% higher. However, sex disparities vary by cancer type. For example, thyroid cancer incidence rates are 3-fold higher in women than in men (21 vs 7 per 100,000 population), despite equivalent death rates (0.5 per 100,000 population), largely reflecting sex differences in the epidemic of diagnosis. Over the past decade of available data, the overall cancer incidence rate (2004-2013) was stable in women and declined by approximately 2% annually in men, while the cancer death rate (2005-2014) declined by about 1.5% annually in both men and women. From 1991 to 2014, the overall cancer death rate dropped 25%, translating to approximately 2,143,200 fewer cancer deaths than would have been expected if death rates had remained at their peak. Although the cancer death rate was 15% higher in blacks than in whites in 2014, increasing access to care as a result of the Patient Protection and Affordable Care Act may expedite the narrowing racial gap; from 2010 to 2015, the proportion of blacks who were uninsured halved, from 21% to 11%, as it did for Hispanics (31% to 16%). Gains in coverage for traditionally underserved Americans will facilitate the broader application of existing cancer control knowledge across every segment of the population. CA Cancer J Clin 2017;67:7-30. (c) 2017 American Cancer Society.