ASCO-2020全球癌症统计报告：癌症跃居中国死因第一（英文）-2021.2-13页_926kb

Cancer Statistics, 2020: Report From National Cancer Registry Programme, India

Core Content

This report presents cancer statistics for India based on data from 28 population-based cancer registries (PBCRs) and 58 hospital-based cancer registries (HBCRs) for the period 2012-2016. The study highlights the incidence, mortality, trends, and projections of cancer in India, along with the stage at presentation and treatment received by patients.

Main Points

Purpose

• The National Cancer Registry Programme (NCRP) under the Indian Council of Medical Research (ICMR) has been systematically collecting cancer data since 1982.
• The study aims to assess the status and trends of cancer in India to support cancer prevention and control efforts.

Methods

• Data from 28 PBCRs and 58 HBCRs were analyzed, with a total of 667,666 patients.
• Time trends in cancer incidence rates were calculated using Joinpoint regression for 16 PBCRs with at least 10 years of continuous good data.
• Data was standardized and quality-controlled using IACR/IARC norms.
• The incidence rate, age-adjusted rate (AAR), crude rate (CR), cumulative risk, and mortality-to-incidence ratio (M:1%) were calculated.

Key Findings

• Incidence Rates:
  • Aizawl district had the highest AAR for males (269.4).
  • Papumpare district had the highest AAR for females (219.8).
  • The projected number of cancer patients in India for 2020 is 1,392,179, with the top 5 sites being breast, lung, mouth, cervix uteri, and tongue.
• Trends:
  • All cancer sites showed an increase in incidence rates in both sexes.
  • Kamrup urban had a significant annual percent change (APC) of 3.8% (P < .05).
• Stage at Presentation:
  • Most patients were diagnosed at locally advanced/locoregional stages.
  • Lung cancer had a high proportion of distant metastasis (44.0% in males and 47.6% in females).
• Treatment:
  • Multimodality treatment was the most common, especially for locoregional and localized cancers.
  • Treatment data was collected from HBCRs, with 58 registries contributing.

Projections

• Projected Incidence for 2020:
  • Males: 679,421 (94.1 per 100,000).
  • Females: 712,758 (103.6 per 100,000).
  • Combined: 1,392,179 (98.7 per 100,000).
• Cumulative Risk:
  • One in 68 males (lung cancer) and one in 29 females (breast cancer) are expected to develop cancer during their lifetime.
  • Overall, one in 9 Indians will develop cancer in their lifetime.

Key Information

Regional Variations

• North: Delhi and Patiala had the highest incidence rates.
• South: Hyderabad, Kollam, and Thiruvananthapuram had notable incidence and mortality rates.
• East: Kolkata showed a moderate incidence rate.
• West: Ahmedabad urban and Mumbai had higher incidence rates.
• Central: Wardha and Bhopal had lower incidence rates.
• Northeast (NE):
  • Aizawl district had the highest AAR for males (269.4) and mortality rate (152.7).
  • Papumpare district had the highest AAR for females (219.8).
  • NE had the highest incidence rate compared to other regions.
  • Common cancer sites in NE: nasopharynx, hypopharynx, esophagus, stomach, liver, gallbladder, larynx, lung, breast, and cervix uteri.
  • The NE region has limited infrastructure for specialized cancer treatment, leading to lower survival rates.

Tobacco-Related Cancers

• Males: 70.4% of cancers were associated with tobacco use.
• Females: 46.5% of cancers were linked to tobacco.
• Highest Proportions: NE region had the highest proportion of tobacco-related cancers, followed by West and Central regions.

Cancer Burden

• Most Common Cancers in Males: Lung, mouth, esophagus, and stomach.
• Most Common Cancers in Females: Breast, cervix uteri, ovary, corpus uteri, and lung.
• Thyroid Cancer: Increasing incidence in females, particularly in Thiruvananthapuram and Kollam districts in Kerala.

Quality Metrics

• Microscopic Verification (MV%): Ranged from 77% to 96.7%.
• Death Certificate Only (DCO%): Ranged from <0.05% to 19.4%.
• Other and Unspecified Sites (O&U%): Ranged from 1.8% to 13.0%.
• Mortality-to-Incidence Ratio (M:1%): High in Barshi rural (67.2%), followed by Wardha (59.2%) and Mumbai (56.0%).

Conclusion

This study provides a comprehensive framework for understanding the status and trends of cancer in India. It emphasizes the need for targeted public health actions to address the rising cancer burden, particularly in regions with high incidence rates and limited treatment infrastructure. The findings will guide efforts to improve cancer prevention and control, aligning with national noncommunicable disease targets and the sustainable development goals.