美国癌症协会-2020美国国家癌症年度报告（英文）-2020.3-25页_1mb

报告摘要

Annual Report to the Nation on the Status of Cancer Summary

Core Content

This document presents the Annual Report to the Nation on the Status of Cancer, Part I, which provides an overview of cancer incidence and mortality trends in the United States from 2001 to 2017. It is a collaborative effort between the American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). The report highlights the progress made in reducing cancer incidence and mortality rates and identifies disparities across different demographic groups.

Main Findings

Cancer Incidence Trends (2012-2016)

Overall: Cancer incidence rates decreased by 0.6% annually.
Males:
- Incidence rates were stable overall (AAPC, -1.0%; P = 0.14).
- Rates were stable for 7 cancers (including prostate), decreased for 5 cancers (including lung and colorectal), and increased for 5 cancers (including liver and melanoma).
Females:
- Incidence rates increased by 0.2% annually (AAPC, 0.2%; P = 0.007).
- Rates increased for 8 cancers (including breast), were stable for 6 cancers (including colorectal), and decreased for 4 cancers (including lung and bladder).
Children (0-14 years):
- Incidence rates increased by 0.8% annually.
Adolescents and Young Adults (AYAs, 15-39 years):
- Incidence rates increased by 0.9% annually.

Cancer Mortality Trends (2013-2017)

Overall: Cancer death rates decreased by 1.5% annually.
Males:
- Death rates decreased by 1.8% annually.
- Decreases were observed for 11 of 19 most common cancers, including lung and colorectal.
Females:
- Death rates decreased by 1.4% annually.
- Decreases were observed for 14 of 20 most common cancers, including lung, colorectal, and breast.
Largest declines:
- Melanoma of the skin: 6.1% among males and 6.3% among females.
- Lung cancer: 4.8% among males and 3.7% among females.
Children (0-14 years):
- Mortality rates decreased by 1.4% annually.
AYAs (15-39 years):
- Mortality rates decreased by 1.0% annually.

Key Information

Data Sources

Incidence data: Collected from population-based cancer registries participating in the CDC's National Program of Cancer Registries (NPCR) and the NCI's Surveillance, Epidemiology, and End Results (SEER) Program.
Mortality data: Derived from the National Vital Statistics System (NVSS) and death certificates.
Population data: Used age-standardized estimates based on the 2000 US standard population.

Demographic Analysis

Sex: Trends varied between males and females.
Race/Ethnicity:
- Among males, incidence rates were stable for white males but decreased for black, API, AI/AN, and Hispanic males.
- Among females, incidence rates increased in all racial/ethnic groups.
Age Groups:
- Children (0-14 years): Incidence rates increased.
- AYAs (15-39 years): Incidence rates increased.
- All ages: Incidence rates decreased slightly for females but were stable for males.

Statistical Methods

Joinpoint regression was used to estimate trends.
Annual Percent Change (APC) and Average Annual Percent Change (AAPC) were calculated.
Confidence intervals (CIs) were used for statistical reliability.
Rates with fewer than 16 cases were considered unreliable and suppressed.

Conclusion

Overall Cancer Death Rates: Continued to decline, with the largest reductions observed in melanoma and lung cancer.
Cancer Incidence Trends: Incidence rates among males remained stable, while they increased slightly among females.
Disparities: Persistent racial/ethnic disparities in cancer incidence and mortality.
Importance of Early Detection: Early detection and treatment are critical for reducing cancer burden.
Public Health Implications: Population-based cancer data can inform strategies to reduce cancer incidence and mortality and monitor progress toward health goals.