摘要目的 分析全国肿瘤登记中心收集的全国各登记处上报的2008—2012年恶性肿瘤的登记资料,估计全国女性乳腺癌的发病和死亡情况.方法 全国肿瘤登记中心共纳入135个登记处上报的数据,纳入登记处至少包括2010—2012年的数据.将入选的登记处按地区(城乡以及东、中、西部)和年龄别的发病率和死亡率分层,估计全国女性乳腺癌的发病和死亡情况.中国人口标化率(中标率)采用2000年全国人口普查的标准人口年龄构成,世界人口标化率(世标率)采用Segi′s标准人口年龄构成.结果 2008—2012年共纳入登记处135个,覆盖登记人口629 333 910人年(其中城市382 669 450人年,农村246 664 460人年).估计全国2008—2012年新发女性乳腺癌13.3万例,死亡3.2万例.女性乳腺癌的发病率为42.67／10万,世标率为28.87／10万;城市( 51.85／10万)高于农村(28.29／10万);东部地区(46.35／10万)高于西部(27.60／10万)和中部地区(36.38／10万).年龄别发病率随年龄的增长而升高,55～59岁组达到高峰(96.36／10万),60岁后开始下降. 2003—2012年女性乳腺癌的中标发病率增长明显,2012年比2003年增长了30.56%;农村地区增长幅度(72.32%)高于城市地区(23.48%).女性乳腺癌的死亡率为10.36／10万,世标率为6.61／10万.城市女性乳腺癌的死亡率(11.64／10万)高于农村(8.36／10万);东部地区(10.81／10万)高于西部( 9.90／10万)和中部地区(7.38／10万).年龄别死亡率随年龄的增长而升高,85岁以上年龄组最高(61.25／10万).2003—2012年间中标死亡率变化不大,2012年比2003年增长了6.23%;增长以农村为主(54.94%),城市地区2012年比2003年下降了2.32%.结论 尽管从世界范围看,中国女性乳腺癌的发病和死亡水平很低,但女性乳腺癌已经成为我国女性恶性肿瘤发病第1位、死亡第6位的恶性肿瘤.全国乳腺癌城乡负担差异明显,今后应根据各地区情况制订相应有效的肿瘤防控策略.

abstractsObjective The registration data of local cancer registries from 2008 to 2012 were collected by National Central Cancer Registry to estimate the incidence and mortality of female breast cancer in China. Methods Data from 135 registries were qualified and selected in the final analysis, and each registry at least has submitted data from 2010 to 2012.Cancer incidence and mortality analyses were stratified by area ( urban／rural, eastern／middle／western areas ) and age group. The age composition of standard population of Chinese census in 2000 and Segi′s population were used for age?standardized incidence and mortality in China and worldwide, respectively. Results A total of 135 registries were recruited in the analysis, covering 629 333 910 person?years (382 669 450 in urban and 246 664 460 in rural). About 13, 258 cases of female breast cancer were diagnosed and 32 205 cases were dead between 2008 and 2012. Female breast cancer incidence was 42.67／100, 000 and age?standardized rate calculated by worldwide standard population was 28.87／100,000.The crude incidence of urban area was 51.85／100,000, higher than 28.29／100,000 of rural area, and the crude incidence of eastern area was 46.35／100,000, higher than 36.38／100,000 of middle area and 27.60／100,000 of western area. The age?specific incidence increased with age and reached the peak at age 55?59 ( 96.36／100, 000 ), and declined at age 60. The age?standardized incidence rate by Chinese standard population increased 30.56% from 2003 to 2012. The increase rate of rural area was 72.32%, faster than 23.48% of urban area. Female breast cancer mortality was 10.36／100,000 and the age?standardized rate calculated by worldwide standard population was 6.61／100,000. The crude mortality of urban area was 11.64／100,000, higher than 8.36／100,000 of rural area, and the crude mortality of eastern area was 10.81／100,000, higher than 7.38／100,000 of middle area and 9.90／100,000 of western area. The age?specific incidence increased with age and reached the peak at age above 85 ( 61.25／100, 000). Age?standardized incidence rate by Chinese standard population remained stable during the period of 2003?2012 (6.23%). The mortality rate mainly increased in rural area (54.94%), while decreased 2.32% in urban area over the 10 years. Conclusions Although the incidence and mortality of breast cancer in China are comparatively low worldwide, in China the incidence and mortality of female breast cancer have rose to the first and sixth place respectively among all the female cancers. The disease burden of breast cancer is very different between urban and rural area. Therefore, the targeted measure and strategy of control and prevention according to the area difference are needed.