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Breast cancer has become the cancer with the highest incidence, but the death caused by lung cancer is still more than the second and third places combined!
Abstract of this article
After two years, the ace article has returned again!
The champion changes hands, but lung cancer is still not to be underestimated!
China has attracted great attention, and the overall proportion has declined steadily!
The burden doubles, and cancer still depends on prevention!
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After two years, the ace article has returned again!
Figure 1.1 2020 edition of global cancer statistics released on World Cancer Day in 2021.
On February 4th, 2021, the ace article of CA Cancer J Clin came back again, giving a gift to World Cancer Day-Global Cancer Statistics 2020. Since the first release of global cancer statistics in 1999, it has been the sixth edition. The release interval of statistical reports has been shortened continuously, and the update after two years has set a record of update frequency. I am afraid it will not become a more annual column in the coming year!
Figure 1.2 Past five editions of global cancer statistics report
Based on the data of GLOBOCAN 2020, the 2020 edition of Global Cancer Statistics counts the incidence and mortality of 36 cancers in 185 countries around the world. The article was written by four authors from the International Agency for Research on Cancer (IARC) and three authors from the American Cancer Society (ACS), which brought us colorful pictures, detailed data and simple analysis … Next, let’s take a look at the important conclusions of the report!
Figure 1.3 Seven authors who co-wrote the report this year.
According to this latest report, there were 19.3 million newly diagnosed cancers in the world in 2020, which continued to rise compared with 18.1 million in 2018; Among them, the number of cancer deaths also stands at the tens of millions mark, which is expected to reach 10 million, which unexpectedly exceeds the data of 9.6 million in 2018. This means that one-fifth of men and one-sixth of women in the world will get cancer at some point in their lives, and one-eighth of men and one-eleventh of women will die of cancer, which is still the same as in 2018.
Figure 1.4 Cancer is one of the leading causes of death in most countries/regions in the world.
Among the countries/regions analyzed in the report, cancer deaths are the first or second cause of death in 112 countries/regions, an increase of 21 compared with 2018; The number of countries/regions occupying three or four places has also reached 23, an increase of one compared with 2018. In the report of 2018, cancer was the second cause of death in China, and in this year’s report, Chinese ranked cancer as the first cause of death.
Figure 1.5 Improvement of global socio-economic development level
Generally speaking, the burden of cancer incidence and death in the world is increasing rapidly. This not only reflects the aging of the population and the sustained growth of the population, but also reflects the global social and economic development to some extent. During 2018-2020, the proportion of countries/regions with extremely high and high population development index increased, while the proportion of countries/regions with medium and low population development index decreased accordingly. However, social and economic development seems to bring cancer risk factors while improving people’s lives.
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The champion changes hands, but lung cancer is still not to be underestimated!
Figure 2.1 Breast cancer has become the first cancer in the world.
The most striking thing about this report is breast cancer! In the proportion of all cancers, breast cancer surpassed lung cancer for the first time and stood as the champion. In 2018, the incidence of breast cancer and lung cancer was 11.6%, but in 2020, it became 11.8% for breast cancer and 11.4% for lung cancer. The next three are still colorectal cancer, prostate cancer and gastric cancer, although the proportion has slightly increased or decreased, but the ranking has not changed.
Figure 2.2 Lung cancer is still the leading cause of death in the world.
However, although the proportion of deaths caused by lung cancer in all cancers decreased to 18.0% in 2020, less than 18.4% in 2018, lung cancer is still the cancer with the largest number of deaths in the world. Subsequently, the proportion of cancer deaths also increased slightly. The four major cancers after lung cancer were colorectal cancer, liver cancer, gastric cancer and breast cancer. It is worth noting that liver cancer surpassed gastric cancer and squeezed into the top three cancer deaths.
Figure 2.3 Male Cancer Incidence and Death
Figure 2.4 Female Cancer Incidence and Death
Cancer is more severe for men. The age-standardized cancer incidence rate (ASR) of men is 222.0 cases/100,000 person-years, which has little change compared with 218.6 cases/100,000 person-years in 2018. The number of women is 186.0/100,000 person-years, which is the same as that of 182.6/100,000 person-years in 2018. However, overall, the incidence of cancer in men is still higher than that in women.
In terms of mortality, the age-standardized cancer mortality rate for men is 120.8 cases/100,000 person-years, which is lower than that of 122.7 cases/100,000 person-years in 2018; Among women, it is 84.2 cases/100,000 person-years, which is still higher than 83.1 cases/100,000 person-years in 2018. However, the cancer mortality rate of men is still nearly 50% higher than that of women.
Figure 2.5 Global map of male cancer incidence
Figure 2.6 Global map of male cancer deaths
The most common cancer among men is lung cancer, accounting for 14.3%, but prostate cancer is the most common cancer in most countries/regions around the world, and lung cancer is the second. However, the incidence of lung cancer among men in China is the highest among all cancers; Other cancers with high incidence in men include colorectal cancer, gastric cancer and liver cancer.
In terms of male cancer deaths, lung cancer continues to lead all cancers, and the proportion of deaths has further increased to 21.5%. It is the leading cancer among men in 93 countries/regions around the world, which is the same as that in 2018. Lung cancer is also the first cancer death among men in China.
Figure 2.7 Global map of female cancer incidence.
Figure 2.8 Global map of female cancer deaths.
The most common cancer among women is breast cancer, accounting for 24.5%. In 2020, it is the first cancer in 159 countries/regions around the world, which is 5 more than that in 2018. On the map, Wuyang Wuyang is all pink, and China is no exception; Other cancers with high incidence in women include colorectal cancer, lung cancer and cervical cancer.
In terms of mortality, breast cancer continues to occupy the first place, accounting for 15.5%; Followed by lung cancer, colorectal cancer and cervical cancer. However, because the most common cause of cancer death among women in China, the United States, Canada, Australia and other countries is lung cancer, the map of cancer death among women doesn’t look so pink, but the number of countries/regions with the first breast cancer death has increased from 103 in 2018 to 110.
Figure 2.9 Breast cancer surpassed lung cancer as the most common cancer.
Figure 2.10 1/4 of female cancers and 1/6 of female cancer deaths are all breast cancer.
Breast cancer is the focus of this report, and two posters have been specially released on the homepage of the International Agency for Research on Cancer, hoping that everyone will pay attention to breast cancer. The poster emphasizes that in 2020, 2.3 million women will unfortunately get breast cancer, and 685,000 women will unfortunately die of breast cancer. This figure means that one quarter of all female cancer patients are breast cancer patients; Of all the women who died of cancer, 1/6 died of breast cancer.
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China has attracted great attention, and the overall proportion has declined steadily!
Figure 3.1 There are so many people that they need to make a separate list.
There are so many Chinese, so many global cancer reports have to list one for China. In this report, the proportion of population in Asia is 59.5%, that in East Asia is 21.5%, and that in China is 18.6%. The proportion of China in the report is close to 1/5, which directly divides the statistical analysis of East Asia into other places except China and China.
Figure 3.2 Regional Distribution of Cancer Incidence and Death in the World
There are many Asians, so are the corresponding cancers, accounting for 49.3% of all cancers in the world, of which China accounts for about a quarter of the world; Cancer deaths from Asia are more than half, reaching 58.3%, of which China accounts for more than a quarter of the world’s total. Although Europe accounts for less than 1/10 of the global population, it contributes 22.8% of cancer cases and 19.6% of cancer deaths. America accounts for about 1/5 of the world’s population, but it also contributes 20.9% of cancer cases and 14.2% of cancer deaths. Compared with Europe and America, the proportion of cancer deaths in Asia and Africa is higher than that in cancer incidence, suggesting that the mortality rate of cancer patients in these areas is higher.
Figure 3.3 Global proportion of male cancer incidence and death in China.
The age-standardized cancer incidence rate of men in China is 225.4 cases/100,000 person-years, which is not only higher than the global average of 222.0 cases/100,000 person-years, but also higher than the own data of 223.0 cases/100,000 person-years in 2018. In terms of mortality, the age-standardized cancer mortality rate of men in China is 163.9 cases/100,000 person-years, which is significantly higher than the global average of 120.8 cases/100,000 person-years, but it is better than the data of 166.6 cases/100,000 person-years in 2018.
Figure 3.4 Global proportion of female cancer incidence and death in China.
The age-standardized cancer incidence rate of women in China is 188.2 cases/100,000 person-years, which is lower than that of men in China, but it is still higher than the global average of 186.0 cases/100,000 person-years, and it is also higher than its own data of 182.6 cases/100,000 person-years in 2018. In terms of mortality, the age-standardized cancer mortality rate of women in China is 98.1 cases/100,000 person-years, higher than the global average of 84.2 cases/100,000 person-years, and higher than the data of 95.2 cases/100,000 person-years in 2018.
Figure 3.5 Global incidence of lung cancer
The report covers the situation of several common cancers in China. Firstly, it is pointed out that the incidence of lung cancer in East Asia is relatively high, mainly because the burden of lung cancer in China is heavier. Although tobacco is still the most important risk factor for lung cancer, the smoking rate of women in China is low, and it seems that tobacco can’t be blamed for their lung cancer. The main risk factors of these female lung cancer patients may come from air pollution, including outdoor air pollution and air pollution caused by burning domestic solid fuel for heating and cooking.
Figure 3.6 Global incidence of liver cancer
The main risk factor of liver cancer is chronic infection of hepatitis B virus or hepatitis C virus, accounting for 56% and 20% of liver cancer cases respectively. The main risk factor of liver cancer in China is hepatitis B infection. However, with the introduction of hepatitis B vaccine, the infection rate of hepatitis B has decreased, and there is no soil for liver cancer related to infection. Since 1970s, the incidence and mortality of liver cancer have decreased in many high-risk countries in East and Southeast Asia, including China. It is believed that the burden of hepatitis B-related liver cancer will continue to decrease in the future.
Figure 3.7 Global incidence of esophageal cancer
Although the incidence and mortality of esophageal cancer are not prominent among all cancers in the world, one out of every 18 cancer deaths in 2020 is esophageal cancer, of which about 70% are men. The burden of esophageal cancer in China is very heavy, which directly pushes East Asia to the position with the heaviest burden of esophageal cancer in the world. Nutritional deficiency, nitrosamines, eat areca, pickles, very hot food and drinks may be the most important risk factors.
Figure 3.8 Global incidence of thyroid cancer
The incidence of thyroid cancer is increasing all over the world, but most thyroid cancers may not be fatal. With the popularization of ultrasound and other diagnostic imaging examinations, a large number of subclinical inert thyroid lesions have been found. It is estimated that in China, South Korea, Italy and other countries, over-diagnosed thyroid cancer cases accounted for 80% ~ 95% of newly diagnosed cases from 2008 to 2012. However, the recent guidelines have gradually turned to suggest that thyroid cancer should not be screened, and advocate active monitoring strategy for tiny thyroid cancer, rather than completely.
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The burden doubles, and cancer still depends on prevention!
Figure 4.1 It is conservatively predicted that there will be 28.4 million new cases of cancer in 2040.
At the end of the report, the global cancer incidence and death in the next 20 years are also prospected, but the situation seems to be not optimistic. Assuming that the incidence of cancer in the future remains at the level of 2020, it is estimated that there will be 28.4 million new cancer cases in the world by 2040, an increase of 47% over 2020. Among them, the number of cases in countries/regions with medium and low population development index increased more significantly, reaching 95% and 64% respectively. As far as the absolute number of cancer patients is concerned, countries/regions with high population development index have the heaviest burden, and the number of new cases will increase by 4.1 million in 2040, and China is just such a case. According to the report, the current forecast is entirely based on population growth and aging, and since the risk factors of cancer may continue to increase in many parts of the world, it is expected that the real number may be even more shocking.
Figure 4.2 Ten Advice for Cancer Prevention
With the development of social economy, cancers related to infection and poverty, such as cervical cancer, liver cancer and gastric cancer, may gradually decrease, while cancers related to various unhealthy lifestyles will gradually increase. Well-known cancer risk factors include smoking, unhealthy diet, overweight and lack of exercise, which may further increase the burden of breast cancer, lung cancer, colorectal cancer and prostate cancer. In order to reduce the burden and risk of cancer in the future, targeted preventive measures and corresponding cancer treatment methods may be the focus.
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This article starts: medical oncology channel
Author: Whale
Original title: "Cancer ranks first in China! The 2020 global cancer statistics report is released, and you must know these changes! 》
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