1990—2019年中国男性泌尿生殖系统肿瘤发病和死亡分析

doi:10.3760/cma.j.cn371439-20240509-00106

摘要/Abstract

摘要：

目的分析1990—2019年中国男性泌尿生殖系统肿瘤流行情况及趋势。方法利用全球疾病负担研究2019数据库，分析中国不同年龄组和不同年份男性泌尿生殖系统肿瘤的发病率和死亡率，利用Joinpoint 5.2.0软件对1990—2019年中国男性泌尿生殖系统肿瘤的发病率和死亡率趋势进行分析，并比较中国、全球以及不同社会人口指数（SDI）地区的男性泌尿生殖系统肿瘤标化发病率和标化死亡率。结果 2019年，中国男性泌尿生殖系统肿瘤发病顺位从高到低依次为前列腺癌（21.17/10万）、膀胱癌（11.41/10万）、肾癌（5.87/10万）和睾丸癌（2.37/10万）；死亡顺位与发病顺位一致，依次为前列腺癌（7.50/10万）、膀胱癌（4.35/10万）、肾癌（2.33/10万）和睾丸癌（0.17/10万）。1990年中国男性生殖泌尿系统肿瘤发病顺位和死亡顺位与2019年均相同。2019年，前列腺癌在20岁年龄组开始出现发病和死亡病例，膀胱癌在15岁年龄组开始出现发病和死亡病例，肾癌和睾丸癌在1~4岁年龄组开始出现发病和死亡病例；55岁以前，男性泌尿生殖系统各类型肿瘤的发病率和死亡率差异不大；55岁以后，前列腺癌的发病率和死亡率高于肾癌、膀胱癌和睾丸癌；2019年男性泌尿生殖系统肿瘤的发病率在各年龄组均高于1990年。1990—2019年，前列腺癌、膀胱癌、肾癌和睾丸癌发病率、死亡率、标化发病率均呈升高趋势，肾癌标化死亡率呈升高趋势，前列腺癌标化死亡率呈降低趋势。与全球平均水平比较，1990年和2019年中国男性泌尿生殖系统肿瘤标化发病率和标化死亡率均较低。与不同SDI地区比较，中国男性肾癌、睾丸癌、膀胱癌的1990年和2019年标化发病率和标化死亡率与中、低SDI地区相接近；中国男性前列腺癌的1990年和2019年标化发病率和标化死亡率均低于不同SDI地区。结论 1990年和2019年中国男性泌尿生殖系统肿瘤发病顺位和死亡顺位均相同，从高到低依次为前列腺癌、膀胱癌、肾癌和睾丸癌。1990—2019年中国男性泌尿生殖系统肿瘤发病率、死亡率、标化发病率均呈升高趋势。1990年和2019年，与全球平均水平比较，中国男性泌尿生殖系统肿瘤标化发病率和标化死亡率均较低。

关键词: 泌尿生殖系统肿瘤, 肾肿瘤, 膀胱肿瘤, 前列腺肿瘤, 睾丸肿瘤, 发病率, 死亡率

Abstract:

Objective To examine the prevalence and trends of male urogenital system tumors in China from 1990 to 2019. Methods The Global Burden of Disease Study 2019 database was used to analyze the incidence and mortality of male urogenital tumors among different age groups and years in China. Joinpoint 5.2.0 software was utilized to analyze the incidence and mortality trends of male urogenital tumors in China from 1990 to 2019. Standardized incidence and mortality rates of male urogenital system tumors in China， in the world and in different sociodemographic index （SDI） regions were compared. Results In 2019， the rank of incidence of male urogenital system tumors in China from high to low was prostate cancer （21.17/100 000）， bladder cancer （11.41/100 000）， kidney cancer （5.87/100 000） and testicular cancer （2.37/100 000）. The rank of mortality was consistent with the rank of incidence， which was prostate cancer （7.50/100 000）， bladder cancer （4.35/100 000）， kidney cancer （2.33/100 000） and testicular cancer （0.17/100 000）. The ranks of incidence and mortality of male urogenital tumors in China in 1990 were the same as those in 2019. In 2019， prostate cancer cases began to appear in the 20-year-old age group， bladder cancer cases in the 15-year-old age group， while kidney cancer and testicular cancer cases began to emerge in the 1-4-year-old age group. Before the age of 55， the incidence and mortality rates of four types of tumors in the male urogenital system did not differ significantly. After the age of 55， the incidence and mortality rate of prostate cancer surpassed those of kidney cancer， bladder cancer and testicular cancer. The incidence rate of male urogenital tumors in 2019 was higher in all age groups than in 1990. From 1990 to 2019， the incidence， mortality and standardized incidence rates of prostate cancer， bladder cancer， kidney cancer and testicular cancer all showed increasing trends. The standardized mortality rate of kidney cancer showed an upward trend， while prostate cancer exhibited a downward trend. Compared with global averages， the standardized incidence and mortality rates of male urogenital system tumors in China were lower in 1990 and 2019. Compared with different SDI regions， the standardized incidence and mortality rates of male kidney cancer， testicular cancer and bladder cancer in China in 1990 and 2019 were similar to those in moderate and low SDI regions. The standardized incidence and mortality rates of prostate cancer in 1990 and 2019 were lower in China than in different SDI regions. Conclusion In 1990 and 2019， the incidence and mortality ranks of male urogenital tumors in China are the same， with prostate cancer， bladder cancer， kidney cancer and testicular cancer in order from high to low. From 1990 to 2019， the incidence， mortality and standardized incidence rates of male urogenital system tumors in China show increasing trends. In 1990 and 2019， compared with the global average， the standardized incidence and mortality rates of male urogenital system tumors in China are lower.

Key words: Urogenital neoplasms, Kidney neoplasms, Urinary bladder neoplasms, Prostatic neoplasms, Testicular neoplasms, Incidence, Mortality

赵明君, 于春虎. 1990—2019年中国男性泌尿生殖系统肿瘤发病和死亡分析[J]. 国际肿瘤学杂志, 2024, 51(10): 632-638.

Zhao Mingjun, Yu Chunhu. Analysis of incidence and mortality of male urogenital system tumors in China from 1990 to 2019[J]. Journal of International Oncology, 2024, 51(10): 632-638.

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癌种	发病例数	发病率（/10万）	死亡例数	死亡率（/10万）
前列腺癌
1990年	26 440	4.33	20 382	3.34
2019年	153 448	21.17	54 391	7.50
膀胱癌
1990年	18 362	3.01	11 910	1.95
2019年	82 681	11.41	31 505	4.35
肾癌
1990年	6 157	1.01	3 329	0.55
2019年	42 554	5.87	16 883	2.33
睾丸癌
1990年	3 233	0.53	782	0.13
2019年	17 169	2.37	1 205	0.17

年份	发病率				标化发病率
年份	肾癌	膀胱癌	前列腺癌	睾丸癌	肾癌	膀胱癌	前列腺癌	睾丸癌
1990	1.01	3.01	4.33	0.53	1.32	5.46	8.88	0.56
1991	1.04	3.10	4.53	0.56	1.36	5.52	9.06	0.58
1992	1.05	3.18	4.65	0.57	1.36	5.55	9.10	0.60
1993	1.06	3.26	4.84	0.58	1.36	5.59	9.26	0.62
1994	1.04	3.34	5.00	0.61	1.34	5.61	9.38	0.65
1995	1.06	3.43	5.22	0.63	1.35	5.64	9.52	0.69
1996	1.12	3.59	5.53	0.67	1.41	5.74	9.82	0.74
1997	1.18	3.76	5.82	0.70	1.47	5.83	10.01	0.77
1998	1.26	3.94	6.11	0.72	1.54	5.95	10.17	0.79
1999	1.38	4.11	6.44	0.75	1.65	6.03	10.39	0.83
2000	1.56	4.41	6.83	0.78	1.83	6.25	10.63	0.87
2001	1.79	4.63	7.24	0.80	2.06	6.36	10.92	0.89
2002	2.04	4.88	7.65	0.83	2.30	6.48	11.13	0.92
2003	2.36	5.24	8.18	0.90	2.58	6.69	11.44	0.98
2004	2.73	5.67	8.81	0.99	2.91	7.00	11.90	1.07
2005	3.00	5.94	9.35	1.04	3.12	7.15	12.27	1.12
2006	3.20	6.12	9.83	1.09	3.24	7.15	12.49	1.17
2007	3.43	6.48	10.52	1.18	3.39	7.35	12.91	1.26
2008	3.70	6.88	11.31	1.28	3.58	7.60	13.42	1.36
2009	4.00	7.37	12.20	1.39	3.80	7.92	13.98	1.48
2010	4.33	7.89	13.13	1.51	4.03	8.27	14.59	1.60
2011	4.53	8.23	13.82	1.57	4.14	8.41	14.90	1.67
2012	4.69	8.56	14.52	1.63	4.20	8.53	15.18	1.72
2013	4.78	8.82	15.16	1.72	4.20	8.58	15.37	1.80
2014	4.91	9.23	16.20	1.85	4.23	8.75	15.86	1.92
2015	4.95	9.56	16.93	1.93	4.20	8.85	16.09	1.98
2016	5.01	9.85	17.57	1.99	4.17	8.89	16.14	2.03
2017	5.26	10.33	18.73	2.14	4.31	9.06	16.57	2.17
2018	5.58	10.84	19.89	2.28	4.48	9.21	16.94	2.31
2019	5.87	11.41	21.17	2.37	4.63	9.38	17.34	2.39
AAPC（%）	6.23	4.63	5.92	5.32	4.45	1.92	2.32	5.12
95%CI（%）	5.91~6.52	4.21~5.13	5.72~6.01	5.12~5.68	4.01~4.78	1.63~2.14	2.13~2.56	4.72~5.59
P值	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05

年份	死亡率				标化死亡率
年份	肾癌	膀胱癌	前列腺癌	睾丸癌	肾癌	膀胱癌	前列腺癌	睾丸癌
1990	0.55	1.95	3.34	0.13	0.85	4.43	8.22	0.16
1991	0.56	1.98	3.43	0.13	0.86	4.43	8.27	0.16
1992	0.56	2.02	3.50	0.13	0.85	4.41	8.22	0.16
1993	0.57	2.05	3.58	0.13	0.85	4.38	8.25	0.15
1994	0.56	2.09	3.67	0.13	0.84	4.38	8.31	0.16
1995	0.58	2.13	3.77	0.14	0.85	4.34	8.31	0.16
1996	0.60	2.18	3.90	0.14	0.87	4.34	8.39	0.16
1997	0.63	2.24	3.99	0.14	0.89	4.31	8.34	0.16
1998	0.66	2.31	4.08	0.14	0.93	4.31	8.27	0.16
1999	0.72	2.37	4.20	0.14	0.98	4.31	8.27	0.16
2000	0.80	2.50	4.34	0.14	1.07	4.36	8.25	0.16
2001	0.90	2.57	4.48	0.14	1.18	4.34	8.27	0.16
2002	1.02	2.64	4.57	0.14	1.29	4.30	8.16	0.15
2003	1.15	2.74	4.68	0.14	1.41	4.28	8.05	0.15
2004	1.30	2.87	4.83	0.14	1.55	4.33	8.04	0.15
2005	1.40	2.93	4.96	0.13	1.64	4.32	8.04	0.15
2006	1.46	2.93	5.02	0.13	1.67	4.20	7.92	0.14
2007	1.53	3.00	5.14	0.13	1.70	4.18	7.87	0.14
2008	1.62	3.09	5.30	0.13	1.76	4.20	7.88	0.13
2009	1.71	3.22	5.49	0.13	1.83	4.26	7.92	0.14
2010	1.83	3.35	5.69	0.13	1.92	4.33	7.99	0.14
2011	1.90	3.44	5.85	0.13	1.95	4.34	8.00	0.14
2012	1.95	3.53	6.01	0.14	1.96	4.35	8.02	0.14
2013	1.97	3.59	6.14	0.14	1.94	4.32	7.97	0.14
2014	2.00	3.70	6.37	0.14	1.92	4.33	8.00	0.14
2015	2.01	3.82	6.57	0.15	1.89	4.36	8.01	0.15
2016	2.04	3.94	6.78	0.15	1.87	4.36	7.96	0.15
2017	2.11	4.05	6.98	0.16	1.88	4.33	7.89	0.15
2018	2.21	4.17	7.19	0.16	1.91	4.28	7.77	0.15
2019	2.33	4.35	7.50	0.17	1.96	4.30	7.79	0.16
AAPC（%）	5.12	2.83	2.86	0.92	2.93	-0.12	-0.26	-0.14
95%CI（%）	4.82~5.35	2.51~3.02	2.61~3.02	0.61~1.22	2.61~3.32	-0.32~0.13	-0.36~-0.14	-0.31~0.24
P值	<0.05	<0.05	<0.05	<0.05	<0.05	>0.05	<0.05	>0.05

国家及地区	1990年标化发病率				2019年标化发病率
国家及地区	肾癌	膀胱癌	前列腺癌	睾丸癌	肾癌	膀胱癌	前列腺癌	睾丸癌
中国	1.32	5.46	8.88	0.56	4.63	9.38	17.34	2.39
全球	4.51	10.94	34.13	1.94	6.24	11.28	38.63	2.79
高SDI地区	10.02	18.07	75.24	6.76	12.54	18.62	79.70	7.75
中-高SDI地区	5.52	15.36	25.32	2.49	8.41	16.47	35.73	5.31
中SDI地区	1.47	4.67	14.48	0.65	3.50	7.31	23.64	1.99
中-低SDI地区	0.98	3.31	12.39	0.46	1.98	4.10	18.53	0.88
低SDI地区	1.03	4.72	16.25	0.41	1.50	4.77	20.25	0.59

国家及地区	1990年标化死亡率				2019年标化死亡率
国家及地区	肾癌	膀胱癌	前列腺癌	睾丸癌	肾癌	膀胱癌	前列腺癌	睾丸癌
中国	0.85	4.43	8.22	0.16	1.96	4.30	7.79	0.16
全球	2.50	6.13	18.13	0.31	2.98	5.09	15.27	0.28
高 SDI 地区	4.59	8.02	25.72	0.38	4.77	6.20	17.65	0.23
中-高 SDI地区	3.21	8.33	16.42	0.43	3.98	6.75	14.77	0.35
中 SDI地区	1.01	3.53	12.57	0.23	1.82	3.55	12.80	0.28
中-低 SDI地区	0.76	2.95	12.28	0.24	1.29	2.88	13.49	0.25
低 SDI地区	0.87	4.46	17.41	0.22	1.15	3.99	19.47	0.22