Objective: The registration data of local cancer registries in 2014 were collected by National Central Cancer Registry (NCCR)in 2017 to estimate the cancer incidence and mortality in China. Methods: The data submitted from 449 registries were checked and evaluated, and the data of 339 registries out of them were qualified and selected for the final analysis. Cancer incidence and mortality were stratified by area, gender, age group and cancer type, and combined with the population data of 2014 to estimate cancer incidence and mortality in China. 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: Total covered population of 339 cancer registries (129 in urban and 210 in rural) in 2014 were 288 243 347 (144 061 915 in urban and 144 181 432 in rural areas). The mortality verified cases (MV%) were 68.01%. Among them, 2.19% cases were identified through death certifications only (DCO%), and the mortality to incidence ratio was 0.61. There were about 3, 804, 000 new cases diagnosed as malignant cancer and 2, 296, 000 cases dead in 2014 in the whole country. The incidence rate was 278.07/100, 000 (males 301.67/100, 000, females 253.29/100, 000) in China, age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population were 190.63/100, 000 and 186.53/100, 000, respectively, and the cumulative incidence rate (0-74 age years old) was 21.58%. The cancer incidence and ASIRC in urban areas were 302.13/100, 000 and 196.58/100, 000, respectively, whereas in rural areas, those were 248.94/100, 000 and 182.64/100, 000, respectively. The cancer mortality in China was 167.89/100, 000 (207.24/100, 000 in males and 126.54/100, 000 in females), age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population were 106.98/100, 000 and 106.09/100, 000, respectively. And the cumulative incidence rate (0-74 age years old) was 12.00%. The cancer mortality and ASMRC in urban areas were 174.34/100, 000 and 103.49/100, 000, respectively, whereas in rural areas, those were 160.07/100, 000 and 111.57/100, 000, respectively. Lung cancer, gastric cancer, colorectal cancer, liver cancer, female breast cancer, esophageal cancer, thyroid cancer, cervical cancer, encephala and pancreas cancer, were the most common cancers in China, accounting for about 77.00% of the new cancer cases. Lung cancer, liver cancer, gastric cancer, esophageal cancer, colorectal cancer, pancreatic cancer, breast cancer, encephala, leukemia and lymphoma were the leading causes of death and accounted for about 83.36% of cancer deaths. Conclusions: The progression of cancer registry in China develops rapidly in these years, with the coverage of registrations is expanded and the data quality was improved steadily year by year. As the basis of cancer prevention and control program, cancer registry plays an important role in making the medium and long term of anti-cancer strategies in China. As China is still facing the serious cancer burden and the cancer patterns varies differently according to the locations and genders, effective measures and strategies of cancer prevention and control should be implemented based on the practical situation.
目的： 分析2017年全国肿瘤登记中心收集的全国各登记处上报的2014年恶性肿瘤登记资料，估计我国恶性肿瘤的发病和死亡情况。 方法： 全国肿瘤登记中心共收到全国449个登记处上报的2014年肿瘤登记数据，通过严格的审核和评估，339个登记处的数据符合标准。将入选的登记处按地区(城乡)、性别、年龄别以及不同恶性肿瘤类型的发病率和死亡率分层，并结合2014年全国人口数据，估计全国恶性肿瘤发病和死亡情况。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： 2014年纳入分析的339个登记处共覆盖登记人口288 243 347人(其中城市144 061 915人，农村144 181 432人)。病理诊断比例为68.01%，只有死亡证明书比例为2.19%，死亡发病比为0.61。估计全国2014年新发恶性肿瘤病例约380.4万例，死亡病例229.6万例。全国恶性肿瘤发病率为278.07/10万(男性301.67/10万，女性253.29/10万)，中标率为190.63/10万，世标率为186.53/10万，累积率(0～74岁)为21.58%。城市地区发病率为302.13/10万，中标发病率为196.58/10万，农村地区发病率为248.94/10万，中标发病率为182.64/10万。全国恶性肿瘤死亡率为167.89/10万(男性207.24/10万，女性126.54/10万)，中标死亡率为106.98/10万，世标死亡率为106.09/10万，累积死亡率(0～74岁)为12.00%。城市地区死亡率为174.34/10万，中标死亡率为103.49/10万。农村地区恶性肿瘤死亡率为160.07/10万，中标死亡率为111.57/10万。肺癌、胃癌、结直肠癌、肝癌、女性乳腺癌、食管癌、甲状腺癌、子宫颈癌、脑瘤和胰腺癌是我国主要的常见恶性肿瘤，约占全部新发病例的77.00%。肺癌、肝癌、胃癌、食管癌、结直肠癌、胰腺癌、乳腺癌、脑瘤、白血病和淋巴瘤是肿瘤的主要死因，约占全部肿瘤死亡病例的83.36%。 结论： 我国肿瘤登记工作发展迅速，肿瘤登记覆盖范围逐年扩大，数据质量稳步提升。肿瘤登记作为肿瘤防治工作的基础，为制订中长期肿瘤防治策略提供可靠依据。我国目前肿瘤负担依然很严重，且城乡、性别间肿瘤负担差异明显，今后应根据实际情况制订肿瘤防控策略，有的放矢地采取有效措施。.
Keywords: Cancer registry; China; Incidence; Malignant tumor; Mortality.