2021年2月4日，正值世界癌症日，影响因子全球排名第一神刊、美国癌症学会旗下《临床医师癌症杂志》在线发表美国癌症学会亚特兰大总部、世界卫生组织国际癌症研究机构法国里昂总部的全球癌症（GLOBOCAN）统计报告2020年版（上一版为2018年版），对全世界185个国家36种癌症的发病和死亡进行了推算，全文共41页（上一版为31页）。
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本文根据国际癌症研究机构于2020年11月25日公布的癌症发病和死亡推算值，提供了全球癌症负担的最新信息。
2020年，全世界大约新发1930万例癌症（不计非黑素瘤皮肤癌为1810万例）和将近1000万例癌症死亡（不计非黑素瘤皮肤癌为990万例）。
中国作为全世界人口第一大国，也毫无争议地成为全世界癌症发病和癌症死亡第一大国。不过，女性乳腺癌的发病率和死亡率相对较低。
女性乳腺癌已超过肺癌，成为第一癌症，2020年大约新发230万例，占全部新发癌症病例的11.7%，其次为肺癌（11.4%）、结直肠癌（10.0%）、前列腺癌（7.3%）、胃癌（5.6%）。
肺癌仍然是癌症死亡的主要原因，2020年大约死亡180万例（18%），其次为结直肠癌（9.4%）、肝癌（8.3%）、胃癌（7.7%）、女性乳腺癌（6.9%）。
发达国家与发展中国家相比，两性癌症总发病率高2～3倍，男性癌症死亡率高达2倍，女性癌症死亡率相似。
不过，发展中国家与发达国家相比，女性乳腺癌、子宫颈癌死亡率较高，分别为10万分之12.8比12.5、10万分之12.4比5.2。
预计到2040年，全球癌症负担将达到2840万例，比2020年增加47%，但是由于人口统计学变化，发展中国家与发达国家相比，增幅较大（64%～95%比32%～56%），全球化和经济增长相关风险因素增加可能进一步加大该增幅。
因此，为了在发展中国家推广癌症预防措施并提供癌症诊疗而建立可持续基础设施的努力对于全球癌症控制至关重要。
CA Cancer J Clin. 2021 Feb 4. Online ahead of print.
Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F.
American Cancer Society, Atlanta, Georgia; International Agency for Research on Cancer, Lyon, France.
This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
KEYWORDS: burden; cancer; epidemiology; incidence; mortality
PMID: 33538338
DOI: 10.3322/caac.21660
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