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Gastric cancer is “poor cancer”, and colon cancer and pancreatic cancer are “rich cancer”?

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Introduction: Digestive system cancer is a malignant tumor that poses a serious threat to human health. Its morbidity and mortality account for more than 50% of all malignant tumors.Recently, “Lancet · Gastrointestinal Liver Disease” published three reports of global disease burden studies (GBD) for the evaluation of digestive cancer (colorectal cancer, stomach cancer, pancreatic cancer). The report pointed out that since 1990, the global knotThe incidence and death toll of rectal and pancreatic cancers have risen sharply.According to the report, the study uses the global disease burden study estimation method to dynamically monitor and evaluate indicators such as morbidity, mortality, and disability-adjusted life years (DALY) in 195 countries and regions, through the social population index (SDI) analyzes the levels and trends over time, and then analyzes the disease burden indicators of different countries or regions, different populations and different diseases worldwide, and identifies the main diseases, high-risk groups and high-incidence areas in different countries or regions.Determine the main health risk factors, and provide decision-making basis for governments to formulate health policies and allocate health resources.Colorectal cancer Colorectal cancer is one of the most common malignant tumors. Colorectal cancer is the second leading cause of cancer worldwide in 2017, second only to lung cancer, and the 16th leading cause of all diseases and injuries.Although colorectal cancer mortality has stabilized or begun to decline slowly in many developed countries, the burden of colorectal cancer is rapidly increasing in most developing countries.1 Incidence rate In 2017, there were about 1.83 million new cases of colorectal cancer worldwide, and the age-standardized incidence rate was 23.2 cases per 100,000 people per year.From 1990 to 2017, the age-standardized incidence of colorectal cancer increased by 9.5%.In 2017, Australia, high-income Asia Pacific and North America had the highest age-standardized incidence rates, compared with South Asia, the west of the Sahara Desert, and the Central Sahara Desert, which had the lowest age-standardized incidence.In 2017, except for Andes-Latin America, the age-standardized incidence rate of males in other regions was higher than that of females.In 1990, 107,038 new cases of colorectal cancer in mainland China, the age-standardized incidence rate was 12.2 per 100,000 people; in 2017, 431,951 new cases of colorectal cancer in mainland China, age-standardized incidence rateIt was 22.4 cases per 100,000 people; the number of cases increased by 3 times in 28 years.2 Mortality In 2017, colorectal cancer caused 896,000 deaths worldwide, with an age-standardized death rate of 11.5 per 100,000 people.From 1990 to 2017, the age-standardized mortality rate for colorectal cancer fell by 13.5%.In 2017, age-standardized mortality was highest in Central and Eastern Europe and Latin America, compared with the lowest age-standardized mortality rates in South Asia, North Africa and the Middle East.Similarly, male age-standardized mortality rates were higher in all regions than in women.In 1990, there were 75,876 deaths from colorectal cancer in mainland China, and 9.3 cases of age-standardized death rate per 100,000 people. In 2017, 187,078 cases of colorectal cancer died in mainland China, with an age-standardized death rate of 100,000.10.1 cases of people; the number of deaths increased by 46.6% in 28 years.3 Disability-adjusted life years From 1990 to 2017, the age-standardized disability-adjusted life year (DALY) for colorectal cancer fell by 14.5%.Age-standardized DALY rates begin to decline in men after 80-80 years, while women are 85-89 years old.In the 80-84 age group, the number of male DALYs is higher than that of women, while the number of DALYs in women at higher ages is slightly higher.4 Incidence increases with age. In 2017, with the increase of age, the incidence of colorectal cancer showed a non-linear growth trend.In all ages, male incidence is higher than female; as shown in Figure 3.The incidence of men and women increases with age, and the gap increases to 85-89 years old, and the gap has begun to shrink.Before the age of 80-84, men had more cases than women and peaked between 65 and 69 years old.5 Risk factors Globally, low dietary calcium (20.5%), alcohol consumption (15.2%) and low intake of dairy products (14.3%) are the top three risk factors for colorectal cancer DALYs..In terms of gender differences, drinking (21.5%), low calcium in the diet (19.8%), and smoking (19.2%) were the top three risk factors for men; women had low calcium in the diet (21.3%).Inadequate intake of dairy products (14.4%) and low dietary fiber intake (12.5%).In terms of age, the biggest risk for the 55-59 age group is alcohol consumption. The biggest risk for people aged 65-69 is smoking. The biggest risk for people aged 85-89 is high fasting blood glucose.Pancreatic cancer is increasing worldwide in both pancreatic cancer morbidity and mortality, and remains one of the worst prognosis cancers with a 5-year overall survival rate of approximately 5% in high-income countries with low and middle incomes.There is not much difference between countries, but in high-income countries, pancreatic cancer has the highest morbidity and mortality.Although the pathogenesis of pancreatic cancer is still not fully understood, some risk factors have been identified, such as smoking, obesity and diabetes.1 Incidence rate In 2017, there were approximately 448,000 new cases of pancreatic cancer worldwide, an increase of 2.3 times over 1990.The male share fell from 52.1% in 1990 to 51.9% in 2017.In 1990, the age-standardized incidence rate of pancreatic cancer worldwide was 5 per 100,000 people per year, and in 2017 it rose to 5.7 per 100,000 people per year.In 2017, 9.1 million DALYs were generated, an increase of 2.1 times over the 4.4 million in 1990.2 Mortality In 2017, pancreatic cancer caused 441,000 deaths worldwide, including 226,000 men and 215,000 women.The age-standardized death rate is 1 case per 100,000 people.From 1990 to 2017, the number of deaths worldwide increased by 2.3 times.The age-standardized mortality rate increased from 5.1 cases per 100,000 person-years in 1990 to 5.6 cases per 100,000 person-years in 2017, an increase of 10.4%.The age-standardized incidence rate of males increased from 5.7 per 100,000 person-years in 1990 to 6.3 in 2017; the age-standardized incidence rate of women increased from 4.5 per 100,000 person-years in 1990 to 5.0 in 2017.From 1990 to 2017, age-standardized morbidity and mortality of pancreatic cancer increased in all regions.In 2017, age-standardized morbidity and mortality were among the highest in the higher-income regions (North America, Western Europe, Central Europe, and Asia Pacific).In contrast, age-standardized morbidity and mortality rates are lowest in South Asia, East Africa, Central Africa, and sub-Saharan Africa.Overall, from 1990 to 2017, the majority of men in the region had higher age-standardized morbidity and mortality than women.With age, both morbidity and mortality of pancreatic cancer increase, and the trend between men and women is similar. Men’s deaths and morbidity peak at 65-69 years, while women peak at 75-79 years old..In addition, in the same age group, the number of deaths and the number of cases of women younger than 75 years old were lower than that of men, while in the age group of 75 years and older, the number of female deaths and the number of cases were higher than that of men.The age pattern of DALYs showed a similar trend to the total number of cases and deaths, but decreased in people over 80 years of age.3 Risk factors smoking In 2017, 93,600 cases of pancreatic cancer deaths were attributable to smoking (21.1%), of which 63.1% were men and 36.9% were women.In 1990, 26.6% of deaths from pancreatic cancer were attributed to smoking, and 5.5% in 28 years.In terms of different regions, the age-standardized death rate of male pancreatic cancer attributable to smoking was highest in Eastern Europe (35.7%) and East Asia (31.3%) in 2017, and in North America (29.3%) and Latin America (27.6).%)highest.In contrast, men and women west of the Sahara Desert had the lowest proportion of standardized deaths from pancreatic cancer due to smoking, 8.0% and 2.1%, respectively.In all age groups, the proportion of age-standardized deaths attributed to smoking among men aged 55-84 was higher than 25%, and that of women of the same age group was higher than 16%.High fasting blood glucose In 2017, 8.9% of globally standardized deaths from pancreatic cancer worldwide were attributable to high fasting blood glucose, which was 9.3% for men and 8.6% for women.In 1990, this ratio was 7.7%, an increase of 1.2% in 28 years.In 2017, men and women in Oceania had the highest proportion of age-standardized deaths from pancreatic cancer due to high fasting blood glucose, which were 16.0% and 17.3%, respectively.East Asian males had the lowest age-standardized death rate for pancreatic cancer due to high fasting blood glucose (5.8%), while women were the lowest in tropical Latin America (6.1%).In the 85-89 age group, the age-standardized death rate for males and females attributed to high fasting blood glucose was highest.Obesity In 2017, 6.2% of age-standardized deaths from pancreatic cancer worldwide were attributable to high BMI, with 5.0% for men and 7.4% for women.In 1990, this ratio was 5%.The age-standardized death rate of pancreatic cancer due to high BMI was highest in North America, with 8.6% and 11.7% for men and women, respectively.Men in the eastern part of the Sahara are attributed to the lowest age-standardized death rate (2.1%) for pancreatic cancer with a high BMI, and the lowest (3.5%) for women in the Asia-Pacific region.Although the proportion of age-standardized deaths attributed to high BMI was higher in the 45-79 age group, the difference in each age group was not significant.From 1990 to 2017, with the increase in SDI, age-standardized mortality and morbidity of pancreatic cancer have increased.That is to say, in all years from 1990 to 2017, countries with lower SDI had the lowest rate of pancreatic cancer, while countries with higher SDI had higher rates of pancreatic cancer.It may be due to an aging population and lifestyle choices that increase exposure to risk factors for pancreatic cancer; in countries with high SDI, certain risk factors for pancreatic cancer are more prevalent than in countries with low SDI.Gastric cancer is a high-risk tumor in the world. More than half of the world’s new cases of gastric cancer are from East Asia each year, especially in China, Japan and South Korea.It is currently believed that Helicobacter pylori infection, dietary factors, genetic factors, bad living habits and other environmental factors are closely related to the development of gastric cancer.1 Incidence rate In 2017, there were about 1.22 million new cases of gastric cancer in the world, and the age-standardized incidence rate was 15.4 cases per 100,000 people per year.The age-standardized morbidity and mortality rates of male gastric cancer are more than twice that of women, but the gap between men and women in Andes-Latin America and South Asia is smaller.The highest incidence rate occurs in high-income Asia-Pacific regions, especially in Japan and South Korea, as well as in East Asia. China alone accounts for nearly half of the world’s new cases of gastric cancer in 2017, followed by Eastern Europe and the Andes Latin America, Africa and high income.North America has the lowest incidence.From 1990 to 2017, the number of cases of gastric cancer increased by about 356,000, and the number of deaths increased by about 96,000. However, the effect of gastric cancer on DALY in 2017 was almost the same as in 1990.East Asia has become the main area for the increase in the number of absolute cases and deaths, and China is the leading country for the increase in the number of cases of gastric cancer in East Asia.In Europe, new cases of gastric cancer and deaths have shown a downward trend.In 1990, there were 295,862 new cases of gastric cancer in mainland China, and the age-standardized incidence rate was 34.1 cases per 100,000 people. In 2017, there were 561,938 new cases of gastric cancer in mainland China, and the age-standardized incidence rate was 290,000 per year.22.4 cases; the number of cases increased by 89.9% in 28 years.2 Mortality In 2017, gastric cancer caused 845,000 deaths worldwide, and the age-standardized death rate was 1 per 100,000 people.In 2017, East Asia had the highest age-standardized mortality rate, followed by Andean Latin America and Central Asia, with high-income Asia Pacific ranking first in age-standardized incidence, age-standardized mortality ranking fourth, and DALY incidence.Ranked sixth.In addition, Mongolia and Afghanistan are the countries with the highest age-standardized morbidity and mortality rates.In high-income North America and Oceania, countries with the lowest age-standardized morbidity and mortality rates.In 1990, there were 284,772 cases of gastric cancer deaths in mainland China, and the age-standardized death rate was 34.2 per 100,000 people. In 2017, there were 355,379 cases of gastric cancer death in mainland China, and the age-standardized death rate was 18.8 per 100,000 people. The number of deaths wasIn 28 years, it has increased by 24.8%.Although the number of cases of gastric cancer has increased, the incidence and mortality rate of global gastric cancer by age has decreased compared with 1990.The global age-standardized incidence rate decreased by 28.0%, while the age-standardized mortality rate decreased by 43.2%, and the age-standardized DALY rate decreased by 47.1%.In addition, the high-income Asia-Pacific region experienced the largest decline in the age-standardization rate between 1990 and 2017 compared to all other regions.In East Asia, the age-standardized incidence rate did not decrease much, but the age-standardized death toll was reduced by 44.5%, which led to a nearly half reduction in the age-standardized DALY rate.3 risk factors.
On a global scale, the causes of gastric cancer can be attributed to high sodium diets and smoking.38.2% of age-standardized DALY was attributed to a high-sodium diet, and men were higher than women.In East Asia, this number is almost twice that of all other regions.For men, 24% of global age-standardized DALY is associated with smoking, and the regions with the highest percentage of smoking age-standardized DALY are Eastern Europe and East Asia.In addition, Helicobacter pylori infection is also one of the most important risk factors for gastric cancer, so most prevention strategies for gastric cancer are concentrated on the infection of the bacteria.The report also pointed out that large-scale eradication of Helicobacter pylori infection is closely related to the reduction of gastric cancer. , please do not reprint without the authorization of the copyright owner.

ouyangshaoxia

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