Based on the World Cancer Report 2020 released by the International Agency for Research on Cancer(IARC)of World Health Organization(WHO),combined with the literature on environmental pollution and cancer prevalence,this paper introduces the latest information of the global cancer incidence and death rates,and summarizes the types and hazards of carcinogenic factors in air,water,and soil.

目的 分析10年间肿瘤专科医院收治肺癌患者病理分型和诊断分期构成及变化趋势.方法 选取2001年1月至2010年12月间中国医学科学院北京协和医学院肿瘤医院收治的肺癌患者住院信息,分析肺癌患者年龄、性别、病理类型和诊断分期的分布及变化特征.结果 共纳入2001-2010年肺癌住院患者16 476例,男11 458例(69.54%),女5018例(30.46%).肺癌住院患者逐年升高,50～69岁患者居多,男性以鳞癌(35.90%)和腺癌(31.41%)为主,女性以腺癌(62.2%)为主;男性和女性腺癌构成分别由2001年的20.99%和38.49%上升到2010年的37.48%和72.71%;鳞癌构成分别由2001年的36.77%和19.08%下降到2010年33.83%和4.82%.男性和女性非小细胞肺癌I期患者占比分别由2001-2005年的17.99%和21.49%上升到2006-2010年的21.95%和26.15%.结论 肺癌住院患者人数在10年间呈逐年增多,腺癌患者多于鳞癌,腺癌比例呈上升趋势,鳞癌呈下降趋势,非小细胞癌I期患者比例呈升高趋势.

介绍我国最新癌症发病和死亡情况,比较2000年至2016年我国癌症发病、死亡及生存水平变化,分析我国与全球癌症流行情况变化及特点.

Objective:To evaluate the performance of rural practitioners of endoscopic cleaning and disinfection participating in the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers and to analyze the influencing factors.Methods:The questionnaires for skill assessment were designed based on the skill scheme and clinical practice of the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China, and the App Early diagnosis, Early treatment was used as the examination platform. The practitioners in 539 county hospitals from 25 provinces participating in the program in 2019 were assessed for techniques and skills for endoscopic cleaning and disinfection and the excellence rate was calculated. Multivariate logistic regression model was used to analyze the influencing factors for the examination. Results:A total of 1 671 endoscopic cleaning and disinfection practitioners participated in the assessment with the score of 73.41±16.60. The passing rate was 85.82%, and the excellence rate was 44.94%. Among all questions, the correct rate of "opportunistic screening flow chart" was the highest (98.21%), and that of "the evaluation index for mass screening" was the lowest (57.89%). The multivariate logistic regression analysis showed that the excellence rate was high in practitioners who had a bachelor degree or above ( OR=1.627,95% CI:1.319-2.007, P<0.001), the career for 5 to <15 years (5 to <10 years: OR=1.329,95% CI:1.045-1.689, P=0.020; 10 to <15 years: OR=1.384,95% CI:1.026-1.867, P=0.033), working in eastern and central regions (eastern regions: OR=3.476,95% CI:2.368-5.103, P<0.001;central regions: OR=4.028,95% CI:2.679-6.057, P<0.001) and with full understanding of the screening scheme ( OR=1.547,95% CI:1.246-1.921, P<0.001) . Conclusion:Practitioners on the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China have mastered the basic screening scheme and skills for endoscopic cleaning and disinfection. The education background, duration of the career, area and understanding of screening scheme are influencing factors for the excellence rate of endoscopic cleaning and disinfection.

目的:了解农村上消化道癌早诊早治地区基层项目管理人员的技术能力.方法:由农村上消化道癌早诊早治项目专家组依据国家现行技术方案和项目实践,编写考核试题库,利用"早诊早治"APP建立考试平台,收集2019年参加农村上消化道癌早诊早治项目的27个省的418家县级医疗卫生机构项目管理人员的能力水平考核信息进行描述性分析.结果:共有827名基层项目管理人员完成考核,考核平均分83.07分,合格率96.86％,优秀率78.36％.其中"人群数据管理和安全"答题平均正确率最高,为99.52％;"人群筛查质量控制"答题平均正确率最低,为67.21％.结论:我国农村上消化道癌早诊早治地区基层项目管理人员较好掌握技术方案和具备数据管理能力,文化程度高、东中部地区、疾控中心的项目人员考核优秀的比例更高,应针对技术水平较低的人员和认知薄弱的技术环节加强培训.

目的 探讨农村上消化道癌早诊早治地区病理医师技术能力水平及相关影响因素.方法 以2019-01-01-2019-12-31参与农村上消化道癌早诊早治项目的病理医师为研究对象,由项目专家组依据现行技术方案和项目实例编写考核试题库,利用"早诊早治"APP建立考试平台进行技术能力考核,计算考核优秀率.采用多因素Logistic回归模型分析考核优秀率的影响因素.结果 共纳入1304名病理医师进行分析,考核平均分为75.71,合格率为94.40％(1231/1304),优秀率为36.58％(477/1304).对于各部分考核内容的平均答题正确率,其中"标本处理与病理诊断"为(78.84±8.83)％,"肿瘤病理诊断标准"为(71.70±9.85)％,"人群筛查质控"和"评价指标"分别为(65.37±9.22)％和(68.66±32.32)％.多因素分析结果显示,本科及以上文化程度(OR研究生=2.185,95％CI为1.393～3.428,P=0.001;OR本科=1.702,95％CI为1.155～2.507,P=0.007)、本专业工作5～<10年(OR=1.589,95％CI为1.072～2.356,P=0.021)、参加项目≥2年(OR=1.315,95％CI为1.034～1.672,P=0.026)、东中部地区(OR东部=2.558,95％CI为1.660～3.942,P<0.001;OR中部=2.294,95％CI为1.462～3.601,P<0.001)的病理医师考核优秀率相对较高.结论 我国农村上消化道癌早诊早治地区病理医师基本掌握技术方案,但总体优秀率偏低.文化程度、本专业工作时长、参加项目时长和所在地区是病理医师考核优秀的主要影响因素,应有针对性继续加强病理医师培训.

[目的]探究农村上消化道癌早诊早治项目筛查内镜医师专业技术能力现状及其影响因素.[方法]由农村上消化道癌早诊早治项目专家组依据国家现行技术方案和项目实践编写考核试题库,并利用"早诊早治"APP建立考试平台,收集2019年参加农村上消化道癌早诊早治项目的内镜医师基本情况,并对内镜医师技术方案掌握情况和内镜诊疗技术能力进行考核,计算考核优秀率.采用多因素Logistic回归模型分析影响考核优秀率的因素.[结果]共3207名内镜医师完成考核,考核平均分(72.60±15.07)分,合格率87.25％,优秀率33.80％.内镜医师对"人群筛查数据管理和安全"相关内容答题平均正确率最高,为99.16％,对"人群筛查评价指标"内容答题平均正确率最低,为59.73％.多因素Logistic回归分析提示,性别、年龄、文化程度、职称、参加项目时长、所在地区和对技术方案理解程度与考核优秀率相关,女性、年龄小于40岁、研究生文化程度、主治医师及以上职称、参加项目2年及以上、东中部地区以及完全理解技术方案的内镜医师考核优秀率相对较高(P均＜0.05).[结论]我国农村上消化道癌筛查内镜医师基本能够掌握技术方案,但总体优秀率偏低,应针对技术能力水平较低的内镜医师和掌握薄弱的技术环节加强培训.

目的 探讨前列腺癌住院患者构成及变化情况.方法 选取1999年1月至2013年12月间中国医学科学院肿瘤医院收治的926例前列腺癌住院患者信息,分析不同时间和年龄组患者疾病分布及变化特征.结果 1999—2013年间,前列腺癌住院患者所占比例随着年份递进而增加,从1999年的11.1％,到2013年的28.9％,患者平均年龄68.13岁,70岁及以上患者最多,占51.0％.临床分期中,Ⅰ期1.5％,Ⅱ期18.5％,Ⅲ期12.2％,Ⅳ期21.0％,分期不详占46.9％.按年份分析,患者平均年龄从1999—2001年的65.41岁至2011—2013年的69.12岁,差异有统计学意义(P<0.05);Ⅰ～Ⅱ期患者分布从1999—2001年的1.0％至2011—2013年的32.5％,同期分期不详患者从93.2％变化至35.5％,差异有统计学意义(P<0.05).结论 高龄前列腺癌患者比例呈上升趋势,早期前列腺癌患者有升高趋势.

目的 了解男性人群对烟草暴露危害和控烟知识的知晓情况.方法 采用自愿和匿名方式,由统一培训调查员对参加肿瘤防治活动的咨询者进行控烟知识调查,选取男性咨询者的调查资料进行量化,分析烟草危害和控烟知识总知晓分和各项知识的知晓率.结果 404名男性调查对象中,从不吸烟者173人,曾经吸烟者105人,现在吸烟者126人.调查对象知晓控烟知识的总知晓评分为60.52分;按年龄 、受教育程度 、收入 、吸烟史和家庭成员吸烟史分组统计的知晓分差异无统计学显著意义.各项控烟知识的知晓率为9.41％ ～95.05％,其中最高的是在公共场所应禁止吸烟,最低的是吸烟者仅有决心不一定就会成功戒烟.知晓率低于50％ 的控烟知识包括吸烟可导致发病风险的肿瘤:肝癌(47.28％)、胃癌(44.80％)、子宫颈癌(36.63％)、胰腺癌(36.14％)、肾癌(34.65％)、膀胱癌(34.16％);对烟草制品的认识:电子烟不能帮助戒烟(38.37％)、低焦油烟不能减少患病风险(31.19％)、低焦油烟不能减少对人体危害(25.74％);对戒烟的认识:吸烟者仅有决心不一定就会成功戒烟(9.41％).调查对象对低焦油烟不能减少患病风险的知晓率,曾经吸烟组高于不吸烟组和现在吸烟组,差异有统计学意义(P=0.015);调查对象对低焦油烟不能减少对人体危害和低焦油烟不能减少患病风险的知晓率,月收入 ≥8000元组高于<5000元组和5000～7999元组,差异有统计学意义(P<0.05).结论 肿瘤防治活动中,男性人群对烟草暴露危害涉及多种肿瘤风险和戒烟知识的认知严重不足,应加强健康科普深度宣传,提升公众认知度并转化为大众健康行动.

[目的]探讨农村厨房污染对女性肺部健康的影响.[方法] 2014年5～9月,在山东沂南马牧池乡女性人群中进行流行病调查和肺部CT检查,分析年龄、吸烟和二手烟暴露、厨房烟尘累积暴露与女性肺部CT阳性的关系.[结果]562名女性完成流行病学调查和低剂量螺旋CT检查,其中不吸烟者557名(99.11％),有二手烟暴露史303名(53.91％),有厨房烟尘暴露者543名(96.62％).胸部CT检查显示,二手烟暴露组和非暴露组CT阳性率分别为14.85％和21.24％,差异有统计学意义(x2=3.891,P＜0.05);厨房烟尘暴露极低水平(＜22 000h)、低水平(22 000～26 999h)、中等水平(27 000h～31 999h)和高水平组(≥32 000h)的CT阳性率分别为10.58％、12.94％、18.18％和23.66％,差异有统计学意义(x2=9.460,P＜0.05).[结论]厨房烟尘长期暴露可能对农村女性肺部健康有较严重影响.

目的 探讨女性人群知晓烟草暴露的健康危害及控烟知识情况.方法 选取2018年4月和2019年4月全国肿瘤防治宣传周期间参加中国医学科学院肿瘤医院肿瘤防治知识咨询的女性人群为研究对象.采用统一培训和匿名方式,对参加肿瘤防治咨询的女性人群进行问卷调查,并进行统计分析.结果 在415名调查对象中,从不吸烟者404名,曾经或现在吸烟者11名;家庭成员无吸烟者236名,有吸烟者179名.调查对象控烟知识总知晓评分为61.52分.对各项控烟知识的平均知晓率为10.3％ ～95.4％;高于80％的控烟知识有8个,低于60％的控烟知识有11个.按调查对象家庭成员是否有人吸烟分组:有吸烟组支持公共场所应禁止吸烟的比例(97.8％)高于无吸烟组(93.6％),有吸烟组认同应该劝告家属、亲友或同事不要吸烟的比例(98.3％)高于无吸烟组(92.8％),差异均有统计学意义(均P ＜0.05).吸烟者仅有决心戒烟不一定就能成功戒烟的知晓率仅为10.3％.结论 女性被动吸烟除损害自身健康外,还会直接或间接影响下一代的生命健康.全面了解吸烟对肿瘤的危害,准确掌握控烟知识要点,对照护患者康复和加强自身防病能力有较大帮助.

目的 探讨肾癌患者构成及变化情况.方法 选取1999年1月至2013年12月间北京市某医院收治的3 891例肾癌患者住院信息,分析不同时间和年龄组患者疾病分布及变化特征.结果 肾癌患者中,男性2 708例(69.6％),女性1183例(30.4％).1999 ～ 2013年间,肾癌患者分布为10.0％ ～32.1％,其中男性为9.7％ ～ 32.2％,女性为10.6％ ～ 31.8％.患者平均年龄54.5岁,40～69岁患者最多(72.3％ ～78.0％).男性Ⅰ期肾癌患者的分布为13.7％ ～ 54.4％,女性为9.6％ ～ 56.9％.结论 男性和女性肾癌患者人数均呈上升趋势,男性约占三分之二.男性和女性Ⅰ期肾癌患者升高显著.

Objective To investigate the awareness of prevention and treatment for breast cancer and cervical cancer among cancer patients.Methods A questionnaire survey was performed on 95 cancer patients who participated in the health education activities of prevention and treatment for breast cancer and cervical cancer in September 2018.Self-made questionnaire about knowledge of prevention and treatment for breast cancer and cervical cancer was used and the response condition of the participants was analyzed.Results The average awareness score of breast cancer and cervical cancer among 95 respondents was (9.6 ± 4.6);the average awareness grade was (36.9 ± 17.8)％.Patients of 55-59 years old showed the highest awareness grade;the awareness grade of patients aged less than 55 years was the lowest.The awareness grade of patients with breast cancer history was significantly higher than that of patients with cervical cancer history (P ＜ 0.05).The awareness rate of breast cancer ranged from 6.3％ to 74.7％.The awareness rate of " at least 1 kind of breast cancer screening indicator" was the highest and that of "4 kinds of breast cancer clinical symptoms and signs" was the lowest.The awareness rate of cervical cancer ranged from 18.9％ to 43.2％.The awareness rate of " healthy women should have screening for cervical cancer once a year" was the highest and that of "regular smoking cannot prevent cervical cancer" was the lowest.Conclusions Cancer patients have poor awareness of prevention and treatment for breast cancer and cervical cancer.Health education is urgently needed for the popularization of breast cancer and cervical cancer knowledge.

Objective To examine the status of cancer patients' knowledge on the prevention and treatment of lung and kidney cancer after health education in three districts in Beijing. Method A total of 102 patients who were participating a health education program on prevention and treatment of lung and kidney cancer were selected in three districts in Beijing from June 2018 to October 2018. Questionnaires assessing patients' knowledge on the prevention and treatment of lung and kidney cancer were given to the patients. Patients' awareness of knowledge on the prevention and treatment of lung and kidney cancer were analyzed. Result The score of patients' knowledge on the prevention and treatment of lung and kidney cancer is 5.10 ±2.31. For the knowledge on lung cancer, highest awareness rate was on“Scratchy throat and dry cough are early symptoms of lung cancer" (71.6%). The lowest one was on "The low-dose CT scan of the chest is the most appropriate method for early detection of lung cancer" (0. 0 %). In terms of the knowledge on kidney cancer, the highest awareness rate was on “Light pink or red urine may be a sign of kidney cancer" (64.7%). The lowest one was on "Early kidney cancer cannot detected by simple urine and blood tests or physical examination" (4.9%). Conclusion Patients lack the knowledge on the prevention and treatment of lung and kidney cancer. The publicity and popularization of cancer related health education especially on the knowledge of cancer prevention and treatment should be strengthened.

目的 探讨肿瘤患者对肺癌和肾癌防治知识的知晓情况.方法 采用非随机自愿参与问卷调查方式对2018年10月在成都参加肺癌和肾癌宣教活动的肿瘤患者进行调查,对肺癌和肾癌防治知识应答量化,统计平均知晓分、知晓评分和知晓率.结果 患者对肺癌和肾癌知识的知晓总分平均为6.90分,知晓评分49.28分.不同性别和年龄患者对肿瘤防治相关知识知晓总分和评分比较,差异无统计学意义(P＞0.05).肺癌防治知识知晓评分为51.73分,不同性别和不同年龄患者对肺癌防治和肾癌防治知识的知晓总分和知晓评分比较,差异无统计学意义(P＞0.05).肺癌防治知识的知晓率为0.0％～87.4％,肾癌防治知识的知晓率为9.6％ ～ 85.4％.知晓率最高的是刺激性干咳是早期最主要临床症状,最低的是早期发现肺癌最恰当的方法是胸部低剂量CT;各项肾癌防治知识知晓率为9.6％～81.3％,知晓率最高的是肥胖人数增多与近来肾癌发病率迅速上升有关,最低的是简单通过尿液检测、血液检测体格检查都不能发现早期肾癌.结论 肿瘤患者对肺癌和肾癌防治知识的认知普遍不足,尤其缺乏对早期肿瘤临床检查方法的认知.

Objective To analyze the prevalence and trend of malignant tumors in men.Methods The medical records of 74 917 male inpatients with malignant tumors were collected from a hospital in Beijing from January 1999 to December 2013.The distribution and characteristics were analyzed at different time and in different age groups.Results Mean age was 55.91±13.29,and most patients were 40 ～ 69 years old accounting for 74.3％.Number of patients had averagely increased 7.3％ annually among which the number of lung cancer increased mostly (3 286 patients,27.0％),followed by colorectal cancer (1 841 patients,15.2％),gastric cancer (1 770 patients,14.6％),thyroid cancer (1 241 patients,10.2％),esophageal cancer (973 patients,8.0％) and liver cancer (801 patients,6.6％).Condusion In the past 15 years,number of inpatients with malignant tumors has increased with time.Among them,lung cancer,colorectal cancer,gastric cancer,thyroid cancer,esophageal cancer and liver cancer have increased significantly.

Objective To analyze the proportion of the female patients with malignant tumors in a hospital in Beijing in recent years.Methods Hospitalization information of 71 318 inpatients with malignant tumors treated at a hospital in Beijing between January 1999 and December 2013 was collected.Distribution and its trend were analyzed at different time and in different age groups.Results Breast cancer,thyroid cancer,lung cancer,colorectal cancer,cervix cancer,ovarian cancer and gastric cancer were the most common cancers for women.Mean age was 51.36 years,and the majority of patients were 40 to 69 years old (73.3％).From 1999 to 2013,the incidence of malignant tumors increased by 9.6％ annually in women.Breast cancer had the greatest rate of increase with 4 006 (26.5％) cases followed by thyroid carcinoma with 3 263 (21.6％) cases,lung cancer with 2 184 (14.5％) cases,colorectal cancer with 1 157 (7.7％) cases,cervix cancer 1 060 (7.0％) cases,ovarian cancer in 838 (5.5％) cases and gastric cancer in 708 (4.7％) cases.Conclusion In the past several years,the overall number of female malignant tumors showed an upward trend,which was mainly due to the increase of breast cancer,thyroid cancer,lung cancer,colorectal cancer and cervix cancer.

Background and objective Studies found that there were changes in histological subtypes of lung cancer patients in China. This study investigated the effect of smoking on lung cancer histology and its trend in Chinese male. Methods Demographic, smoking history and histological information about male lung cancer patients diagnosed or treated from 2000 to 2012 was collected from Cancer Hospital, Chinese Academy of Medical Science. Trends of histological subtypes calculated with annual percentage change (APC).Results A total of 14,106 patients with lung cancer were enrolled, with smoking 11,750 cases and non-smoking 2,356 cases. The main histological type of smoking lung cancer was squamous cell car-cinoma (SCC)(39.38%), followed by adenocarcinoma (ADC)(29.85%). Among smokers, the proportion of SCC decreased from 44.19% to 35.50% (APC=-1.9%,P<0.001), however, the ADC increased from 15.25% to 41.85% (APC=6.8%,P<0.001). Adenosquamous carcinoma (ASC) was from 4.13% to 0.72% (APC=-14.9%,P<0.001). In non-smokers, the ADC was 53.86%, and SCC was 16.64%. ADC increased from 38.03% to 67.83% (APC=4.3%,P<0.001). Distributions of LCC and ASC were scattered.Conclusion Proportion of ADC increased significantly in smoking and non-smoking lung cancer patients, and the relationship between non-smoking factor exposure and lung cancer should be further studied.

Objective To examine the association between smoking and mortality of lung cancer in females in urban China. Method Used the national census data on causes of death and smoking from January 1986 to December 1988, and the data of 35 to 69 year-old females who died of lung cancer were selected, in 27 cities with adequate dead of lung cancer to analyze the correlation coefifcient between mortality rates of lung cancer and the smoking proportion of dead. Result From 1986 to 1988, mortality rate of lung cancer in 35 to 69 year-old females were 35.65/100 000 and the proportion of smoking infemales died of lung cancer were 38.42% in 27 cities. The proportions of smokers who started smoking in ages less than 20, 20 to 25 year-old and daily smoking from 10 to 19, the cumulated years of smoking for 40 years or over were founded signiifcantly positive correlated with the mortality rates of lung cancer in females of urban, with correlation coefifcients were at 0.59 (P=0.001), 0.51 (P=0.007), 0.44 (P=0.02) and 0.55 (P=0.003), respectively. Mortality rates of lung cancer in ages of 35 to 49, 50 to 59 years in females were significantly positive correlated with the percentage of females smokers dead from lung cancer, with correlation coefifcients were at 0.52 (P=0.005) and 0.44 (P=0.02). Conclusion The age to start smoking, daily smoking, cumulative years of smoking as well as smoking are important risk factors to lung cancer in females in urban China.

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