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癌癥死亡人數(shù)下降, 50 歲以下女性發(fā)病率卻在上升

Beth Greenfield
2025-01-21

目前,50歲以下女性癌癥發(fā)病率比男性高出82%。

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圖片來源:Getty Images

中青年女性癌癥發(fā)病率不斷上升且超過了同齡男性。50歲以下的女性最令人擔心,其癌癥發(fā)病率比同齡男性高出82%。

美國癌癥協(xié)會(ACS)首席科學官威廉·達胡特表示,這是該協(xié)會最新癌癥統(tǒng)計報告中與年齡和性別相關(guān)的 “顯著趨勢 ”之一。在一場新聞發(fā)布會上,達胡特介紹了報告重點。

2025年報告中也有好消息: 由于吸煙人數(shù)減少、早期檢測和治療手段改進,1991年至2022年期間美國癌癥死亡率總體下降了34%,意味著約有450萬死亡案例得以避免。

“由于吸煙率人數(shù)減少、治療手段提升和早期檢測,癌癥死亡率持續(xù)下降無疑是好消息,”報告第一作者,也是美國癌癥學會高級科學主任麗貝卡·西格爾在一份新聞稿中說。

她指出,“然而中青年女性患癌率上升,為好消息蒙上了一層陰影。中青年女性往往肩負著照護家人的責任。癌癥負擔從男性向女性轉(zhuǎn)移這一現(xiàn)象不禁讓人回想起 20 世紀初,當時女性罹患癌癥也更為常見?!?/p>

盡管癌癥死亡率總體上有所下降,不過(女性患)口腔癌、胰腺癌、子宮內(nèi)膜癌和肝癌的死亡率出現(xiàn)上升。

癌癥在美國是僅次于心臟病的第二大死因,也是 85 歲以下人群的最主要死因。報告稱,2025 年美國預計將有 2,041,910 例新增癌癥病例(每天5,600 例),癌癥死亡病例達618,120 例。

為編寫該報告,美國癌癥協(xié)會采用了癌癥登記處收集截至2021 年的數(shù)據(jù),以及國家衛(wèi)生統(tǒng)計中心收集截至 2022 年的死亡率數(shù)據(jù)。

性別差距

20世紀后期,尤其是90年代以來,男性癌癥發(fā)病率一直高于女性,不過現(xiàn)在50-64歲女性的發(fā)病率已超過男性。(發(fā)病率指的是在特定時間段內(nèi),各高危人群新確診的疾病或病例數(shù))。達胡特說,50歲以下女性的發(fā)病率比男性高82%,高于2002年的51%,主要由乳腺癌和甲狀腺癌導致。

過去四十年里,存活率下降的唯一一種癌癥是女性特有的子宮內(nèi)膜癌(又稱子宮體癌),該病是女性第四常見的癌癥,也是癌癥致死的第五大死因。報告指出,針對該癌癥取得的進展“落后于其他常見癌癥,至少部分反映出長期資金不足的問題”。

同樣值得注意的是,在65歲以下人群中,2021年女性肺癌發(fā)病率首次超過男性。

“現(xiàn)在65歲以下的女性肺癌的幾率要高于同齡男性?!彼赋觯摂?shù)據(jù)一定程度上反映了煙草的發(fā)展趨勢,女性開始吸煙的時間比男性晚,戒煙的速度也比男性慢。不過仍有20%的肺癌診斷病例并非吸煙者。

他補充說,肺癌的總體篩查率 “極其糟糕”,因為必須符合嚴格的檢測標準,例如每年20 包的吸煙史?!拔覀冊谔剿魅绾胃鐧z測出肺癌,即便(患者)不符合傳統(tǒng)標準,”達胡特說。

癌癥趨勢方面更多亮點

美國癌癥協(xié)會報告中的其他發(fā)現(xiàn)也發(fā)表在《臨床醫(yī)師癌癥雜志》(CA: A Cancer Journal for Clinicians)上,包括以下內(nèi)容:

? “驚人的 ”癌癥死亡率不平等現(xiàn)象依然存在:美國印第安人患腎癌、肝癌、胃癌和宮頸癌的比例是白人的兩到三倍。黑人死于前列腺癌、胃癌和子宮癌的幾率是白人的兩倍,死于宮頸癌的幾率比白人高 50%,而宮頸癌可以預防。

? 胰腺癌死亡情況: 胰腺癌是美國癌癥死亡的第三大原因,發(fā)病率和死亡率都在上升。

? 特定癌癥發(fā)病率攀升:(女性)乳腺癌、前列腺癌、胰腺癌、子宮癌、(女性)肝癌、(與人類乳頭狀瘤病毒有關(guān)的)口腔癌以及(女性)黑色素瘤等皮膚癌的發(fā)病率持續(xù)上升。

? 腸癌: 65 歲以下男性和女性的腸癌新確診率,30-44歲女性宮頸癌新確診率均有所上升。

? 兒童和青少年: 15-19歲青少年癌癥發(fā)病率持續(xù)上升,14歲及以下兒童的發(fā)病率有所下降。1970年以來,兒童癌癥死亡率下降了70%,青少年死亡率下降了63%,很大程度上因為白血病治療手段進步。

如何預防癌癥?

“患癌癥風險與家族史關(guān)系很大,”達胡特指出,這份報告 “呼吁人們更深入了解家族病史”。他強調(diào)稱,了解家族史可為個人癌癥篩查指南提供指導。

“積極調(diào)整飲食”同樣重要,應(yīng)避免食用過度加工的食品,多吃富含營養(yǎng)素和抗氧化劑的植物性食物;規(guī)律堅持某種形式的鍛煉;避免接觸已知的致癌物,包括煙草和酒精,因為煙草和酒精與至少七種癌癥存在明確關(guān)聯(lián),所以美國衛(wèi)生局局長才會呼吁在酒類標簽上標注癌癥警示。

美國癌癥協(xié)會臨時首席執(zhí)行官韋恩·弗雷德里克在新聞稿中表示,希望新報告中列出的數(shù)據(jù)能助力醫(yī)學界改善未來個人的健康狀況。

“報告強調(diào)了加大癌癥治療和護理投資的必要性,包括推進公平的篩查項目,尤其是針對弱勢群體患者和癌癥康復者。篩查項目是癌癥早期檢測的關(guān)鍵環(huán)節(jié),擴大服務(wù)覆蓋面可挽救無數(shù)生命。”他說。

“也要認真應(yīng)對癌癥發(fā)病率的變化,主要是女性群體發(fā)病率上升。”弗雷德里克補充說,“醫(yī)療提供方、政策制定者和社區(qū)應(yīng)重視開展協(xié)同合作,評估死亡率上升的具體情況和原因?!保ㄘ敻恢形木W(wǎng))

譯者:梁宇

審校:夏林

中青年女性癌癥發(fā)病率不斷上升且超過了同齡男性。50歲以下的女性最令人擔心,其癌癥發(fā)病率比同齡男性高出82%。

美國癌癥協(xié)會(ACS)首席科學官威廉·達胡特表示,這是該協(xié)會最新癌癥統(tǒng)計報告中與年齡和性別相關(guān)的 “顯著趨勢 ”之一。在一場新聞發(fā)布會上,達胡特介紹了報告重點。

2025年報告中也有好消息: 由于吸煙人數(shù)減少、早期檢測和治療手段改進,1991年至2022年期間美國癌癥死亡率總體下降了34%,意味著約有450萬死亡案例得以避免。

“由于吸煙率人數(shù)減少、治療手段提升和早期檢測,癌癥死亡率持續(xù)下降無疑是好消息,”報告第一作者,也是美國癌癥學會高級科學主任麗貝卡·西格爾在一份新聞稿中說。

她指出,“然而中青年女性患癌率上升,為好消息蒙上了一層陰影。中青年女性往往肩負著照護家人的責任。癌癥負擔從男性向女性轉(zhuǎn)移這一現(xiàn)象不禁讓人回想起 20 世紀初,當時女性罹患癌癥也更為常見?!?/p>

盡管癌癥死亡率總體上有所下降,不過(女性患)口腔癌、胰腺癌、子宮內(nèi)膜癌和肝癌的死亡率出現(xiàn)上升。

癌癥在美國是僅次于心臟病的第二大死因,也是 85 歲以下人群的最主要死因。報告稱,2025 年美國預計將有 2,041,910 例新增癌癥病例(每天5,600 例),癌癥死亡病例達618,120 例。

為編寫該報告,美國癌癥協(xié)會采用了癌癥登記處收集截至2021 年的數(shù)據(jù),以及國家衛(wèi)生統(tǒng)計中心收集截至 2022 年的死亡率數(shù)據(jù)。

性別差距

20世紀后期,尤其是90年代以來,男性癌癥發(fā)病率一直高于女性,不過現(xiàn)在50-64歲女性的發(fā)病率已超過男性。(發(fā)病率指的是在特定時間段內(nèi),各高危人群新確診的疾病或病例數(shù))。達胡特說,50歲以下女性的發(fā)病率比男性高82%,高于2002年的51%,主要由乳腺癌和甲狀腺癌導致。

過去四十年里,存活率下降的唯一一種癌癥是女性特有的子宮內(nèi)膜癌(又稱子宮體癌),該病是女性第四常見的癌癥,也是癌癥致死的第五大死因。報告指出,針對該癌癥取得的進展“落后于其他常見癌癥,至少部分反映出長期資金不足的問題”。

同樣值得注意的是,在65歲以下人群中,2021年女性肺癌發(fā)病率首次超過男性。

“現(xiàn)在65歲以下的女性肺癌的幾率要高于同齡男性?!彼赋?,該數(shù)據(jù)一定程度上反映了煙草的發(fā)展趨勢,女性開始吸煙的時間比男性晚,戒煙的速度也比男性慢。不過仍有20%的肺癌診斷病例并非吸煙者。

他補充說,肺癌的總體篩查率 “極其糟糕”,因為必須符合嚴格的檢測標準,例如每年20 包的吸煙史?!拔覀冊谔剿魅绾胃鐧z測出肺癌,即便(患者)不符合傳統(tǒng)標準,”達胡特說。

癌癥趨勢方面更多亮點

美國癌癥協(xié)會報告中的其他發(fā)現(xiàn)也發(fā)表在《臨床醫(yī)師癌癥雜志》(CA: A Cancer Journal for Clinicians)上,包括以下內(nèi)容:

? “驚人的 ”癌癥死亡率不平等現(xiàn)象依然存在:美國印第安人患腎癌、肝癌、胃癌和宮頸癌的比例是白人的兩到三倍。黑人死于前列腺癌、胃癌和子宮癌的幾率是白人的兩倍,死于宮頸癌的幾率比白人高 50%,而宮頸癌可以預防。

? 胰腺癌死亡情況: 胰腺癌是美國癌癥死亡的第三大原因,發(fā)病率和死亡率都在上升。

? 特定癌癥發(fā)病率攀升:(女性)乳腺癌、前列腺癌、胰腺癌、子宮癌、(女性)肝癌、(與人類乳頭狀瘤病毒有關(guān)的)口腔癌以及(女性)黑色素瘤等皮膚癌的發(fā)病率持續(xù)上升。

? 腸癌: 65 歲以下男性和女性的腸癌新確診率,30-44歲女性宮頸癌新確診率均有所上升。

? 兒童和青少年: 15-19歲青少年癌癥發(fā)病率持續(xù)上升,14歲及以下兒童的發(fā)病率有所下降。1970年以來,兒童癌癥死亡率下降了70%,青少年死亡率下降了63%,很大程度上因為白血病治療手段進步。

如何預防癌癥?

“患癌癥風險與家族史關(guān)系很大,”達胡特指出,這份報告 “呼吁人們更深入了解家族病史”。他強調(diào)稱,了解家族史可為個人癌癥篩查指南提供指導。

“積極調(diào)整飲食”同樣重要,應(yīng)避免食用過度加工的食品,多吃富含營養(yǎng)素和抗氧化劑的植物性食物;規(guī)律堅持某種形式的鍛煉;避免接觸已知的致癌物,包括煙草和酒精,因為煙草和酒精與至少七種癌癥存在明確關(guān)聯(lián),所以美國衛(wèi)生局局長才會呼吁在酒類標簽上標注癌癥警示。

美國癌癥協(xié)會臨時首席執(zhí)行官韋恩·弗雷德里克在新聞稿中表示,希望新報告中列出的數(shù)據(jù)能助力醫(yī)學界改善未來個人的健康狀況。

“報告強調(diào)了加大癌癥治療和護理投資的必要性,包括推進公平的篩查項目,尤其是針對弱勢群體患者和癌癥康復者。篩查項目是癌癥早期檢測的關(guān)鍵環(huán)節(jié),擴大服務(wù)覆蓋面可挽救無數(shù)生命?!彼f。

“也要認真應(yīng)對癌癥發(fā)病率的變化,主要是女性群體發(fā)病率上升?!备ダ椎吕锟搜a充說,“醫(yī)療提供方、政策制定者和社區(qū)應(yīng)重視開展協(xié)同合作,評估死亡率上升的具體情況和原因?!保ㄘ敻恢形木W(wǎng))

譯者:梁宇

審校:夏林

Cancer rates in young and middle-aged women are rising, surpassing those in men of the same age—most alarmingly in women under 50, whose rates are now 82% higher than those of their male counterparts.

It’s among the “striking trends” related to age and gender found in the American Cancer Society’s latest cancer statistics report, said ACS chief scientific officer Dr. William Dahut, who presented highlights at a press conference this week.

There was also good news in the 2025 report, released on Thursday: The American cancer mortality rate is down overall, declining 34% between 1991 and 2022 because of smoking reductions, earlier detection, and improved treatments, representing approximately 4.5 million prevented deaths.

“Continued reductions in cancer mortality because of drops in smoking, better treatment, and earlier detection is certainly great news,” said lead author and ACS senior scientific director Rebecca Siegel in a news release.

“However,” she noted, “this progress is tempered by rising incidence in young and middle-aged women, who are often the family caregivers, and a shifting cancer burden from men to women, harkening back to the early 1900s when cancer was more common in women.”

And despite overall declines in cancer mortality, death rates are increasing for cancers of the mouth and oral cavities, pancreas, lining of the uterus, and liver (for women).

Cancer is the second leading cause of death in the U.S., behind heart disease, and the leading cause among those under 85. Overall, in 2025, there will be an estimated 2,041,910 new cancer diagnoses in the U.S. (5,600 each day) and 618,120 cancer deaths, according to the report.

To compile it, ACS used data from national cancer registries through 2021 and mortality data collected from the National Center for Health Statistics through 2022, using .

The gender gap

While men, since the later 1900s and particularly in the ’90s, have had a higher cancer incidence than women, incidence rates in women 50-64 years of age have now surpassed those in men. (Incidence refers to the newly identified cases of a disease or condition per population at risk over a specified timeframe.) The higher rates in women under 50—82% higher than their male counterparts, up from 51% in 2002—are being driven largely by breast and thyroid cancers, said Dahut.

The only cancer for which survival has decreased over the past four decades is one specific to women: endometrial cancer (also called uterine corpus cancer), which is the fourth most common cancer in women and the fifth most common cause of cancer death. Progress “has lagged behind other common cancers, at least in part reflecting persistent underfunding,” the report notes.

Also notable is that women’s lung cancer rates surpassed those of men in the under-65 population for the first time in 2021.

“Now, if you’re a woman under 65, you have a greater chance of developing lung cancer than a man of that age,” said Dahut. It’s something that in part reflects tobacco trends, he noted, and the fact that women began smoking later than men and were slower to quit—although 20% of lung cancer diagnoses still come from non-smokers.

Plus, he adds, overall screening rates for lung cancer are “abysmal,” as one must fit into strict criteria for testing, including having a 20-pack-a-year history. “We are interested in ways to detect earlier on, even if [patients] don’t fit into traditional guidelines,” Dahut said.

More important cancer-trend highlights

Other findings in the ACS report, also published today in CA: A Cancer Journal for Clinicians, include the following:

? “Alarming” cancer mortality inequalities persist: Rates in Native American people are two to three times higher than white people for kidney, liver, stomach, and cervical cancers. Black people are twice as likely to die than white people from prostate, stomach, and uterine corpus cancers, and 50% more likely to die from cervical cancer, which is preventable.

? Pancreatic cancer deaths: The third leading cause of cancer death in the U.S. is seeing an increase in both incidence and mortality rates.

? Climbing incidence rates for specific cancers: Rates continue to climb for cancers of the breast (for women), prostate, pancreas, uterus, liver (for women), mouth (as associated with the human papillomavirus), and skin in the form of melanoma (for women).

? Colorectal cancer: The rate of new diagnoses of colorectal cancer in men and women under 65 and cervical cancer in women 30-44 has increased.

? Kids and adolescents: Cancer incidence among adolescents 15-19 has continued to rise, while incidence in children 14 and under has declined. Mortality rates in children have dropped by 70% and by 63% in adolescents since 1970, thanks largely to improved leukemia treatments.

What can I do about cancer?

“There is a really important link between risk and family history,” said Dahut, noting that this report is a “call-out for people to understand their family history better.” And knowing that history, he stressed, will guide individual cancer screening guidelines.

Also important is to be “proactive on diet,” avoiding ultra-processed foods and eating foods rich in nutrients and antioxidants that are largely plant-based; to regularly do some form of exercise; and to avoid known carcinogens including tobacco and alcohol—which has a clear link to at least seven types of cancer and just prompted the U.S. Surgeon General to call for a cancer warning on alcohol labels.

Hopefully the data contained in the new ACS report will help the medical world make a difference to future outcomes of individuals, said Dr. Wayne A. I. Frederick, interim chief executive officer of ACS, in the news release.

“This report underscores the need to increase investment in both cancer treatment and care, including equitable screening programs, especially for underserved groups of patients and survivors. Screening programs are a critical component of early detection, and expanding access to these services will save countless lives,” he said.

“We also must address these shifts in cancer incidence, mainly among women,” Frederick added. “A concerted effort between healthcare providers, policymakers and communities needs to be prioritized to assess where and why mortality rates are rising.”

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