幻灯片 1

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1 中国内地癌症防治三年行动计划 China s Prevention and Treatment Three-year Action Plan 常继乐 Jile CHANG 国家卫生计生监察专员中华人民共和国国家卫生计生委疾病预防控制局 Commissioner Bureau of Disease Prevention & Control National Health & Family Planning Commission of People s Republic of China (NHFPC)

2 内容概要 Contents 1 中国内地癌症防控形势 Status of Control in China 2 行动计划内容介绍 Introduction of The Action Plan 3 未来合作建议 Suggestion for Future Collaboration Action 2

3 中国内地癌症流行情况 Trends for Crude and Age-standardized Rates of in China Crude and Age-standardized rates/ 发病率 1/ 男性粗率男性调率女性粗率女性调率 Male crude rate Male standardized rate Female crude rate Female standardized rate 全球每年癌症新增病例 1400 万, 中国内地占 24%, 发病率位居 68 位部分癌症如食管癌胃癌中国内地发病人数占全球发病人数的 50% 以上 The number of new cancer cases is around 14 million worldwide each year, China accounts for 24% of them, ranks 68 in incidence rate. Some cancers like esophageal cancers and stomach cancers accounts for more than 50% of the number of incidence worldwide. 3

发病前 10 位恶性肿瘤及构成 Incidence Rate of Top 10 s 男女 Lung 肺癌 23.01% Breast Stomach 胃癌 15.45% Lung Liver 肝癌 13.79% Colorectal Esophageal Colorectal 食管癌结直肠癌 10.71% 9.

4 发病前 10 位恶性肿瘤及构成 Incidence Rate of Top 10 s 男女 Lung 肺癌 23.01% Breast Stomach 胃癌 15.45% Lung Liver 肝癌 13.79% Colorectal Esophageal Colorectal 食管癌结直肠癌 10.71% 9.30% Stomach Liver Bladder 膀胱癌 2.77% Cervical cancer Prostate Pancreatic Brain Tumor 前列腺癌胰腺癌脑瘤 2.55% 2.37% 2.26% Esophageal Thyroid Uterine Lymphoma 淋巴瘤 2.15% Ovarian 数据来源 :(2014 年中国内地肿瘤统计报告 ) 4

5 Mortality Rate 死亡率 1/ 中国内地癌症死亡率变化 Trends of Mortality Rate of s in China 男性粗率男性调率女性粗率女性调率 Male crude rate Male age-standardized rate Female crude rate Female age-standardized rate 年份全球每年癌症死亡约 820 万, 中国内地占 27% 死亡率位居 42 位 The number of cancer deaths is around 8.2 million worldwide each year, China accounts for 27% of them, ranks 42 in mortality rate. 5

中国内地疾病死因构成 Causes of Deaths in China 100 90 80 70 60 50 40 30 20 10 23.

6 中国内地疾病死因构成 Causes of Deaths in China % Infectious Infectious and parasitic diseases Malignant s neoplasms Heart diseasesheart Diseases Cerebrovascular Cerebrovascular diseases diseases Diseases of the respiratory system Injuries Injuries Others Unknown 6

7 死亡前 10 位恶性肿瘤及构成 Mortality Rate of Top 10 s 男女 Lung Lung Liver Stomach Esophageal Colorectal Pancreatic Brain Tumor Leukemia Stomach Liver Esophageal Colorectal Breast Pancreatic Cervical Lymphoma Bladder Brain Tumor Leukemia 数据来源 :(2014 年中国内地肿瘤统计报告 ) 7

8 癌种中国内地癌症 5 年生存率 (%) 5-Year Survival Rate of s in China (%) 中国内地肺癌 Lung 16.1 胃癌 Stomach 27.4 肝癌 Liver 10.1 食管癌 Esophageal 20.9 卵巢癌 Ovarian 38.9 皮肤黑色素瘤 Melanoma Skin 38.8 结直肠癌 Colorectal 47.2 女性乳腺癌 Female Breast 73.1 前列腺癌 Prostate 53.8 白血病 Leukemia 19.6 脑瘤 Brain Tumor 18.2 胰腺癌 Pancreatic 11.7 合计

9 人口老龄化 Ageing population 影响因素流行情况 Prevalence of Risk Factors 2014 年底 60 岁以上老人 15.5% By the end of 2014, 15.5% of the total population aged 60 or above 慢性感染 Chronic Infection 不健康生活方式 Unhealthy Lifestyles 42% 的居民体重超过正常水平 42% of the total population are overweight 15 岁以上人群吸烟率 28.1% Smoking rate for people over 15 years old is 28.1% 饮酒者中有害饮酒率为 9.3% 9.3% of alcohol consumers practise binge drinking 成人经常锻炼率为 18.7% 18.7% of adults exercise regularly 环境污染 Environmental Pollution 职业暴露 Occupational Exposure 9

10 发展趋势 Trends of Development 兼具发达国家与发展中国家癌谱特征 spectrum consistent with the characteristics in the developed and developing countries 肝癌胃癌食管癌 : 下降趋势, 但仍是主要发病死亡原因 Liver cancers, stomach cancers & esophageal cancers: Decreasing trends but are still the main causes of death 肺癌乳腺癌结直肠癌 : 迅速上升 Lung cancers, breast cancers, colorectal cancers: Accelerating trends 老龄化进程加快 Accelerating trend of population ageing 世界卫生组织预测, 到 2050 年, 中国内地将有 35% 的人口超过 60 岁 Estimated by the World Health Organization, 35% of the population in Mainland China will be over 60 years old by 环境与健康问题形势仍然严峻 Environmental and Health problems are still critical 10

11 16 字工作机制 Working Principles Government-led Directives Departmental Collaboration Community Engagement Citizens Participation 11

12 健康管理模式 Health Management Model 健康 Health 自我为主人际互助社会支持政府指导 Self-motivated Interpersonal Assistance Community Support Governmental Guidance 12

13 内容概要 Contents 1 中国内地癌症防控形势 Status of Control in China 2 行动计划内容介绍 Introduction of The Action Plan 3 未来合作建议 Suggestion for Future Collaboration Action 13

14 中国内地癌症防治三年行动计划 ( 年 ) China s Prevention and Treatment Three-Year Action Plan ( ) 16 部委联合印发 Jointly issued by NHFPC and16 other governmental departments 延续幵深入推进既往有效策略措施 Continue and further foster existing effective strategies and measures 聚焦于近期迫切需要解决的问题 Focus on the urgent need to solve the recent problems 14

15 总目标 Goals give priority to prevention, integrate prevention and treatment, combine traditional Chinese and western medicine 坚持预防为主防治结合中西医幵重加强癌症防治体系建设, 提高癌症防治能力 strengthen cancer prevention and controls, improve treatment and prevention strategies 实施癌症综合防治策略和措施, 为遏制癌症增长降低癌症疾病负担奠定基础 Implement integrated strategies and measures of cancer prevention & controls 15

16 到 2017 年达到的具体目标 Specific Goals to be achieved by 2017 ( 一 ) 建立国家和省级癌症防治工作领导协调机制, 落实部门职责, 控制主要可防可控致癌因素增长水平 1. Establish a national and provincial cancer prevention and treatment leadership coordination system to carry out department responsibilities and bring major carcinogenic factors under control. ( 二 ) 完善国家癌症中心机构能力建设并充分发挥其技术指导作用, 基本建立以医院疾控机构为主体和基层医疗机构上下联动的癌症综合防治网络依托现有资源加快提升区域癌症综合防治服务管理水平 2. Improve the capacity of the national cancer center and increase its role in technical guidance. Build a comprehensive cancer prevention and treatment network that involves hospitals, disease control institutes and community-level medical facilities. Upgrade regional cancer service management. ( 三 ) 进一步规范肿瘤登记制度, 肿瘤登记覆盖全国 30% 以上人口, 掌握全国和各省 ( 区市 ) 癌症发病和死亡情况, 绘制全国癌症地图 3. Further standardize a canccer registration system to cover 30 percent of the population, track cancer occurrences and deaths in provinces, autonomous regions and municipalities, and formulate a national cancer map. 16

17 到 2017 年达到的具体目标 Specific Goals to be achieved by 2017 ( 四 ) 癌症防治核心知识知晓率达到 60%, 成人吸烟率下降 3% 4. Increase knowledge of cancer prevention and treatment in 60 percent of the population, and reduce the adult smoking rate by three percent. ( 五 ) 以肺癌肝癌胃癌食管癌大肠癌乳腺癌宫颈癌鼻咽癌为重点, 扩大癌症筛查和早诊早治覆盖面, 重点地区重点癌症早诊率达到 50% 5. Focus on lung, liver, gastric, esophageal, colorectal, breast, cervical and nasopharygeal cancers, expand cancer screening, early diagnosis and treatment coverage, and ensure 50 percent of major cancers can be diagnosed and treated at an early stage in major areas. ( 六 ) 完善重点癌症的诊疗规范, 推广癌症机会性筛查和规范化诊疗, 逐步提高重点癌症 5 年生存率, 降低病死率 6. Improve standardized diagnosis and treatment of major cancers, expand cancer opportunistic screening and standardized diagnosis and treatment, gradually increase the five-year survival rate for major cancers and reduce the overall fatality rate. 17

18 1 履行部门职责, 落实综合措施 Carry out departmental duties and implement integrated measures 具体措施 Concrete Measures 多部门联合发文, 明确各部门职责分工 Define job descriptions of different departments 卫生计生部门 : 负责制订癌症防治规划规范技术标准, 做好癌症防治工作的组织协调技术指导健康教育预防诊治和监测评估 Health Planning Department: Coordination of cancer control plans, specifications, technical standards, departmental coordinations, technical guidance, health education, preventive treatment, monitoring and evaluation 发展改革部门 Reformations Developing Department 教育部门 Education Department 科技部门 Information Technology Department 18

19 具体措施 Concrete Measures 2. 加强体系建设, 提高服务能力 Strengthen structure of system and enhance service capacity 2009 年成立国家癌症中心 National Centre was developed in 省建立肿瘤防治研究办公室 26 provinces established Research Office 加快推进国家癌症中心机构能力建设, 提升区域癌症防治服务能力 Accelerate institutional capacity-building in National Center, also enhance regional cancer prevention service capacity 建立以医院疾控机构为主体和基层医疗机构上下联劢的癌症综合防治网络 Setting up hospitals and disease control agencies as the main and primary health care institutions, connecting with basic healthcare systems to form a comprehensive cancer prevention network 19

3. 加强肿瘤信息收集工作 Strengthen the collection of cancer related information 具体措施 Concrete Measures 2002 年启劢全国肿瘤登记工作, 目前覆盖近 3 亿人口 Set up National Registry in 2002, it currently

20 3. 加强肿瘤信息收集工作 Strengthen the collection of cancer related information 具体措施 Concrete Measures 2002 年启劢全国肿瘤登记工作, 目前覆盖近 3 亿人口 Set up National Registry in 2002, it currently covers nearly 300 million people 扩大肿瘤登记覆盖面,2017 年覆盖全国 30% 以上人口 ( 约 4 亿人口 ) Expand the coverage of cancer registries, aim at covering the more than 30% of the country's population in 2017 (about 400 million people) 定期发布癌症相关信息 Release cancer related information regularly 编绘全国癌症地图 Compilte national cacner atlas 收集癌症临床诊治及预后信息, 科学指导癌症规范化诊疗 Collect information about clinical diagnosis and prognosis of cancer, develop evidence based standardized cancer treatment 20

21 具体措施 Concrete Measures 4. 推进癌症危险因素综合防控 Implement comprehensive prevention and control of risk factors for cancer 烟草控制 : 促进国家控烟规划实施严格实施公共场所全面禁烟禁止烟草广告促销赞劣强化卷烟包装标识健康危害警示提高烟草制品价格 ( 到 2017 年成人吸烟率下降 3%) Tobacco control: the promotion of implementing national tobacco control plan, strict banning on smoking in public places, prohibit tobacco advertising and sponsorship, stress the health hazards of smoking on cigarette packaging, raise the price of tobacco products ( adult smoking rate drops 3% by 2017) 疫苗接种 : 乙肝疫苗 HPV 疫苗 Vaccination: Hepatitis B Vaccination, HPV Vaccination 环境污染整治 Rectificating environmnetal pollution 职业暴露控制 Controlling occupational exposure 21

22 具体措施 Concrete Measures 5. 推广癌症筛查及早诊早治策略 Promote cancer screening, early detection and treatment strategies 项目名称 Project Name 农村癌症早诊早治项目 early detection and treatment project in rural areas 农村妇女宫颈癌乳腺癌检查项目 Cervical cancer & breast cancer screening project for women in rural areas 淮河流域癌症早诊早治项目 early detection and treatment project in Huaihe River Basin 启劢时间 Starting Time 2005 年 Year 年 Year 年 Year 2007 覆盖地区 Area covered 32 个省区 177 个县 32 provinces & 177 counties 各省区 Every Province & county 4 个省 26 个县区 4 provinces & 26 counties 受益人口 Beneficiar y population 156 万 1.56 million 4887 万 million 26 万 0.26 million 城市癌症早诊早治项目 early detection and treatment project in urban cities 2012 年 Year 个省区 16 provinces 30 万 0.3 million 22

23 具体措施 Concrete Measures 5. 推广癌症筛查及早诊早治策略 Promote cancer screening, early detection and treatment strategies 对发病率高筛查手段成熟的食管癌宫颈癌等重点癌症, 逐步扩大早诊早治项目覆盖面到 2017 年重点地区重点癌症早诊率达到 50% Expanding the coverage of early detection and treatment project for cancers with high incidence rate and mature screening methods, for example cervical cancer and esophageal cancers. (early detection rate reaches 50% by 2017 for key cancers in key areas) 对筛查手段尚丌成熟的重点癌症, 开展联合攻关, 优化适宜技术 Conduct research and optimize appropriate technology for other major cancers which screening methods are not yet well developed. 23

24 具体措施 Concrete Measures 6. 提高癌症诊疗水平 Enhance quality of cancer diagnosis and treatment 完善重点癌症诊疗规范 Improve major cancer diagnostic and treatment practices 加强诊疗规范培训 Strengthening tranings on diagnostic and treatment practices 推广新技术 Promote new technology 提高重点癌症 5 年生存率, 降低病死率 Increase the 5-year survival rates and decrease mortality rates in major cancers. 24

25 具体措施 Concrete Measures 7. 推劢抗肿瘤药研制生产 Promote research and manufacture of anti-cancer drugs 针对丌同情况, 提出提高药物可及性的相应措施 Proposed measures to increase the availability of drugs according to different situations 支持研制开发具有中国自主知识产权的创新药 Support research and development of new and innovative drugs 建立谈判机制, 降低采购价格 Establish negotiation mechanism, reduce the purchase price of drugs 25

26 具体措施 Concrete Measures 8. 加大中医药防治癌症工作力度 Enhance the role of Traditional Chinese Medicine (TCM) in cancer prevention and treatment 充分发挥中医药在肿瘤防治中的优势和作用 Fully express the advantages and usage of TCM in cancer prevention and control 强化肿瘤中医临床防治能力建设 Strengthening the capacity building in clinical cancer prevention and control of TCM 优化临床路径和诊疗方案 Optimizing clinical pathways and treatment programs 创新中医药不现代技术相结合的中医肿瘤诊疗模式 Develop cancer treatment models by combining modern technology with innovatice chinese medicine. 26

27 具体措施 Concrete Measures 9. 加强科学研究和国际合作 Strengthen scientific research and International collaboration 致癌因素癌前病变等基础性研究 Basic cancer research on carcinogens and precancerous pathological changes 早期筛查检测等应用性研究 Applied research on early screening detections 早期诊断试剂疫苗等药物研究 Pharmaceutical research on early diagnostic reagents, vaccines, etc 中医药研究 Research on TCM 27

28 10. 加强科普宣传, 提高全民防癌意识 Enhance media promotion, increase awareness of the general public on cancer prevention 传统媒体 : 广播电视等 Traditional Media: radio, television, etc 新媒体 : 互联网微博微信等 New Media: internet, weibo, wechat, etc 形式多样 : 防癌公益广告与题节目影视文艺作品科普图书 Diversified formats: Anti-cancer commcercials, special programs, films, art works, books 充分利用卫生相关节日纨念日 Make good use of the health-related festival anniversaries 鼓励社会组织和癌症防治机构共同行劢 Encourage collaboration between social organizations and cancer prevention organizations 具体措施 Concrete Measures 28

29 内容概要 Contents 1 中国内地癌症防控形势 Status of Control in China 2 行动计划内容介绍 Introduction of The Action Plan 3 未来合作建议 Suggestion for Future Collaboration Action 29

30 健康亚太 2020 倡议 Healthy Asia-Pacific 2020 慢性病等疾病威胁的增加对各国卫生系统乃至经济社会环境可持续发展产生重大挑战 The threats of diseases like chronic diseases have increased the burden of the national health systems. It has also created major challenges economically, socially and environmentally 加强慢性非传染性疾病的防控是健康亚太 2020 的四大重点工作领域之一 One of the four main areas in the work of the Healthy Asia-Pacific 2020 is strengthen the prevention and control of non-communicable chronic diseases 倡导通过全政府行劢全社会参不全区域合作的方式, 实现生命全程的健康不福祉 With full governmental action, full society participation and full regional cooperation to achieve healthy and well-being of the entire life 30

31 合作建议 Suggestion for Future Cooperation 加强经验交流和政策共享 Strengthen the exchange and sharing of experience and policy 加强技术协作和能力建设 Strengthen technical cooperation and capacity-building 加强人员交流不互访 Strengthen personnel exchanges and visits 重点领域 : Main focus 致癌因素防控 Control risk factors 癌症早诊早治政策不适宜技术 Policy and technology in cancer early detection and treatment 癌症诊疗技术 treatment technology 康复晚期姑息治疗和临终关怀 Rehabilitation, palliative and hospice care 31

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<4D F736F F D D323630D6D0B9FAD3A6B6D4C6F8BAF2B1E4BBAFB5C4D5FEB2DFD3EBD0D0B6AF C4EAB6C8B1A8B8E6> 中国应对气候变化的政策与行动 2013 年度报告国家发展和改革委员会二〇一三年十一月 100% 再生纸资源目录前言... 1 一应对气候变化面临的形势... 3 二完善顶层设计和体制机制... 4 三减缓气候变化... 8 四适应气候变化... 20