Liver cancer incidence and mortality in China: Temporal trends and projections to 2030

Objective: Liver cancer is one of the most common cancers and major cause of cancer deaths in China,which accounts for over 50% of new cases and deaths worldwide.The systematic liver cancer statistics including of projection through 2030 could provide valuable information for prevention and control strategies in China,and experience for other countries.Methods: The burden of liver cancer in China in 2014 was estimated using 339 cancer registries’ data selected from Chinese National Cancer Center(NCC).Incident cases of 22 cancer registries were applied for temporal trends from 2000 to 2014.The burden of liver cancer through 2030 was projected using age-period-cohort model.Results: About 364,800 new cases of liver cancer(268,900 males and 95,900 females) occurred in China,and about 318,800 liver cancer deaths(233,500 males and 85,300 females) in 2014.Western regions of China had the highest incidence and mortality rates.Incidence and mortality rates decreased by about 2.3% and 2.6% per year during the period of 2000-2014,respectively,and would decrease by more than 44% between 2014 and 2030 in China.The young generation,particularly for those aged under 40 years,showed a faster down trend.Conclusions: Based on the analysis,incidence and mortality rates of liver cancer are expected to decrease through 2030,but the burden of liver cancer is still serious in China,especially in rural and western areas.Most cases of liver cancer in China can be prevented through vaccination and more prevention efforts should be focused on high risk groups.

中国预期寿命与癌症发病率和死亡率的相互影响:基于人群的聚类分析

背景与目的在发达国家和发展中国家中,癌症和预期寿命之间的相关性均得到了良好的确立。中国幅员辽阔,人口结构和医疗保健有着显著的地理差异,这为分析预期寿命与癌症发病率和死亡率之间复杂的相关性提供了难得的机会。方法提取全国肿瘤登记中心2013年共255个单位(城市或县)的癌症数据。单位水平的预期寿命数据从国家疾病预防控制中心获得。采用线性回归分析方法分析癌症粗发病率和死亡率与预期寿命的相关性。在另一项分析中,预期寿命被定级为低(<76岁)、中(76–80岁)或高(>80岁)。结果总体而言,癌症发病和死亡率均与男性和女性的预期寿命呈正相关(R分别为0.37和0.50,P<0.001)。这种相关性在下列癌症中显著:男性的肺癌、结直肠癌、前列腺癌、膀胱癌、胰腺癌与淋巴瘤(R:0.36–0.58,P <0.001);女性的肺癌、乳腺癌、结直肠癌、甲状腺癌、子宫癌与卵巢癌(R:0.18–0.51,P<0.001)。我们未观察到上消化道癌症与预期寿命相关。预期寿命为低、中、高水平的肿瘤登记点个数分别为110、101和44个。在预期寿命水平高的地区观察到的癌症年龄标准化发病率(192.83/100,000)最高。在预期寿命最低的地区年龄标准化死亡率(118.44/100,000)最高。胃癌、肝癌和食管癌是低、中预期寿命地区的主要癌症类型。相比之下,预期寿命高的地区结直肠癌、女性乳腺癌和男性前列腺癌的发病率和死亡率高。结论在中国,预期寿命越长总体癌症发病率和死亡率越高。不同预期寿命水平地区的癌症模式不同。在制订预防和治疗癌症策略时必须考虑预期寿命水平的影响。

The epidemiology of colorectal cancer in China

Objective:Colorectal cancer(CRC)is one of the most common cancers and the major cause of cancer death in China.The aim of this study was to estimate the burden of CRC in China.Materials and methods:Data from the National Cancer Center(NCC)of China was used and stratified by area(urban/rural),sex(male/female)for analyzing the age-speci c incidence and mortality rates.Time trend of colorectal cancer was calculated based on the 22 high-quality cancer registries in China.National new cases and deaths of colorectal cancer were estimated using age-speci c rates multiplied by the corresponding national population in 2014.The Chinese population in 2000 and Segi’s world population were used to calculate age-standardized rates of colorectal cancer in China.Results:Overall,370,400 new colorectal cancer cases and 179,600 deaths were estimated in China in 2014,with about 214,100 new cases in men and 156,300 in women.Meanwhile,104,000 deaths cases of colorectal cancer were men and 75,600 deaths were women,which accounted for 9.74%and 7.82%of all cancer incidence and deaths in China,separately.Relatively higher incidence and mortality was observed in urban areas of China.And the Eastern areas of China showed the highest incidence and mortality.The age-standardized incidence and mortality rate of colorectal cancer has increased by about 1.9%per year for incidence and about 0.9%per year for mortality rate from 2000 to 2014.Conclusion:With gradually higher incidence and mortality rate in the past 15 years,colorectal cancer became a major challenge to China’s public health.E ective control strategies are needed in China.

Incidence and mortality of cervical cancer in China in 2015

Objective:To estimate the incidence and mortality of cervical cancer in China based on the cancer registration data in 2015,collected by the National Central Cancer Registry(NCCR).Methods:There were 501 cancer registries that submitted data to the NCCR,whose data were the basis for estimating the incidence and mortality of cervical cancer in China in 2015.After evaluating the data quality,368 registries’data were accepted for the analysis and stratified by area(urban/rural)and age group.Combined with data on the national population in 2015,the nationwide incidence and mortality of cervical cancer were estimated.Cervical Cancer cases of 22 cancer registries were applied for temporal trends from 2000 to 2015.The Chinese population census in 2000 and Segi’s population were used to calculate age-standardized incidence and mortality rates.Results:An estimated 111,000 new cases were attributed to cervical cancer in China in 2015,accounting for 6.24%of all female new cancer cases in that year in China.The crude rate(CR)of incidence and age-standardized incidence rates by the China standard population(ASIRC)and by Segi’s world standard population(ASIRW)of cervical cancer were 16.56/100,000,11.78/100,000,and 10.86/100,000,respectively.The cumulative incidence rate from birth to 74 years old was 1.15%,whereas the calculation of incidence rates over the truncated age range of 35-64 years by Segi’s world standard population(T-ASIRW)was 27.66/100,000.The estimates of cervical cancer deaths were about 33,800 and 3.94%of all female cancer-related deaths in China in 2015,with a crude mortality rate of 5.04/100,000.The age-standardized mortality rates adjusted by the Chinese standard population(ASMRC)and by world Segi’s population(ASMRW)were 3.29/100,000 and 3.15/100,000,respectively,with a cumulative mortality rate(0-74 years old)of 0.35%.Both the incidence and mortality were higher in rural than in urban areas.The age-specific cervical cancer incidence significantly increased with age,particularly after age 25 years,and peaked at 50-54 years old,whereas age-specific mortality increased rapidly after 35 years old,peaking at 80-84 years old.The age-standardized incidence rates increased by about 8.6(95%CI:6.9,10.3)per year during the period of 2000−2015.The age at diagnosis of patients with cervical cancer tended to be younger.In rural areas,the mean age at diagnosis decreased about 3.22 years from 2000 to 2015(𝛽=-0.33,P<0.001).Conclusions:China has a high burden of cervical cancer and important disparities among different regions.Es-pecially in the middle and western areas and rural areas,cervical cancer is a serious issue in women’s health,and prevention strategies need to be enhanced.Prevention and control strategies need to be enhanced and imple-mented with reference to local status,such as human papillomavirus(HPV)vaccination and screening programs.

Interactions between life expectancy and the incidence and mortality rates of cancer in China: a population-based cluster analysis

Background:The relationship between cancer and life expectancy is well established in both developed and developing countries.China is a vast country with significant geographical differences in population structure and healthcare,and thus provides a unique opportunity to analyze the complex relationship between life expectancy and cancer incidence and mortality rates.Methods:Cancer data were extracted for a total of 255 units(cities or counties)from the 2013 National Central Cancer Registry.Life expectancy data at the unit level were obtained from the National Centers for Disease Control and Prevention.Linear regression analysis was used to analyze the relationship between life expectancy and crude incidence and mortality rates of cancer.In a separate analysis,life expectancy was rated as low(<76.0 years),middle(76-80 years),or high(>80 years).Results:Overall,the cancer incidence and mortality rates positively correlated with life expectancy in both sexes(R at 0.37 and 0.50,P<0.001).The correlation was significant for the following cancers:lung,colorectal,prostate,blad-der and pancreas,as well as for lymphoma in men(R 0.36-0.58,P<0.001),lung,breast,colorectal,thyroid,uterus,and ovary in women(R 0.18-0.51,P<0.001).We failed to observe an association between upper gastrointestinal cancer and life expectancy.The number of cities/counties with low,middle and high life expectancy levels were 110,101 and 44,respectively.The highest age-standardized cancer incidence rate was observed in areas with a high life expec-tancy level(192.83/100,000).The highest age-standardized mortality rate was in areas with the lowest life expectancy(118.44/100,000).Cancers of the stomach,liver and esophagus are major cancer types in areas with low and middle life expectancy.In contrast,areas with high life expectancy had high incidence and mortality rates of colorectal can-cer,breast cancer in women and prostate cancer in men.Conclusions:Longer life expectancy is associated with higher overall cancer incidence and mortality in China.The cancer pattern also varies substantially across areas with different life expectancy levels.Life expectancy levels must be considered when developing strategies to prevent and treat cancers.