The incidences and mortalities of major cancers in China, 2009

In 2012, the National Central Cancer Registry (NCCR) of China collected cancer registration information for the year 2009 from local cancer registries and analyzed it to describe the incidences and mortalities of cancers in China. Based on the data quality criteria from NCCR, data from 104 registries covering 85,470,522 people (57,489,009 in urban areas and 27,981,513 in rural areas) were checked and evaluated. The data from 72 registries were qualified and accepted for the cancer registry annual report in 2012. The total cancer incident cases and cancer deaths were 244,366 and 154,310, respectively. The morphologically verified cases accounted for 67.23%, and 3.14% of the incident cases only had information from death certifications. The crude incidence in the Chinese cancer registration areas was 285.91/ 100,000 (317.97/100,000 in males and 253.09/100,000 in females). The age-standardized rates for incidences based on the Chinese standard population (ASRIC) and the world standard population (ASRIW) were 146.87/100,000 and 191.72/100,000, respectively, with a cumulative incidence of 22.08%. The cancer mortality in the Chinese cancer registration areas was 180.54/100,000 (224.20/100,000 in males and 135.85/100,000 in females). The age-standardized rates for mortalities based on the Chinese standard population (ASRMC) and the world standard population (ASRMW) were 85.06/100,000 and 115.65/100,000, respectively, and the cumulative mortality was 12.94% . Lung cancer, gastric cancer, colorectal cancer, liver cancer, esophageal cancer, pancreatic cancer, encephaloma, lymphoma, female breast cancer, and cervical cancer were the most common cancers, accounting for 75% of all cancer cases. Lung cancer, gastric cancer, liver cancer, esophageal cancer, colorectal cancer, pancreatic cancer, breast cancer, encephaloma, leukemia, and lymphoma accounted for 80% of all cancer deaths. The cancer registration's population coverage has been increasing, and its data quality is improving. As the basis of the cancer control program, the cancer registry plays an important role in directing anticancer strategies in the medium and long term. Because cancer burdens are different in urban and rural areas in China, prevention and control efforts should be based on practical situations.

The incidence and mortality of major cancers in China,2012

Background:The National Central Cancer Registry(NCCR) collected population-based cancer registration data in 2012 from local registries and estimated the cancer incidence and mortality in China.Methods:In the middle of 2015,261 cancer registries submitted reports on new cancer cases and deaths occurred in 2012.Qualified data from 193 registries were used for analysis after evaluation.Crude rates,number of cases,and age-standardized rates stratified by area(urban/rural),sex,age group,and cancer type were calculated according to the national population in 2012.Results:The covered population were 198,060,406 from 193 qualified cancer registries(74 urban and 119 rural registries).The major indicators of quality control,percentage of cases morphologically verified(MV%),death certificateonly cases(DCO%),and the mortality to incidence(M/l) ratio,were 69.13%,2.38%,and 0,62,respectively.It was estimated that there were 3,586,200 new cancer cases and 2,186,600 cancer deaths in 2012 in China with an incidence of 264.85/100,000[age-standardized rate of incidence by the Chinese standard population(ASRIC) of 191.89/100,000]and a mortality of 161.49/100,000[age-standardized rate of mortality by the Chinese standard population(ASRMC)of 112.34/100,000].The ten most common cancer sites were the lung,stomach,liver,colorectum,esophagus,female breast,thyroid,cervix,brain,and pancreas,accounting for approximately 77.4% of all new cancer cases.The ten leading causes of cancer death were lung cancer,liver cancer,gastric cancer,esophageal cancer,colorectal cancer,pancreatic cancer,female breast cancer,brain tumor,leukemia,and lymphoma,accounting for 84.5% of all cancer deaths.Conclusions:Continuous cancer registry data provides basic information in cancer control programs.The cancer burden in China is gradually increasing,both in urban and rural areas,in males and females.Efficient cancer prevention and control,such as health education,tobacco control,and cancer screening,should be paid attention by the health sector and the whole society of China.

Incidence and mortality of gastric cancer in China

胃的癌症是在世界上的最经常的癌症之一；几乎三分之二个胃的癌症盒子和死亡在更少的发达区域发生。在中国，基于在1970年代和1990年代进行的二国家死亡调查，有在这个国家的胃的癌症的地域分布的一个明显的聚类，与死亡主要是在农村区域定位了的高度，特别在 Gansu ，河南省， Hebei ，在中国的中间西方的部分的山西和 Shaanxi 省。尽管有到 1990 年代初的从 1970 年代的细微增加，在胃的癌症死亡的显著衰落被注意在几乎全部人口在在中国的最后十年期间。在经济改革二十年以前开始了以后，这些衰落大部分由于在社会经济的环境，生活方式，营养，教育和护理系统的戏剧的改进。不过，胃的癌症将当前仍然是重要癌症负担并且在中国是在癌症预防和控制策略的关键问题之一。在 2005，从胃的癌症的 30 万死亡和 40 万个新盒子将评价第三很普通的癌症，这被预言。为在中国的胃的癌症的预防和控制策略的必要包裹将集中于控制 Helicobacter pylori (H。pylori ) 感染，改善教育层次，倡导的健康食谱和反烟草竞选，寻找划算的早察觉，诊断和治疗为可医好的管理和辩解的照顾包括途径编程序。

Report of incidence and mortality in China cancer registries, 2009

Objective： The National Central Cancer Registry （NCCR） collected cancer registration data in 2009 from local cancer registries in 2012, and analyzed to describe cancer incidence and mortality in China. Methods： On basis of the criteria of data quality from NCCR, data submitted from 104 registries were checked and evaluated. There were 72 registries＇ data qualified and accepted for cancer registry annual report in 2012. Descriptive analysis included incidence and mortality stratified by area （urban/rural）, sex, age group and cancer site. The top 10 common cancers in different groups, proportion and cumulative rates were also calculated. Chinese population census in 1982 and Segi＇s population were used for age-standardized incidence/mortality rates. Results： All 72 cancer registries covered a total of 85,470,522 population （57,489,009 in urban and 27,981,513 in rural areas）. The total new cancer incident cases and cancer deaths were 244,366 and 154,310, respectively. The morphology verified cases accounted for 67.23%, and 3.14% of incident cases only had information from death certifications. The crude incidence rate in Chinese cancer registration areas was 285.91/100,000 （males 317.97/100,000, females 253.09/100,000）, age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 146.87/100,000 and 191.72/100,000 with the cumulative incidence rate （0-74 age years old） of 22.08%. The cancer incidence and ASIRC were 303.39/100,000 and 150.31/100,000 in urban areas whereas in rural areas, they were 249.98/100,000 and 139.68/100,000, respectively. The cancer mortality in Chinese cancer registration areas was 180.54/100,000 （224.20/100,000 in males and 135.85/100,000 in females）, age-standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were 85.06/100,000 and 115.65/100,000, and the cumulative incidence rate （0-74 age years old） was 12.94%. The cancer mortality and ASMRC were 181.86/100,000 and 80.86/100,000 in urban areas, whereas in rural areas, they were 177.83/100,000 and 94.40/100,000 respectively. Lung cancer, gastric cancer, colorectal cancer, liver cancer, esophageal cancer, pancreas cancer, encephaloma, lymphoma, female breast cancer and cervical cancer, were the most common cancers, accounting for 75% of all cancer cases in urban and rural areas. Lung cancer, gastric cancer, liver cancer, esophageal cancer, colorectal cancer, pancreatic cancer, breast cancer, encephaloma, leukemia and lymphoma accounted for 80% of all cancer deaths. The cancer spectrum showed difference between urban and rural areas, males and females. The main cancers in rural areas were cancers of the stomach, followed by esophageal cancer, lung cancer, liver cancer and colorectal cancer, whereas the main cancer in urban areas was lung cancer, followed by liver cancer, gastric cancer and colorectal cancer. Conclusions： The coverage of cancer registration population has been increasing and data quality is improving. As the basis of cancer control program, cancer registry plays an important role in making anti- cancer strategy in medium and long term. As cancer burdens are different between urban and rural areas in China, prevention and control should be implemented based on practical situation.

Cancer Incidence and Mortality in China,2007

Objective： Cancer incidence and mortality data collected from population-based cancer registries were analyzed to present the overall cancer statistics in Chinese registration areas by age, sex and geographic area in 2007. Methods： In 2010, 48 cancer registries reported cancer incidence and mortality data of 2007 to National Central Cancer Registry of China. Of them, 38 registries＇ data met the national criteria. Incidence and mortality were calculated by cancer sites, age, gender, and area. Age-standardized rates were described by China and World population. Results： The crude incidence rate for all cancers was 276.16/100,000 （305.22/100,000 for male and 246.46/100,000 for female; 284.71/100,000 in urban and 251.07/100,000 in rural）. Age-standardized incidence rates by China and World population were 145.39/100,000 and 189.46/100,000 respectively. The crude mortality rate for all cancers was 177.09/100,000 （219.15/100,000 for male and 134.10/100,000 for female; 173.55/100,000 in urban and 187.49/100,000 in rural）. Age-standardized mortality rates by China and World population were 86.06/100,000 and 116.46/100,000, respectively. The top 10 most frequently common cancer sites were the lung, stomach, colon and rectum, liver, breast, esophagus, pancreas, bladder, brain and lymphoma, accounting for 76.12% of the total cancer cases. The top 10 causes of cancer death were cancers of the lung, liver, stomach, esophagus, colon and rectum, pancreas, breast, leukemia, brain and lymphoma, accounting for 84.37% of the total cancer deaths. Conclusion： Cancer remains a major disease threatening people＇s health in China. Prevention and control should be enhanced, especially for the main cancers.

Liver cancer incidence and mortality in China, 2009

Liver cancer is a common cancer and a leading cause of cancer deaths in China. To aid the government in establishing a control plan for this disease, we provided real-time surveillance information by analyzing liver cancer incidence and mortality in China in 2009 reported by the National Central Cancer Registry. Liver cancer incidence and cases of death were retrieved from the national database using the ICD-10 topography code "C22". Crude incidence and mortality were calculated and stratified by sex, age, and location (urban/rural). China's population in 1982 and Segi (world) population structures were used for age-standardized rates. In cancer registration areas in 2009, the crude incidence of liver cancer was 28.71/100,000, making it the fourth most common cancer in China, third most common in males, and fifth most common in females. The crude mortality of liver cancer was 26.04/100,000, making it the second leading cause of cancer death in China and urban areas and the third leading cause in rural areas. Incidence and mortality were higher in males than in females and were higher in rural areas than in urban areas. The age-specific incidence and mortality were relatively low among age groups under 30 years but dramatically increased and peaked in the 80 -84 years old group. These findings confirm that liver cancer is a common and fatal cancer in China. Primary and secondary prevention such as health education, hepatitis B virus vaccination, and early detection should be carried out both in males and females, in urban and rural areas.

Incidence and mortality of laryngeal cancer in China, 2011

Objective： Laryngeal cancer is the common cancer of the upper aerodigestive tract. We aimed to use the national cancer registration data in 2011 to estimate the incidence and mortality of laryngeal cancer within China. Methods： Comparable, high-quality data from 177 population-based cancer registries were qualified for analysis. The pooled data were stratified by area, sex and age group. National new cases and deaths of laryngeal cancer were estimated using age-specific rates and national population in 2010. All incidence and death rates were age-standardized to the 2000 Chinese standard population and Segi＇s population, which were expressed per 100,000 populations. Results： All 177 cancer registries covered a total of 175,310,169 population （98,341,507 in urban and 76,968,662 in rural areas）, accounting for 13.01% of the national population. The data quality indicators of proportion of morphological verification （MV%）, percentage of cancer cases identified with death certification only （DCO%） and mortality to incidence ratio （Mr/） were 77.98%, 2.62% and 0.55, respectively. Estimated 20,875 new cases of laryngeal cancer were diagnosed and 11,488 deaths from laryngeal cancer occurred in China in 2011. The crude incidence rate of laryngeal cancer was 1.55/100,000 （2.69/100,000 in males and 0.35/100,000 in females）. Age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 1.13/100,000 and 1.14/100,000, respectively. Laryngeal cancer is much rarer in females than in males. The incidence rate was higher in urban areas than that in rural areas. The crude mortality rate of laryngeal cancer was 0.85/100,000 （1.42/100,000 in males and 0.25/100,000 in females）. Age-standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were both 0.61/100,000. The mortality rate in males was much higher than that in females. There was no definite difference in mortality rates of laryngeal cancer between urban and rural areas. Conclusions： Larynx is a specialized area and cancer of larynx significantly affects the quality of life for the patients. Comprehensive measures should be carried out to prevent the ascent of laryngeal cancer.

Pancreatic cancer incidence and mortality patterns in China, 2011

Objective： The National Central Cancer Registry （NCCR） collected population-based cancer registration data in 2011 from all cancer registries in China. The incidence and mortality rates for pancreatic cancer were compiled and pancreatic cancer incident new cases and deaths were estimated. Methods： A total of 234 cancer registries submitted cancer data to NCCR. Data from 177 cancer registries were qualified and compiled for cancer statistics in 2011. Pancreatic cancer cases were extracted and analyzed from the national database. The pooled data were stratified by area （urban/rural）, gender and age group （0, 1-4, 5-9, 10-14...85＋）. Pancreatic cancer incident cases and deaths were estimated using age-specific rates and national population in 2010. The national census in 2000 and Segi＇s population were used for age- standardized rates. Results： All 177 cancer registries （77 in urban and I00 in rural areas） covered 175,310,169 populations （98,341,507 in urban and 76,968,662 in rural areas）. The morphology verified pancreatic cancer cases （MV%） accounting for 40.52% and 4.33% of pancreatic cancer incident cases were identified through death certifications only （DCO%） with mortality to incidence ratio （M/I） of 0.91. The estimated number of newly diagnosed pancreatic cancer cases and deaths were 80,344 and 72,723 in 2011, respectively. The crude incidence rate was 5.96/100,000 （males 6.57/100,000, females 5.32/100,000）. The age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 4.27/100,000 and 4.23/100,000 respectively, ranking 10th among all cancers. Pancreatic cancer incidence rate and ASIRC were 7.03/100,000 and 4.94/100,000 in urban areas whereas they were 4.84/100,000 and 3.56/100,000 in rural areas. The incidence rate of pancreatic cancer of 33 cancer registries increased from 3.24/I00,000 in 2003 to 3.59/100,000 in 2011 with an annual percentage change （APC） of 1.44. The pancreatic cancer mortality rate was 5.40/100,000 （males 5.88/100,000, females 4.89/100,000）, ranking 6th among all cancers. The age-standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were 3.81/100 000 and 3.79/100 000. The pancreatic cancer mortality and ASMRC were 6.47/100,000 and 4.48/100,000 in urban areas, and 4.27/100,000 and 3.08/100,000 in rural areas, respectively. The mortality rates of pancreatic cancer showed an approximately 1.14-fold increase, from 2.85/100,000 in 2003 to 3.26/100,000 in 2011, with an APC of 1.68. Conclusions： The burden of pancreatic cancer is increasing in China. Identification of high-risk population and adequate treatment and prevention are important.

Cancer Incidence And Mortality in China,2006

Objective：To describe the cancer incidence and mortality rates in 2006 and evaluate the cancer burden in China.Methods：Cancer registration data in 2006 from 34 cancer registries were collected,evaluated and pooled to calculate cancer incidence and mortality rates.The data analyses included mortality to incidence ratio（MI）,morphological verification percentage（MV%） and proportion of death certification only（DCO%）.Cumulative incidence and mortality rates were calculated using crude data,age-standardized data,and specific data for cancer site,age,sex and area（urban or rural）.Results：In 2006,34 registries with qualified registration data covered a total population of 59,567,322（46,558,108 in urban areas and 13,009,214 in rural areas）.The crude and age-standardized cancer incidence rates were 273.66 per 100,000 and 190.54 per 100,000,respectively.The crude and age-standardized cancer mortality rates were 175.70 per 100,000 and 117.67 per 100,000,respectively.Cancers of lung,stomach,colon and rectum,liver,and breast in female were the five most common forms of cancer in China,which accounted for 58.99% of all new cancer cases.Lung cancer was the leading cause of cancer death,followed by stomach cancer,liver cancer,esophageal cancer and colorectal cancer.Conclusion：Cancer is still an important public health issue in China with an increasing disease burden.Specifically,the incidence rates for lung cancer,colorectal cancer and breast cancer were increasing,but those for stomach cancer and esophageal cancer were decreasing.However,age-specific incidence rate remained stable,indicating that the aging population was the major source of the increasing cancer burden.

Ovary cancer incidence and mortality in China, 2011

Objective： To evaluate and analyze ovary cancer incidence and mortality in China in 2011 using ovary cancer data from population-based cancer registration in China, and to provide scientific information for its control and prevention. Methods： Invasive cases of ovary cancer were extracted and analyzed from the overall Chinese cancer database in 2011, which were based on data from 177 population-based cancer registries distributing in 28 provinces. The crude, standardized, and truncated incidences and mortalities et al. were calculated and new and deaths cases from ovary cancer throughout China and in different regions in 2011 were estimated using Chinese practical population. Results： The estimates of new ovary cancer cases and deaths were 45,223 and 18,430, respectively, in China in 2011. The crude incidence rare, age-standardized rate by Chinese standard population （ASR-C） and age- standardized rate by world standard population （ASR-W） incidence were 6.89/100,000, 5.35/100,000 and 5.08/100,000, respectively; the crude, ASR-C and ASR-W mortalities were 2.81/100,000, 2.01/100,000 and 1.99/100,000, respectively. The incidence and mortality in urban areas were higher than those in rural areas. The age-specific incidence and mortality increased rapidly from age 35-39 and peaked at age 60-64 or 75- 79 years. After age 45 or 55, the age-specific incidence and death rates in urban were much higher than those in rural areas. Conclusions： Compared with GLOBOCAN 2012 data, the ovary cancer incidence in China in 2011 was at middle level, but its mortality was at low level worldwide.

The influence of stage at diagnosis and molecular subtype on breast cancer patient survival: a hospital.based multi.center study

Background: Stage at diagnosis and molecular subtype are important clinical factors associated with breast cancer patient survival. However, subgroup survival data from a large study sample are limited in China.To estimate the survival differences among patients with different stages and various subtypes of breast cancer, we conducted a hospital-based multi-center study on breast cancer in Beijing, China.Methods: All resident patients diagnosed with primary, invasive breast cancer between January 1,2006 and December 31,2010 from four selected hospitals in Beijing were included and followed up until December 31,2015. Hospitalbased data of stage at diagnosis, hormone receptor status, and selected clinical characteristics, including body mass index(BMI), menopausal status, histological grade, and histological type, were collected from the medical records of the study subjects. Overall survival(OS) and cancer-specific survival(CSS) were estimated. Cox proportional hazards models were employed to evaluate the associations of stage at diagnosis and molecular subtype with patient survival.Results: The 5-year OS and CSS rates for all patients were 89.4% and 90.3%. Survival varied by stage and molecular subtype. The 5-year OS rates for patients with stage I, Ⅱ, Ⅲ, and IV diseases were 96.5%, 91.6%, 74.8%, and 40.7%,respectively, and the corresponding estimates of 5-year CSS rates were 97.1%, 92.6%, 75.6%, and 42.7%, respectively.The 5-year OS rates for patients with luminal A, luminal B, HER2, and triple-negative subtypes of breast cancer were92.6%, 88.4%, 83.6%, and 82.9%, respectively, and the corresponding estimates of 5-year CSS rates were 93.2%, 89.1 %,85.4%, and 83.5%, respectively. Multivariate analysis showed that stage at diagnosis and molecular subtype were important prognostic factors for breast cancer.Conclusions: Survival of breast cancer patients varied significantly by stage and molecular subtype. Cancer screening is encouraged for the early detection and early diagnosis of breast cancer. More advanced therapies and health care policies are needed on HER2 and triple-negative subtypes.

Cancer incidence and mortality in China, 2014

Background： National Central Cancer Registry of China（NCCRC） updated nationwide cancer statistics using population-based cancer registry data in 2014 collected from all available cancer registries.Methods： In 2017, 449 cancer registries submitted cancer registry data in 2014, among which 339 registries＇ data met the criteria of quality control and were included in analysis. These cancer registries covered 288,243,347 population, accounting for about 21.07% of the national population in 2014. Numbers of nationwide new cancer cases and deaths were estimated using calculated incidence and mortality rates and corresponding national population stratified by area, sex, age group and cancer type. The world Segi＇s population was applied for agestandardized rates.Results： A total of 3,804,000 new cancer cases were diagnosed, the crude incidence rate was 278.07/100,000（301.67/100,000 in males, 253.29/100,000 in females） and the age-standardized incidence rate by world standard population（ASIRW） was 186.53/100,000. Calculated age-standardized incidence rate was higher in urban areas than in rural areas（191.6/100,000 vs. 179.2/100,000）. South China had the highest cancer incidence rate while Southwest China had the lowest incidence rate. Cancer incidence rate was higher in female for population between20 to 54 years but was higher in male for population younger than 20 years or over 54 years. A total of 2,296,000 cancer deaths were reported, the crude mortality rate was 167.89/100,000（207.24/100,000 in males,126.54/100,000 in females） and the age-standardized mortality rate by world standard population（ASMRW） was106.09/100,000. Calculated age-standardized mortality rate was higher in rural areas than in urban areas（110.3/100,000 vs. 102.5/100,000）. East China had the highest cancer mortality rate while North China had the lowest mortality rate. The mortality rate in male was higher than that in female. Common cancer types and major causes of cancer death differed between age group and sex.Conclusions： Heavy cancer burden and its disparities between area, sex and age group pose a major challenge to public health in China. Nationwide cancer registry plays a crucial role in cancer prevention and control.

Comparison of cancer incidence and mortality in three GDP per capita levels in China, 2013

Objective：In this research,the patterns of cancer incidence and mortality in areas with different gross domestic product per capita（GDPPC）levels in China were explored,using data from population-based cancer registries in 2013,collected by the National Central Cancer Registry（NCCR）.Methods：Data from 255 cancer registries were qualified and included in this analysis.Based on the GDPPC data of 2014,cities/counties were divided into 3 levels：high-,middle-and low-GDPPC areas,with 40,000 and 80,000 RMB per year as cut points.We calculated cancer incidences and mortalities in these three levels,stratified by gender and age group.The national population of the Fifth Census in 2000 and Segi’s population were applied for age-standardized rates.Results：The crude incidence and mortality rates as well as age-standardized incidence rate（ASIR）showed positive associations with GDPPC level.The age-standardized mortality rate（ASMR）nevertheless showed a negative association with GDPPC level.The ASMR in high-,middle-and low-GDPPC areas was 103.12/100,000,112.49/100,000 and 117.43/100,000,respectively.Lung cancer was by far the most common cancer in all three GDPPC levels.It was also the leading cause of cancer death,regardless of gender and GDPPC level.Negative associations with GDPPC level were found for the ASIRs of lung,stomach,esophageal and liver cancer,whereas colorectal and breast cancer showed positive associations.Except for breast cancer,the ASMRs of the other five cancers were always higher in middle-and low-GDPPC areas than in high-GDPPC areas.Conclusions：The economic development is one of the main factors of the heavy cancer burden on Chinese population.It would be reasonable to implement cancer control strategies referring to the local GDPPC level.

Annual report on status of cancer in China, 2011

Objective： The National Central Cancer Registry （NCCR） collected population-based cancer registration data in 20l 1 from all cancer registries. National cancer incidence and mortality were compiled and cancer incident new cases and cancer deaths were estimated. Methods： In 2014, there were 234 cancer registries submitted cancer incidence and deaths occurred in 2011. All datasets were checked and evaluated based on the criteria of data quality from NCCR. Total 177 registries＇ data were qualified and compiled for cancer statistics in 2011. The pooled data were stratified by area （urban/rural）, gender, age group （0, 1-4, 5-9, 10-14...85＋） and cancer type. Cancer incident cases and deaths were estimated using age-specific rates and national population in 2011. All incidence and death rates are age-standardized to the 2000 Chinese standard population and Segi＇s population expressed per 100,000 persons. Results： All 177 cancer registries （77 in urban and 100 in rural areas） covered 175,310,169 populations （98,341,507 in urban and 76,968,662 in rural areas）. The morphology verified cases （MV%） accounting for 70.14% and 2.44% of incident cases were identified through death certifications only （DCO%） with mortality to incidence ratio of 0.63. The estimates of new cancer incident cases and cancer deaths were 3,372,175 and 2,113,048 in 2011, respectively. The incidence rate was 250.28/100,000 （males 277.77/100,000, females 221.37/100,000）, and the age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 186.34/100,000 and 182.76/100,000 with the cumulative incidence rate （0-74 years old） of 21.20%. The cancer incidence and ASIRC in urban areas were 261.38/100,000 and 189.89/100,000 compared to 238.60/100,000 and 182.10/100,000 in rural areas, respectively. The cancer mortality was 156.83/100,000 （194.88/100,000 in males and 116.81/100,000 in females）, the age-standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were 112.88/100,000 and 111.82/100,000, and the cumulative mortality rate （0-74 years old） was 12.69%. The cancer mortality and ASMRC were 154.37/100,000 and 108.20/100,000 in urban areas, and 159.42/100,000 and 117.97/100,000 in rural areas, respectively. Cancers of lung, female breast, stomach, liver, colon and rectum, esophageal, cervix, uterus, prostate and ovary were the most common cancers, accounting for about 75% of all cancer new cases. Lung cancer, liver cancer, stomach cancer, esophageal cancer, colorectal cancer, female breast cancer, pancreatic cancer, brain tumor, cervical cancer and leukemia were the leading causes of cancer death, accounting for about 80% of all cancer deaths. The cancer incidence, mortality and spectrum showed difference between urban and rural areas, males and females. Conclusions： The coverage of cancer registration population had a greater increase than that in the last year. The data quality and representativeness are gradually improved. As the basic work of cancer prevention and control, cancer registry is playing an irreplaceable role. The disease burden of cancer is increasing, and the health department has to take effective measures to contain the increased cancer burden in China.

Annual report on status of cancer in China,2010

Objective：Population-based cancer registration data in 2010 were collected,evaluated and analyzed by the National Central Cancer Registry （NCCR） of China.Cancer incident new cases and cancer deaths were estimated.Methods：There wvere 219 cancer registries submitted cancer incidence and death data in 2010.All data were checked and evaluated on basis of the criteria of data quality from NCCR.Total 145 registries＇ data were qualified and accepted for cancer statistics in 2010.Pooled data were stratified by urban/rural,area,sex,age group and cancer site.Cancer incident cases and deaths were estimated using age-specific rates and national population.The top ten common cancers in different groups,proportion and cumulative rate were also calculated.Chinese census in 2000 and Segi＇s population were used for age-standardized incidence/ mortality rates.Results：All 145 cancer registries （63 in urban and 82 in rural） covered a total of 158,403,248 population （92,433,739 in urban and 65,969,509 in rural areas）.The estimates of new cancer incident cases and cancer deaths were 3,093,039 and 1,956,622 in 2010,respectively.The morphology verified cases （MV％） accounted for 67.11％ and 2.99％ of incident cases were identified through death certifications only （DCO％） with mortality to incidence ratio （M/I） of 0.61.The crude incidence rate was 235.23/100,000 （268.65/100,000 in males,200.21/100,000 in females）,age-standardized incidence rates by Chinese standard population （ASIRC,2000） and by world standard population （ASIRW） were 184.58/100,000 and 181.49/100,000 with the cumulative incidence rate （0-74 years old） of 21.l 1％.The cancer incidence and ASIRC were 256.41/100,000 and 187.53/100,000 in urban areas whereas in rural areas,they were 213.71/100,000 and 181.10/100,000,respectively.The crude cancer mortality in China was 148.81/100,000 （186.37/100,000 in males and 109.42/100,000 in females）,age-standardized incidence rates by Chinese standard population （ASMRC,2000） and by world standard population （ASMRW） were 113.92/100,000 and 112.86/100,000,and the cumulative incidence rate （0-74 years old） was 12.78％.The cancer mortality and ASMRC were 156.14/100,000 and 109.21/100,000 in urban areas,whereas in rural areas,they were 141.35/100,000 and 119.00/100,000 respectively.Lung cancer,gastric cancer,colorectal cancer,liver cancer,esophageal cancer,pancreas cancer,encephaloma,lymphoma,female breast cancer and cervical cancer,were the most common cancers,accounting for 75％ of all cancer cases in urban and rural areas.Lung cancer,gastric cancer,liver cancer,esophageal cancer,colorectal cancer,pancreatic cancer,breast cancer,encephaloma,leukemia and lymphoma accounted for 80％ of all cancer deaths.Conclusions：The coverage of cancer registration population had a rapid increase and could reflect cancer burden in each area and population.As the basis of cancer control program,cancer registry plays an irreplaceable role in cancer epidemic surveillance,evaluation of cancer control programs and making anticancer strategy.China is facing serious cancer burden and prevention and control should be enhanced.

Nasopharyngeal carcinoma incidence and mortality in China in 2009

Nasopharyngeal carcinoma (NPC) is rare globally but common in China and exhibits a distinct ethnic and geographic distribution. In 2009, the National Central Cancer Registry in China provided real-time surveillance information on NPC. Individual NPC cases were retrieved from the national database based on the ICD-10 topography code C11. The crude incidence and mortality of NPC were calculated by sex and location (urban/rural). China's population in 1982 and Segi's world population structures were used to determine age-standardized rates. In regions covered by the cancer registries in 2009, the crude incidence of NPC was 3.61/100,000 (5.08/100,000 in males and 2.10/100,000 in females; 4.19/100,000 in urban areas and 2.42/100,000 in rural areas). Age-standardized incidences by Chinese population (ASIC) and Segi's world population (ASIW) were 2.05/100,000 and 2.54/100,000, respectively. The crude mortality of NPC was 1.99/100,000 (2.82/100,000 in males and 1.14/100,000 in females; 2.30/100,000 in urban areas and 1.37/100,000 in rural areas). The age-standardized mortalities by Chinese population (ASMC) and world population (ASMW) were 1.04/100,000 and 1.35/100,000, respectively. The incidence and mortality of NPC were higher in males than in females and higher in urban areas than in rural areas. Both agespecific incidence and mortality were relatively low in persons younger than 30 years old, but these rates dramatically increased. Incidence peaked in the 60-64 age group and mortality peaked in the over 85 age group. Primary and secondary prevention, such as lifestyle changes and early detection, should be carried out in males and females older than 30 years of age.

Cancer statistics: updated cancer burden in China

Cancer is a major public health issue in most of countries, including China. Accurate and valid information on cancer incidence, mortality, survival and relevant factors is irreplaceable for cancer prevention and control. Since the national program of cancer registry was launched by the Ministry of Health of China in 2008, the National Central Cancer Registry （NCCR） has been releasing the cancer incidence and mortality based on the data collected from cancer registries supported by the program. The cancer statistics provide current data from registered areas and aims to accurately reflect the cancer burden and epidemic in China. In 2014, the NCCR collected data for calendar year 2011 from 234 registries. After comprehensive quality＇ evaluation, data from 177 registries have been selected as sources of the reports reflecting cancer incidence and mortaliD, in the registration areas in 2011. These reports are the updated cancer statistics so far, covering much more registries and a hig population.

High Spicy Food Intake and Risk of Cancer： A Meta-analysis of Case-control Studies

Background：Studies on the association between spicy food intake and cancer risk have reported inconsistent results.We quantitatively assessed this association by conducting a meta-analysis based on evidence from case-control studies.Methods：PubMed,EMBASE,and the Cochrane Library were searched for eligible publications.Combined odds ratios （ORs） with their 95% confidence interval （CI） were calculated using a random-or fixed-effects model.The methodological quality of the included articles was assessed using the Newcastle-Ottawa scale （NOS）.All data were analyzed using STATA 1 1.0 software （version 11.0;StataCorp.,College Station,TX,USA）.Subgroup analyses were also performed with stratification by region,sex,number of cases,cancer subtype,source of the control group,and NOS score.Results：A total 39 studies from 28 articles fulfilled the inclusion criteria for the meta-analysis （7884 patients with cancer and 10,142 controls）.Comparison of the highest versus lowest exposure category in each study revealed a significant OR of 1.76 （95% CI =1.35-2.29） in spite of significant heterogeneity （P 〈 0.00l）.In the subgroup analyses,this positive correlation was still found for gastric cancer,different regions,different numbers of cases,different sources of the control group,and high-quality articles （NOS score of≥ 7）.However,no statistically significant association was observed for women,esophageal cancer,gallbladder cancer,or low-quality articles （NOS score of〈7）.No evidence of publication bias was found.Conclusions：Evidence from case-control studies suggested that a higher level of spicy food intake may be associated with an increased incidence of cancer despite significant heterogeneity.More studies are warranted to clarify our understanding of the association between high spicy food intake and the risk of cancer.

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.

Long-term outcomes of intraoperative radiotherapy for early-stage breast cancer in China: amulticenter real-world study

Dear Editor,Intraoperative radiotherapy(IORT)is an accelerated par-tial breast irradiation(APBI)treatment that is accom-plished intraoperatively.Numerous clinical trials indicate that IORT is safe and effective,non-inferior to standard whole-breast external beam radiotherapy(EBRT)for low-risk patients who receive breast-conserving surgery[1-3].Nevertheless,these studies mainly included non-Asians and thus lack adequate evidence to support the value of IORT in Asian patients with breast cancer.