Estimation and projection of the national profile of cancer mortality in China: 1991–2005

Abstract

There are no national-level data on cancer mortality in China since two surveys in 1973 -1975 and 1990 -1992 (a 10% sample), but ongoing surveillance systems, based on nonrandom selected populations, give an indication as to the trends for major cancers. Based on a log-linear regression model with Poisson errors, the annual rates of change for 10 cancers and all other cancers combined, by age, sex and urban/rural residence were estimated from the data of the surveillance system of the Center for Health Information and Statistics, covering about 10% of the national population. These rates of change were applied to the survey data of 1990 -1992 to estimate national mortality in the year 2000, and to make projections for 2005. Mortality rates for all cancers combined, adjusted for age, are predicted to change little between 1991 and 2005 (À0.8% in men and þ 2.5% in women), but population growth and ageing will result in an increasing number of deaths, from 1.2 to 1.8 million. The largest predicted increases are for the numbers of female breast ( þ 155.4%) and lung cancers ( þ 112.1% in men, þ 153.5% in women). For these two sites, mortality rates will almost double. Cancer will make an increasing contribution to the burden of diseases in China in the 21st century. The marked increases in risk of cancers of the lung, female breast and large bowel indicate priorities for prevention and control. The increasing trends in young age groups for cancers of the cervix, lung and female breast suggest that their predicted increases may be underestimated, and that more attention should be paid to strategies for their prevention and control.

Trends in the incidence of cancer in Qidong, China, 1978–2002

“…20 These declines have been ascribed to a combination of screening, and to reduction in risk (sexual behaviour change and use of barrier contraception). However, as noted in the national mortality data, 15 rates are increasing in young women, under the age of 45. Li et al 46 noted that the changes in mortality rates in Shandong province were birth-cohort related, and suggested that the increased rates among younger women may reflect rapid changes in sexual mores, with increasing high-risk sexual behaviour, and greater prevalence of infection with human papilloma virus and other sexually transmitted agents.…”

“…14 Liver cancer is the leading cause of cancer mortality in Qidong (and in second place in China as a whole). 15 The high rates of liver cancer are the consequence of high prevalence of chronic infection with Hepatitis B virus, 16 and, in the past at least, of exposure to aflatoxin in maize. [17][18][19] Incidence in Qidong is more or less constant, as are the national mortality rates, 12 although incidence has been reported to be decreasing in other registry areas, such as Shanghai 20 and Tianjin.…”

Lung cancer screening

“…Lung cancer kills more than 1.3 million people every year (Peto et al, 1996), with figures registering a continual increase in the Far East in countries such as China (Yang et al, 2004). Improvements in clinical management have been modest over the past 20 years, with an overall 5-year survival rate just above 10% in Europe (Verdecchia et al, 2007).…”

p16, MGMT, RARβ2, CLDN3, CRBP and MT1G gene methylation in esophageal squamous cell carcinoma and its precursor lesions

“…Esophageal squamous cell carcinoma (ESCC) continues to be a significant cause of morbidity and mortality worldwide, and is the fourth most common cause of cancer death in China (1). Within China, the Taihang mountain region in Hebei, Henan and Shanxi Provinces has the highest incidence and mortality rates, reaching more than 100/100,000/year (2).…”