Kexin Sun

BACKGROUND: From 2003 to 2005, standardised 5-year cancer survival in China was much lower than in developed countries and varied substantially by geographical area. Monitoring population-level cancer survival is crucial to the understanding of the overall effectiveness of cancer care. We therefore aimed to investigate survival statistics for people with cancer in China between 2003 and 2015. METHODS: We used population-based data from 17 cancer registries in China. Data for the study population was submitted by the end of July 31, 2016, with follow-up data on vital status obtained on Dec 31, 2015. We used anonymised, individual cancer registration records of patients (aged 0-99 years) diagnosed with primary, invasive cancers from 2003 to 2013. Patients eligible for inclusion had data for demographic characteristics, date of diagnosis, anatomical site, morphology, behaviour code, vital status, and last date of contact. We analysed 5-year relative survival by sex, age, and geographical area, for all cancers combined and 26 different cancer types, between 2003 and 2015. We stratified survival estimates by calendar period (2003-05, 2006-08, 2009-11, and 2012-15). FINDINGS: There were 678 842 records of patients with invasive cancer who were diagnosed between 2003 and 2013. Of these records, 659 732 (97·2%) were eligible for inclusion in the final analyses. From 2003-05 to 2012-15, age-standardised 5-year relative survival increased substantially for all cancers combined, for both male and female patients, from 30·9% (95% CI 30·6-31·2) to 40·5% (40·3-40·7). Age-standardised 5-year relative survival also increased for most cancer types, including cancers of the uterus (average change per calendar period 5·5% [95% CI 2·5-8·5]), thyroid (5·4% [3·2-7·6]), cervix (4·5% [2·9-6·2]), and bone (3·2% [2·1-4·4]). In 2012-15, age-standardised 5-year survival for all patients with cancer was higher in urban areas (46·7%, 95% CI 46·5-47·0) than in rural areas (33·6%, 33·3-33·9), except for patients with oesophageal or cervical cancer; but improvements in survival were greater for patients residing in rural areas than in urban areas. Relative survival decreased with increasing age. The increasing trends in survival were consistent with the upward trends of medical expenditure of the country during the period studied. INTERPRETATION: There was a marked overall increase in cancer survival from 2003 to 2015 in the population covered by these cancer registries in China, possibly reflecting advances in the quality of cancer care in these areas. The survival gap between urban and rural areas narrowed over time, although geographical differences in cancer survival remained. Insight into these trends will help prioritise areas that need increased cancer care. FUNDING: National Key R&D Program of China, PUMC Youth Fund and the Fundamental Research Funds for the Central Universities, and Major State Basic Innovation Program of the Chinese Academy of Medical Sciences.

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 age-standardized rates. RESULTS: . 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.

The burden of cancer showed a continuous upward trend in China. Cancer prevention and control faces the problem of the disparity in different areas and different cancer burden between men and women. The cancer pattern in China presents the coexistence of the cancer patterns in developed and developing countries. The situation of cancer prevention and control is still serious in China.

Background: National Cancer Center (NCC) updated nationwide cancer statistics using population-based cancer registry data in 2015. Methods: 501 cancer registries submitted data, among which 368 registries with high quality data were included in analysis. Numbers of nationwide new cancer cases and deaths were estimated using incidence and mortality rates and corresponding national population stratified by area, sex, age group and cancer site. The world Segi's population was applied for the calculation of age-standardized rates. Results: About 3,929,000 new cancer cases were diagnosed. The crude incidence rate was 285.83/100,000 and the age-standardized incidence rate by world standard population (ASIRW) was 186.39/100,000. ASIRW was higher in urban areas than in rural areas. South China had the highest ASIRW while Southwest China had the lowest ASIRW. Age-specific incidence rate was higher in males for population younger than 20 years or over 49 years. From 2000 to 2015, the ASIRWs for esophageal cancer, gastric cancer and liver cancer decreased significantly. The ASIRWs for colorectal cancer in whole population and for lung cancer, breast cancer, cervix cancer, uterus cancer and thyroid cancer in females increased significantly. 2,338,000 cancer deaths were reported. The crude mortality rate was 170.05/100,000 and the age standardized mortality rate by world standard population (ASMRW) was 105.84/100,000. ASMRW was higher in rural areas than in urban areas. Central China had the highest ASMRW while North China had the lowest ASMRW. Age-specific mortality rates in males were higher than that in females in every age group. From 2000 to 2015, the ASMRWs for esophageal cancer, gastric cancer, liver cancer and lung cancer decreased significantly. The ASMRWs for colorectal cancer, pancreas cancer and prostate cancer in males and for breast cancer, cervix cancer and thyroid cancer in females increased significantly. Conclusions: Cancer has become a major life-threatening disease in China. Disease burdens differed across areas. Disease burdens for esophageal cancer, gastric cancer and liver cancer have decreased, while disease burdens for colorectal cancer, female breast cancer, cervix cancer and thyroid cancer have increased over the last 15 years. National and regional initiative for cancer prevention and control should be prioritized.