Economic burden of lung cancer attributable to smoking in China in 2015.

BACKGROUND: Lung cancer is substantially attributable to smoking, but detailed related estimates on smoking-attributable expenditure (SAE) in China are not available yet, which could inform tobacco control and cancer prevention initiatives. METHODS: A prevalence-based approach was adopted to estimate the total SAE, including direct expenditure (medical and non-medical) and indirect cost (disability and premature death). Detailed per-patient data on direct expenditure and work-loss days were acquired from a unique multicentre survey in China. Other parameters were from literatures and official reports. RESULTS: The total estimated SAE of lung cancer was US$5249 million in China in 2015 (0.05 % of gross domestic product for China). The estimated direct SAE was US$1937 million (36.9 % of the total SAE), accounting for 0.29 % of total healthcare expenditure for China. The medical and non-medical direct expenditures were US$1749 million and US$188 million, respectively. The estimated indirect cost was US$3312 million (63.1 % of the total SAE), including US$377 million due to disability and US$2935 million due to premature death. The SAE increased with age, peaking at 60-64 years (US$1004 million), and was higher among men, in urban areas and in eastern China. If smoking prevalence was reduced to 20%, as is the goal of Healthy China 2030, the total SAE would be decreased by 4.9 %. CONCLUSIONS: Smoking-attributable economic burden caused by lung cancer was substantial in China in 2015, and will continue increasing given current trends in lung cancer. However, future economic burden can be prevented with implementation of effective tobacco control and other interventions.

Tobacco smoking and trends in histological subtypes of female lung cancer at the Cancer Hospital of the Chinese Academy of Medical Sciences over 13 years.

BACKGROUND: Lung cancer is the leading cause of cancer mortality among women in China, and incidence and mortality continue to rise despite the fact that smoking prevalence is very low among Chinese women. AIM: This study investigated tobacco smoking and trends in histological subtypes of female lung cancer in a central cancer hospital in China. METHODS: Demographic, smoking history and histological information on female lung cancer patients diagnosed or treated from 2000 to 2012 was collected from the Cancer Hospital, Chinese Academy of Medical Science (CHCAMS). The classification of histological subtypes and clinical stages were conducted using the ICD-O-3 and Eighth AJCC Cancer Staging Manuals. Time-trends of histological subtypes were analyzed based on annual percentage change (APC). RESULTS: Overall, 5870 female cases of lung cancer were included in the analysis. The number of female lung cancer patients increased from 509 (2000-2002) to 1744 (2011-2012). The most common histological type of lung cancer was adenocarcinoma (ADC) (72.93%), followed by small cell lung cancer (SCLC) (11.06%), squamous cell carcinoma (SCC) (8.38%) and other (7.63%). Among smokers, the proportion of SCC decreased from 40.5% to 23.7% (P = 0.005), while ADC increased from 35.7% to 50.7% (P = 0.009). In non-smokers, ADC increased from 63.1% to 80.6% (P = 0.006) and SCC decreased from 13.6% to 4.5% (P = 0.016). Among SCC cases, smokers made up a larger proportion of early stage (I/II: 47.1%) compared with late stages (III, 34.3%; IV, 18.6%). CONCLUSION: The number of female lung cancer patients has increased in CHCAMS. In both smoking and non-smoking cases, the proportion of adenocarcinoma increased. Squamous cell carcinomas were more likely to be diagnosed in early stages among smokers.

[Epidemiological Features of Lung Cancer Mortality between 1990 and 2016 in Xuanwei City,Yunnan Province].

Objective To describe the trend of lung cancer mortality in Xuanwei City,Yunnan Province,from 1990 to 2016 and provide scientific evidence for the prevention and control of lung cancer in Xuanwei.Methods Mortality data from the 2nd(year 1990-1992)and 3rd(year 2004-2005)Retrospective Survey on Causes of Death,and the Routine Death Registration System(year 2011-2013 and 2014-2016)in Xuanwei were used in this study.We calibrated the missing report of the mortality data for the corresponding periods,calculated the crude mortality rates,standardized mortality rates and corresponding 95% CI of different types of lung cancers in the above four periods.Results The crude mortality rates of all lung cancers in Xuanwei for these four periods(1990-1992,2004-2005,2011-2013,and 2014-2016)were 34.0/100 000,89.8/100 000,102.3/100 000 and 87.2/100 000 respectively.The standardized morality rate of lung cancer remain high in Xuanwei although it has been decreasing since 2004.Morality rates of lung cancer for most age groups showed decreasing trends.The decrease has been statistically significant in the ≤ 40 year group since 2014.Except for Longchang,the standardized mortality rates have decreased in all other townships with high lung cancer prevalence.Conclusions Although the mortality rate of lung cancer remains high in Xuanwei,it has shown a decreasing trend since 2004.The decrease in lung cancer mortality in populations younger than 40 years is statistically significant.

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 (OR s) 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 11.0 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 < 0.001). 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.

Epidemic trend, screening, and early detection and treatment of cancer in Chinese population.

Epidemiological studies showed the incidence mortality rates of cancer were increasing in recent decades in Chinese population. National and regional preventive programs aim to reduce the health hazards of cancer and focuse the population at high risks for specific cancer, particularly in rural areas and to offer the access to early detection for multlple cancers in urban areas. The early screening, early detection and treatment have been put into operation for the population at risks in rural areas at first, and in the urban areas in recent years. To understand the epidemic patterns and trends of cancer, and the experiences in applying early detection strategies in China, selected literatures were reviewed for brief summary.

Helping smokers quit: behaviours and attitudes of Chinese Registered Nurses.

AIMS: To describe the self-reported frequency of Chinese nurses' interventions to help smokers quit, using the 5 As (i.e. Ask, Advise, Assess, Assist, Arrange), attitudes towards tobacco control and differences in consistency interventions by demographic and professional characteristics prior to an educational intervention to increase nurses' support for quit efforts. BACKGROUND: Tobacco use is the leading cause of preventable death in China; quitting smoking reduces health risks and premature death. The China Tobacco Cessation Treatment Guideline supports the 5 As model for intervention, but nurses' frequency of delivering smoking cessation interventions is unknown. DESIGN: Descriptive survey using a convenience sample. METHODS: Nurses from eight hospitals in Beijing and Hefei, China completed a web-based survey in 2012. Differences in consistency of the 5 As by nurse characteristics were determined using multivariate logistic regression. Overall importance of nurses in tobacco control was evaluated on a 1-5 scale (5 = most important). RESULTS: Nurses (N = 2440; 1404 Beijing, 1036 Hefei) participated. 64% consistently asked about smoking status, 85% advised patients to quit, 52% assessed readiness to quit and assisted with smoking cessation and 17% arranged for follow-up. Interventions varied by nurses' education and clinical setting. Nurses positively viewed involvement in tobacco control (4·3/5) and thought nurses should be smoke-free role models (4·8/5·0). CONCLUSIONS: This study demonstrates that the majority of nurses asked about smoking status, but few assisted patients with quitting. Further efforts are needed to help nurses actively promote smoking cessation interventions.

Evaluation of a web-based educational programme on changes in frequency of nurses' interventions to help smokers quit and reduce second-hand smoke exposure in China.

AIMS: To evaluate a web-based educational smoking cessation programme on changes in the frequency of hospital-based nurses' self-reported interventions to help smokers quit using the 5 As (i.e. Ask, Advise, Assess, Assist, Arrange), to reduce exposure to second-hand smoke and to change attitudes about nurses' involvement in tobacco control. BACKGROUND: Few nurses in China support smokers' quit attempts using evidence-based smoking cessation interventions based on the 5 As. Limited knowledge is a barrier to intervention. Web-based tobacco cessation programs have the potential to reach a large population of nurses. DESIGN: A prospective single-group design with pre-, 3- and 6-month follow-up after the educational programme evaluated the feasibility of conducting web-based educational programs in two cities in China in 2012-2013. METHODS: Frequency of interventions was assessed using a valid and reliable web-based survey with a convenience sample of nurses from eight hospitals in Beijing and Hefei, China. Generalized linear models, adjusting for age, clinical setting, education and site were used to determine changes in the consistent (usually/always) use of the 5 As from baseline to 3 and to 6 months. RESULTS: Nurses (N = 1386) had baseline and/or 3- and 6-month data. At 6 months, nurses were significantly more likely to Assess, Assist and Arrange for smoking cessation and recommend smoke-free home environments. There was significant improvement in attitudes about tobacco control. CONCLUSIONS: Nurses receiving web-based smoking cessation education significantly increased self-reports of frequency of providing interventions to patients who smoke, including recommending smoke-free home environments to support quit attempts.

Increased lung cancer mortality rates in the Chinese population from 1973-1975 to 2004-2005: An adverse health effect from exposure to smoking.

BACKGROUND: Lung cancer incidence and mortality rates have increased substantially in China despite improvements in clinical diagnosis and treatment approaches as well as significant advances in the implementation of tobacco-control policies in recent decades. METHODS: Age-standardized mortality rates and age-specific rates of lung cancer in China were estimated for the periods 1973 to 1975, 1990 to 1992, and 2004 to 2005 using data from 3 National Death Surveys. Among patients with lung cancer who were identified from a hospital-based information system, the percentages of ever-smokers were analyzed according to histologic and demographic variables. RESULTS: Age-standardized mortality from lung cancer in China dramatically increased from 7.30 per 100,000 during 1973 through 1975 to 27.62 per 100,000 during 2004 through 2005. Increases in lung cancer age-standardized mortality were consistent among men and women in urban and rural populations. Among men ages 75 to 79 years, lung cancer mortality increased remarkably to 453.67 per 100,000 in 2004 and 2005 (from 246.78 per 100,000 during 1990-1992 and from 53.65 per 100,000 during 1973-1975). Among 6674 patients with lung cancer who were identified from 2003 to 2007 from a hospital-based database, 82.97% of men were ever-smokers (73.35% of men with adenocarcinoma and 91.8% of men with squamous cell carcinoma), and 11.18% of women were ever-smokers (6% of women with adenosquamous carcinoma and 39.02% of women with squamous cell carcinoma). Differences in the numbers of ever-smokers were observed between age groups but not according to the year of diagnosis. CONCLUSIONS: The consistent and rapid increases in lung cancer mortality rates observed in the Chinese population and the high prevalence of exposure to smoking in China prompt a strong call for the implementation of a comprehensive tobacco-control policy and specific public health educational strategies.

The incidences and mortalities of major cancers in China, 2010.

To estimate the cancer incidences and mortalities in China in 2010, the National Central Cancer Registry (NCCR) of China evaluated data for the year of 2010 from 145 qualified cancer registries covering 158,403,248 people (92,433,739 in urban areas and 65,969,509 in rural areas). The estimates of new cancer cases and cancer deaths were 3,093,039 and 1,956,622 in 2010, respectively. The percentage of morphologically verified cases were 67.11%; 2.99% of incident cases were identified through death certification only, with the mortality to incidence ratio of 0.61. The crude incidence was 235.23/100,000 (268.65/100,000 in males and 200.21/100,000 in females). The age-standardized rates by Chinese standard population (ASR China) and by world standard population (ASR world) were 184.58/100,000 and 181.49/100,000, respectively, with a cumulative incidence (0-74 years old) of 21.11%. The crude cancer mortality was 148.81/100,000 (186.37/100,000 in males and 109.42/100,000 in females). The ASR China and ASR world were 113.92/100,000 and 112.86/100,000, respectively, with a cumulative mortality of 12.78%. Lung, breast, gastric, liver, esophageal, colorectal, and cervical cancers were the most common cancers. Lung, liver, gastric, esophageal, colorectal, breast, and pancreatic cancers were the leading causes of cancer deaths. The coverage of cancer registration has rapidly increased in China in recent years and may reflect more accurate cancer burdens among populations living in different areas. Given the increasing cancer burden in the past decades, China should strengthen its cancer prevention and control.

Histological subtypes of lung cancer in Chinese males from 2000 to 2012.

OBJECTIVE: To characterize the histological and epidemiological features of male lung cancer patients in China. METHODS: The demographic and histological information about male lung cancer patients identified from 2000-01-01 to 2012-12-31, was collected from the Cancer Hospital of the Chinese Academy of Medical Sciences. Relative frequencies (RF) were estimated for major histological subtypes and compared according to the years of diagnosis and birth. RESULTS: The RF of adenocarcinoma (ADC) increased from 21.96% to 43.36% and the RF of squamous cell carcinoma (SCC) decreased from 39.11% to 32.23% from 2000 to 2012 in the 15 427 male lung cancer patients included in this study (Z=17.909, P<0.0001; Z=-6.117, P<0.0001). The RF of ADC increased from 28.72% in 2000-2004, 36.88% in 2005-2008 to 48.61% in 2009-2012 in patients born after 1960. The age-adjusted RF of ADC in 2007-2012 increased consistently in all the investigated areas. CONCLUSION: The increased RF of ADC in male lung cancer patients highlights the need for further investigation of the etiologic factors of these tumors. Smoke-free policies rather than modifying tobacco products should be enforced.

Histological subtypes of lung cancer in Chinese women from 2000 to 2012.

BACKGROUND: The aim of the study was to characterize the histological and epidemiological features of lung cancer in Chinese women. METHODS: Demographic and histological information on female lung cancer cases identified during 1 January 2000 through 31 December 2012 from the Cancer Hospital of the Chinese Academy of Medical Sciences were collected. The International Classification of Diseases for Oncology system was used to classify the histological subtypes. Relative frequencies (RF) were estimated for major histological subtypes and compared by the years of diagnosis and birth, and among residential areas. Statistical differences were tested for RFs in the time periods with a trend test and with Pearson Chi square tests for distribution. RESULTS: Of 7070 female Chinese lung cancer cases, the major histological subtypes were adenocarcinoma (ADC) 65.79%; squamous cell carcinoma (SCC) 10.21%; small cell cancer 8.12%; large cell carcinoma, 2.79%; and adeno-squamous carcinoma (ASC), 2.19%. ADC increased, with RFs from 46.72% in the cases identified in 2000-2002 to 76.49% in 2011-2012 (Z = 16.998, P < 0.0001); SCC decreased from 15.69% to 5.97% (Z = -8.750, P < 0.0001). Compared to the cases identified in 2000-2006, the age-adjusted RFs of ADC in 2007-2012 consistently increased in all study areas. CONCLUSION: The significant increase of ADC of the lung in Chinese women suggests that a persistently strong exposure to potential carcinogens in the Chinese population should be further and fully investigated.

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 age-specific 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.

[Analysis and prediction of breast cancer incidence trend in China].

OBJECTIVE: Based on the registered female breast cancer data from 1998 to 2007, to analyze the incidence of female breast cancer during the period and then to predict its trend from 2008 to 2015. METHODS: The incidence data of breast cancer from 1998 to 2007 were sorted from National Cancer Registry Database, including 74 936 cases from urban areas and 8230 cases from rural areas, separately covering 164 830 893 and 55 395 229 person years. The crude incidence rates in urban and rural areas were calculated, and the age-standardized rate (ASR) was adjusted by World Segi's population composition. JoinPoint software was applied to analyze the 10 years' incidence trend and calculated the annual percentage of changing (APC), while Age-Period-Cohort Bayesian Model was used to fit the data and predict the incidence of breast cancer between 2008 and 2015. RESULTS: From 1998 to 2007, the incidence of breast cancer in the urban cancer registration areas was 45.46/100 000 (74 936/164 830 893), whose ASR was 31.28/100 000. While in rural registration areas, the incidence and ASR was 14.86/100 000 (8230/55 395 229) and 12.13/100 000. The breast cancer incidence in urban and rural areas separately rose from 36.17/100 000 (3920/10 838 355) and 10.39/100 000 (436/4 197 806) in 1998 to 51.24/100 000 (11 302/22 057 787) and 19.61/100 000 (1475/7 522 690) in 2007. During the 10 years, the breast cancer incidence increased both in urban and rural areas, but the increase rate in rural incidence (6.3%) was more significant than it in urban areas (3.9%). Age-Period-Cohort Bayesian Model predicted that the breast cancer incidence would increase to 53.87/100 000 (185 585 new cases) in urban areas and 40.14/100 000 (132 432 new cases) in rural areas, respectively. CONCLUSION: The breast cancer incidence has been increasing annually both in urban and rural areas in China; and an annually increase number of new cases have been predicted.

[Trend analysis and prediction of cancer incidence in China].

OBJECTIVE: Based on the national cancer incidence database from 1998 to 2007, to analyze the cancer incidence trend and predict the cancer burden between 2008 and 2015. METHODS: We picked up the cancer incidence data of 40 cancer registry sites from National Central Cancer Registry Database between 1998 and 2007. In total, 1 109 594 cancer cases were registered, covering 446 734 668 person-year. The separate incidence by district and gender were calculated, and the standardized incidence rate was calculated by world's population age structure. The incidence trend between the 10 years was analyzed by JoinPoint software, as well as the age-percentage-changes (APC). Age-Period-Cohort Bayesian Model was applied to fit the cancer incidence data stratified by age, district and gender. The cancer incidence between 2008 and 2015 was then predicted. RESULTS: During the period of 1998 - 2007, in urban areas, the male cancer incidence rate was 277.61/100 000 (472 307/170 131 309), with the age standardized rate (ASR) at 202.05/100 000; while the female cancer incidence rate was 236.35/100 000 (389 586/164 830 893), with the ASR at 159.15/100 000; in rural areas, the male and female cancer incidence rates were separately 272.23/100 000 (153 478/56 377 236) and 170.09/100 000 (94 223/55 395 230), with the corresponding ASR at 244.34/100 000 and 137.90/100 000. Crude incidence rate in urban men increased from 247.00/100 000 (27 758/11 237 967) in 1998 to 305.76/100 000 (68 953/22 551 353) in 2007; while it increased from 207.37/100 000 (22 476/10 838 355) to 263.20/100 000 (58 055/22 057 787) among urban women. The crude incidence rate in rural men increased from 232.33/100 000 (10 045/4 323 628) to 303.65/100 000 (23 313/7 677 484) and it increased from 139.03/100 000 (5836/4 197 806) to 197.40/100 000 (14 850/7 522 690) among rural women. After age adjustment, the urban male APC value (95%CI) was 0.5% (-0.2% - 1.3%), showed no significantly statistical difference. However, the urban female APC value (95%CI), rural male APC value (95%CI) and rural female APC value (95%CI) were separately 1.7% (1.3% - 2.0%), 1.8% (0.9% - 2.6%) and 2.8% (1.8% - 3.7%), all showed an obvious uptrend. The outcome of Age-Period-Cohort Bayesian model predicted that by year 2015, the incidence cancer rate in urban areas will reach 309.13/100 000 (1.140 million new cases) among males and 303.79/100 000 (1.046 million new cases) among females; while in rural areas the rate will reach 288.66/100 000 (1.019 million new cases) among males and 222.59/100 000 (0.734 million new cases) among females. CONCLUSION: The cancer incidence has increased annually; the uptrend in rural areas was more obvious than it in urban areas; the uptrend in females was more obvious than it in males. It is predicted that the annual incidence will continue to increase in the next years, and effective control programs should be carried out immediately.

[Analysis and prediction of liver cancer incidence in China].

OBJECTIVE: Based on the cancer registry data during 1998 - 2007, to analyze the incidence of liver cancer in China and predict the trend of incidence of liver cancer between 2008 and 2015. METHODS: Liver cancer incidence data from cancer registry between 1998 and 2007 was collected, including a total of 115 417 cases, covering 446 734 668 person-year. We calculated the annual incidence rate of liver cancer by gender and area. Age-standardized rate (ASR) was calculated by the world's population age structure. JoinPoint software was applied to analyze the incidence trend and calculate annual percent change (APC). Age-Period-Cohort Bayesian Model was used to fit the incidence trend and predict the incidence trend between 2008 and 2015. RESULTS: From 1998 to 2007, according to the data from cancer registry, the liver cancer incidence was 25.84/100 000 (115 417/446 734 668), with the ASR at 18.82/100 000. In urban areas, the male incidence was 34.30/100 000 (58 353/170 131 309), with ASR at 24.99/100 000; while the female incidence was 12.33/100 000 (20 324/164 830 893), with ASR at 7.99/100 000. In rural areas, the male incidence was 48.56/100 000 (27 378/56 377 236), with ASR at 42.27/100 000; while the female incidence was 16.90/100 000 (9362/55 395 230), with ASR at 13.52/100 000. During the decade, in urban areas, the APC of male and female liver cancer incidence rates were separately 1.1% and -0.5%, with ASR at -0.5% and -1.9%; while in rural areas, the APC of male and female liver cancer incidence rates were separately 3.7% and 3.1%, with ASR at 1.9% and 1.3%. Age-Period-Cohort Bayesian Model predicted that in urban areas, the male and female incidence of liver cancer in 2015 would reach 30.73/100 000 (113 279 cases) and 10.44/100 000 (35 978 cases), with ASR at 23.70/100 000 and 7.21/100 000, respectively; while in rural areas, the incidence rates would increase to 51.67/100 000 (182 382 cases) and 15.03/100 000 (49 580 cases), with ASR at 39.80/100 000 and 10.45/100 000, respectively. CONCLUSION: The incidence of liver cancer will increase between 2008 and 2015, but its ASR will decrease slightly. In the near future, the number of new liver cancer cases will keep increasing. Liver cancer is still the dominant cancer and one key point for cancer prevention and control in China.

[Analysis and prediction of esophageal cancer incidence trend in China].

OBJECTIVE: Based on the registered esophageal cancer data from 1998 to 2007, to analyze the incidence of esophageal cancer during the period and then to predict its trend between year 2008 and 2015. METHODS: The incidence data of esophageal cancer between 1998 and 2007 were sorted from National Cancer Registry Database. Data from forty selected registries were qualified and recruited in the study, including 86 427 cases in total, covering 446 734 668 person years. Crude incidence rates were calculated by area and gender. The standardized incidence rate was adjusted by World Segi's population composition. JoinPoint software was applied to analyze the 10 years' incidence trend and calculated the annual percentage change, while Age-Period-Cohort Bayesian Model was used to fit the data and predict the incidence between 2008 and 2015. RESULTS: Between 1998 and 2007, the crude incidence rates among males and females in urban areas were separately 16.58/100 000 (28 207/170 131 309) and 7.14/100 000 (11 761/164 830 893), with standardized rates at 12.06/100 000 and 4.55/100 000, respectively. In rural areas, the crude incidence rates and the standardized rates were separately 51.98/100 000 (29 303/56 377 236) and 47.18/100 000 among males, and 30.97/100 000 (17 156/55 395 230) and 25.30/100 000 among females. During the ten years, the crude incidence trend of esophageal cancer among urban females decreased from 10.29/100 000 (1115/10 838 355) in 1998 to 6.29/100 000 (1387/22 057 787) in 2007. However, the crude incidence rate among rural males increased from 47.69/100 000 (2062/4 323 628) to 54.80/100 000 (4207/7 677 484) in the same period. And the rate among rural females and urban males did not change obviously. After adjusting population structure, in urban areas, the male incidence rate decreased by 2.1% annually and female incidence rate dropped by 7.5% annually. In rural areas, the female incidence rate fell by 1.3% annually, while the male incidence rate remained the same without significant changes. The prediction model estimated that there would be 134 474 new esophageal cancer cases diagnosed in year 2015, including 104 400 males and 30 074 females, while 52 506 cases came from urban areas and the other 81 968 cases were from rural areas. CONCLUSION: The esophageal cancer incidence showed a downtrend, especially among urban females. By year 2015, the threat of esophageal cancer will be alleviated.

[Analysis and prediction of colorectal cancer incidence trend in China].

OBJECTIVE: Based on the data from National Cancer Registry between 1998 and 2007, to analyze the colorectal cancer incidence trend in China, and further to predict its incidence between 2008 and 2015. METHODS: We picked up the incidence data of 111 281 cases of colorectal cancer in total from National Central Cancer Registry Database between 1998 and 2007, covering 446 734 668 person-year. The annual incidence rate of colorectal cancer both by area and gender were calculated; while the age standardized rate (ASR) was standardized by world's population age structure. The incidence trend was analyzed and the annual percentage change (APC) was calculated by JoinPoint software. Age-Period-Cohort Bayesian Model was applied to fit the colorectal cancer incidence trend in China between 1998 and 2007; and further to predict its incidence between 2008 and 2015. RESULTS: From 1998 to 2007, the colorectal cancer registered incidence was 24.91/100 000 (111 281/446 734 668), with the ASR at 17.67/100 000. The incidence in male population was 26.50/100 000 (60 015/226 508 545), with ASR at 19.90/100 000; and the incidence in female was 23.28/100 000 (51 266/220 226 123), with ASR at 15.73/100 000. In urban area, the male incidence rose from 23.29/100 000 (2617/11 237 967) in 1998 to 37.84/100 000 (8534/22 551 353) in 2007; while the female incidence increased from 21.75/100 000 (2357/10 838 355) to 31.34/100 000 (6913/22 057 787). And in rural areas, the male and female incidences rose from 10.36/100 000 (448/4 323 628) and 8.86/100 000 (372/4 197 806) in 1998 to 16.80/100 000 (1290/7 677 484) and 13.00/100 000 (978/7 522 690) in 2007 respectively. In this decade, the colorectal cancer incidence has increased both in urban and rural areas. In urban area, the male APC value was 5.5% and the female APC value was 4.0%; while in rural area, the male and female APC values were 6.0% and 4.3% respectively. After adjusted by age structure, the uptrend became gently; with the urban male and urban female APC values separately increased by 3.7%, 2.5% and 2.3%. The rural male APC value rocketed up by 8.4% after its inflection point in 2004. The Bayesian model predicted that the male and female colorectal cancer incidences would separately reach 33.92/100 000 (125 thousand cases) and 27.13/100 000 (93 thousand cases) in urban areas; and 13.61/100 000 (48 thousand cases) and 13.68/100 000 (45 thousand cases) in rural areas by year 2015. CONCLUSION: The colorectal cancer incidence in China has been increasing annually; and it will continue to rise in the next years.

Epidemiological characteristics of cancer in elderly chinese.

Background. Population of elder Chinese has been increasing, but the pattern and trend of cancer in that population was rarely reported. Methods. Mortality rates for cancer of all sites and of the site specific of the overall and elderly Chinese from 2004 to 2005 were estimated. The age structure of world population was used to observe the changes in the age-standardized mortality rates from 1975 to 2005 using the data from the national death surveys, Disease Surveillance Points, and cancer registries in China. Results. The mortalities among the elderly Chinese were 782.12 per 100,000, substantially higher than those of the people less than 60 years old. The mortalities for cancers of lung, stomach, liver, and esophagus in elderly population showed great increase compared to younger ages. Stomach cancer ranked as the second most common cancer following lung cancer in the elderly, and those two malignancies had similar mortality rates in male elderly, while in female, it ranked as first, surpassed lung cancer. Consistent decreased trends of M/I ratios of cancer were observed in all age groups. Conclusion. Strategies in cancer prevention and cost-effective preventive intervention should be highly considered and strongly implemented among the elderly Chinese.

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.

[An analysis of lung cancer mortality in China, 2004 - 2005].

OBJECTIVE: To analyze the mortality distribution characteristics and epidemiological trend of lung cancer in 2004 - 2005 in China. METHODS: A total of 142 660 482 person years (72 970 241 person years in male, 69 690 241 person years in female) was covered in the Third National Retrospective Sampling Survey of Death Causes in China, 2004 - 2005. All death records of cancer of trachea, bronchus and lung were extracted. According to the different variations such as gender, urban or rural areas and three territory regions-Eastern, Central and Western China for lung cancer deaths, crude, age-adjusted, area-adjusted death rate, the constitute proportion to all cancer deaths, age-standardized death rate by Chinese standard population and by world standard population and rank of cancer-specific mortality were calculated. The statistic indexes of mortality were compared with that of previous retrospective death surveys in 1973 - 1975 and 1990 - 1992. RESULTS: In the National Death Survey 2004 - 2005, there were 43 993 deaths caused by lung cancer with crude death rate of 30.84/100 000, age-standardized death rate by Chinese standard population of 20.24/100 000 and 27.62/100 000 by world standard population, accounted for 22.70% of total cancer deaths (193 841 cases). There were a total of 30 167 cancer deaths in male with crude death rate of 41.34/100 000 and 13 826 in female with crude death rate of 19.84/100 000. Lung cancer mortality was increased with age. In urban areas, the lung cancer was ranked the first cancer death causes with crude death rate of 40.98/100 000 (19 628/47 899 806), accounted for 27.29% of all cancer deaths. While in rural areas, the lung cancer was the second cancer death following liver cancer with crude death rate of 25.71/100 000 (24 365/94 760 676), accounted for 19.99% of all cancer deaths (121 905 cases). There were different death rates by different location division. Lung cancer crude death rate in east was the highest with rate of 37.85/100 000 (19 893/52 556 694) and in west was the lowest with rate of 21.76/100 000(8774/40 322 563). Crude death rate of lung cancer increased by 75.83% compared with the second survey (crude death rate was 17.54/100 000) in 1990 - 1992, increased by 464.84% compared with the first survey (crude death rate was 5.46/100 000) in 1973 - 1975, showing a significant uptrend. CONCLUSION: Lung cancer is the most important cancer affecting the health of Chinese urban residents. The mortality has been increasing significantly.