4.5 Article

Trends in cancer mortality in China from 2004 to 2018: A nationwide longitudinal study

Journal

CANCER COMMUNICATIONS
Volume 41, Issue 10, Pages 1024-1036

Publisher

WILEY
DOI: 10.1002/cac2.12195

Keywords

age-standardized mortality rate; breast cancer; colorectal cancer; crude mortality rate; demographic distribution; liver cancer; national mortality surveillance system; premature death; site-specific cancer; stomach cancer; trend

Categories

Funding

  1. National Natural Science Foundation of China [81673250, 81520108021, 91529305]
  2. Key discipline from the 3-year public health promotion program of Shanghai Municipal Health Commission

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The study on cancer mortality trends in China from 2004 to 2018 showed a decrease in the overall cancer death rate, but lung and liver cancer remained the leading causes of cancer-related premature death. Furthermore, lung, colorectal, and pancreatic cancers showed an increasing trend in mortality rates among rural residents.
Background The long-term trend in cancer death in a rapidly developing country provides information for cancer prophylaxis. Here, we aimed to identify the trends in cancer mortality in China during the 2004-2018 period. Methods Using raw data from the national mortality surveillance system of China, we assessed the mortalities of all cancer and site-specific cancers during the 2004-2018 period. The participants were divided into three age groups: >= 65 years, 40-64 years, and <= 39 years. Changing trends in cancer death by gender, residency, and tumor location were estimated using fitting joinpoint models to log-transformed crude mortality rates (CMRs) and age-standardized mortality rates (ASMRs). Results Cancer death accounted for 24% of all-cause of death in China during 2014-2018. The CMR of all cancer was 150.0 per 100,000 persons. Cancer was the leading cause of death in the population <65 years. The six major cancer types (lung/bronchus cancer, liver cancer, stomach cancer, esophagus cancer, colorectal cancer, and pancreas cancer) accounted for 75.85% of all cancer deaths. The CMR of all cancer increased while the ASMR decreased during 2014-2018 (P < 0.001). Lung/bronchus cancer and liver cancer were the leading causes of cancer death in the population <65 years, accounting for 45.31% (CMR) and 44.35% (ASMR) of all cancer death, respectively. The ASMR of liver cancer was higher in the 40-64 years population than in the >= 65 years population, in contrast to the other five major cancers. The ASMRs of liver cancer, stomach cancer, and esophagus cancer decreased although they were higher in rural residents than in urban residents; the ASMRs of lung/bronchus cancer, colorectal cancer, and pancreas cancer increased in rural residents although they were higher in urban residents than in rural residents during 2014-2018. Conclusion Although the ASMR of all cancer decreased in China during 2004-2018, lung/bronchus cancer and liver cancer remained the leading causes of cancer-related premature death. Lung/bronchus cancer, colorectal cancer, and pancreas cancer increased in rural residents.

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