Cancer incidence and mortality: A cohort study in China, 2008–2013

The National Central Cancer Registry of China (NCCR) was the only available source of cancer monitoring in China, even though only about 70% of cancer registration sites were qualified by now. In this study, based on a national large prospective cohort‐the China Kadoorie Biobank (CKB), we aimed to provide additional cancer statistics and compare the difference of cancer burden between urban and rural areas of China. A total of 497,693 cancer‐free participants aged 35–74 years were recruited and successfully followed up from 2004 to 2013 in 5 urban and 5 rural areas across China. Except for traditional registration systems, the national health insurance system and active follow‐up were used to determine new cancer incidents and related deaths. The mortality‐to‐incidence ratio (MIR) was used to compare the differences of cancer burden between urban and rural areas of China. We found that cancer mortality coincided well between our cohort and NCCR, while the incidence was much higher in our cohort. Based on CKB, we found the MIR of all cancers was 0.54 in rural areas, which was approximately one‐third higher than that in urban areas with 0.39. Cancer profiles in urban areas were transiting to Western distributions, which were characterized with high incidences of breast cancer and colorectal cancer; while cancers of the esophagus, liver and cervix uteri were still common in rural areas of China. Our results provide additional cancer statistics of China and demonstrate the differences of cancer burden between urban and rural areas of China.

[1]  A. Jemal,et al.  Cancer statistics in China, 2015 , 2016, CA: a cancer journal for clinicians.

[2]  J. Hébert,et al.  The application of the mortality‐to‐incidence ratio for the evaluation of cancer care disparities globally , 2016, Cancer.

[3]  Eddy R. Segura,et al.  Conceptual considerations and methodological recommendations for the use of the mortality‐to‐incidence ratio in time‐lagged, ecological‐level analysis for public health systems‐oriented cancer research , 2016, Cancer.

[4]  Alan D. Lopez,et al.  Cause-specific mortality for 240 causes in China during 1990–2013: a systematic subnational analysis for the Global Burden of Disease Study 2013 , 2016, The Lancet.

[5]  Wanqing Chen,et al.  The incidence and mortality of major cancers in China, 2012 , 2013, Chinese journal of cancer.

[6]  R. Collins,et al.  Emerging Tobacco-Related Cancer Risks in China: A Nationwide, Prospective Study of 0.5 Million Adults , 2015, Cancer.

[7]  R. Goldsby,et al.  Intestinal Obstruction in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study. , 2015, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[8]  L. Qi,et al.  Consumption of spicy foods and total and cause specific mortality: population based cohort study , 2015, BMJ : British Medical Journal.

[9]  Nobhojit Roy,et al.  The Global Burden of Cancer 2013. , 2015, JAMA oncology.

[10]  M. Engelgau,et al.  Cervical Cancer Screening Among Adult Women in China, 2010. , 2015, The oncologist.

[11]  J. Hébert,et al.  The colorectal cancer mortality‐to‐incidence ratio as an indicator of global cancer screening and care , 2015, Cancer.

[12]  Ning Wang,et al.  Cancer survival in China, 2003–2005: A population‐based study , 2015, International journal of cancer.

[13]  A. Jemal,et al.  Global cancer statistics, 2012 , 2015, CA: a cancer journal for clinicians.

[14]  Jie He,et al.  Annual report on status of cancer in China, 2011. , 2015, Chinese journal of cancer research = Chung-kuo yen cheng yen chiu.

[15]  Jun Wang,et al.  Challenges to effective cancer control in China, India, and Russia. , 2014, The Lancet. Oncology.

[16]  Jie He,et al.  Annual report on status of cancer in China, 2010. , 2014, Chinese journal of cancer research = Chung-kuo yen cheng yen chiu.

[17]  Alan D. Lopez,et al.  Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010 , 2013, The Lancet.

[18]  S. Franceschi,et al.  Meeting the global demands of epidemiologic transition — The indispensable role of cancer prevention , 2013, Molecular oncology.

[19]  Jie He,et al.  Report of incidence and mortality in China cancer registries, 2009. , 2013, Chinese journal of cancer research = Chung-kuo yen cheng yen chiu.

[20]  Jie He,et al.  Report of incidence and mortality in China Cancer Registries, 2008 , 2012, Chinese journal of cancer research = Chung-kuo yen cheng yen chiu.

[21]  R. Peto,et al.  Epidemiology and the control of disease in China, with emphasis on the Chinese Biobank Study. , 2012, Public health.

[22]  R. Collins,et al.  China Kadoorie Biobank of 0.5 million people: survey methods, baseline characteristics and long-term follow-up. , 2011, International journal of epidemiology.

[23]  C. Navarro,et al.  Population-based cancer registries in Spain and their role in cancer control. , 2010, Annals of oncology : official journal of the European Society for Medical Oncology.

[24]  鮫島 浩,et al.  Population-based study からみた神経予後不良因子の検討 , 2009 .

[25]  J. Hébert,et al.  Mapping cancer mortality‐to‐incidence ratios to illustrate racial and sex disparities in a high‐risk population , 2009, Cancer.

[26]  S. Anand,et al.  China's human resources for health: quantity, quality, and distribution , 2008, The Lancet.

[27]  H. Quan,et al.  Rural and Urban Disparity in Health Services Utilization in China , 2007, Medical care.

[28]  H. Tsukuma,et al.  Early- and Late-Onset Breast Cancer Types Among Women in the United States and Japan , 2007, Cancer Epidemiology Biomarkers & Prevention.

[29]  Xiaomei Ma,et al.  Global Burden of Cancer , 2006, The Yale journal of biology and medicine.

[30]  P. Eastman Annual Report on Status of Cancer from ACS, NCI, CDC, Cancer Registries: Targeted Focus on Latinos Will Likely Improve US Cancer Rates , 2006 .

[31]  P. Hall,et al.  Profound changes in breast cancer incidence may reflect changes into a Westernized lifestyle: A comparative population‐based study in Singapore and Sweden , 2005, International journal of cancer.

[32]  A. Jemal,et al.  Global cancer statistics , 2011, CA: a cancer journal for clinicians.

[33]  Yang Gh,et al.  National public health surveillance in China: implications for public health in China and the United States. , 1997 .

[34]  S. Thacker,et al.  National public health surveillance in China: implications for public health in China and the United States. , 1997, Biomedical and environmental sciences : BES.

[35]  Louette R. Johnson Lutjens Research , 2006 .

[36]  N. Dubrawsky Cancer statistics , 1989, CA: a cancer journal for clinicians.

[37]  Edwin Silverberg,et al.  Cancer statistics, 1970 , 1970, CA: a cancer journal for clinicians.

[38]  F. Rosi,et al.  [Bimodal distribution, according to age, of cervix uteri neoplasms in Perugia (1957-1968)]. , 1969, Lavori dell'Istituto di anatomia e istologia patologica, Universita degli studi di Perugia.

[39]  F. de Waard,et al.  The bimodal age distribution of patients with mammary carcinoma. Evidence for the existence of 2 types of human breast cancer , 1964, Cancer.