Cancer in China

With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. But China's massive population (1.37 billion) has limited previous national incidence and mortality estimates to small samples of the population (less than 2%) using data from the 1990s or based on a specific year.

Recently, high-quality data from an additional number of population-based registries has been available through the National Central Cancer Registry of China. For the new report, Cancer Statistics in China, 2015, published in CA: A Cancer Journal for Clinicians, researchers led by Wanqing Chen, PhD, MD, of the National Cancer Center in Beijing, analyzed data from 72 local, population-based cancer registries (2009-2011), representing 6.5% of the population.

The report finds:

• It is predicted that there will be about 4,292,000 newly diagnosed invasive cancer cases in 2015 in China, corresponding to an average of almost 12,000 new cancer diagnoses each day.
• Among men, the five most common cancers are: cancers of the lung, stomach, esophagus, liver, and colorectum, which together account for about two-thirds of all cancer cases.
• Among women, the most common cancers are breast, lung and bronchus, stomach, colorectum, and esophagus, accounting for nearly 60% of all cases. Breast cancer alone is expected to account for 15% of all new cancers in women in China.
• It is estimated that about 2,814,000 Chinese will die from cancer in 2015, corresponding to over 7500 cancer deaths on average per day.
• The five leading causes of cancer death among both men and women in China are cancers of the lung and bronchus, stomach, liver, esophagus, and colorectum, accounting for about three-quarters of all cancer deaths.
• Similar to the incidence rates, the mortality rate for all cancers combined is substantially higher in men than in women (165.9 vs 88.8 per 100,000) and in rural areas than in urban areas.
• For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (10.2% per year), whereas they increased significantly (12.2% per year) among females.
• In contrast, the mortality rates since 2006 have decreased significantly for both males (21.4% per year) and females (21.1% per year).
• Despite this favorable trend, the number of cancer deaths substantially increased (73.8% increase) during the corresponding period because of the aging and growth of the population.
• Much cancer and many cancer deaths in China could be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.
• The largest contributor to avoidable cancer deaths in China is chronic infection, which is estimated to account for 29% of cancer deaths, predominantly from stomach cancer (H. pylori), liver cancer (HBV and HCV), and cervical cancer (HPV).
• Tobacco smoking accounted for about one-quarter of all cancer deaths in China; yet over one-half of adult Chinese men were current smokers in 2010, and smoking rates in adolescents and young adults are still rising.
• Outdoor air pollution, considered to be among the worst in the world, indoor air pollution through heating and cooking using coal and other biomass fuels, and the contamination of soil and drinking water mean that the Chinese population is exposed to many environmental carcinogens.