The Lancet - Oncology: 40 years of changes and prevention and control of the cancer burden in China from the tumor registration.

In the latest issue of The Lancet-Oncology, the director of the National Cancer Center of China and the president of the Oncology Hospital of the Chinese Academy of Medical Sciences, He Jie, published an important review, introduced the development milestones and current situation of the China Cancer Registration Center, and analyzed the changes in the cancer burden in China in the past 40 years from the tumor registration data, as well as the impact on prevention and control.
Screenshot Source: Lancet Oncology China Cancer Registration Development Research team outlines the rapid development of tumor registration in China by introducing key milestones.
1959, China established its first cancer registration center to investigate the high incidence of esophageal cancer in Linzhou, Henan Province.
1963, China's first urban cancer registration center was established in Shanghai.
the 1970s, the first national retrospective survey of cancer mortality in China was completed, covering 96.7% of the country.
the report, cancer registries were subsequently established in areas with high cancer mortality rates.
2002, the China National Cancer Registry was established to continuously collect and analyze cancer data at the national level.
2008, China's National Cancer Registration and Follow-up Project was launched, and in 2015, the Measures for the Administration of Tumor Registration were issued.
with the support of a series of policies, the number of cancer registration centres has increased rapidly from 43 in 2008 to 574 in 2019, reaching 438 million people (31.5 per cent of China's total population), of whom 48 per cent are urban and rural and 52 per cent are urban and rural, respectively.
, cancer Chinese mainland been carried out in all 31 provincial areas of the country.
All hospitals, medical institutions and health facilities should submit cancer case records, the Vital Statistics System should provide data on the cause of death of the population, and cross-supplement and corred information through data from multiple sources, including death monitoring data, insurance records, funeral records, etc.
data quality through the development of relevant standards.
all patient information is protected.
40 years, the cancer burden in China has changed In 1990-1992 and 2005, the Oncology Registration Team conducted the second and third national cancer mortality studies in China, respectively.
combined with monitoring data accumulated over the years by the Cancer Registry, the Hertzer team noted that, overall, the cancer burden in China increased between 1973 and 2005, and the changing trends of the burden of different types of cancer were characterized.
Chinese of cancer deaths among the group increased from 10.1 per cent between 1973 and 1975 to 24.2 per cent in 2015.
crude cancer mortality rate rose from 74.2 per 100,000 to 170.1 per 100,000, the age-standardized mortality rate has been declining gradually since 1990-1992, from 94.4 per 100,000 to 779 per 100,000 in 2015.
suggests that the main reason for the increase in overall cancer mortality is an ageing population.
note that the cancer burden on men is growing faster on three indicators.
the burden of cancer deaths from 1973 to 2015, A: the relative proportion of cancer deaths to total deaths;
(Photo Source: Reference 1) The burden of death from stomach, esophageal and liver cancers has been high in terms of different cancer species, although age-standardized mortality rates have decreased significantly, while overall and age-standardized mortality rates for lung, female and colorectal cancers have all shown an upward trend.
addition to an aging population, increasing obesity and lack of exercise, widespread smoking and air pollution, and improved control of infection-related diseases may also lead to changes in the characteristics of China's cancer burden, according to the review.
The mortality rate of the 10 most common types of cancer in China from 1973 to 2015 (source: data source: Reference: 1; Translation: New Medical View point) The overall incidence of all cancers has also increased since 2000-2015, with the incidence of age-standardized cancer increasing for women and stabilizing for men.
the highest incidence of cancer in men are lung, stomach, liver, colorectal, esophageal and bladder cancers.
women are most likely to develop breast, lung, colorectal, thyroid, stomach and cervical cancers.
the incidence of cancer in the general population, men and women in China from 2000 to 2015.
ASR-Age Standardized Incidence, CR-Total Incidence (Photo Source: Reference: Reference) The five-year survival rate of all cancers in China has also increased, from 30.9% in 2003-2005 to 40.5% in 2012-2015.
pancreatic cancer remains the "king of cancer", with a five-year survival rate of only 7.2% between 2012 and 2015, while thyroid cancer, mostly lazy cancer, has a five-year survival rate of 84.3%.
five-year survival rate for eight types of cancer has improved substantially, including esophageal, stomach, throat, bone, cervical, uterine, bladder and thyroid cancers.
of pancreatic and gallbladder cancers, which are highly lethal, has made little progress.
Oncology Registration Data Drive Cancer Prevention and Control The Hertzer team points out that overall, tumor registration data play an important role in three areas: assessing the cancer burden and progress in prevention and control in different parts of China;
Based on the insights provided by these data, a series of projects have begun to land: the National Cancer Prevention and Control Plan (1986-2000) focuses on the prevention and control of cancers with the highest mortality rates, such as stomach cancer, esophageal cancer, liver cancer, lung cancer and colorectal cancer, while ensuring that cancer registration covers 5% of china's population;
China Cancer Prevention and Control Three-Year Action Plan (2015-2017) further requires cancer registration to cover 30% of China's population and promote national cancer mapping.
in the more recent China Medium- and Long-Term Plan for the Prevention and Control of Chronic Diseases (2017-2025) and healthy China, improving cancer survival and reducing premature deaths from chronic diseases, including cancer, are major goals.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (pre-diagnosis and treatment of cancer in some urban areas (lung cancer, colorectal cancer, esophageal cancer, stomach cancer, liver cancer and female breast cancer), and screening for "two cancers" (breast and cervical) in women in rural areas.
of cancer in the project area exceeded 80%, the treatment rate reached 90%, the cancer mortality rate of the screening population decreased by 46%, and the cost of early diagnosis and treatment was nearly 70% lower than in the middle and late stages.
two cases were shared in the review on cancer causes and prevention.
Analysis of the national cancer registration data from 1990 to 2009 found that the increased risk of lung cancer was related to PM2.5 exposure and ozone air pollution, while in Qidong, Jiangsu Province, where liver cancer is high, more than 40 years of tumor registration data laid the foundation for random clinical studies, revealing that hepatitis B vaccine prevention of infection can reduce liver cancer risk.
summary notes that the epidemiological shift in cancer over the past few decades suggests that Chinese mouths are facing the double burden of increasing infection-related and lifestyle-related cancers.
, comprehensive assessment of cancer prevention, treatment and treatment can not be separated from continuous and comprehensive coverage of tumor registration data.
, China needs to continue to improve the quality and breadth of cancer registration data, especially in rural areas in the west, compared with the level of cancer registration coverage of more than 90 percent of the population in some European and American countries, according to the team.
the growing burden of cancer, tumor registration data are an effective and unique way to understand and evaluate cancer prevention and control.
: Wenqiang Wei, et al., (2020). Cancer registration in China and its role in cancer prevention and control. The Lancet Oncology, DOI: