"The Lancet - Oncology" Hertje led the study: from the tumor registration to see the chinese cancer burden 40 years of change and prevention and control.

Nearly half a century ago, the cancer incidence rate and mortality rate of Chinese population has been increasing.at the same time, since its establishment in 1959, the cancer registry has been developing continuously, and has played an important role in cancer burden monitoring and prevention and control plan.in the latest issue of Lancet Oncology, academician He Jie, director of China National Cancer Center and President of Cancer Hospital of Chinese Academy of Medical Sciences, published an important review, introduced the development milestone and current situation of China Cancer Registration Center, and analyzed the changes of cancer burden in China in recent 40 years from tumor registration data, and the impact on prevention and control.screenshot: Lancet Oncology's development history of cancer registration in China, the research team outlined the rapid development of cancer registration in China by introducing key milestones.in 1959, in order to investigate the high incidence of esophageal cancer in Linzhou, Henan Province, the first cancer registration center was established in China.in 1963, China's first urban regional cancer registration center was established in Shanghai.in the 1970s, the first national retrospective survey of cancer mortality in China was completed, covering 96.7% of the whole country.according to the report, cancer registries have been established in areas with high cancer mortality.in 2002, China's National Cancer Registration Center was established to continuously collect and analyze cancer data at the national level.in 2008, China's national cancer registration and follow-up program was launched, and in 2015, the "management measures for tumor registration" was issued.with the support of a series of policies, the number of cancer registration centers increased rapidly from 43 in 2008 to 574 in 2019, covering 438 million people (31.5% of China's total population), of which the urban and rural population accounted for 48% and 52% respectively.currently, all 31 Chinese mainland provinces have registered cancer.all hospitals, medical institutions and health institutions should submit cancer case records. The vital statistics system needs to provide the cause of death data of the population. In addition, the data from death monitoring data, insurance records, funeral records and other channels are used as cross supplementary and related information.the establishment of relevant standards ensures the data quality.all patient information can be protected.} as of July 2019, the larger the circle, the more population covered.(photo source: reference [1]) in the past 40 years, the cancer registration team conducted the second and third national cancer mortality survey in China from 1990 to 1992 and 2005. combined with the monitoring data accumulated by the cancer registration center for many years, the academician team of herjie pointed out in the review that, in general, the cancer burden in China increased continuously from 1973 to 2005, and the change trend of the burden of different cancer types had their own characteristics. the proportion of cancer deaths in China increased from 10.1% in 1973-1975 to 24.2% in 2015. the crude mortality rate of cancer increased from 74.2/100000 to 170.1/100000, but the age standardized mortality rate began to decline from 1990 to 1992, from 94.4/100000 to 77.9/100000 in 2015. this suggests that the main reason for the increase in overall cancer mortality is the aging of the population. it is worth noting that the cancer burden of men increases faster in all three indicators. } cancer death burden from 1973 to 2015, a: the relative proportion of cancer death in total death; B: crude cancer mortality rate; C: age standardized mortality rate of cancer. (photo source: reference [1]) the death burden of gastric cancer, esophageal cancer and liver cancer has always been high, although the age standardized mortality rate has been significantly reduced; at the same time, the overall mortality rate and age standardized mortality rate of lung cancer, female breast cancer and colorectal cancer are on the rise. the review points out that in addition to the aging population, obesity and lack of exercise are becoming more and more serious, smoking and air pollution are widespread, and the control of infection related diseases is improved, which may also lead to changes in the characteristics of cancer burden in China. Incidence rate of China's 10 most common cancer types in 1973-2015 (2000: ): the total incidence rate of all cancers has also been increasing, with the incidence of standardized cancer incidence increasing, while males are stabilizing. the most common types of cancer in men are lung cancer, gastric cancer, liver cancer, colorectal cancer, esophageal cancer and bladder cancer. the highest incidence of breast cancer, lung cancer, colorectal cancer, thyroid cancer, gastric cancer and cervical cancer was found in women. The incidence rate of cancer in China's total population, men and women in . The incidence rate of incidence of ASR- age and CR- incidence rate (photo source: reference [1]) the 5 year survival rate of all cancers in China has also increased from 2003-2005 to 30.9% in 2012-2015. 40.5%. pancreatic cancer is still the "king of cancer". The 5-year survival rate of pancreatic cancer from 2012 to 2015 was only 7.2%, while the 5-year survival rate of thyroid cancer, which was mostly "lazy cancer", was as high as 84.3%. the 5-year survival rates of 8 kinds of cancers, including esophageal cancer, gastric cancer, laryngeal cancer, bone cancer, cervical cancer, uterine cancer, bladder cancer and thyroid cancer, have been substantially improved. the survival rate of pancreatic cancer and gallbladder cancer with high lethality has little progress. cancer registration data promote cancer prevention and control. Academician herjie pointed out that overall, tumor registration data play an important role in three aspects: assessing the cancer burden and progress of prevention and control in different regions of China; guiding resource coordination in cancer prevention and control; and supporting related research on cancer causes and prevention. based on the insights brought about by these data, a series of projects have been launched: the National Cancer Prevention and control program (1986-2000) focuses on the prevention and control of cancers with the highest mortality rate, such as gastric cancer, esophageal cancer, liver cancer, lung cancer and colorectal cancer, while ensuring that tumor registration covers 5% of China's population; the outline of China's cancer prevention and control program (2004-2010) has promoted agriculture Comprehensive cancer prevention and control in village areas and high cancer incidence areas. the three-year action plan for cancer prevention and control in China (2015-2017) further requires that tumor registration cover 30% of China's population and promote the mapping of national cancer maps. in the more recent "China medium and long term plan for the prevention and treatment of chronic diseases (2017-2025)" and the "healthy China" plan, improving cancer survival rate and reducing premature death of chronic diseases, including cancer, have become major goals. } academician He Jie, director of National Cancer Center of China and President of Cancer Hospital of Chinese Academy of Medical Sciences, is the corresponding author of this article (photo source: Official Website of Cancer Hospital of Chinese Academy of Medical Sciences), since 2005, China has launched a number of targeted cancer screening programs, including high incidence areas in rural areas (esophageal cancer and gastric cancer), Huaihe River Basin (esophageal cancer, liver cancer, gastric cancer, etc.) Early diagnosis and treatment of cancer in some urban areas (lung cancer, colorectal cancer, esophageal cancer, gastric cancer, liver cancer and female breast cancer), as well as "two cancers" (breast cancer and cervical cancer) screening in rural areas. in the project area, the early diagnosis rate of cancer is over 80%, the treatment rate is 90%, the cancer mortality rate of screening population is reduced by 46%, and the cost of diagnosis and treatment of early cases is nearly 70% less than that of middle and late stage cases. in terms of cancer etiology and prevention, two cases are shared in the review. 1990-2009 national cancer registration data analysis found that the increased risk of lung cancer was related to PM2.5 exposure and ozone air pollution; in Qidong, Jiangsu Province, where the incidence of liver cancer was high, more than 40 years of tumor registration data laid the foundation for randomized clinical studies, revealing that hepatitis B vaccine infection prevention can reduce the risk of liver cancer. the summary points out that the epidemiological changes of cancer in the past few decades suggest that the Chinese population is facing the double burden of infection related cancer and lifestyle related cancer. at the same time, the comprehensive evaluation of cancer prevention and control, diagnosis and treatment can not do without continuous and comprehensive coverage of tumor registration data. academician Hejie pointed out that compared with the level of more than 90% of the population in some European and American countries, China still needs to continue to improve the data quality and coverage of tumor registration, especially in the western rural areas. the burden of cancer is becoming increasingly severe. Cancer registration data is an effective and unique method to understand and evaluate cancer prevention and control. References: Wenqiang Wei, et al., (2020). Cancer registration in China and its role in cancer prevention and control. The Lancet Oncology, DOI: Note: This paper aims to introduce the progress of medical and health research, not to recommend treatment options. if you need guidance on treatment plan, please go to a regular hospital.