The National Cancer Center's latest release: More than half of patients with these 5 common cancers are diagnosed at an advanced stage

Recently, "The Lancet Public Health" (The Lancet Public Health) released the "China Special Issue", focusing on China's important health issues from multiple perspectives, including high incidence of cancer, stroke (stroke), accidental injuries and other non-communicable diseases , and progress in the elimination of major infectious diseases such as malaria and tuberculosis

As we all know, the incidence and mortality of cancer are increasing day by day, and it has become a major disease that threatens human health and causes death in the 21st century

Analyzing the staging differences at the time of diagnosis of different types of cancer in the general population and specific populations is of great significance for the overall prevention and control of cancer

The team of Academician He Jie of the National Cancer Center and Professor John S.

This observational study showed that 52.

Screenshot source: The Lancet Public Health

The paper was recently published in the internationally renowned journal The Lancet Public Health

According to the paper, this research is "the most comprehensive and up-to-date data analysis study on the differences in the diagnosis and staging of cancer in China.

The current multicenter, hospital-based observational study included 23 hospitals in 12 provincial-level regions in China, and focused on five common cancers in China: lung, stomach, esophagus, colorectal, and breast cancer

Data for the study were primarily derived from personal electronic medical records at local hospitals and from population-wide cancer registries (a total of 52,103 eligible patients diagnosed between January 1, 2016 and December 31, 2017), Information on patient sociodemographic characteristics, life>

▲Research process (picture source: Reference [1])

Common cancers have the highest diagnosis rate at advanced stage, and lung cancer is the most obvious

Overall, the median age of patients diagnosed with these common cancers between 2016 and 2017 was 60.

Of the 41,671 patients with known stage at diagnosis, 22,009 (52.

Phase I accounted for 19.

Phase II accounted for 27.

Phase III accounted for 29.

Stage IV accounted for 23.

Among these different types of cancer, breast cancer had the smallest proportion (21.

Which groups are more likely to be diagnosed at a later stage?

In terms of gender, males were at higher risk of advanced disease at diagnosis than females (both adults and minors), accounting for 64.
1% (14,084/21,973) and 40.
2% (7,925/19,698) of advanced disease, respectively (a[ OR]=1.
3, 95% CI 1.
2-1.
5)
.
This difference was most pronounced in lung and esophageal cancers
.

The relationship between age at diagnosis and disease stage also has different characteristics in different types of cancer
.

For gastric cancer, patients over the age of 75 were more likely to be diagnosed at an advanced stage than those under the age of 55
.

In contrast, for colorectal cancer, patients who were younger at the time of diagnosis had a significantly higher risk of being advanced! The article explained that this may be related to the different pathogenesis of early-onset colorectal cancer and late-onset colorectal cancer
.
Based on the research findings, it is necessary to explore high-risk groups for early-onset colorectal cancer in the future
.

In terms of family history, compared with patients without a family history of cancer, patients with a family history of cancer are less likely to be diagnosed with advanced lung, gastric, esophageal and breast cancer! This is consistent with previously reported findings that patients with a family history of cancer may be more vigilant about cancer-related symptoms and more likely to undergo routine cancer screening
.

Smoking and drinking have different effects on the risk of cancer in different organs
.
Results of the current analysis showed that smoking was associated with a diagnosis of advanced lung cancer; alcohol consumption was associated with a diagnosis of advanced colorectal and esophageal cancers
.
These findings provide further evidence for the role of life>
.

Differences in cancer diagnosis and staging suggest the importance of early screening

Similar to evidence from previous studies, the current study found persistent diagnostic differences between rural and urban areas (a[OR]=1.
2, 95% CI 1.
1-1.
4), which was most pronounced in lung cancer
.
Compared with people living in urban areas, people living in rural areas are more likely to be diagnosed with advanced lung cancer, breast cancer, and gastric cancer; at the same time, the staging of colorectal cancer diagnosis in urban and rural areas in China is not the same.
No significant difference
.

Compared with the group with urban medical insurance, the risk of advanced disease at diagnosis was significantly higher in the NRCMS group (a[OR]=1.
4, 95% CI 1.
1-1.
9)
.

▲ Differences in the staging of different types of cancer in China and the United States (Image source: Reference [1])

In addition, the researchers compared the staging of cancer diagnoses between China and the United States
.
Overall, compared with the United States, the proportion of Chinese patients diagnosed with advanced lung cancer, gastric cancer, colorectal cancer and breast cancer is higher, and the cancer with the largest early diagnosis gap is breast cancer and colorectal cancer (China vs.
US stage II-IV disease).
Diagnosis rate: breast cancer 72.
4% vs 48.
8%; lung cancer 82.
7% vs 74.
7%; colorectal cancer 84.
8% vs 75.
9%)
.

The authors of the paper emphasize that the differences in health awareness and the promotion of early screening among people in different regions are one of the important factors that cause differences in the diagnosis rate of advanced diseases
.
Differences in cancer diagnosis and staging between rural and urban areas in China and between China and the United States once again suggest the need for effective early screening of tumors that contribute to a significant disease burden in China
.

summary

The current study conducted a detailed analysis of the staging distribution and related factors of five main types of cancer in China at the time of diagnosis.
The results of the study are of great significance for improving cancer prevention and cancer early detection awareness, and improving cancer prevention and control policies
.

The authors of the paper emphasized that medical insurance support, rural medical facilities, and the improvement of early cancer screening strategies are expected to provide important help in narrowing the gap in early cancer diagnosis between urban and rural areas, and the differences in the data results of cancer diagnosis and staging in different regions have once again confirmed the development of cancer in the Chinese population.
The importance of early screening!

References

[1] Hongmei Zeng, et al.
, (2021).
Disparities in stage at diagnosis for five common cancers in China: a multicentre, hospital-based, observational study.
The Lancet Public Health, DOI: https://doi.
org /10.
1016/S2468-2667(21)00157-2