Interpretation of cancer death burden data from disease surveillance sites in China from 2005 to 2020

Abstract

In December 2023, the Chinese Center for Disease Control and Prevention published National and subnational trends in cancer burden in China, 2005-2020: an analysis of national mortality surveillance data.on Lancet Public Health, covering the mortality rate and average years of life lost from 23 specific tumor sites in people in 31 provinces and cities across the country. The analysis suggests that in 2020, the number of deaths from cancer in China was 2.3978 million, with a mortality rate of 170.80/100 000. The top 10 tumor deaths cases are as follows: lung cancer 761,000, liver cancer 367,700, stomach cancer 291,200, colorectal cancer 182,400, esophageal cancer 173,300, pancreatic cancer 100,400, breast cancer 57,100, leukemia 54,900, cranial nerve cancer 54,200, cervical cancer 44,800, accounting for 32.0%, 15.3%, 12.1%, 7.6%, 7.2%, 4.2%, 2.4%, 2.3%, 2.3%, 1.9% of the total number of deaths due to tumors, respectively. The mortality rates were 54.57/100 000, 26.19/100 000, 20.74/100 000, 13.00/100 000, 12.34/100 000, 7.15/100 000, 4.06/100 000, 3.91/100 000, 3.86/100 000 and 3.19/100 000, respectively. In 2020, the average years of life lost (AYLL) due to cancer in China was 23.60 years, which was 3.74 years lower than that in 2015. Among them, leukemia caused an AYLL of 37.35 years, with a decrease of 13.36 years from the AYLL of 50.71 years caused by leukemia in 2005, but it was still the tumor that caused the most life loss. Prostate cancer was the tumor that caused the least AYLL. The composition of China’s cancer spectrum is changing to those in developed countries. Lung cancer, breast cancer and colorectal cancer, which are highly prevalent in developed countries, are showing an increasing disease burden trend in China. In 2020, the mortality rates of lung cancer, breast cancer and colorectal cancer all increased during this period, increasing by 78.98%, 19.41% and 47.56% respectively compared with those in 2005. GLOBOCAN2022 suggests that the top 10 cancer incidence rates in China in 2020 are lung cancer (40.8/100 000), breast cancer (33.0/100 000), thyroid cancer (24.6/100 000), liver cancer (20.1/100 000), cervical cancer (15.0/100 000), gastric cancer (13.8/100 000), prostate cancer (13.7/100 000), esophageal cancer (9.7/100 000), uterine cancer (8.7/100 000) and ovarian cancer (6.8/100 000). Five of the top 10 common cancer in China and the United States overlap, and lung cancer is the leading cause of death in both countries. Changes in the spectrum of tumor diseases have made the promotion and implementation of proven tumor prevention and control measures more urgent.

Keywords

• |cancer|mortality rate|cancer spectrum|screening