Preface
Cancer has become a major public health problem in the mainland, seriously affecting the health of mainland residents and the national economic and social development. February 4, 2024 is the 25th "World Cancer Day", which aims to remind the public to pay attention to cancer prevention and control, advocate a healthy lifestyle, and achieve early detection, early diagnosis and early treatment of cancer. The National Cancer Center (NCC) also recently released the 2022 China Malignant Neoplasm Disease Burden (MARC) results, which are jointly calculated by the National Cancer Center and the International Agency for Research on Oncology (IARC), which are consistent with the GLOBOCAN 2022 data released by IARC in China and released simultaneously.
Incidence of malignant tumors in China in 2022
The number of new cancer cases in 2022 is estimated at 4,824,700, of which 2,533,900 were males and 2,290,800 were females. The age-standardized incidence rate (ASIR) was 201.61 cases per 100,000 population, and it showed the following characteristics:
- The incidence of cancer in all parts of the age group of 0~34 years is low, the incidence rate of cancer in the age group of 35~39 years increases sharply, and the incidence rate of 80~84 years old is the highest.
- The overall incidence is lower in males than females in the age group of 25-54 years, and higher in females after the age of 60 years.
- In 2022, lung cancer (1,060,600 cases) was the most common cancer in China, followed by colorectal cancer (517,100 cases), thyroid cancer (466,100 cases), liver cancer (367,700 cases), and gastric cancer (358,700 cases), accounting for 57.42% of the total number of new cancer cases. The top five cancers in men were lung cancer, colorectal cancer, liver cancer, gastric cancer and esophageal cancer, accounting for 65.05% of the total number of new cancer cases in men. The most common cancer in women is lung cancer, followed by breast, thyroid, colorectal and cervical cancers, accounting for 63.75% of the total number of new cases of cancer in women.
Fig. 1 Estimated age-specific incidence of all cancers in China in 2022
Malignant tumor deaths in China in 2022
The number of cancer deaths in 2022 is estimated at 2,574,200, of which 1,629,300 were males and 944,900 were females. The age-standardized mortality rate (ASMR) was 96.47 per 100,000 and was characterized by:
- Crude mortality and age-standardized mortality were higher in males than females in all cancer sites.
- Mortality increases markedly after the 40-44 age group, peaking in the 85 and older age group. In people over the age of 40, the mortality rate is higher in men than in women.
- The leading cause of cancer deaths was lung cancer (733,300 deaths), followed by liver cancer (316,500 deaths), gastric cancer (260,400 deaths), colorectal cancer (240,000 deaths), and esophageal cancer (187,500 deaths), accounting for 67.50% of the total cancer deaths. In the case of men, the top five causes of cancer deaths are lung, liver, stomach, colorectal, and esophageal cancers, accounting for 74.28% of all cancer deaths. The top five causes of cancer deaths in women are lung cancer, colorectal cancer, liver cancer, stomach cancer, and breast cancer, accounting for 58.78% of the total cancer deaths.
Figure 2 Estimated age-specific mortality rate for all cancers in China in 2022
General trends
The overall incidence is increasing
During the period 2000-2018, ASIR for all cancers increased significantly at a rate of about 1.4% per year. The combined ASIR for all cancers in men remained stable, but there was a significant increase of 2.6% per year in women, mainly due to increased diagnoses of thyroid and cervical cancers. In addition, ASIR for uterine, lung, and breast cancers in women is also on the rise, but ASIR for esophageal, gastric, and liver cancers is on the decline. Between 2014 and 2018, there was a significant upward trend in ASIR for thyroid and lung cancer in women. The average annual rate of ASIR growth in cervical cancer has decreased from 14.8% before 2008 to 1.7% now.
The incidence of thyroid, prostate and colorectal cancers is on the rise in men, while the incidence of esophageal, gastric and liver cancers is decreasing. The trend of lung cancer remained stable between 2000 and 2014. Between 2014-2018, there was a significant upward trend in ASIR for thyroid, prostate, colorectal, and lung cancers in men.
Overall mortality is decreasing
From 2000 to 2018, the total ASMR for all cancers decreased significantly by about 1.3% per year, mainly due to the decline in esophageal, gastric and liver cancer mortality rates. ASMR for all cancers in men decreased by about 1.2% per year, and between 2014-2018, there was a significant decrease in ASMR for stomach, liver, and esophageal cancers in men. And the ASMR for all cancers in women is declining by 1.3% per year. However, ASMR for cervical cancer and ovarian cancer is on the rise. Between 2014 and 2018, there was a significant decrease in ASMR for esophageal, gastric and liver cancers in women.
Fig. 3 Trends in age-standardized incidence and mortality by sex for selected cancers in China from 2000 to 2018. (A) Male incidence. (b) Female incidence. (c) Male mortality. (d) Female mortality.
summary
The projected number of new cancer cases and deaths in China in 2022 has increased compared to previous years. The increase in the number of cases is due to the aging of the population, and the second is that with the improvement of public awareness of cancer prevention and more convenient medical conditions, more and more residents take the initiative to participate in tumor physical examination and national screening and early diagnosis and early treatment programs, and more cancer cases are detected in time. The increase in the number of deaths is more due to the aging of the population.
Lung cancer is the leading cause of morbidity and mortality from malignant tumors in China, which may be attributed to the high rate of smoking. The top five malignant tumors were lung cancer, colorectal cancer, thyroid cancer, liver cancer, and gastric cancer, and the top five malignant tumors in death were lung cancer, liver cancer, gastric cancer, colorectal cancer, and esophageal cancer. The structure of China's cancer spectrum still presents a situation of coexistence between developed and developing countries.
During the period from 2000 to 2018, the standardized mortality rate of all cancer species decreased by 1.3% per year on average, especially the age-standardized incidence and mortality of esophageal cancer, gastric cancer and liver cancer showed a significant downward trend, which reflects the initial effect of China's long-term adherence to the above-mentioned comprehensive cancer prevention and treatment, especially the gradual promotion of upper gastrointestinal cancer screening since 2005.
In the future, we should continue to implement the specific requirements of the Healthy China Action and the Cancer Prevention and Control Action Implementation Plan, and make steady progress in key areas such as comprehensive prevention and control of risk factors, tumor screening, early diagnosis and treatment, and standardized diagnosis and treatment, so as to help reduce the increasing burden of cancer and improve the health of the Chinese people.
Bibliography:
[1] Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent. 2024; 4(1):page. DOI: 10.1016/j.jncc.2024.01.006
Editor: Faline
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