Annual report on status of cancer in China, 2011

Abstract

Objective: The National Central Cancer Registry (NCCR) collected population-based cancer registration data in 2011 from all cancer registries. National cancer incidence and mortality were compiled and cancer incident new cases and cancer deaths were estimated.

Methods: In 2014, there were 234 cancer registries submitted cancer incidence and deaths occurred in 2011. All datasets were checked and evaluated based on the criteria of data quality from NCCR. Total 177 registries' data were qualified and compiled for cancer statistics in 2011. The pooled data were stratified by area (urban/rural), gender, age group (0, 1-4, 5-9, 10-14…85+) and cancer type. Cancer incident cases and deaths were estimated using age-specific rates and national population in 2011. All incidence and death rates are age-standardized to the 2000 Chinese standard population and Segi's population expressed per 100,000 persons.

Results: All 177 cancer registries (77 in urban and 100 in rural areas) covered 175,310,169 populations (98,341,507 in urban and 76,968,662 in rural areas). The morphology verified cases (MV%) accounting for 70.14% and 2.44% of incident cases were identified through death certifications only (DCO%) with mortality to incidence ratio of 0.63. The estimates of new cancer incident cases and cancer deaths were 3,372,175 and 2,113,048 in 2011, respectively. The incidence rate was 250.28/100,000 (males 277.77/100,000, females 221.37/100,000), and the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 186.34/100,000 and 182.76/100,000 with the cumulative incidence rate (0-74 years old) of 21.20%. The cancer incidence and ASIRC in urban areas were 261.38/100,000 and 189.89/100,000 compared to 238.60/100,000 and 182.10/100,000 in rural areas, respectively. The cancer mortality was 156.83/100,000 (194.88/100,000 in males and 116.81/100,000 in females), the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 112.88/100,000 and 111.82/100,000, and the cumulative mortality rate (0-74 years old) was 12.69%. The cancer mortality and ASMRC were 154.37/100,000 and 108.20/100,000 in urban areas, and 159.42/100,000 and 117.97/100,000 in rural areas, respectively. Cancers of lung, female breast, stomach, liver, colon and rectum, esophageal, cervix, uterus, prostate and ovary were the most common cancers, accounting for about 75% of all cancer new cases. Lung cancer, liver cancer, stomach cancer, esophageal cancer, colorectal cancer, female breast cancer, pancreatic cancer, brain tumor, cervical cancer and leukemia were the leading causes of cancer death, accounting for about 80% of all cancer deaths. The cancer incidence, mortality and spectrum showed difference between urban and rural areas, males and females.

Conclusions: The coverage of cancer registration population had a greater increase than that in the last year. The data quality and representativeness are gradually improved. As the basic work of cancer prevention and control, cancer registry is playing an irreplaceable role. The disease burden of cancer is increasing, and the health department has to take effective measures to contain the increased cancer burden in China.

Keywords: Cancer registry; China; epidemiology; incidence; mortality.

Figure 1

Map of the 177 contributing cancer registries and geographic regions in China (the dots are location of the cancer registries).

Figure 2

Age-specific cancer incidence rates in urban and rural areas, 2011.

Figure 3

Age-specific cancer mortality in urban and rural areas, 2011.