Lung Cancer Mortality Trends in China from 1988 to 2013: New Challenges and Opportunities for the Government

Abstract

Background: As lung cancer has shown a continuously increasing trend in many countries, it is essential to stay abreast of lung cancer mortality information and take informed actions with a theoretical basis derived from appropriate and practical statistical methods. Methods: Age-specific rates were collected by gender and region (urban/rural) and analysed with descriptive methods and age-period-cohort models to estimate the trends in lung cancer mortality in China from 1988 to 2013. Results: Descriptive analysis revealed that the age-specific mortality rates of lung cancer in rural residents increased markedly over the last three decades, and there was no obvious increase in urban residents. APC analysis showed that the lung cancer mortality rates significantly increased with age (20-84), rose slightly with the time period, and decreased with the cohort, except for the rural cohorts born during the early years (1909-1928). The trends in the patterns of the period and cohort effects showed marked disparities between the urban and rural residents. Conclusions: Lung cancer mortality remains serious and is likely to continue to rise in China. Some known measures are suggested to be decisive factors in mitigating lung cancer, such as environmental conservation, medical security, and tobacco control, which should be implemented more vigorously over the long term in China, especially in rural areas.

Keywords: age-period-cohort models; air pollution; lung cancer mortality; medical security; tobacco control.

Figure 1

Lung cancer age-specific mortality rates (per 100,000 persons) for urban males, urban females, rural males, and rural females from 1988 to 2013 in China.

Figure 2

Lung cancer mortality relative risks due to (a) age; (b) period; and (c) cohort effects.