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. 2023 Jan 12;15(2):476.
doi: 10.3390/cancers15020476.

Changing Patterns in Cancer Mortality from 1987 to 2020 in China

Binbin Su  1 , Panliang Zhong  1 , Yundong Xuan  2 , Junqing Xie  3 , Yu Wu  1 , Chen Chen  1 , Yihao Zhao  1 , Xinran Shen  1 , Xiaoying Zheng  1
Affiliations

Changing Patterns in Cancer Mortality from 1987 to 2020 in China

Binbin Su et al. Cancers (Basel). .

Abstract

Background: China has the highest number of new cancer cases and deaths worldwide, posing huge health and economic burdens to society and affected families. This study comprehensively analyzed secular trends of national cancer mortality statistics to inform future prevention and intervention programs in China.

Methods: The annual estimate of overall cancer mortality and its major subtypes were derived from the National Health Commission (NHC). Joinpoint analysis was used to detect changes in trends, and we used age-period-cohort modeling to estimate cohort and period effects in Cancers between 1987 and 2020. Net drift (overall annual percentage change), local drift (annual percentage change in each age group), longitudinal age curves (expected longitudinal age-specific rate), and period (cohort) relative risks were calculated.

Results: The age-standardized cancer mortality in urban China has shown a steady downward trend but has not decreased significantly in rural areas. Almost all cancer deaths in urban areas have shown a downward trend, except for colorectal cancer in men. Decreasing mortality from cancers in rural of the stomach, esophagus, liver, leukemia, and nasopharynx was observed, while lung, colorectal cancer female breast, and cervical cancer mortality increased. Birth cohort risks peaked in the cohorts born around 1920-1930 and tended to decline in successive cohorts for most cancers except for leukemia, lung cancer in rural, and breast and cervical cancer in females, whose relative risks were rising in the very recent cohorts. In addition, mortality rates for almost all types of cancer in older Chinese show an upward trend.

Conclusions: Although the age-standardized overall cancer mortality rate has declined, and the urban-rural gap narrowed, the absolute cancer cases kept increasing due to the growing elderly population in China. The rising mortality related to lung, colorectal, female breast, and cervical cancer should receive higher priority in managing cancer burden and calls for targeted public health actions to reverse the trend.

Keywords: China; age-period-cohort effects; cancer mortality; long-term trends; urban-rural disparity.

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Conflict of interest statement

The authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Trends in Age-Standardized Cancer Mortality in urban and rural China by sex: 1987–2020.
Figure 2
Figure 2
Local drift with net drift values for Cancer mortality and sex difference by area in China from 1987 to 2020. (Net drift represents the overall annual percentage change. Local drift values represent the annual percentage change in each age group).
Figure 3
Figure 3
Parameter estimates of age, period, and cohort effects on Cancer mortality rate in China from 1987 to 2020.
See this image and copyright information in PMC

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