Lung cancer burden and trends from 2000 to 2018 in China: Comparison between China and the United States

Abstract

Objective: This study aims to provide an analysis of the current status and trends of lung cancer incidence and mortality rates in China, comparing trends with those in the United States (U.S.).

Methods: Data on lung cancer incidence and mortality rates spanning 2000 to 2018 were extracted from the China Cancer Registry Annual Report and the Surveillance, Epidemiology, and End Results database for China and the U.S., respectively. Crude incidence and mortality rates were calculated by sex and age, with age-standardized incidence rates (ASIR) and mortality rates (ASMR) calculated using the Segi-Doll world standard population. Trend analyses employed Joinpoint regression models to determine average annual percentage change (AAPC). The study also assessed the proportion of new cases and deaths by sex and age.

Results: In 2018, the ASIR of lung cancer for males in China was 50.72 per 100,000 and the ASMR was 39.69 per 100,000, the ASIR for females was 26.25 per 100,000 and the ASMR was 15.24 per 100,000. Both ASIR and ASMR were higher in males and the highest in the population aged 65 years and older, with the lowest among those aged 20-49 years. In China, female ASIR demonstrated an increasing trend (AAPC: 1.16%), while ASMR decreased in both sexes (AAPCs: -0.48% for males, -1.00% for females). The U.S. exhibited decreasing trends in both ASIR and ASMR across sexes and age groups.

Conclusions: The study identified an increasing trend in lung cancer incidence among females and a decreasing mortality trend in both sexes in China. These trends are likely linked to factors such as smoking prevalence, advancements in cancer screening, and improved medical care. The findings underscore the need for tailored lung cancer prevention measures in China, particularly the reinforcement of anti-smoking policies.

Keywords: China; incidence; lung cancer; mortality; trends.

Figure 1

Age-specific incidence and mortality rates of lung cancer by sex and age in China and the U.S., 2000−2018. (A) Incidence in China; (B) Mortality in China; (C) Incidence in the U.S.; (D) Mortality in the U.S. Dots indicate incidence or mortality rates, triangles represent males, circles represent females, and colors from gray to red refer to the period from 2000 to 2018.

Figure 2

Trends in ASIR and ASMR for lung cancer by sex and age group in China and the U.S., 2000−2018. (A−D) ASIR in 20−49 years (A), 50−64 years (B), 65 years and older (C), and all ages (D), respectively; (E−H) ASMR in 20−49 years (E), 50−64 years (F), 65 years and older (G), and all ages (H), respectively. Lines indicate incidence or mortality rates, yellow and green lines represent the rates for China and the U.S., and solid and dashed lines represent rates for males and females, respectively. ASIR, age-standardized incidence rate; ASMR, age-standardized mortality rate.

Figure S1

Trends in incidence and mortality for lung cancer by sex and age in China and the U.S., 2000−2018. (A) Incidence in China; (B) Mortality in China; (C) Incidence in the U.S.; (D) Mortality in the U.S. Dots and lines through the dots represent AAPC (% per year) and 95% CIs for the incidence and mortality rates from the Joinpoint regression models for 14 age groups (5-year increments from age 20 years). AAPC, average annual percent changes; 95% CI, 95% confidence interval.

Figure S2

Proportion of lung cancer new cases and deaths by age group. (A) New cases in 2000; (B) Deaths in 2000; (C) New cases in 2018; (D) Deaths in 2018.

Figure S3

Proportion of lung cancer new cases and deaths by age group, 2000−2018. (A−D) is the proportion of new cases in 0−19 years (A), 20−49 years (B), 50−64 years (C), and 65 years and older (D), respectively; (E−H) is the proportion of deaths in 0−19 years (E), 20−49 years (F), 50−64 years (G), and 65 years and older (H), respectively.