It feels like there are more and more cancer patients. Is this a real trend or a perception bias?

You may have noticed that recently there are frequent reports of someone dying of cancer, and it seems that many doctors I know or have heard of have malignant tumors. Is this my illusion?

This is not an illusion, but the overall cancer incidence rate of Chinese people is increasing. When the nest is overturned, no egg is left unbroken. Doctors are no different from other groups. Even if you say you can treat illnesses and maintain health, when compared with the main causes of cancer: age, environment, diet and genetics, in what aspect do you think doctors can surpass the general public? As for work pressure, I guess many industries, such as IT, have something to say.

01 China Cancer Statistics

This is the first time that the Chinese Cancer Center has released Chinese cancer statistics on CA Cancer. We can clearly see that the incidence of cancer in China is continuing to increase (but the rate is slowing down, which is a good thing).

The blue line in the figure represents the total incidence and mortality. In terms of gender, green is for males and red is for females. Incidence means onset and mortality means death.

What does this mean? As long as you are a Chinese group, you will follow this general trend (this is the most authoritative and comprehensive survey report in China). So, what is the main reason?

02 Why are there so many cancers?

The answer may surprise many people: aging. Yes, that's right, because with the rapid economic growth and improved living conditions, the life expectancy of Chinese people is increasing, and the primary risk factor for cancer is age.

Cancer increases with age, which is a conclusion verified all over the world.

In other words, as long as China's aging population continues to increase, the incidence of cancer will inevitably increase. So, apart from age, are there other factors?

03 Are there any other factors besides age?

The answer is yes. Other important factors of cancer include: environmental factors, eating habits, genetic factors , etc. I mentioned in an article that the characteristics of Chinese cancer are:

1. The overall incidence of cancer is similar in rural and urban areas, with lung cancer, stomach cancer and esophageal cancer ranking in the top three, followed by liver cancer and intestinal cancer. This distribution is different from that in the United States. Our diet plays a big role in this.

2. When it comes to a specific type of cancer, the two show typical differences. The incidence of lung cancer and colon cancer in cities is significantly higher than in rural areas. This has a lot to do with urban air quality and the fact that urban residents consume too little fiber.

Rural areas are the hardest hit by esophageal cancer and gastric cancer. This may be due to nutrition problems and dietary structure problems in rural areas, such as the large intake of pickled foods and leftovers. There are also dietary hygiene issues.

3. 30-44 years old is a period of rapid change for cancer. When you reach middle age, you must pay attention to your health.

4. Men should pay attention to the prostate and women should pay attention to the thyroid gland. These two diseases have suddenly accelerated in recent years.

5. Lung cancer is the leading cause of death among men. There is clear evidence that smoking causes lung cancer. Therefore, for the sake of your health, it is better to smoke less.

The specific information is as follows.

04 Characteristics of Cancer in China

Let me take urban and rural areas as an example. Here, the urban and rural data are basically the same (the incidence rate is 190 million and 210 million respectively), but when it comes to a certain type of cancer, there are typical differences between the two, which I marked with a red box.

For example, the incidence of lung cancer in cities is significantly higher than that in rural areas (445 vs 288). Considering that the smoking rates in urban and rural areas are basically the same (17.5% in cities and 19.2% in rural areas) , I believe that air quality should be a very critical factor.

The incidence of esophageal cancer and stomach cancer in rural areas is significantly higher than that in urban areas (esophageal cancer 364 vs 113; stomach cancer 444 vs 235), which shows that there are very big problems in rural diet. I think this may be a problem of nutrition and diet structure in rural areas, such as the large intake of pickled foods and the problem of leftovers. There is also a problem of food hygiene.

The incidence of colon cancer in cities is significantly higher than in rural areas (263 vs 113). The main causes of colon cancer are high-fat diet and insufficient fiber intake. This means that urban people do not seem to have a healthy diet, especially fiber intake. Therefore, we should eat more vegetables, whole grains and fruits!

Regarding the incidence of cancer, it basically increases with age . However, there is a sensitive age group, which is 30-44 years old. Basically, in this age group, many diseases have changed by an order of magnitude. For example, the incidence of colon cancer has increased 10 times, which corresponds to middle-aged people. Therefore, at this time, you must pay attention to regular physical examinations.

The cancer prognosis rate basically reflects the economic level . The prognosis rate of urban residents is nearly 50% higher than that of rural residents. Therefore, good medical conditions and economy are also the guarantee for cancer treatment. There is not much difference between regions.

However, are we hopeless?

05 Where is the way forward in the face of cancer?

Not necessarily. The United States, which has always been the most promising country in everyone's eyes, has achieved a reversal. The total cancer mortality rate in the United States has been increasing for most of the 20th century. After reaching its peak in 1991 (215.1 people/100,000 people), the cancer mortality rate has gradually decreased . By 2011 (168.7 people/100,000 people), the cumulative decrease was 22% , and more than 1.5 million people were saved from cancer deaths.

This is a graph showing cancer incidence (dashed line) and mortality (solid line) trends in the United States.

In terms of the overall cancer incidence rate, the rate for women remained basically the same as in previous years, while it decreased by 3.1% each year (from 2009 to 2012) for men. The main reason was the successful development of screening markers for prostate cancer, the most common cancer in men.

According to the changes in many medical data trends over the years, our future is likely to follow the American model. With the discovery of detection methods such as various screening markers, changes in medical conditions, and improvements in environmental quality (this should happen) , China will inevitably go through this process, that is, achieve a turning point in cancer. This is our hope.

06 Common tumor markers

Seeing that many people are more concerned about cancer marker detection, I attached a common clinical marker. These can be done through physical examinations, but you need to pay for the test yourself. It is recommended to test once a year. It is worth it.

Finally, the best way to prevent and treat cancer is early detection and early treatment. Whether you are a medical staff or an ordinary person, you should regularly do a physical examination for yourself, especially for several cancer markers, so that you can do a better job in preventing cancer.