The latest data from The Lancet: Over the past 15 years, the number of cancer-related deaths in China has increased by 21.6%

Cancer has always been a serious public health problem. In recent years, due to factors such as environment, diet, and population aging, the global cancer incidence rate has continued to rise, and cancer has become increasingly prominent as a major cause of death.

According to the latest global cancer data for 2020 released by the International Agency for Research on Cancer, China has become a veritable cancer superpower. As one of the most populous countries in the world, China's cancer data is not optimistic. Facing cancer, China's biggest problem is not the large number of patients, but the high mortality rate. China's cancer incidence rate is only at the world average level, which is much lower than that of developed countries. However, my country's mortality rate ranks among the highest in the world, significantly higher than that of developed countries.

We are so close to cancer!!!

Significant differences in cancer profiles between men and women

Recently, Yin Peng, Qi Jinlei from the Chinese Center for Disease Control and Prevention, Li Menglong from Capital Medical University and others published a research paper titled "National and subnational trends in cancer burden in China, 2005-20: an analysis of national mortality surveillance data" in The Lancet Public Health.

Studies show that from 2005 to 2020, the total number of cancer-related deaths increased by 21.6%, and the three cancers with the highest mortality rates were lung cancer, liver cancer, and stomach cancer.

For men, the five most deadly cancers are lung cancer, liver cancer, stomach cancer, esophageal cancer and colorectal cancer, with mortality rates of 75.05/100,000, 38.31/100,000, 27.84/100,000, 18.18/100,000 and 14.63/100,000 respectively.

For women, the five most deadly cancers are lung cancer, liver cancer, gastric cancer, colorectal cancer and breast cancer, with mortality rates of 33.19/100 000, 13.54/100 000, 13.33/100 000, 11.29/100 000 and 8.21/100 000, respectively (Figure 1).

Figure 1 Ranking of cancer deaths among Chinese men (A) and women (B) from 2005 to 2020

At the same time, in this study, the researchers analyzed 31 provinces in China, analyzed the overall cancer mortality rate and 23 specific site cancer mortality rates through the National Mortality Surveillance System, and evaluated the changes in China's national and local cancer burden from 2005 to 2020.

Overall, there were 2.4 million cancer-related deaths and 56.6 million years of life lost (YLL) due to cancer in China in 2020. From 2005 to 2020, cancer-related deaths increased by 21.6% and YLL increased by 5%.

Between 2005 and 2020, the mortality rates of most cancers decreased significantly, while the number of deaths increased. The proportion of deaths related to tracheal cancer, bronchial cancer, and lung cancer, which topped the list, increased, mainly due to population growth and aging.

The second to fifth cancers with the highest mortality rates for men remained unchanged, with the mortality rates of these four cancers decreasing from 55.8% in 2005 to 45.3% in 2020. However, among women, liver cancer has risen from third to second, colorectal cancer from fifth to fourth, and breast cancer from sixth to fifth, and the mortality rates of the second to fifth cancers in women have decreased from 46.6% to 38.3%.

Cancer-related mortality rates vary widely, with a decrease in urban areas and an increase in rural areas

When it comes to cancer, China's urban and rural areas are completely different. In urban areas, the age-standardized annual life loss rate for almost all types of cancer in both men and women (except prostate cancer in men and multiple myeloma in women) has shown a significant decline. In rural areas, more than half of the standardized mortality rates and standardized YLL rates of cancer are on the rise. The reasons behind the urban-rural differences are diverse and complex, and have a great impact on medical care, economy, education and other aspects.

From 2005 to 2020, the incidence of pancreatic cancer, prostate cancer, bladder cancer, kidney cancer, oral cancer, and thyroid cancer among rural men rose in ranking; the incidence of colorectal cancer, lymphoma, laryngeal cancer, bile duct cancer, and multiple myeloma remained unchanged; the ranking of liver cancer, leukemia, brain tumors and nervous system tumors, nasopharyngeal cancer, skin cancer, and breast cancer declined. For women in rural areas, the number of years of life lost due to bladder cancer and thyroid cancer increased.

Different cancers kill different people at different ages

From the perspective of age, the causes of cancer death in different age groups are also different. In general, the mortality rate of young and middle-aged people is much lower than that of the elderly. Specifically, among people aged 0-19, regardless of gender, leukemia, brain/nervous system cancer and liver cancer are the top three causes of death. Among men aged 20-39, liver cancer, leukemia and lung cancer are the top three, while for women, they are breast cancer, leukemia and cervical cancer. Among people aged 40-59, the three most deadly cancer types for men are liver cancer, lung cancer and stomach cancer, while for women, they are lung cancer, breast cancer and cervical cancer.

For people aged 60 to 79, the top three deadly cancer types for both men and women are lung cancer, liver cancer, and stomach cancer. For people aged 80 or above, the top three causes of cancer-related death for men are lung cancer, stomach cancer, and liver cancer, while lung cancer, stomach cancer, and colorectal cancer are the top three causes of cancer-related death for women.

In summary, the total number of cancer-related deaths and YLL in China increased significantly from 2005 to 2020, and China's cancer burden is heavy and continues to rise. Due to China's large population base, the number of cancer deaths still ranks first in the world, and we must work hard to further reduce the death burden of major cancers such as tracheal cancer, bronchial cancer, lung cancer and new cancers.