Cancer statistics in China, 2016 / 中华肿瘤杂志

Objective: Data for 2016 from cancer registries were used to estimate cancer incidence and mortality in China in 2016. Methods: According to the quality control process of the National Central Cancer Registry, the data from 683 cancer registries submitted by each province were evaluated, and the data of 487 cancer registries were qualified and included in the final analysis. Age-specific incidence and mortality rates were calculated by area (urban/rural), sex, age and cancer site, combined with national population data to estimate cancer incidence and mortality in China in 2016. Chinese population census in 2000 and Segi's population were used for age-standardized incidence and mortality rates. Results: Total population covered by 487 cancer registries was 381 565 422 (192 628 370 in urban and 188 937 052 in rural areas). The percentages of morphologically verified (MV%) and death certificate-only cases (DCO%) accounted for 68.31% and 1.40%, respectively, and the mortality to incidence ratio was 0.61. It was estimated about 4 064 000 new cases occurred in China in 2016, with the crude incidence rate being 293.91/100 000 (the rates of males and females were 315.52/100 000 and 271.23/100 000), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 190.76/100 000 and 186.46/100 000, with the cumulative incidence rate (0-74 years old) being 21.42%. The crude incidence and ASIRC were 314.74/100 000 and 196.38/100 000 in urban areas, whereas in rural areas, they were 265.90/100 000 and 182.21/100 000, respectively. It was estimated about 2 413 500 cancer deaths occurred in China in 2016, the crude mortality rate was 174.55/100 000 (216.16/100 000 in males and 130.88/100 000 in females), the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 106.00/100 000 and 105.19/100 000, and the cumulative mortality rate (0-74 years old) was 11.85%. The crude mortality and ASMRC were 180.31/100 000 and 104.44/100 000 in urban areas, whereas in rural areas, they were 166.81/100 000 and 108.01/100 000, respectively. The most common cancer cases include lung, colorectal, stomach, liver and female breast cancers. The top five cancers accounted for about 57.27% of all cancer cases. The most common cancer deaths included lung, liver, stomach, colorectal and esophageal cancers. The top five cancers accounted for about 69.25% of all cancer deaths. Conclusions: The burden of cancer shows a continuous increasing trend in China. Regional and gender differences in cancer burden are obvious. The cancer patterns still show the coexistence of cancer patterns in developed countries and developing countries. The situation of cancer prevention and control is still serious in China.

Incidence and mortality of liver cancer in China in 2011 / 癌症

<p><b>BACKGROUND</b>Liver cancer is a common cancer with poor prognosis in China. In this study, the national population-based cancer registration data were used to evaluate and analyze liver cancer incidence and mortality in China in 2011 and provide a reference for liver cancer prevention and control.</p><p><b>METHODS</b>We collected and evaluated the incidence and mortality data of liver cancer in 2011 from 177 cancer registries with qualified data. These data were used in the final analysis including calculating crude, standardized, and truncated incidences and mortalities, and estimated new liver cancer cases and deaths using age-specific rates and the corresponding populations. The national census in 2000 and Segi's population were used for age-standardized rates.</p><p><b>RESULTS</b>The estimates of new liver cancer cases and deaths were 355,595 and 322,416, respectively, in China in 2011. The crude incidence, age-standardized rate of incidence by Chinese standard population (ASRIC), and age-standardized rate of incidence by world standard population (ASRIW) of liver cancer were 26.39/100,000, 19.48/100,000, and 19.10/100,000, respectively; the crude mortality, age-standardized rate of mortality by Chinese standard population (ASRMC), and age-standardized rate of mortality by world standard population (ASRMW) of liver cancer were 23.93/100,000,17.48/100,000, and 17.17/100,000, respectively. The incidence and mortality were higher in rural areas than in urban areas and higher in males than in females. The age-specific incidence and mortality of liver cancer increased greatly with age, particularly after 30 years and peaked at 80-84 or 85+ years.</p><p><b>CONCLUSIONS</b>Liver cancer is a common cancer in China, particularly for males and residents in rural areas. Targeted prevention, early detection, and treatment programs should be carried out.</p>

Trend analysis of cervical cancer incidence and mortality rates in Chinese women during 1989-2008 / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the trend of cervical cancer incidence and mortality rates during 1989-2008 in Chinese women, so as to inform the development of relevant policies and strategies in China.</p><p><b>METHODS</b>The incidence and mortality rates of cervical cancer during 1989-2008 in urban and rural areas were calculated based on the data from the National Cancer Registry Database. Age-standardized rates were calculated using the Chinese population of 1982 and World Segi's population of 1985. Joinpoint regression analysis was performed to obtain annual percentage changes (APC) so as to assess the trend of incidence and mortality rates over the period from 1989 to 2008.</p><p><b>RESULTS</b>The crude incidence rate of cervical cancer in Chinese women increased from 3.06/10(5) in 1989-1990 to 11.87/10(5) in 2007-2008 (from 4.96/10(5) to 11.98/10(5) in urban registration areas and from 2.39/10(5) to 11.77/10(5) in rural registration areas).The crude mortality rate slightly increased from 2.19/10(5) in 1989-1990 to 3.20/10(5) in 2007-2008 (from 3.21/10(5) to 2.56/10(5) in urban registration areas and from 1.82/10(5) to 3.75/10(5) in rural registration areas). Generally, the upward trends of crude incidence rates were shown over the year 1989-2008, with an APC of 14.4% after 1997 in urban areas and 22.5% after 1999 in rural areas.After age standardization of world population, the APC of incidence rates in recent decade in urban areas remained stable, and the one in rural areas slightly decreased.Although the overall crude and world age-standardized mortality rates had no significant changes during 1989-2008, the crude mortality rates increased by 8.1% annually after 1999.The upward trends were also shown for crude and world age-standardized mortality rates in urban areas after 2001 with an APC of 7.3%.The crude mortality rates in rural areas increased by 3.9% annually during 1989-2008, but no significant change was found after age standardization.</p><p><b>CONCLUSIONS</b>Over the last decade, the cervical cancer incidence and mortality rates ascended by year in China. It is particularly urgent to establish a comprehensive prevention and control system that combines cervical cancer screening and human papillomavirus vaccination, so as to reduce the burden of cervical cancer in Chinese women.</p>

The incidences and mortalities of major cancers in China, 2010 / 癌症

To estimate the cancer incidences and mortalities in China in 2010, the National Central Cancer Registry (NCCR) of China evaluated data for the year of 2010 from 145 qualified cancer registries covering 158,403,248 people (92,433,739 in urban areas and 65,969,509 in rural areas). The estimates of new cancer cases and cancer deaths were 3,093,039 and 1,956,622 in 2010, respectively. The percentage of morphologically verified cases were 67.11%; 2.99% of incident cases were identified through death certification only, with the mortality to incidence ratio of 0.61. The crude incidence was 235.23/100,000 (268.65/100,000 in males and 200.21/100,000 in females). The age-standardized rates by Chinese standard population (ASR China) and by world standard population (ASR world) were 184.58/100,000 and 181.49/100,000, respectively, with a cumulative incidence (0-74 years old) of 21.11%. The crude cancer mortality was 148.81/100,000 (186.37/100,000 in males and 109.42/100,000 in females). The ASR China and ASR world were 113.92/100,000 and 112.86/100,000, respectively, with a cumulative mortality of 12.78%. Lung, breast, gastric, liver, esophageal, colorectal, and cervical cancers were the most common cancers. Lung, liver, gastric, esophageal, colorectal, breast, and pancreatic cancers were the leading causes of cancer deaths. The coverage of cancer registration has rapidly increased in China in recent years and may reflect more accurate cancer burdens among populations living in different areas. Given the increasing cancer burden in the past decades, China should strengthen its cancer prevention and control.

Nasopharyngeal carcinoma incidence and mortality in China in 2010 / 癌症

Nasopharyngeal carcinoma (NPC) is common in South China. Although regional epidemiological data on NPC in China is available, national epidemiological data have been unavailable up to now. The goal of this study was to analyze the NPC incidence and mortality data in some domestic cancer registries, estimate these rates in China in 2010, and provide scientific information that can be harnessed for NPC control and prevention. To accomplish this goal, NPC incidence and mortality data for 2010 were collected from 145 Chinese cancer registries from which data were included in the 2013 National Cancer Registry Annual Report. Such indices as its incident and death numbers, crude rates, age-standardized rates and truncated rates were calculated and analyzed. The incidence and mortality in China and constituent areas were estimated according to the national population in 2010. An estimated 41,503 new cases and 20,058 deaths were attributed to NPC in China in 2010, accounting for 1.34% of all new cancer cases and 1.03% of all cancer-related deaths that year in China. Crude incidence and mortality were 3.16/100,000 and 1.53/100,000, respectively. World age-standardized incidence and mortality were 2.44/100,000 and 1.18/100,000, respectively. Incidence and mortality were higher among males than among females and slightly higher in urban areas than in rural areas. Among seven Chinese administrative regions, NPC incidence and mortality were obviously higher in South China than in other regions and lowest in North China. The male and female age-specific incidence and mortality both rose quickly from age 25-29 years, but peaked at different ages and varied by location. These results demonstrated that NPC incidence and mortality in China especially in South China were at high levels in the world, and suggested that control and prevention efforts should be enhanced.

Incidence and mortality of liver cancer in China, 2010 / 癌症

Liver cancer is a common malignant tumor in China and a major health concern. We aimed to estimate the liver cancer incidence and mortality in China in 2010 using liver cancer data from some Chinese cancer registries and provide reference for liver cancer prevention and treatment. We collected and evaluated the incidence and mortality data of liver cancer in 2010 from 145 cancer registries, which were included in the 2013 Chinese Cancer Registry Annual Report, calculated crude, standardized, and truncated incidences and mortalities, and estimated new liver cancer cases and deaths from liver cancer throughout China and in different regions in 2010 from Chinese practical population. The estimates of new liver cancer cases and deaths were 358,840 and 312,432, respectively, in China in 2010. The crude incidence, age-standardized rate by Chinese standard population (ASR China), and age-standardized rate by world standard population (ASR world) were 27.29/100,000, 21.35/100,000, and 20.87/100,000, respectively; the crude, ASR China, and ASR world mortalities were 23.76/100,000, 18.43/100,000, and 18.04/100,000, respectively. The incidence and mortality were the highest in western regions, higher in rural areas than in urban areas, and higher in males than in females. The age-specific incidence and mortality of liver cancer showed a rapid increase from age 30 and peaked at age 80-84 or 85+. Our results indicated that the 2010 incidence and mortality of liver cancer in China, especially in undeveloped rural areas and western regions, were among high levels worldwide. The strategy for liver cancer prevention and treatment should be strengthened.

Nasopharyngeal carcinoma incidence and mortality in China in 2009 / 癌症

Nasopharyngeal carcinoma (NPC) is rare globally but common in China and exhibits a distinct ethnic and geographic distribution. In 2009, the National Central Cancer Registry in China provided real-time surveillance information on NPC. Individual NPC cases were retrieved from the national database based on the ICD-10 topography code C11. The crude incidence and mortality of NPC were calculated by sex and location (urban/rural). China's population in 1982 and Segi's world population structures were used to determine age-standardized rates. In regions covered by the cancer registries in 2009, the crude incidence of NPC was 3.61/100,000 (5.08/100,000 in males and 2.10/100,000 in females; 4.19/100,000 in urban areas and 2.42/100,000 in rural areas). Age-standardized incidences by Chinese population (ASIC) and Segi's world population (ASIW) were 2.05/100,000 and 2.54/100,000, respectively. The crude mortality of NPC was 1.99/100,000 (2.82/100,000 in males and 1.14/100,000 in females; 2.30/100,000 in urban areas and 1.37/100,000 in rural areas). The age-standardized mortalities by Chinese population (ASMC) and world population (ASMW) were 1.04/100,000 and 1.35/100,000, respectively. The incidence and mortality of NPC were higher in males than in females and higher in urban areas than in rural areas. Both age-specific incidence and mortality were relatively low in persons younger than 30 years old, but these rates dramatically increased. Incidence peaked in the 60-64 age group and mortality peaked in the over 85 age group. Primary and secondary prevention, such as lifestyle changes and early detection, should be carried out in males and females older than 30 years of age.

Trend and prediction on the incidence of pancreatic cancer in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze and predict the incidence trends and burden of pancreatic cancer from 2008 to 2015.</p><p><b>METHODS</b>Registration data on pancreatic cancer of cancer registration in 1998 - 2007, were retrieved and utilized for analyzing the annual incidence of pancreatic cancer. Age-standardized rate by Chinese population (ASR) was calculated, using the direct method. JoinPoint software was applied for trend analysis. Bayesian Age-Period-Cohort Modeling Prediction Package was used to estimate age, period and cohort effects as well as to predict the incidence rates.</p><p><b>RESULTS</b>From 1998 to 2007, the annual incidence for men and women in urban areas showed an increase of 1.86% and 2.1% per year, but the increasing trend on the age-standardized rate was not obvious in both men and women. However, the incidence rates for men and women in rural areas increased by 7.54% and 7.83% and the age-standardized rates increased by 4.82% and 5.48% per year.</p><p><b>RESULTS</b>from the projection model showed that the trends were mainly caused by age, period and cohort effects. Based on the analysis, up to 2015, the annual new cases of pancreatic cancer would be 103 428 (60 500 for males and 42 928 for females), with 15 277 cases more than that of 2008.</p><p><b>CONCLUSION</b>There appeared an increasing trend of pancreatic cancer incidence which was more significant in the rural areas than the slowly increasing trend in the urban areas. The increasing trend of pancreatic cancer would be slow until the year 2015. However, in the short term pancreatic cancer is still a major cancer.</p>

Incidence and mortality of oral and pharyngeal cancers in China, 2003 to 2007 / 中华流行病学杂志

Objective To analyze the incidence and mortality of oral and pharyngeal cancers from 32 cancer registration centers,2003 to 2007.Methods Data from 32 eligible cancer registries were included in this study.Both crude and age-standardized incidence and mortality of oral and pharyngeal cancers from 2003 to 2007 were calculated and stratified by area and gender.Age-stratified incidence and mortality,as well as the proportions of new and death cases of oral and pharyngeal cancer were also calculated at each site.Results Mouth,tongue and salivary gland were the most predilcction sitcs of oral and pharyngeal cancers.The crude incidence for both oral and pharyngeal cancers was 3.15/105 from 2003 to 2007.The age-standardized incidence rates using the Chinese population (1982) and the World Segi' s population were 1.75/105 and 2.26/105.The crude mortality of oral and pharyngeal cancer was 1.37/105 from 2003 to 2007; with age-standardized mortality rates,using the Chinese population (1982) and the World Segi' s population were 0.69/105 and 0.94/105.Both incidence and mortality were higher in males than in females,higher in urban than in rural areas,and ascended with age.Age-standardized incidence and mortality in Zhongshan city ranked first among all the cancer registration areas.Age-standardized incidences by gender and area increased slightly from 2003 to 2007,while age-standardized mortalities were stable.Conclusion Although the incidence and mortality of oral and pharyngeal cancer were low in China from 2003 to 2007,attention should also be paid since the exposure of relative risk factors did not seem to have reduced and the incidence increased slightly.

Liver cancer incidence and mortality in China, 2009 / 癌症

Liver cancer is a common cancer and a leading cause of cancer deaths in China. To aid the government in establishing a control plan for this disease, we provided real-time surveillance information by analyzing liver cancer incidence and mortality in China in 2009 reported by the National Central Cancer Registry. Liver cancer incidence and cases of death were retrieved from the national database using the ICD-10 topography code "C22". Crude incidence and mortality were calculated and stratified by sex, age, and location (urban/rural). China's population in 1982 and Segi (world) population structures were used for age-standardized rates. In cancer registration areas in 2009, the crude incidence of liver cancer was 28.71/100,000, making it the fourth most common cancer in China, third most common in males, and fifth most common in females. The crude mortality of liver cancer was 26.04/100,000, making it the second leading cause of cancer death in China and urban areas and the third leading cause in rural areas. Incidence and mortality were higher in males than in females and were higher in rural areas than in urban areas. The age-specific incidence and mortality were relatively low among age groups under 30 years but dramatically increased and peaked in the 80-84 years old group. These findings confirm that liver cancer is a common and fatal cancer in China. Primary and secondary prevention such as health education, hepatitis B virus vaccination, and early detection should be carried out both in males and females, in urban and rural areas.

Incidence and mortality of oral cavity and pharyngeal cancer in China, 2009 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the incidence and mortality of oral cavity and pharyngeal cancer in cancer-registration areas of China in 2009.</p><p><b>METHODS</b>We collected data about incidence of oral cavity and pharyngeal from 72 cancer registry sites of National Central Registry Database in 2009, covering 85 470 522 person (57 489 009 were from urban areas, 27 981 513 were from rural areas).Incidence and mortality rates, proportions, cumulative rate (0-74 years old), cut rate (35-64 years old), age-specific rate were then calculated and analyzed respectively. The age-standardized rate was calculated and adjusted by the Chinese standard population in 1982 as well as the Segi's world standard population.</p><p><b>RESULTS</b>There were 2803 new diagnosed oral cavity and pharyngeal cancer cases, 1793 male and 1010 female, with the sex ratio at 1.78: 1. The crude incidence rate of oral cavity and pharyngeal cancer was 3.28/100 000(2803/85 470 522). The crude incidence rate of males was 4.15/100 000(1793/43 231 554) while it was 2.39/100 000(1010/42 238 968) among females. The age-standardized incidence rates by Chinese standard population (ASIRC) and the world standard population were 1.72/100 000 and 2.23/100 000 respectively, and the cumulative rate and cut rate was separately 0.26% and 4.02/100 000. The crude incidence and ASIRC of oral cavity and pharyngeal cancers were 3.87/100 000 (2225/57 489 009) and 1.97/100 000 in urban areas, whereas in rural areas, they were 2.07/100 000(578/27 981 513) and 1.17/100 000. There were 1172 death cases, including 825 males and 347 females. The crude mortality rate was 1.37/100 000 (1172/85 470 522), while it was 1.91/100 000(825/43 231 554) among males and 0.82/100 000(347/42 238 968) among females. The age-standardized incidence rates were 0.64/100 000 and 0.88/100 000 respectively, by Chinese standard population (ASMRC) and the world standard population. The cumulative mortality rate (0-74 age years old) and cut rate were separately 0.10% and 1.34/100 000. The mortality and ASMRC were 1.59/100 000(915/57 489 009) and 0.72/100 000 in urban areas, whereas in rural areas, they were 0.92/100 000(257/27 981 513) and 0.48/100 000 respectively.</p><p><b>CONCLUSIONS</b>Both the incidence and mortality of oral cavity and pharyngeal cancer in China were still low in 2009.</p>

Trend analysis and prediction of cancer incidence in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>Based on the national cancer incidence database from 1998 to 2007, to analyze the cancer incidence trend and predict the cancer burden between 2008 and 2015.</p><p><b>METHODS</b>We picked up the cancer incidence data of 40 cancer registry sites from National Central Cancer Registry Database between 1998 and 2007. In total, 1 109 594 cancer cases were registered, covering 446 734 668 person-year. The separate incidence by district and gender were calculated, and the standardized incidence rate was calculated by world's population age structure. The incidence trend between the 10 years was analyzed by JoinPoint software, as well as the age-percentage-changes (APC). Age-Period-Cohort Bayesian Model was applied to fit the cancer incidence data stratified by age, district and gender. The cancer incidence between 2008 and 2015 was then predicted.</p><p><b>RESULTS</b>During the period of 1998 - 2007, in urban areas, the male cancer incidence rate was 277.61/100 000 (472 307/170 131 309), with the age standardized rate (ASR) at 202.05/100 000; while the female cancer incidence rate was 236.35/100 000 (389 586/164 830 893), with the ASR at 159.15/100 000; in rural areas, the male and female cancer incidence rates were separately 272.23/100 000 (153 478/56 377 236) and 170.09/100 000 (94 223/55 395 230), with the corresponding ASR at 244.34/100 000 and 137.90/100 000. Crude incidence rate in urban men increased from 247.00/100 000 (27 758/11 237 967) in 1998 to 305.76/100 000 (68 953/22 551 353) in 2007; while it increased from 207.37/100 000 (22 476/10 838 355) to 263.20/100 000 (58 055/22 057 787) among urban women. The crude incidence rate in rural men increased from 232.33/100 000 (10 045/4 323 628) to 303.65/100 000 (23 313/7 677 484) and it increased from 139.03/100 000 (5836/4 197 806) to 197.40/100 000 (14 850/7 522 690) among rural women. After age adjustment, the urban male APC value (95%CI) was 0.5% (-0.2% - 1.3%), showed no significantly statistical difference. However, the urban female APC value (95%CI), rural male APC value (95%CI) and rural female APC value (95%CI) were separately 1.7% (1.3% - 2.0%), 1.8% (0.9% - 2.6%) and 2.8% (1.8% - 3.7%), all showed an obvious uptrend. The outcome of Age-Period-Cohort Bayesian model predicted that by year 2015, the incidence cancer rate in urban areas will reach 309.13/100 000 (1.140 million new cases) among males and 303.79/100 000 (1.046 million new cases) among females; while in rural areas the rate will reach 288.66/100 000 (1.019 million new cases) among males and 222.59/100 000 (0.734 million new cases) among females.</p><p><b>CONCLUSION</b>The cancer incidence has increased annually; the uptrend in rural areas was more obvious than it in urban areas; the uptrend in females was more obvious than it in males. It is predicted that the annual incidence will continue to increase in the next years, and effective control programs should be carried out immediately.</p>

Analysis and prediction of liver cancer incidence in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>Based on the cancer registry data during 1998 - 2007, to analyze the incidence of liver cancer in China and predict the trend of incidence of liver cancer between 2008 and 2015.</p><p><b>METHODS</b>Liver cancer incidence data from cancer registry between 1998 and 2007 was collected, including a total of 115 417 cases, covering 446 734 668 person-year. We calculated the annual incidence rate of liver cancer by gender and area. Age-standardized rate (ASR) was calculated by the world's population age structure. JoinPoint software was applied to analyze the incidence trend and calculate annual percent change (APC). Age-Period-Cohort Bayesian Model was used to fit the incidence trend and predict the incidence trend between 2008 and 2015.</p><p><b>RESULTS</b>From 1998 to 2007, according to the data from cancer registry, the liver cancer incidence was 25.84/100 000 (115 417/446 734 668), with the ASR at 18.82/100 000. In urban areas, the male incidence was 34.30/100 000 (58 353/170 131 309), with ASR at 24.99/100 000; while the female incidence was 12.33/100 000 (20 324/164 830 893), with ASR at 7.99/100 000. In rural areas, the male incidence was 48.56/100 000 (27 378/56 377 236), with ASR at 42.27/100 000; while the female incidence was 16.90/100 000 (9362/55 395 230), with ASR at 13.52/100 000. During the decade, in urban areas, the APC of male and female liver cancer incidence rates were separately 1.1% and -0.5%, with ASR at -0.5% and -1.9%; while in rural areas, the APC of male and female liver cancer incidence rates were separately 3.7% and 3.1%, with ASR at 1.9% and 1.3%. Age-Period-Cohort Bayesian Model predicted that in urban areas, the male and female incidence of liver cancer in 2015 would reach 30.73/100 000 (113 279 cases) and 10.44/100 000 (35 978 cases), with ASR at 23.70/100 000 and 7.21/100 000, respectively; while in rural areas, the incidence rates would increase to 51.67/100 000 (182 382 cases) and 15.03/100 000 (49 580 cases), with ASR at 39.80/100 000 and 10.45/100 000, respectively.</p><p><b>CONCLUSION</b>The incidence of liver cancer will increase between 2008 and 2015, but its ASR will decrease slightly. In the near future, the number of new liver cancer cases will keep increasing. Liver cancer is still the dominant cancer and one key point for cancer prevention and control in China.</p>

Analysis and prediction of esophageal cancer incidence trend in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>Based on the registered esophageal cancer data from 1998 to 2007, to analyze the incidence of esophageal cancer during the period and then to predict its trend between year 2008 and 2015.</p><p><b>METHODS</b>The incidence data of esophageal cancer between 1998 and 2007 were sorted from National Cancer Registry Database. Data from forty selected registries were qualified and recruited in the study, including 86 427 cases in total, covering 446 734 668 person years. Crude incidence rates were calculated by area and gender. The standardized incidence rate was adjusted by World Segi's population composition. JoinPoint software was applied to analyze the 10 years' incidence trend and calculated the annual percentage change, while Age-Period-Cohort Bayesian Model was used to fit the data and predict the incidence between 2008 and 2015.</p><p><b>RESULTS</b>Between 1998 and 2007, the crude incidence rates among males and females in urban areas were separately 16.58/100 000 (28 207/170 131 309) and 7.14/100 000 (11 761/164 830 893), with standardized rates at 12.06/100 000 and 4.55/100 000, respectively. In rural areas, the crude incidence rates and the standardized rates were separately 51.98/100 000 (29 303/56 377 236) and 47.18/100 000 among males, and 30.97/100 000 (17 156/55 395 230) and 25.30/100 000 among females. During the ten years, the crude incidence trend of esophageal cancer among urban females decreased from 10.29/100 000 (1115/10 838 355) in 1998 to 6.29/100 000 (1387/22 057 787) in 2007. However, the crude incidence rate among rural males increased from 47.69/100 000 (2062/4 323 628) to 54.80/100 000 (4207/7 677 484) in the same period. And the rate among rural females and urban males did not change obviously. After adjusting population structure, in urban areas, the male incidence rate decreased by 2.1% annually and female incidence rate dropped by 7.5% annually. In rural areas, the female incidence rate fell by 1.3% annually, while the male incidence rate remained the same without significant changes. The prediction model estimated that there would be 134 474 new esophageal cancer cases diagnosed in year 2015, including 104 400 males and 30 074 females, while 52 506 cases came from urban areas and the other 81 968 cases were from rural areas.</p><p><b>CONCLUSION</b>The esophageal cancer incidence showed a downtrend, especially among urban females. By year 2015, the threat of esophageal cancer will be alleviated.</p>

Analysis and prediction of colorectal cancer incidence trend in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>Based on the data from National Cancer Registry between 1998 and 2007, to analyze the colorectal cancer incidence trend in China, and further to predict its incidence between 2008 and 2015.</p><p><b>METHODS</b>We picked up the incidence data of 111 281 cases of colorectal cancer in total from National Central Cancer Registry Database between 1998 and 2007, covering 446 734 668 person-year. The annual incidence rate of colorectal cancer both by area and gender were calculated; while the age standardized rate (ASR) was standardized by world's population age structure. The incidence trend was analyzed and the annual percentage change (APC) was calculated by JoinPoint software. Age-Period-Cohort Bayesian Model was applied to fit the colorectal cancer incidence trend in China between 1998 and 2007; and further to predict its incidence between 2008 and 2015.</p><p><b>RESULTS</b>From 1998 to 2007, the colorectal cancer registered incidence was 24.91/100 000 (111 281/446 734 668), with the ASR at 17.67/100 000. The incidence in male population was 26.50/100 000 (60 015/226 508 545), with ASR at 19.90/100 000; and the incidence in female was 23.28/100 000 (51 266/220 226 123), with ASR at 15.73/100 000. In urban area, the male incidence rose from 23.29/100 000 (2617/11 237 967) in 1998 to 37.84/100 000 (8534/22 551 353) in 2007; while the female incidence increased from 21.75/100 000 (2357/10 838 355) to 31.34/100 000 (6913/22 057 787). And in rural areas, the male and female incidences rose from 10.36/100 000 (448/4 323 628) and 8.86/100 000 (372/4 197 806) in 1998 to 16.80/100 000 (1290/7 677 484) and 13.00/100 000 (978/7 522 690) in 2007 respectively. In this decade, the colorectal cancer incidence has increased both in urban and rural areas. In urban area, the male APC value was 5.5% and the female APC value was 4.0%; while in rural area, the male and female APC values were 6.0% and 4.3% respectively. After adjusted by age structure, the uptrend became gently; with the urban male and urban female APC values separately increased by 3.7%, 2.5% and 2.3%. The rural male APC value rocketed up by 8.4% after its inflection point in 2004. The Bayesian model predicted that the male and female colorectal cancer incidences would separately reach 33.92/100 000 (125 thousand cases) and 27.13/100 000 (93 thousand cases) in urban areas; and 13.61/100 000 (48 thousand cases) and 13.68/100 000 (45 thousand cases) in rural areas by year 2015.</p><p><b>CONCLUSION</b>The colorectal cancer incidence in China has been increasing annually; and it will continue to rise in the next years.</p>

Analysis and prediction of breast cancer incidence trend in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>Based on the registered female breast cancer data from 1998 to 2007, to analyze the incidence of female breast cancer during the period and then to predict its trend from 2008 to 2015.</p><p><b>METHODS</b>The incidence data of breast cancer from 1998 to 2007 were sorted from National Cancer Registry Database, including 74 936 cases from urban areas and 8230 cases from rural areas, separately covering 164 830 893 and 55 395 229 person years. The crude incidence rates in urban and rural areas were calculated, and the age-standardized rate (ASR) was adjusted by World Segi's population composition. JoinPoint software was applied to analyze the 10 years' incidence trend and calculated the annual percentage of changing (APC), while Age-Period-Cohort Bayesian Model was used to fit the data and predict the incidence of breast cancer between 2008 and 2015.</p><p><b>RESULTS</b>From 1998 to 2007, the incidence of breast cancer in the urban cancer registration areas was 45.46/100 000 (74 936/164 830 893), whose ASR was 31.28/100 000. While in rural registration areas, the incidence and ASR was 14.86/100 000 (8230/55 395 229) and 12.13/100 000. The breast cancer incidence in urban and rural areas separately rose from 36.17/100 000 (3920/10 838 355) and 10.39/100 000 (436/4 197 806) in 1998 to 51.24/100 000 (11 302/22 057 787) and 19.61/100 000 (1475/7 522 690) in 2007. During the 10 years, the breast cancer incidence increased both in urban and rural areas, but the increase rate in rural incidence (6.3%) was more significant than it in urban areas (3.9%). Age-Period-Cohort Bayesian Model predicted that the breast cancer incidence would increase to 53.87/100 000 (185 585 new cases) in urban areas and 40.14/100 000 (132 432 new cases) in rural areas, respectively.</p><p><b>CONCLUSION</b>The breast cancer incidence has been increasing annually both in urban and rural areas in China; and an annually increase number of new cases have been predicted.</p>

Incidence and mortality of larynx cancer in China during 2003-2007 / 中华流行病学杂志

Objective To analyze the patterns of incidence and mortality on larynx cancer in China.Methods Data from 32 Cancer Registries in China were examined,sorted,and analyzed by the National Cancer Registry,to obtain the crude,Chinese national and world age- standardized rates (ASR) of incidence and mortality and their trends.Results The crude incidence and mortality rates of larynx cancer wcrc 2.04/105 and 1.06/105 in China during 2003-2007.The rates were higher in males than those in females,and also higher in urban areas than those in rural areas.The highest Chinese ASRs of incidence and mortality of larynx cancer in 32 cancer registries in China were 2.08/105 in Zhongshan city,Guangdong province,and 1.58/105 in She county,Hebei province respectively.The trend of incidence and mortality of larynx cancer was stable from 2003 to 2007.Conclusion Although both the incidence and mortality of larynx cancer in China were still in low level,comprehensive measures should be carried out to prevent the increase on both the incidence and mortality of larynx cancer.

Trend analysis and projection of cancer incidence in China between 1989 and 2008 / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Nationwide cancer incidence data were used to analyze the trends of cancer incidence in China in order to provide basic information for making cancer control strategy.</p><p><b>METHODS</b>We retrieved and re-sorted valid cancer incidence data from the National Central Cancer Registry Database over the 20 year-period 1989-2008. Crude incidence rate and age-standardized incidence rate were calculated for analysis. Annual percent changes in incidence for all cancers combined were estimated using Joinpoint software.</p><p><b>RESULTS</b>The cancer incidence rate in cancer registration areas was increased from 184.81/10(5) in 1989 to 286.69/10(5) in 2008 (from 209.33/10(5) to 307.04/10(5) in urban and from 176.10/10(5) to 269.57/10(5) in rural areas). Uptrends of crude cancer incidence were shown in both male and female in urban and rural areas over the 20 year-period. After standardized by age, overall incidence rate kept stable with 0.5% annual increase in urban and no change in rural areas. Since 2000, the cancer incidences in both sexes and areas were significantly increased. The incidence increased for most major cancers, especially lung cancer, colorectal cancer, female breast cancer and cervical cancer.</p><p><b>CONCLUSIONS</b>Over the 20 year-period 1989-2008, cancer incidence of most cancers has been increasing by time. The incidences of gastric cancer, liver cancer and esophageal cancer still keep gradually increasing. The incidences of lung cancer, female breast cancer, colorectal cancer and cervical cancer are markedly going up, so that cancer prevention and control should be enhanced. Cancer registration will play an important role on cancer control in China along with the number of registries increasing and data quality improving.</p>

Trend analysis of cancer mortality in China between 1989 and 2008 / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Cancer is one of the leading causes of death in China. The study aimed to examine the temporal trend of cancer mortality rate during 1989-2008 in urban and rural areas of China.</p><p><b>METHODS</b>The mortality data of all cancers from 1989 to 2008 from National Cancer Registry database were sorted and checked. Age standardized mortality rates were calculated by the direct methods using the China population of 1982 and World Segi's population. Joinpoint regression was performed to obtain the annual percentage changes (APC) in mortality rates. The top ten cancer sites were calculated and analyzed. The mortality rates were compared with statistics of the United States.</p><p><b>RESULTS</b>From 1989 to 2008, the trend of crude cancer mortality increased with an annual percentage change (APC) of 1.0%. After age standardization, the mortality rate was significantly decreased, with an APC of -1.2%. In urban areas, lung cancer was the most common cancer of death, whereas in rural areas, stomach cancer and esophageal cancer remained top cancers of death. Especially, in both urban and rural areas, the mortality of lung cancer was on increase. The mortality rates of stomach and esophageal cancers showed a decrease in urban areas. Compared with the cancer mortality rates of the United States, the Chinese cancer mortality rate in males remained highest. The decreasing trend of cancer mortality in females of China was less obvious than that of the United States.</p><p><b>CONCLUSIONS</b>The crude mortality rates of cancer in China show an increase whereas the age standardized mortality raters has declined between 1989 and 2008. Cancer is still a major public health issue threatening people's life in China. Effective intervention for cancer control and prevention is needed in the future.</p>

Affinity maturation of a single chain antibody against VEGFR2 by hydrophilic shuffling / 药学学报

Abstract: This study is to improve the affinity of scFv-AK404R against VEGFR2. The secondary mutational library was constructed by hydrophilic shuffling in CDR3 region of the heavy chain. VEGFR2-specific screening was performed by phage display technology and the protein of mutants was expressed in periplasm of E.coli HB2151 and purified by affinity chromatography. The affinity constant of scFvs was measured by competitive ELISA, and the structure of scFvs was analyzed by bioinformatics. The result showed that a library with 6.4x10(5) scFv members was established by electro-transformation. Two mutated clones with high absorbance value were isolated after screening. After purification by affinity chromatography, electrophoretically pure scFv proteins were obtained. The competitive ELISA showed that the affinities of WZ01 and WZ02 were three times higher than that of the parental AK404R, and bioinformatics analysis showed that the enlarged contact surface and fitted closely with KDR3 surface may be the reasons for improved affinity. These results suggest that introducing hydrophilic amino acids to the heavy chain CDR3 region is an effective approach to improve the affinity of scFv.