[Cancer incidence and mortality in China, 2022].

Objective: The National Central Cancer Registry estimates the number of new cancer cases and deaths in China in 2022, using incidence and mortality data collected by the National Cancer Center. Methods: According to the data of 700 cancer registries in 2018 and the data of 106 cancer registries from 2010 to 2018, the age-period-cohort model was used to estimate the incidence rate and mortality rate of all cancers and 23 types of cancer in 2022, stratified by gender and urban and rural areas. We estimated the number of new cancer cases and deaths in China in 2022 based on the estimated rate and population data in 2022. Results: The estimated results showed that in 2022, there were approximately 4 824 700 new cancer cases in China (2 533 900 in males and 2 290 800 in females), with an age-standardized incidence rate of Chinese population (ASIR) of 208.58 per 100 000 (212.67 per 100 000 for males and 208.08 per 100 000 for females). Approximately 2 903 900 new cancer cases occurred in urban areas, with an ASIR of 212.95 per 100 000. It was estimated about 1 920 800 new cancer cases in rural areas, and the ASIR was 199.65 per 100 000. The top five cancers (lung cancer 1 060 600, colorectal cancer 517 100, thyroid cancer 466 100, liver cancer 367 700 and female breast cancer 357 200) accounted for 57.4% of all new cases. The estimated number of deaths from cancer in China in 2022 was 2 574 200 (1 629 300 in males and 944 900 in females), with an age-standardized mortality rate of Chinese population (ASMR) of 97.08 per 100 000 (127.70 per 100 000 in males and 68.67 per 100 000 in females). The number of deaths from cancer in urban and rural areas was about 1 400 600 and 1 173 400, with the ASMR of 92.37 and 103.97 per 100 000 in urban and rural areas, respectively. The top five leading cause of cancers death (lung cancer 733 300, liver cancer 316 500, gastric cancer 260 400, colorectal cancer 240 000 and esophageal cancer 187 500) accounted for 67.5% of all cancer deaths. Lung cancer ranked first in the incidence and mortality in men and women. The incidence rate in urban areas was higher than that in rural areas, while the mortality rate was lower than that in rural areas. Conclusions: The burden of cancer in China is still relatively heavy, with significant differences in cancer patterns in gender, urban-rural, and regional. The burden of cancer presents a coexistence of developed and developing countries, and the situation of cancer prevention and control is still serious in China.

[Cancer statistics in China, 2016].

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.

[The incidence and mortality of endometrial cancer in China, 2015].

Objective: To estimate endometrial cancer (EC) incidence and mortality in China in 2015. Methods: Qualified cancer registry data collected in 2011-2015 were pooled for analysis, from which EC cases and deaths were extracted. EC cases were classified into endometrioid, nonendometrioid and other & unspecified according to their histologic types. Incidence and mortality rates stratified by region and age group were calculated. Population data of 2015 was used to estimate cancer cases and deaths in China. Segi's population was used for the calculation of age-standardized rates by world standard population (ASW). Results: Data from 158, 176, 239, 235, 231 qualified cancer registries of 2011 to 2015 were pooled together. These registries covered about 488 million population, including about 255 million population in urban area and 233 million population in rural area. In 2015, a total of 53 600 EC cases were estimated, with a crude incidence rate of 7.74/100 000 and an ASW of 5.13/100 000. Incidence rates were higher in urban areas (9.15/100 000) than in rural areas (6.20/100 000). A total of 10 700 deaths were estimated, with a crude mortality rate of 1.60/100 000 and an ASW of 0.98/100 000. Mortality rate was higher in urban areas (1.78/100 000) than in rural areas (1.40/100 000). Among reported EC cases during 2011-2015, 70.92% (23 641 cases) were endometrioid, 5.13% (1 709 cases) were nonendometrioid and 23.95% (7 982 cases) were other & unspecified. The mean age at onset of all EC cases was 55.9±10.6. The mean age at onset of endometrioid cases (55.7±10.0) was younger than that of nonendometrioid cases (57.7±10.8) (P<0.001). The mean age at onset of all histologic types in urban areas was higher than that in rural areas (P<0.001). The mean age at death for EC deaths was 63.9±12.5. The mean age at death in urban areas (65.3±12.5) was higher than that in rural areas (61.4±12.2) (P<0.001). Conclusion: EC disease burden differs between urban and rural areas. Targeted cancer prevention and control strategies should be made for each region.

[Analysis of risk factors of axillary lymph node metastasis and prognosis in T1 breast cancer: a large-scale retrospective study based on the SEER database].

Objective: To analyze the clinicopathological characteristics of T1 breast cancer, the risk of lymph node metastasis and related prognostic factors. Methods: The National Cancer Institute Surveillance, Epidemiology and Results (SEER) database was utilized to search and screen out 73 421 female patients with T1 breast cancer from 2010 to 2015 for retrospective analysis. Logistic regression was used to assess the risk factors of lymph node metastasis. Kaplan-Meier survival analysis was used to analysis overall survival (OS) and breast cancer-specific survival (BCSS); Log-rank test and Cox risk model were used for prognostic analysis. Results: A total of 73 421 female patients were enrolled, including 61 955 (84.4%) N0 stage, 9 995 N1 stage (13.6%), 1 087 N2 stage (1.5%) and 384 N3 stage (0.5%). Patients with invasive cancer, histological grade 3, T1c stage, progesterone receptor (PR) positive and human epidermal growth factor receptor-2 (HER-2) positive were most likely to develop lymph node metastasis (all P<0.05). The median follow-up time was 55 months. The 5-year survival rate was 93.8%, and the 5-year BCSS rate was 98.2%. Cox regression analysis showed that T stage (HR=1.517, 95%CI: 1.382-1.666, P<0.01), N stage (HR=5.173, 95%CI: 4.424-6.049, P<0.01), estrogen receptor (ER) status (HR=0.774, 95%CI: 0.607-0.987, P=0.039), PR status (HR=0.745, 95%CI: 0.689-0.806, P<0.01) and subtype (HR=1.439, 95%CI: 1.078-1.478, P=0.011) were independent prognostic risk factors for the OS. Histological grade (HR=2.100, 95%CI: 1.766-2.483, P<0.01), T stage (HR=1.310, 95%CI: 1.193-1.439, P<0.01), N stage (HR=21.230, 95%CI: 17.980-25.060, P<0.01), PR status (HR=0.855, 95%CI: 0.791-0.925, P<0.01) were independent prognostic risk factors for the BCSS in T1 breast cancer. Conclusions: The lymph node metastasis rate of T1 breast cancer is low and the overall prognosis is good. Pathological type, histological grade, tumor size and subtype maybe helpful in predicting the lymph node metastasis of T1 breast cancer.

[Clinical features and prognostic analysis of female breast cancer in different diagnosed ages].

Objective: To evaluate 5-years breast cancer-specific survival (CCS) by age, and the relationship of age at diagnosis and the risk of breast cancer mortality. Methods: Medical records of 3 470 resident patients diagnosed with primary, invasive female breast cancer between January 1, 2006 and December 31, 2010 in four hospitals in Beijing were reviewed and collected. All patients were followed up until December 31, 2018 to acquire survival outcome. Five-years breast CCS of the five subgroups was estimated by the life-table method. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of different levels of age stratification and breast cancer mortality, and restricted cubic spline (RCS) model was used to detect the dose-response relationship. Results: The median diagnosis age among 3 470 female breast cancer patients was 53.2 years. There were 1 289 patients in the age-group of 45~54 years, with the highest proportion of 37.15%. However, only 126 patients occurred in the age-group of less than 35 years, with the lowest proportion of 3.63%. A total of 528 (15.22%) patients died of breast cancer during the study period. Overall 5-year CCS was 90.72% (95%CI: 89.74%~91.70%), 88.68% (95%CI: 83.09%~94.27%) and 87.05% (95%CI: 84.27%~89.82%) for all of the patients, aged less than 35 years and those aged 65 years and older. Compared with patients with diagnosis age of 45~54 years, the multivariate-adjusted HRs for breast cancer mortality associated with patients in age-group of <35 years and those in the age-group of ≥65 years were 1.72 (95% CI: 1.06~2.81) and 1.89 (95% CI: 1.43~2.49), respectively. In addition, patients aged ≥65 years had significantly higher risk of breast cancer mortality in Luminal subtypes, with HR of 1.70 (95% CI: 1.17~2.46) for Luminal A breast cancer and HR of 3.84 (95% CI: 1.74~8.49) for Luminal B breast cancer. RCS analysis exhibited a non-linear ( "J-shaped" ) relationship between diagnosis age of female breast cancer and the risk of breast cancer mortality (nonlinear P<0.000 1). In addition, patients aged ≥65 years had significantly higher risk of breast cancer mortality in Luminal subtypes, with HR of 1.70 (95% CI: 1.17~2.46) for Luminal A breast cancer and HR of 3.84 (95% CI: 1.74~8.49) for Luminal B breast cancer. RCS analysis exhibited a non-linear ( "J-shaped" ) relationship between diagnosis age of female breast cancer and the risk of breast cancer mortality (nonlinear P<0.000 1). Conclusion: Age at diagnosis is an important prognostic factor for female breast cancer, with worse outcome for both young and old patients.

[Statistical analysis of incidence and mortality of prostate cancer in China, 2015].

Objective: To estimate the incidence and mortality rates of prostate cancer in China in 2015. Methods: The data from 501 cancer registries in China collected by the National Cancer Center were reviewed and evaluated, and the qualified data were included in the final analysis. According to the national population data in 2015, the nationwide incidence and mortality of the prostate cancer were estimated. Chinese standard population in 2000 and world Segi's population were used to calculate the age-standardized (ASR) incidence and mortality rates (ASR China and world, respectively). Results: After data review, the data reported by 368 registries were included in the final analysis, covering a total population of 309 553 499, accounting for 22.52% of the national population at the end of 2015. There were 72 thousand new prostate cancer cases estimated in China in 2015, with a crude incidence rate of 10.23/100 000. The ASR China and ASR world are 6.59/100 000 and 6.47/100 000, respectively, which is the sixth incidence of male malignant tumor.The estimated number of prostate cancer death was 3.07 thousand in China in 2015, with a crude mortality rate of 4.36/100 000; The ASR China and ASR world mortality rates were 2.61/100 000 and 2.65/100 000, respectively, which is the tenth leading cause of death in male malignant tumor.The ASR China incidence and mortality of prostate cancer in males were higher in urban areas (8.40/100 000 and 3.11/100 000) than those in rural areas (4.16/100 000 and 1.90/100 000). The incidence and mortality rates in the eastern areas (8.54/100 000 and 2.99/100 000) were higher than those in the central (5.28/100 000 and 2.34/100 000) and western areas (5.32/100 000 and 2.37/100 000) of China. Conclusions: The incidence and mortality rates of prostate cancer in China are lower than the global average, but there is an increasing trend. The incidence and mortality of prostate cancer in China have obvious regional differences.

[Feasibility and efficacy of indocyanine green used in laparoscopic gastrectomy for advanced gastric cancer patients].

Objective: To identify the feasibility and efficacy of indocyanine green (ICG) used in laparoscopic gastrectomy for advanced gastric cancer patients. Methods: From December 2018 to August 2019, the clinical data of 82 patients preoperatively diagnosed as advanced gastric cancer undergoing laparoscopic radical gastrectomy were retrospectively analyzed. These patients were divided into ICG group(n=38) and a historical control group (non-ICG group, n=44). The number of retrieved lymph nodes, operation time, blood loss, hospital stay, fever time, evacuation time and complications were compared between these two groups. Results: The operation time [(172.8±45.8) min vs (162.6±45.7) min], blood loss [(80.1±91.9) ml vs (78.6±89.8) ml], hospital stay [(7.0±2.0) d vs (7.5±2.4) d], fever time [(2.3±1.2) d vs (2.9±1.9) d], evacuation time [(3.4±0.8) d vs (3.4±1.1) d] and incidence of complications (5.3% vs 9.1%) were not significantly different between the ICG and historical control groups (P>0.05). The number of retrieved lymph nodes in ICG group was significantly increased compared with that of the historical control group (46.5 vs 33.0, P=0.005). Conclusions: The ICG method applied in lymph node dissection of laparoscopic radical gastrectomy is safe. Moreover, ICG might elevate the efficiency of regional lymph node dissection.

[Analysis of incidence and mortality of esophageal cancer in China, 2015].

Objective: To estimate the incidence and mortality rates of esophageal cancer in China in 2015. Methods: Based on the data quality review and assessment, the esophageal cancer data from 368 cancer registries in 31 provinces (autonomous regions and municipalities) in China were included in this study. According to the national population data in 2015, the nationwide incidence and mortality of the esophageal cancer were estimated. Chinese standard population in 2000 and world Segi's population were used to calculate the age-standardized (ASR) incidence and mortality rates (ASR China and world, respectively). Results: The 368 cancer registries covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. There were 245 651 new esophageal cancer cases estimated in China in 2015, with a crude incidence rate of 17.87/100 000. The ASR China and ASR world were 11.14/100 000 and 11.28/100 000, respectively. The estimated number of esophageal cancer death was 188 044 in China in 2015, with a crude mortality rate of 13.68/100 000; The ASR China and ASR world mortality rates were 8.33/100 000 and 8.36/100 000, respectively. The ASR China incidence and mortality of esophageal cancer in males were higher in males (16.50/100 000 and 12.66/100 000) than those in females (5.92/100 000 and 4.17/100 000), and they were higher in rural areas (15.95/1100 000 and 11.67/100 000) than those in urban areas (7.59/100 000 and 5.87/100 000). Conclusion: The incidence and mortality of esophageal cancer in China are higher than the global average. The disparity of the incidence and mortality rates of esophageal cancer significantly differed in genders and areas.

[Liver cancer epidemiology in China, 2015].

Objective: Using updated population-based cancer registration (PBCR) data, we estimated nation-wide liver cancer statistics overall, by sex and by areas in China. Methods: Qualified PBCR data of liver cancer in 2015 which met the data quality criteria were stratified by geographical locations, sex, and age groups. Age-specific incidence and mortality rates by sex and area were calculated. The burden of liver cancer was evaluated by multiplying these rates by the year of 2015 population. Chinese standard population in 2000 and World Segi's population were used for the calculation of age-standardized rates (ASR) of incidence and mortality. Results: Qualified 368 cancer registries covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. It is estimated that there were 370 000 new cases (274 000 males and 96 000 females) of liver cancer in China. The age-standardized incidence rates by Chinese standard population (ASR China) and World Segi's population (ASR World) were 17.64 per 100 000 and 17.35 per 100 000, respectively. Rural areas showed higher incidence (ASR China: 20.07 per 100 000, ASR World: 19.67 per 100 000) than urban areas (ASR China: 15.90 per 100 000, ASR world: 15.67 per 100 000). Subgroup analysis showed that western areas of China had highest incidence rate of liver cancer, with the ASR China of 20.65 per 100 000 and 20.22 per 100 000 for ASR world, respectively. For new cases of liver cancer deaths, there were 326 000 new deaths (242 000 males and 84 000 females) in China, with age-standardized mortality rate by Chinese standard population and World Segi's population of 15.33 per 100 000 and 15.09 per 100 000, respectively. Rural areas showed higher mortality (ASR China: 17.17 per 100 000, ASR world: 16.86 per 100 000) than urban areas (ASR China: 14.00 per 100 000, ASR World: 13.81 per 100 000). Conclusions: There is still a heavy burden of liver cancer in China. Rural residents have higher incidence and mortality of liver cancer compared with urban counterparts. It is likely that many factors such as hepatitis virus infection, and aflatoxin exposure play a dominating role. Prevention and control strategies should be enhanced in the future.

[Analysis of the clinical characteristics of 8 081 primary lung cancer].

Objective: To characterize the clinical epidemiological features of primary lung cancer patients based on massive clinical data. Methods: The demographic and histological information of 8 081 primary lung cancer patients who were initially identified from 1 January 2012 to 31 December 2013 in 16 hospitals from 6 provinces were retrospectively analyzed to determine the characteristics of different histological subtypes among different gender, age-group and birth cohort. Results: Among the 8 081 lung cancer patients, 5 422 (67.10%) were male and 2 659 (32.90%) were female, the average age was (60.96±10.14) years. The most common histological subtypes of lung cancer successively were adenocarcinoma (ADC), squamous cell carcinoma (SCC), small cell carcinoma and large cell carcinoma, and the proportions of these subtypes were 53.13%, 24.51%, 14.59% and 0.66%, respectively, which collectively accounted for 92.89%. The current highest smoking rate was observed in SCC patients, which was 62.45%, while lowest in ADC, which was 29.68%. The incidence of lung cancer in male was significantly higher that that of female, with a sex ratio of 2.04∶1. The highest sex ratio was observed in SCC, which was 9.14∶1, while lowest in ADC, which was 1.14∶1. The distribution of histological subtypes in male lung cancer patients was consistent with the general situation.While among the female lung cancer patients, the proportion of ADC was the highest (75.42%), followed by SCC (10.08%), squamous cell carcinoma (7.34%) and large cell carcinoma (0.39%). Analyzed by the birth cohort, the proportion of ADC gradually increased with the age, while the reduced tendency was observed in SCC (P<0.000 1). Conclusion: Adenocarcinoma is the most important histological subtype of lung cancer, and the distribution characteristics of histological subtypes of lung cancer differs among genders, age and birth cohort.

[Report of cancer epidemiology in China, 2015].

Objective: Data from local cancer registries were pooled to estimate cancer incidence and mortality in China, 2015. Methods: Data submitted from 501 cancer registries were checked & evaluated according to the criteria of data quality control, and 368 registries' data were qualified for the final analysis. Data were stratified by area (urban/rural), sex, age group and cancer sites, and combined with national population data to estimate cancer incidence and mortality in China, 2015. Chinese population census in 2000 and Segi's population were used for age-standardized. Results: Total population covered by 368 cancer registries were 309 553 499 (148 804 626 in urban and 160 748 873 in rural areas). The percentage of morphologically verified cases (MV) and the percentage of death certificate-only cases (DCO) accounted for 69.34% and 2.09%, respectively, and the mortality to incidence ratio was 0.61. About 3 929 000 new cancer cases were reported in 2015 and the crude incidence rate was 285.83 per 100 000 population (males and females were 305.47 and 265.21 per 100 000 population). Age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 190.64 and 186.39 per 100 000 population, respectively, with the cumulative incidence rate (0-74 age years old) of 21.44%. The cancer incidence and ASIRC were 304.96/100 000 and 196.09/100 000 in urban areas and 261.40/100 000 and 182.70/100 000 in rural areas, respectively. About 2 338 000 cancer deaths were reported in 2015 and the cancer mortality was 170.05/100 000 (210.10/100 000 in males and 128.00/100 000 in females). Age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 106.72/100 000 and 105.84/100 000, respectively, with the cumulative incidence rate (0-74 age years old) of 11.94%. The cancer mortality and ASMRC were 172.61/100 000 and 103.65/100 000 in urban areas and 166.79/100 000 and 110.76/100 000 in rural areas, respectively. The most common cancer cases including lung, gastric, colorectal, liver and female breast, the top 10 cancer incidence accounted for about 76.70% of all cancer new cases. The most common cancer deaths including lung, liver, gastric, esophageal and colorectal, the top 10 cancer deaths accounted for about 83.00% of all cancer deaths. Conclusions: The burden of cancer showed a continuous upward trend in China. Cancer prevention and control faces the problem of the disparity in different areas and different cancer burden between men and women. The cancer pattern in China presents the coexistence of the cancer patterns in developed and developing countries. The situation of cancer prevention and control is still serious in China.

[Epidemiological characteristics of gastric cancer in China, 2015].

Objective: To estimate the morbidity and mortality of gastric cancer and its distribution in China in 2015 and provide information for future cancer prevention and control study and policy decision. Methods: In 2018, a total of 501 cancer registry systems reported data to the office of National Central Cancer Registry, and the data from 368 cancer registry systems met the criteria. The overall, gender specific, age specific and area specific morbidity and mortality rates of gastric cancer in China were estimated based on national population data in 2015. Chinese standard population in 2000 and World Segi's population data were used to calculate the age-standardized rates (ASR) of morbidity and mortality, including ASR of China and the world. Results: In 2015, the qualified 368 cancer registry system covered a total of 309 553 499 population in China, including 156 934 140 males and 152 619 359 females. We estimated that there were 403 000 new gastric cancer cases, with the crude morbidity rate of 29.31 per 100 000, ASR China of 18.68 per 100 000, ASR world of 18.57 per 100 000, and a cumulative rate of 2.29% for 0-74 years. There were 290 900 new gastric cancer deaths, with the crude mortality rate of 21.16 per 100 000, ASR China of 13.08 per 100 000, ASR world of 12.92 per 100 000, and a cumulative rate of 1.5% for 0-74 years. Gastric cancer ranked second as the most common cancers and third as the most common cancer causes of death in China. In general, both the morbidity rate (ASR China, male: 26.54 per 100 000; female: 11.09 per 100 000; rural area: 21.82 per 100 000; urban area: 16.37 per 100 000) and mortality rate (ASR China, male: 18.75 per 100 000; female: 7.72 per 100 000; rural area: 15.84 per 100 000; urban area: 11.05 per 100 000) were higher in males than those in females, and higher in rural area than those in urban area. The morbidity and mortality rates of gastric cancer increased from the age of 40 years and peaked in age group of 80-years. The case number of gastric cancer significantly increased from the age group of 50-years, peaked at 60-70 years, and the majority of cases occured in age group of 55-80 years. There was an overall consistent trend of the age-specific morbidity and mortality rates across different subgroups by sex and geographic areas, with the rates were higher in males than those in females, and higher in rural area than that in urban area. Conclusions: The incidence of gastric cancer varied with sex, age and areas (urban area and rural area). The present analysis provides the latest data on the prevalence of gastric cancer in China, which can help optimize the current screening guidelines and the prevention and control strategies of gastric cancer to reduce the disease burden caused by gastric cancer in China.

[The incidence and mortality of lung cancer in China, 2014].

Objective: To estimate lung cancer incidence and mortality in China using population-based cancer registry data in 2014 collected by National Central Cancer Registry of China (NCCRC). Methods: 449 cancer registries submitted cancer registry data in 2014. All datasets were evaluated and 339 registries' data which met the quality control criteria of NCCRC were analyzed. Numbers of new lung cancer cases and deaths were estimated using calculated incidence and mortality rates and corresponding national population stratified by areas, sexes and age groups. The standard population of Chinese census in 2000 and world Segi' s population were applied to calculate age-standardized incidence and mortality rates in China and worldwide, respectively. Results: A total of 781, 500 new lung cancer cases were diagnosed in 2014. The crude incidence rate was 57.13 per 100 000 and the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 36.71 per 100 000 and 36.63 per 100 000, respectively. The cumulative incidence rate (0-74 years old) was 4.50%. Lung cancer was the most common cancer in male (ASIRW: 50.04 per 100 000) and the second most common cancer in female (ASIRW: 23.63 per 100 000). The incidence rates were slightly similar in urban areas and in rural areas (ASIRW: 36.64 per 100 000 vs 36.56 per 100 000). A total of 626 400 lung cancer deaths were reported. The crude mortality rate was 45.80 per 100 000 and the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 28.49 per 100 000 and 28.31 per 100 000, respectively. The cumulative mortality rate (0-74 years old) was 3.32%. Lung cancer was the most common cause of cancer deaths both in male (ASMRW: 40.21 per 100 000) and female (ASMRW: 16.88 per 100 000). The mortality rate was slightly higher in rural areas than in urban areas (ASMRW: 28.63 per 100 000 vs 28.04 per 100 000). Both lung cancer incidence and mortality rates increased with age, and the peak age was 80-84 years group. Conclusions: The disease burden of lung cancer is heavy in China. Efficient national health policies and prevention and control strategies against lung cancer should be promoted.

[Incidence and mortality of laryngeal cancer in China, 2014].

Objective: To estimate the incidence and mortality of laryngeal cancer in China based on the cancer registration data in 2014, collected by the National Central Cancer Registry (NCCR), and to provide support data for the control and prevention of laryngeal cancer. Methods: The incident and death data of laryngeal cancer in 2014 from 339 cancer registries met the quality criteria of NCCR, and then adopted for analysis. The incident and death number, crude rate, age standardized rate, truncated rate and proportion which stratified by areas (urban/rural) and age were calculated. The nationwide incidence and mortality of laryngeal cancer in 2014 were estimated by combining with those data on national population in 2014. Chinese population census in 2000 and Segi's population were used for age-standardized incidence/mortality rates. Results: It was estimates that 23.4 thousand new cases of laryngeal cancer occurred in China in 2014. There were 20.8 thousand males and 2.6 thousand females. And 14.5 thousand occurred in urban areas, while 8.9 thousand in rural areas. The age standardized rates of incidence by world standard population (ASRs world) in male, female and both genders were 2.05/100, 000, 0.24/100, 000 and 1.14/100, 000, respectively, whereas those were 1.22/100, 000 and 1.03/100, 000 for urban and rural areas. The incidence was much higher in males than females, and slightly higher in urban areas than those in rural areas. Moreover, it was estimates that 13.2 thousand death cases of laryngeal cancer occurred in China in 2014. There were 11.5 thousand males and 1.7 thousand females. And 7.8 thousand occurred in urban areas, while 5.4 thousand in rural areas. The age standardized rates of mortality by ASRs world in male, female and both genders were 1.08/100, 000, 0.14/100, 000 and 0.60/100, 000, respectively, whereas those were 0.60/100, 000 and 0.59/100, 000 for urban and rural areas. The mortality was much higher in males than females, and slightly higher in urban areas than those in rural areas. In males, the age specific incidence and mortality of laryngeal cancer increased greatly from 40-44 and 45-44 years old, respectively, and peaked at age group of 75-79 and >85 years old. In females, the age specific incidence and mortality increased slowly from 50-54 and 60-64 years old, respectively, and peaked at age group of 80-84 and >85 years old. The trends remained similar in urban and rural areas, except for the different peak ages. Conclusions: The incidence and mortality of laryngeal cancer in China are at middle-low levels worldwide, and there are obvious differences between urban and rural areas with distinct gender disparity. Comprehensive prevention and control strategies should be carried out according to local status and age groups.

[Incidence and mortality of bladder cancer in China, 2014].

Objective: To estimate the incidence and mortality of bladder cancer in China based on the cancer registration data in 2014, collected by the National Central Cancer Registry (NCCR). Methods: There were 449 cancer registries submitted bladder cancer new cases and deaths occurred in 2014 to NCCR. After evaluating the data quality, 339 registries' data were finally accepted for analysis. According to the national population data of 2014, the nationwide incidence and mortality of bladder cancer were estimated by stratification in the area (urban or rural), gender, and age. Chinese population census in 2000 and Segi's population were used for age-standardized incidence/mortality rates. Results: All 339 cancer registries covered a total of 288 243 347 populations (144 061 915 in urban and 144 181 432 in rural areas). The percentage of morphologically verified cases and death certificate-only cases were 74.86% and 1.45%, respectively. The mortality to incidence ratio was 0.41. The estimates of new bladder cancer cases were 78 100 in China in 2014, with a crude incidence rate of 5.71/100 000. The age-standardized incidence rates by China standard population (ASR China) and world standard population (ASR world) of bladder cancer were 3.61/100 000 and 3.56/100 000, respectively. Cumulative incidence rate of bladder cancer in China was 0.41%. The crude and ASR China incidence rates in urban areas were 6.88/100 000 and 4.07/100 000, respectively, whereas those were 4.29/100, 000 and 2.96/100 000 in rural areas. The estimates of bladder cancer deaths caused by bladder cancer were about 32 100 in China in 2014, with a crude mortality rate of 2.35/100 000. The ASR China and ASR world mortality rates were both 1.30/100 000 with a cumulative mortality rate (0-74 years old) of 0.12%. The crude and ASR China mortality rates were 2.79/100 000 and 1.41/100 000 in urban areas, respectively, whereas those were 1.81/100 000 and 1.14/100 000 in rural areas. Conclusions: The incidence and mortality pattern of bladder cancer were different in urban and rural areas. The incidence and mortality were higher in urban areas than that in rural areas, and higher for male than for female. We should focus on strengthening the prevention and control of bladder cancer in key population, especially men in urban areas.

[Incidence and mortality of nasopharyngeal carcinoma in China, 2014].

Objective: To estimate the incidence and mortality of nasopharyngeal carcinoma in China based on cancer registration data in 2014, collected by the National Central Cancer Registry (NCCR). Methods: 449 cancer registries submitted nasopharyngeal carcinoma incidence and deaths occurred in 2014 to NCCR. After evaluating the data quality, 339 registries' data were accepted for analysis and stratified by area (urban/rural) and age group. Combined with data on national population in 2014, the nationwide incidence and mortality of nasopharyngeal carcinoma were estimated. Chinese population census in 2000 and Segi's population were used for age-standardized incidence and mortality rates. Results: The estimates of new nasopharyngeal carcinoma incident cases and deaths were 44.6 thousands and 24.2 thousands, respectively. The crude incidence rate was 3.26/100 000 (Male 4.51/100 000, Female 1.94/100 000). Age-standardized incidence rates by Chinese standard population (ASIRC, 2000) and by world standard population (ASIRW) were 2.48/100 000 and 2.33/100 000, respectively. Male to female ratio was 2.32∶1. The ASIRC in urban and rural areas were all 2.48/100 000. The crude mortality rate of nasopharyngeal carcinoma was 1.77/100 000 (Male 2.55/100 000, Female 0.95/100 000). Age-standardized mortality rates by Chinese standard population (ASMRC, 2000) and by world standard population(ASMRW) were 1.23/100 000 and 1.20/100 000, respectively. The ASMRC in urban and rural areas were all 1.23/100 000. The cumulative incidence and mortality rates(0-74 years old)were 0.25% and 0.14%, respectively. Conclusions: Incidence and mortality of nasopharyngeal carcinoma in China in 2014 were at high levels in the world. Corresponding prevention and control measures should be established according to the epidemic characteristics and risk factors of nasopharyngeal carcinoma.

[Analysis on incidence and mean age at diagnosis for Global Cancer].

Objective: To analyze the age distribution characteristics of different cancers in the world according to the database from Cancer Incidence in Five Continents published by the International Association of Cancer Registries, and to compare the age differences of cancer incidence in different regions. Methods: Cancer incidence data from volume XI of Cancer Incidence in Five Continents including 339 population-based cancer registries in 65 countries during 2008-2012 have been extracted. The average age of cancer incidence in different regions, gender and cancer sites were analyzed and stratified according to the human development Index and the level of national or regional development UN Development. The Segi's world standard population (world standard) was standardized to calculate the average age of the cancer incidence and to analyze the effect of age structure of the population on the average age of cancer diagnosis. Results: This study included 4 812 008 148 person-years in the global population (including 2 367 458 302 men and 2 444 549 846 women), and 21 892 093 of the new cancer cases, including 11 450 515 men and 10 441 578 women. The analysis showed that the average age of cancer incidence in the world was 65.73 years, and men and women were 66.70 and 64.67 years old, respectively. Among them, the average incidence age of testicular cancer was the youngest, with an average age of 36.67 years, and that of gallbladder cancer was the highest with average age of 71.55 years. After adjusting for population structure, the average incidence age was highest in gallbladder cancer, followed with bladder cancer and prostate cancer, and the testicular was with the lowest average age of incidence, followed by bone cancer and brain tumor. The results showed that the average age of cancer incidence in developed countries or regions was 66.38 years old, and that in less developed countries or regions was 61.75 years old, but in China it was 63.47 years old. According to the human development index (HDI), the higher the country or region with HDI, the higher the average age of cancer incidence, and the difference is reduced after the adjustment of the age structure of the population. Conclusions: There are different characteristics of the age distribution for different cancer sites. In terms of the age of cancer incidence, those of gallbladder cancer and bladder cancer are relatively old, while those of the testis, bone and thyroid cancer are relatively young. The average age of cancer incidence in China is between developed and less developed countries. Prevention and control of cancer should be carried out according to the age distribution characteristics of different cancers.

[Incidence trend and change in the age distribution of female breast cancer in cancer registration areas of China from 2000 to 2014].

Objective: To estimate the incidence trend and change in the age distribution of female breast cancer in cancer registry areas in China from 2000 to 2014. Methods: 22 cancer registries in China with continuous monitoring data from 2000 to 2014 were selected. All datasets were checked and evaluated based on data quality control criteria and were included in the analysis. The cancer registries covered 675 954 193 person-years, including 342 010 930 person-years of male and 333 943 263 person-years of female. Female breast cancer cases (International Classification of Diseases-10(th) Revision: C50) were extracted. Crude incidence rate (CR), age-standardized incidence rate by Chinese standard population(ASIRC), annual percent change (APC), crude and adjusted mean age at onset were calculated. Incidence rates stratified by regions and age groups were calculated. Results: Female breast cancer incidence rate significantly increased from 31.90/100 000 in 2000 to 63.30/100 000 in 2014. Incidence rate increased rapidly from 2000 to 2008 (CR: APC=6.5%, 95%CI: 5.3%-7.8%; ASIRC: APC=4.6%, 95%CI: 3.6%-5.7%). Its increment slowed down from 2008-2014 (CR: APC=3.2%, 95%CI: 1.4%-5.1%; ASIRC: APC=1.4%, 95%CI:-0.1%-2.9%). The crude mean age at onset increased from 54.4 in 2000 to 57.0 in 2014. Adjusted mean age at onset remained around 54.3 in 2014. Crude mean age at onset increased significantly over time in all registry areas (ß=0.192, P<0.001), urban (ß=0.205, P<0.001) and rural (ß=0.092, P=0.014) areas, while adjusted mean age at onset remained stable in all registry areas (ß=0.009, P=0.289), urban (ß=0.017, P=0.139) and rural (ß=-0.054, P=0.109) areas. Conclusion: Female breast cancer incidence rate in China increased from 2000 to 2014. Aging of the population resulted in a significant increase in crude mean age at onset. After age adjustment, no significant changes in age distribution were found.

[Trend analysis of age of diagnosis for liver cancer in cancer registry areas of China, 2000-2014].

Objective: To investigate trends of mean age of diagnosis for liver cancer during 2000 to 2014, which may provide basic information for making feasible cancer prevention strategies. Methods: Based on the continuous cancer incidence data from 22 cancer registries of China between 1 January 2000 and 31 December 2014, the incidence by birth-cohort (year of birth between 1925 and 1994) and age specific incidence rates were calculated. The incidence of different age groups were also calculated. World Segi's population was used for age standardization. The liner regression model was applied to analyze the changing trend of mean age of diagnosis. Results: In 2014, the incidence rate for population with 80 years older and above was 108.21 per 100 000, whereas the rate for population at 30-39 years old was 5.09 per 100 000. But the mean age of diagnosis for liver cancer showed an increasing trend from 2000 to 2014. For male, it had increased from 58.80 to 62.35 (t=18.70, P<0.001) . For female, it had increased from 64.02 to 68.99 (t=20.50, P<0.001) . After age standardization, the mean age of diagnosis still showed increasing trend. Meanwhile, the proportion of liver cancer in people above 70 years old was 25.05% in 2014, which was higher than that in 2000 (22.49%). Conclusion: The mean age of liver cancer incidence was increasing during 2000-2014.

[Trend analysis on incidence and age at diagnosis for lung cancer in cancer registration areas of China, 2000-2014].

Objective: To analyze the incidence trend and mean age at diagnosis for lung cancer in cancer registration areas of China from 2000 to 2014. Methods: The data of lung cancer incidence used in this study were from 22 registries submitted to National Central Cancer Registry with continuous data during 2000 and 2014, covering about 621 593 469 person-years. All cancer cases were coded as C33-C34 according to the International Classification of Diseases-10(th) Revision (ICD-10) were extracted for this analysis with about 343 663 patients. The incidence of different sex and regional population, the standardized incidence rate by Chinese population, the average annual change percentage (AAPC), the mean age and adjusted mean age of cancer incidence were calculated. The incidence of each year was described by regional and age groups, and the linear regression model was employed to analyze the relationship between mean age at onset and year. Results: The crude incidence rate and age-standardized incidence rate (ASR) of lung cancer for men in cancer registry areas in 2000 were 56.98 per 100 000 and 48.43 per 100 000, respectively. The rates were 89.51 per 100 000 and 46.85 per 100 000 in 2014, respectively. For women in the same areas, the rates were 27.77 per 100 000 and 20.17 per 100 000 in 2000; while 51.31 per 100 000 and 25.44 per 100 000 in 2014, respectively. The crude incidence rate increased along with the age. In 2000-2014, the trend of crude rate and ASR of lung cancer were significantly increased (CR: AAPC=3.8%, 95%CI: 3.5%-4.1%; ASR: AAPC=0.4%, 95%CI: 0.2%-0.7%). The rise of crude rate in females was higher than that in males (Male: AAPC=3.5%, 95%CI: 3.2%-3.7%; Female: AAPC=4.5%, 95%CI: 4.1%-5.0%). However, the rise of the ASR declined for both male and female (Male: AAPC=-0.2%, 95%CI:-0.4%-0.0%; Female: AAPC=1.4%, 95%CI: 1.0%-1.9%). The average age at diagnosis of lung cancer in rural areas was 64.35 years old in 2000, and increased to 65.97 years old in 2014 (ß=0.11, P<0.001), while adjusted mean age at onset remained stable in all areas and urban areas (P>0.05). And the average age at onset increased significantly over time in male (ß=-0.02, P=0.014), which was not seen in female (ß=-0.01, P=0.522). Conclusion: The crude incidence rate of lung cancer in cancer registry areas in China increased slowly during 2000-2014; and the standardized average age of male at diagnosis decreased slightly, while the age in rural areas increased during 2000-2014. Lung cancer will still be the focus of cancer prevention and control in the near future.