Abstract
BackgroundCancer is a serious health issue in China, but accurate national counts for cancer incidence are not currently available. Knowledge of the cancer burden is necessary for national cancer control planning. In this study, national death survey data and cancer registration data were used to calculate the cancer burden in China using a Bayesian approach.MethodsCancer mortality and incidence rates for 2004–2005 were obtained from the National Cancer Registration database. The third National Death Survey (NDS), 2004–2005 database provided nationally representative cancer mortality rates. Bayesian modeling methods were used to estimate mortality to incidence (MI) ratios from the registry data and national incidence from the NDS for specific cancer types by age, sex and urban or rural location.ResultsThe total estimated incident cancer cases in 2005 were 2,956,300 (1,762,000 males, 1,194,300 females). World age standardized incidence rates were 236.2 per 100,000 in males and 168.9 per 100,000 in females in urban areas and 203.7 per 100,000 and 121.8 per 100,000 in rural areas.ConclusionsMI ratios are useful for estimating national cancer incidence in the absence of representative incidence or survival data. Bayesian methods provide a flexible framework for smoothing rates and representing statistical uncertainty in the MI ratios. Expansion of China’s cancer registration network to be more representative of the country would improve the accuracy of cancer burden estimates.
Highlights
Cancer is a serious health issue in China, but accurate national counts for cancer incidence are not currently available
We modeled for the Poisson variability in incidence and mortality rates, smoothed across age using penalized splines, modeled for variation between cancer registries using random effects and estimated the statistical imprecision in the estimates of the national cancer incidence
We showed in Additional file 2 that the Poisson model used by Jensen and colleagues does not incorporate the uncertainty in incidence, and from a simulation sub-study, we showed that their model leads to under-coverage, with potential over-fitting during model selection
Summary
Cancer is a serious health issue in China, but accurate national counts for cancer incidence are not currently available. Knowledge of the cancer burden is necessary for national cancer control planning. National death survey data and cancer registration data were used to calculate the cancer burden in China using a Bayesian approach. ; there are currently no national cancer incidence data and limited cancer mortality data in China [2,3]. These deficiencies limit the evidence available for national policy on cancer control. An accurate estimate of the whole cancer burden and major types of cancer in China would greatly assist policy development
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