Cancer incidence and mortality across diverse geographical regions in China, 2024

Objective: To evaluate the incidence and mortality status of thyroid cancer in China, 2013. Methods: Incidence and mortality data of thyroid cancer were derived from 255 population-based cancer registries in China. Age-specific and age standardized incidence and mortality rates of thyroid cancer in different areas (urban and rural) with different gender were calculated based on the stratification of area (urban and rural), gender, age and tumor position. Chinese census in 2000 and the world Segi's population were used for age-standardized incidence/mortality rates. The incident cases and deaths were estimated using age-specific rates and national population data in 2013. Results: The estimates of new cancer incident cases and deaths were 143.9 thousand and 6 500, respectively. The crude incidence rate was 10.58/100 000 (Male 5.12/100 000, Female 16.32/100 000). Age-standardized incidence rates by Chinese standard population (ASIRC, 2000) and by world standard population (ASIRW) were 8.82/100 000 and 7.67/100 000, respectively. Male to female ratio was 1∶3.2. The crude incidence rate in urban and rural areas were 15.03/100 000 and 5.41/100 000, respectively. After adjustment by China standard population, the rate in urban areas was 2.57 times higher than that of rural areas. The crude mortality rate of thyroid cancer was 0.48/100 000 (Male 0.33/100 000, Female 0.63/100 000). Age-standardized mortality rates by Chinese standard population (ASIRC, 2000) and by world standard population (ASIRW) were 0.33/100 000 and 0.32/100 000, respectively. The crude mortality rate in urban and rural areas were 0.57/100 000 and 0.38/100 000, respectively. After adjustment by China standard population, the rate in urban areas was 1.41 times higher than that of rural areas. The cumulative incidence and mortality rates (0-74 years old) were 0.74% and 0.03%, respectively. According to the data from 255 cancer registries, papillary carcinoma is the main pathology type, which accounted for 89.9% of all malignant tumors. Conclusions: The disease burden of thyroid cancer in urban areas is higher than that in rural areas. Females have the higher incidence rate than that of males. The reasons related to the higher incidence rate of thyroid cancer should be further investigated to provide evidence for appropriate cancer control strategies and policies to be made in China.

PURPOSEUterine cancer is a top-ranking women’s cancer worldwide, with wide incidence variations across countries and by rural and urban areas. Hormonal exposures and access to health care vary between rural and urban areas, globally. Egypt has an overall low incidence of uterine cancer but variable rural and urban lifestyles. Are there changes in the incidence of uterine cancer in rural and urban areas in middle-income countries such as Egypt? No previous studies have addressed this question from a well-characterized and validated population-based cancer registry resource in middle-income countries. The aim of this study was to explore the differences in clinical and demographic characteristics of uterine cancer over the period of 1999 to 2010 in rural and urban Gharbiah province, Egypt.METHODSData were abstracted for all 660 patients with uterine cancer included in the Gharbiah Population-based Cancer Registry. Clinical variables included tumor location, histopathologic diagnosis, stage, grade, and treatment. Demographic variables included age, rural or urban residence, parity, and occupation. Crude and age-adjusted incidence rates (IRs) and rate ratios by rural or urban residence were calculated.RESULTSNo significant differences were observed in most clinical and demographic characteristics between rural and urban patients. The age standardized IR (ASR) was 2.5 times higher in urban than in rural areas (6.9 and 2.8 per 100,000 in urban and rural areas, respectively). The rate ratio showed that the IR in urban areas was 2.46 times the rate in rural areas.CONCLUSIONThis study showed that the disease IR in rural areas has increased in the past decade but is still low compared with the incidence in urban areas in Egypt, which did not show a significant increase in incidence. Nutritional transitions, obesity, and epidemiologic and lifestyle changes toward Westernization may have led to IRs increasing more in rural than in urban areas in Egypt. This pattern of increasing incidence in Egypt, which used to have a low incidence of uterine cancer, may appear in other middle-income countries that experience emerging nutritional and epidemiologic transitions. The rate of uterine cancer in urban areas in Gharbiah is almost similar to the corresponding rates globally. However, the rate in rural areas in this population has increased over the past decade but is still lower than the corresponding global rates. Future studies should examine the etiologic factors related to increasing rates in rural areas and quantify the improvement in rural case finding.

The National Central Cancer Registry (NCCR) collected cancer registration data in 2009 from local cancer registries in 2012, and analyzed to describe cancer incidence and mortality in China. On basis of the criteria of data quality from NCCR, data submitted from 104 registries were checked and evaluated. There were 72 registries' data qualified and accepted for cancer registry annual report in 2012. Descriptive analysis included incidence and mortality stratified by area (urban/rural), sex, age group and cancer site. The top 10 common cancers in different groups, proportion and cumulative rates were also calculated. Chinese population census in 1982 and Segi's population were used for age-standardized incidence/mortality rates. All 72 cancer registries covered a total of 85,470,522 population (57,489,009 in urban and 27,981,513 in rural areas). The total new cancer incident cases and cancer deaths were 244,366 and 154,310, respectively. The morphology verified cases accounted for 67.23%, and 3.14% of incident cases only had information from death certifications. The crude incidence rate in Chinese cancer registration areas was 285.91/100,000 (males 317.97/100,000, females 253.09/100,000), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 146.87/100,000 and 191.72/100,000 with the cumulative incidence rate (0-74 age years old) of 22.08%. The cancer incidence and ASIRC were 303.39/100,000 and 150.31/100,000 in urban areas whereas in rural areas, they were 249.98/100,000 and 139.68/100,000, respectively. The cancer mortality in Chinese cancer registration areas was 180.54/100,000 (224.20/100,000 in males and 135.85/100,000 in females), age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 85.06/100,000 and 115.65/100,000, and the cumulative incidence rate (0-74 age years old) was 12.94%. The cancer mortality and ASMRC were 181.86/100,000 and 80.86/100,000 in urban areas, whereas in rural areas, they were 177.83/100,000 and 94.40/100,000 respectively. Lung cancer, gastric cancer, colorectal cancer, liver cancer, esophageal cancer, pancreas cancer, encephaloma, lymphoma, female breast cancer and cervical cancer, were the most common cancers, accounting for 75% of all cancer cases in urban and rural areas. Lung cancer, gastric cancer, liver cancer, esophageal cancer, colorectal cancer, pancreatic cancer, breast cancer, encephaloma, leukemia and lymphoma accounted for 80% of all cancer deaths. The cancer spectrum showed difference between urban and rural areas, males and females. The main cancers in rural areas were cancers of the stomach, followed by esophageal cancer, lung cancer, liver cancer and colorectal cancer, whereas the main cancer in urban areas was lung cancer, followed by liver cancer, gastric cancer and colorectal cancer. The coverage of cancer registration population has been increasing and data quality is improving. As the basis of cancer control program, cancer registry plays an important role in making anti-cancer strategy in medium and long term. As cancer burdens are different between urban and rural areas in China, prevention and control should be implemented based on practical situation.

To analyze the incidence and mortality trends of female breast cancer in urban and rural areas of Beijing from 2004 to 2008. The incidence and mortality data of female breast cancer from 2004 to 2008 were sorted from Beijing Cancer Registry Database, including 15 527 new diagnosed cases and 3219 deceased cases in total, covering population 29 351 258 person years; among which 11 065 new cases and 2378 deceased cases were from urban areas, covering 17 877 128 person years and 4462 new diagnosed cases and 841 deceased cases were from rural areas, covering 11 474 130 person years. The incidence cases aged 25 and above were divided into 13 age groups by 5 years. The cases under 49 years (≤ 49) and over 49 years (> 49) were separately defined as premenopausal group and postmenopausal group. Incidence and mortality rates in each year, age-specific incidence and mortality rates in urban and rural areas in Beijing were calculated. The annual standard incidence and mortality rates were adjusted by world population constitution; and the incidence rates ratio in different years related to the place of residence, urban or rural were calculated. JoinPoint software was applied to analyze the incidence trend and calculated the annual percentage of changing (APC). The age of female breast cancer patients in urban Beijing in 2004 was (55.83 ± 13.01), while it changed to (56.10 ± 12.80) in 2008, increasing by 0.27 years old. The proportion of the patients who were under 49 years declined from 38.32% (732/1910) in 2004 to 34.02% (894/2628) in 2008. While the average age of the patients in rural areas have improved 0.21 year old, from (52.15 ± 11.33) years old in 2004 to (52.36 ± 11.59) years old in 2008; and the proportion of the patients under 49 years also declined from 45.44% (314/691) in 2004 to 43.40% (454/1046) in 2008. From 2004 to 2008, the incidence and mortality rate of female breast cancer in urban areas of Beijing separately rose from 55.43/100 000 (1910/3 445 812) and 10.65/100 000 (367/3 445 812) to 70.70/100 000 (2628/3 717 436) and 15.01/100 000 (558/3 717 436). And in rural areas, those rates separately rose from 30.60/100 000 (691/2 257 953) and 5.54/100 000 (125/2 257 953) in 2004 to 44.78/100 000 (1046/2 336 040) and 7.49/100 000 (175/2 336 040) in 2008. After adjusting by world population constitution, the difference showed no statistical significance in mortality trend of female breast cancer in rural areas of Beijing (P > 0.05). In year 2004, the female breast cancer incidence rate ratio of urban to rural areas in Beijing fluctuated between 1.34 and 4.47, with the average ratio value at 1.81. In year 2008, the ratio value fluctuated between 1.15 and 2.37, with the average ratio value at 1.57. During 2004 and 2008, the peak age group of the female breast cancer incidence in urban areas was in 60 - 64 years old group, with the rate of 126.92/100 000 (998/786 300) whereas the mortality rate was increasing within aging. In rural areas the peak age groups of the incidence and mortality were separately in 50 - 54 and 80 - 84 years old groups, with the rate of 80.63/100 000 (793/983 516) and 29.17/100 000 (40/137 132) respectively. The incidence and mortality of breast cancer in urban areas in Beijing, as well as the incidence of breast cancer in rural areas in Beijing showed increasing trend annually. The gap in breast cancer incidence between rural and urban areas in Beijing was narrowing, while the incidence rate among different aging groups and the peak mortality rate showed significant difference between urban and rural areas in Beijing.

In this study, we aimed to estimate the updated incidence and mortality rate of stomach cancer based on the cancer registration data in 2014, collected by the National Central Cancer Registry of China (NCCRC). In 2017, 339 registries' data were qualified based on the criteria of data quality control of the NCCRC. Cases of stomach cancer were retrieved from the national database. We estimated numbers of stomach cancer cases and deaths in China using age-specific rates and corresponding national population stratified by area, sex, age-group (0, 1-4, 5-9, 10-14, …, 85+). Chinese standard population in 2000 and Segi's world population were applied for age-standardized incidence and mortality rates. In 2014, 410,400 new stomach cancer cases and 293,800 cancer-associated deaths were estimated to have occurred in China. The crude incidence rate of stomach cancer was 30.00/100,000, age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 19.62/100,000 and 19.51/100,000, respectively. The crude mortality rate of stomach cancer was 21.48/100,000, age-standardized mortality rates by Chinese (ASMRC) and by world standard population (ASMRW) were 13.44/100,000 and 13.30/100,000, respectively. Incidence and mortality rates in rural areas were both higher than that in urban areas. Stomach cancer has a strong relationship with gender and age. The disease has occurred more frequently among men than women with a male to female ratio of 2.4 for ASIRC. After age group of 40-44 years, incidence rates are substantially higher in men than in women, same pattern was seen for age-specific mortality rates. There is still a heavy burden of stomach cancer in China. The incidence and mortality patterns of stomach cancer show substantial gender and regional disparities. Great effort is needed to provide more accessible health services, sufficient financial resources, and adequate cancer-care infrastructure for the Chinese population, especially for people living in rural areas.

Estimating the incidence and mortality rate of cervical cancer became necessary to establish prevention measures and healthy policies. The aim of this study was to estimate the updated incidence and mortality rate of cervical cancer in 2013 in China. According to the evaluation criteria developed by the National Central Cancer Registry of China, the data submitted from 255 cancer registries met the required standards in 2013. Cervical cancer cases were retrieved from the national database and combined with the 2013 national population data. The age-standardized incidence and mortality rates were based on the demographic structure of the national census 2000 and Segi's world population. In 2013, the estimated number of new cases and deaths from cervical cancer were 100,700 and 26,400, respectively. The crude incidence of cervical cancer was 15.17/100,000. The age-standardized incidence rates based on the Chinese standard population (ASIRC) and the world standard population (ASIRW) were 11.30/100,000 and 10.30/100,000, respectively. The incidence of cervical cancer in urban areas was 15.62/100,000 and the ASIRC was 11.12/100,000. The incidence of cervical cancer in rural areas was 14.65/100,000 and the ASIRC was 11.47/100,000. The mortality rate of cervical cancer was 3.98/100,000. The age-standardized mortality rates based on the Chinese (ASMRC) and world standard populations (ASMRW) were 2.76/100,000 and 2.62/100,000, respectively. The mortality rate of cervical cancer in urban areas was 3.85/100,000 and in rural areas was 4.14/100,000. Cervical cancer incidence and mortality increased with age. Urban areas had a higher incidence of cervical cancer and lower mortality rates when compared with rural areas. Dynamic monitoring of cervical cancer incidence and mortality is the fundamental work of cervical cancer prevention and control. Cervical cancer is a serious issue in women's health, and prevention strategies need to be enhanced, such as human papilloma virus (HPV) vaccination and screening programs.

Objective Population-based cancer registration data in 2012 from all available cancer registries in Henan province were collected by Henan Office for Cancer Research and Control. The numbers of new cancer cases and cancer deaths in Henan province with compiled cancer incidence and mortality rates were estimated.Methods In 2015, all registries’ data in Henan province were qualified for the national cancer registry annual report in 2012. The pooled data were stratified by area (urban/rural), gender, age group (0, 1.4, 5.9, 10.14, …, 85+) and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding population of Henan province in 2012. The Chinese census data in 2000 and Segi’s population were applied for age-standardized rates. All the rates were expressed per 100,000 person-years.Results Qualified 19 cancer registries (4 urban and 15 rural registries) covered 16,082,688 populations of Henan province in 2012. The percentage of cases with morphologically verified (MV%) and death certificateonly cases (DCO%) were 69.84% and 2.30%, respectively, and the mortality to incidence rate ratio (M/I) was 0.64. It was estimated that there were 248,510 new cancer cases and 158,630 cancer deaths in Henan province in 2012. The incidence rate was 266.17/100,000 (288.61/100,000 in males and 241.86/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 208.95/100,000 and 206.41/100,000 with the cumulative incidence rate (0.74 years old) of 24.30%. The crude incidence rate in urban areas was higher than that in rural areas. However, after adjusted by age, the cancer incidence rate in rural was higher than that in urban areas. The crude mortality of all cancers in Henan province was 169.90/100,000 (201.23/100,000 in males and 135.95/100,000 in females). The age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 131.20/100,000 and 130.80/100,000, respectively. Among the patients aged 0.74 years, the cumulative mortality rate was 15.03%. The crude cancer mortality rate in urban areas was higher than that of rural areas. However, the age-standardized rate in rural areas was higher than that of urban areas. Cancers of lung, stomach, esophagus, liver, female breast, colorectum, cervix, brain, uterus and ovary were the most common cancers, accounting for about 82.80% of all cancer new cases. Lung cancer, stomach cancer, esophageal cancer, liver cancer, colorectal cancer, female breast cancer, brain cancer, leukemia, pancreatic cancer and cervix cancer were the leading causes of cancer deaths, accounting for about 88.50% of all cancer deaths. The burden between urban and rural, males and females were different.Conclusions Registration data of Henan province was qualified to provide basic information on population-based cancer incidence, mortality for cancer prevention and control. The upper digestive tract cancer burden in Henan province, especially for males in rural areas, was higher. The incidence rate of female breast cancer was higher in urban areas. Targeted prevention, early detection and treatment programs should be carried out by health department to control the cancer burden.

Objective: To analysis the incidence rate and mortality rate of endometrial cancer in China from 2004 to 2017 according to the data from China Cancer Registry Annual Report. Methods: The incidence and mortality data of endometrial cancer were extracted from the China Cancer Registry Annual Report 2004 to 2017, and the incidence, mortality, number of new cases, number of deaths were extracted according to the region (national, urban, rural and eastern, middle and western areas) and the age composition of population to estimate the incidence and mortality of endometrial cancer nationwide. The age-standardized incidence rate and mortality rate were calculated based on the Chinese standard population in 2000 (ASIRC, ASIRW) and Segi's world population (ASMRC, ASMRW). Join Point regression was used to calculate the annual percentage change of morbidity rate, and Cochran-Armitage trend test was used to analyze the changing trend of morbidity and mortality. Results: From 2004 to 2017, the number of women covered by the China Cancer Registry Annual Report has increased from 35 571 657 to 215 201 995, and the total population of the covered areas has increased from 5.53% to 31.39%. The crude incidence rate of endometrial cancer increased from 6.20/100 000 to 10.06/100 000, and showed an upward trend over time (P<0.001). After adjusting for age, ASIRC increased from 5.75/100 000 in 2004 to 6.79/100 000 in 2017, and ASIRW increased from 5.60/100 000 in 2004 to 6.56/100 000 in 2017, both showing an upward trend over time (all P<0.001). The crude incidence rates in urban area and rural area were respectively 10.89/100 000 and 9.25/100 000 in 2017, and the ASIRC was higher in urban than rural areas (7.14/100 000 vs 6.43/100 000) after adjusting for age. The ASIRW was higher in eastern areas than middle areas and western areas (7.16/100 000 vs 6.44/100 000 vs 5.60/100 000). The incidence rate in rural areas showed more significant growth than urban areas [annual percent change (APC): 3.2% vs 0.7%, P<0.001]. The age-specific incidence rate increased with age and reached a peak in the age group of 50-54 years (25.70/100 000). Incidence rate in the under-40 age group increased more in rural areas than in urban areas (69.84% vs-7.09%). From 2004 to 2017, the age-standardized mortality rate shows a decreasing trend, with the ASMRC from 1.83/100 000 to 1.47/100 000, and the ASMRW from 1.81/100, 000 to 1.46/100, 000. There was no significant difference between urban and rural areas in mortality of endometrial cancer. Age-specific mortality rates increased with age, reaching a peak in the age group 85 years and older (13.16/100 000). Conclusions: Recent years, there was an increasing incidence rate of endometrial cancer in China. Especially in rural areas, the incidence rate of endometrial cancer is increasing rapidly in young women under 40 years of age. There were differences between urban and rural areas and regions in the incidence rate of endometrial cancer. The incidence rates of endometrial cancer in some high-income cities have occupied the first place of female reproductive system malignant cancers. The age-standardized mortality rate of endometrial cancer shows a decreasing trend.

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.

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.

Annual cancer incidence and mortality in 2008 were provided by National Central Cancer Registry in China, which data were collected from population-based cancer registries in 2011. There were 56 registries submitted their data in 2008. After checking and evaluating the data quality, total 41 registries' data were accepted and pooled for analysis. Incidence and mortality rates by area (urban or rural areas) were assessed, as well as the age- and sex-specific rates, age-standardized rates, proportions and cumulative rate. The coverage population of the 41 registries was 66,138,784 with 52,158,495 in urban areas and 13,980,289 in rural areas. There were 197,833 new cancer cases and 122,136 deaths in cancer with mortality to incidence ratio of 0.62. The morphological verified rate was 69.33%, and 2.23% of cases were identified by death certificate only. The crude cancer incidence rate in all areas was 299.12/100,000 (330.16/100,000 in male and 267.56/100,000 in female) and the age-standardized incidence rates by Chinese standard population (ASIRC) and world standard population (ASIRW) were 148.75/100,000 and 194.99/100,000, respectively. The cumulative incidence rate (0-74 years old) was of 22.27%. The crude incidence rate in urban areas was higher than that in rural areas. However, after adjusted by age, the incidence rate in urban was lower than that in rural. The crude cancer mortality was 184.67/100,000 (228.14/100,000 in male and 140.48/100,000 in female), and the age-standardized mortality rates by Chinese standard population (ASMRC) and by world population were 84.36/100,000 and 114.32/100,000, respectively. The cumulative mortality rate (0-74 years old) was of 12.89%. Age-adjusted mortality rates in urban areas were lower than that in rural areas. The most common cancer sites were lung, stomach, colon-rectum, liver, esophagus, pancreas, brain, lymphoma, breast and cervix which accounted for 75% of all cancer incidence. Lung cancer was the leading cause of cancer death, followed by gastric cancer, liver cancer, esophageal cancer, colorectal cancer and pancreas cancer, which accounted for 80% of all cancer deaths. The cancer spectrum varied by areas and sex in rural areas, cancers from digestive system were more common, such as esophageal cancer, gastric cancer and liver cancer, while incidence rates of lung cancer and colorectal cancer were much higher in urban areas. In addition, breast cancer was the most common cancer in urban women followed by liver cancer, gastric cancer and colorectal cancer. Lung cancer, gastric cancer, colorectal cancer, liver cancer, esophageal cancer and female breast cancer contributed to the increased incidence of cancer, which should be paid more attention to in further national cancer prevention and control program. Different cancer control strategies should be carried out due to the varied cancer spectrum in different groups.

Female breast cancer incidence and mortality data for the duration of 2008, in China, retrieved from the National Central Cancer Registry, was analyzed. In 2008, there were 56 registries that submitted cancer registration data. Based on the criteria of data quality, a total of 41 registries' data met the requirement and were accepted for analysis. The incidence and mortality rates of breast cancer in females were calculated, including age specific rates, age-standardized rates, proportions, and cumulative rates, stratified by areas (urban/rural). The number of cases included from 41 registries was 66 138 784, with 32 798 187 of these cases found in women (25 898 251 in urban areas and 6 899 936 in rural areas). There were 15 625 new cases reported and 3414 deaths of women with breast cancer, resulting in a mortality to incidence ratio of 0.22. The morphological verified rate was 91.96%, and 0.43% of cases were identified by death certificate only. The crude cancer incidence rate in all areas was 47.64/100 000, and the Age-Standardized Incidence Rates by Chinese standard population, (ASIRC) and World standard population (ASIRW) were 25.26/100 000 and 31.71/100 000, respectively. The cumulative incidence rate (0-74 years old) was 3.44%. Both crude and adjusted incidence rates in urban areas were much higher than those in rural areas. The crude cancer mortality was 10.41/100 000, and the Age-Standardized Mortality Rates by Chinese standard population (ASMRC) and by World population (ASMRW) were 4.90/100 000 and 6.48/100 000, respectively. The cumulative mortality rate (0-74 years old) was 0.071%. Age-adjusted mortality rates in urban areas were also higher than in rural areas. Age specific incidence rates peaked in age group 50-54 in all areas (108.27/100 000) and in urban areas (119.68/100 000). It reached the peak in the 55-59 age group for rural women. Age specific mortalities rose with the increase of age for both women in urban and rural areas, with mortality rates of 76.16/100 000 and 23.73/100 000 in age groups of 85 and above, respectively. Breast cancer is the most common cancer diagnosed in Chinese women. Preventative measures, such as health education and screening, are needed in the general population, but especially for those in the high-risk group found in urban areas.

The National Central Cancer Registry (NCCR) collected population-based cancer registration data in 2011 from all cancer registries. National cancer incidence and mortality were compiled and cancer incident new cases and cancer deaths were estimated. In 2014, there were 234 cancer registries submitted cancer incidence and deaths occurred in 2011. All datasets were checked and evaluated based on the criteria of data quality from NCCR. Total 177 registries' data were qualified and compiled for cancer statistics in 2011. The pooled data were stratified by area (urban/rural), gender, age group (0, 1-4, 5-9, 10-14…85+) and cancer type. Cancer incident cases and deaths were estimated using age-specific rates and national population in 2011. All incidence and death rates are age-standardized to the 2000 Chinese standard population and Segi's population expressed per 100,000 persons. All 177 cancer registries (77 in urban and 100 in rural areas) covered 175,310,169 populations (98,341,507 in urban and 76,968,662 in rural areas). The morphology verified cases (MV%) accounting for 70.14% and 2.44% of incident cases were identified through death certifications only (DCO%) with mortality to incidence ratio of 0.63. The estimates of new cancer incident cases and cancer deaths were 3,372,175 and 2,113,048 in 2011, respectively. The incidence rate was 250.28/100,000 (males 277.77/100,000, females 221.37/100,000), and the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 186.34/100,000 and 182.76/100,000 with the cumulative incidence rate (0-74 years old) of 21.20%. The cancer incidence and ASIRC in urban areas were 261.38/100,000 and 189.89/100,000 compared to 238.60/100,000 and 182.10/100,000 in rural areas, respectively. The cancer mortality was 156.83/100,000 (194.88/100,000 in males and 116.81/100,000 in females), the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 112.88/100,000 and 111.82/100,000, and the cumulative mortality rate (0-74 years old) was 12.69%. The cancer mortality and ASMRC were 154.37/100,000 and 108.20/100,000 in urban areas, and 159.42/100,000 and 117.97/100,000 in rural areas, respectively. Cancers of lung, female breast, stomach, liver, colon and rectum, esophageal, cervix, uterus, prostate and ovary were the most common cancers, accounting for about 75% of all cancer new cases. Lung cancer, liver cancer, stomach cancer, esophageal cancer, colorectal cancer, female breast cancer, pancreatic cancer, brain tumor, cervical cancer and leukemia were the leading causes of cancer death, accounting for about 80% of all cancer deaths. The cancer incidence, mortality and spectrum showed difference between urban and rural areas, males and females. The coverage of cancer registration population had a greater increase than that in the last year. The data quality and representativeness are gradually improved. As the basic work of cancer prevention and control, cancer registry is playing an irreplaceable role. The disease burden of cancer is increasing, and the health department has to take effective measures to contain the increased cancer burden in China.

Introduction: Disparities in the incidence, mortality, and survival of cancer types between urban and rural areas in China reflect the effects of different risk factor exposure, education, and different medical availability. We aimed to characterize the disparities in the incidence, mortality, and survivals of cancer types between urban and rural areas in Shanghai, China, 2002-2015.Materials and Methods: The incidence and mortality were standardized by Segi's world standard population. Trends in the incidence and mortality of cancers were compared using annual percent change. The 5-year observed and relative survivals were calculated with life table and Ederer II methods.Results: Age-standardized incidences and mortalities were 212.55/105 and 109.45/105 in urban areas and 210.14/105 and 103.99/105 in rural areas, respectively. Female breast cancer and colorectal cancer occurred more frequently in urban than in rural areas, quite in contrast to liver cancer and cervical cancer. Cancers of lung and bronchus, liver, stomach, and colon and rectum were the leading causes of cancer death in both areas. Age-standardized incidence of female breast cancer and colorectal cancer in urban areas increased while gastric cancer and liver cancer decreased in both areas. Age-standardized mortalities of cancers of breast, esophagus, stomach, colon and rectum, liver, and lung and bronchus decreased in both areas. For all cancers combined, the 5-year observed and relative survivals of cancer patients were higher in urban than in rural areas. The 5-year observed and relative survivals of cancers of liver, pancreas, stomach, brain and central nervous system (CNS), and prostate were higher in urban than in rural areas. The 5-year observed and relative survivals of cervical cancer were higher in rural than in urban areas.Conclusions: Factors promoting female breast cancer and colorectal cancer in urban areas and liver cancer and cervical cancer in rural areas should be specifically intervened in cancer prophylaxis. Improved medical services can greatly prolong the survival of major cancers in rural areas.

Objective: To analyze the changing trend of cervical cancer epidemiological characteristics and disease burden in cancer registration areas of Guangxi Zhuang Autonomous Region (Guangxi) from 2010 to 2017, and to provide scientific basis for the development of cervical cancer prevention and control strategies in Guangxi. Methods: Using descriptive analysis method, based on the incidence and death data of cervical cancer in the tumor registration areas of Guangxi from 2010 to 2017, Crude morbidity, crude mortality, age-standardized morbidity and mortality (referred to as the winning rate), disability adjusted life years (DALYs) rate and the annual percentage change (APC) and average annual percentage change (AAPC) of the above indicators were calculated, and stratified analysis was conducted for urban and rural areas and different age groups. Results: From 2010 to 2017, the crude incidence rate of cervical cancer in Guangxi showed a significant upward trend, rising from 10.31/105 in 2010 to 19.94/105 in 2017, with an average annual growth rate of 7.9% (P＜0.05). However, after age standardization, the trend of the age-standardized incidence rate of cervical cancer was not statistically significant (P＞0.05). During the same period, the crude mortality rate of cervical cancer increased from 2.69/105 to 6.21/105, with an average annual growth rate of 13.1% (P＜0.05), and the trend of the age-standardized mortality rate was basically consistent with that of the crude mortality rate. The analysis of urban-rural differences showed that the growth rates of the crude incidence rate and crude mortality rate of cervical cancer in rural areas were higher than those in urban areas from 2010 to 2017 (AAPC incidence rate: 21.3% vs. 2.3%; AAPC mortality rate: 20.1% vs. 8.4%). The analysis of age differences showed that the crude incidence rate and crude mortality rate of cervical cancer in all age groups increased to varying degrees, among which the growth rate of the incidence rate (AAPC=16.2%, P＜0.05) and mortality rate (AAPC=14.7%, P＜0.05) of cervical cancer in women aged 65 and above was the fastest. In addition, the DALYs rate of cervical cancer in Guangxi increased from 50.6/105 in 2010 to 111.0/105 in 2017, with an average annual increase of 11.9% (P＜0.05). The growth rate of the DALYs rate in rural areas was higher than that in urban areas, and the growth rate of the DALYs rate in the 50-59 age group was higher than those in other age groups. Conclusions: From 2010 to 2017, the incidence rate, mortality rate and DALYs rate of cervical cancer in Guangxi showed an upward trend. Comprehensive prevention and control measures for cervical cancer, such as improving the early diagnosis and treatment system, promoting the popularization of HPV vaccination and strengthening health education, should be taken to reduce the disease burden of cervical cancer.