Improvement of cancer control in mainland China: epidemiological profiles during the 2004–10 National Cancer Prevention and Control Program

Abstract

BackgroundFollowing the appeal of the World Health Assembly for national cancer plans and programmes, the Chinese Ministry of Health issued governmental outlines of the National Cancer Prevention and Control Programme (2004–10). This study aimed to evaluate the efficacy of that programme in mainland China. MethodsThe Chinese Ministry of Health outlines aimed to establish a national cancer registry system, enhance the population health education, and organise prevention, early detection, and early treatment for principal cancers, especially in rural areas for high-incidence cancers. We retrieved the crude incidence and mortality (per 100 000 people) in urban and rural areas from annual reports of the National Central Cancer Registry from 2004 to 2010. We estimated mortality index [MI=mortality/(incidence+mortality)] to represent the overall efficacy of screening and treatment for cancers. Trends of epidemiological profiles were observed over time. Only descriptive results are provided in this abstract, a statistical test was not performed. FindingsThe all-cancer incidence reached the peak at the 2008 and then decreased, whereas the all-cancer mortality changed accordingly. All-cancer incidence was higher in urban areas than in rural areas, but the urban MI was lower. The all-cancer MIs decreased more sharply in the rural population (from 43·2% to 39·8%) than in the urban population (from 38·8% to 37·8%), while rural-to-urban ratios of MI were decreased, especially among women (from 1·19 to 1·05). Lung, colorectal, and breast cancers were predominant among urban populations, whereas oesophageal, gastric, and liver cancers were predominant among the rural population. Particularly, rural-to-urban ratios of oesophageal cancer incidence and mortality were decreased from 3·73 to 1·65 for incidence and from 3·82 to 1·61 for mortality, but MIs never differed between rural and urban populations. The rural-to-urban ratio of MI for breast cancer was decreased from 1·47 to 1·08. InterpretationThe National Cancer Prevention and Control Programme (2004–10) obtained obvious achievement in narrowing the urban-rural gap of the worse cancer incidence or survival in the rural areas, especially for oesophageal and breast cancers respectively. However, the overall health burden from cancers is still heavy in mainland China and requires further governmental support to improve the cancer control. FundingNational Natural Science Foundation of China (81301866) and Outstanding Young Scientific Scholarship Foundation of Sichuan University, from the Fundamental Research Funds for the Central Universities of China (2015SCU04A43).