Abstract
ObjectiveThe objective of this study was to characterize secular trends in the sex-specific, age-standardized incidence of lung cancer by histological type in Beijing, China, from 2000 to 2016 based on data from a population-based cancer registry.MethodsData on the incidence of cancer from 2000 to 2016 were obtained from the Beijing Cancer Registry. We examined trends in the sex-specific, age-standardized incidence of lung cancer by histological type using a Joinpoint regression model.ResultsA total of 117,409 cases of lung cancer were diagnosed from 2000 to 2016. Overall, 73,062 (62.23%) patients were males. The most common histological type among both sexes was adenocarcinoma; however, the proportion of adenocarcinoma differed significantly between males and females (45.36% vs. 77.14%, respectively, P<0.0001). The age-standardized incidence of total lung cancer increased from 2000 to 2010 with an annual percent change (APC) of 2.2% [95% confidence interval (95% CI), 1.5% to 2.9%] and stabilized thereafter. Among males, the incidence of total lung cancer peaked in 2008 and then decreased slightly, with an APC of −1.1% (95% CI, −2.1% to −0.1%). Among females, the incidence increased continuously during the study period, with an APC of 1.4% (95% CI, 0.9% to 1.9%). The incidence of squamous cell carcinoma decreased significantly in recent years among both sexes, with APCs of −2.6% (95% CI, −4.5% to −0.6%) from 2007 to 2016 for males and −5.4% (95% CI, −7.2% to −3.6%) from 2004 to 2016 for females. In contrast, the incidence of adenocarcinoma increased continuously throughout the study period, by APCs of 4.0% (95% CI, 2.6% to 5.4%) for males and 6.2% (95% CI, 4.8% to 7.6%) for females. The incidence of small cell carcinoma peaked in 2007 and stabilized thereafter among males, whereas it peaked in 2012 and then decreased with an APC of −14.7% (95% CI, −25.3% to −2.6%) among females. The incidence of large cell carcinoma and other specified malignant neoplasm did not change much, whereas the incidence of unspecified type decreased among both sexes during the study period. ConclusionsAlthough the incidence of squamous cell carcinoma decreased significantly among both sexes in recent years in Beijing, China, adenocarcinoma increased continuously throughout the study period among both sexes. Knowledge of differences in trends is useful for surveillance and control of lung cancer. However, the reason for the increase in adenocarcinoma remains unclear and warrants investigation.
Highlights
Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer deaths in China [1]
Knowledge of differences in trends is useful for surveillance and control of lung cancer
Lung cancer was classified into six groups by histological type, according to the criteria of the International Agency for Research on Cancer [17]: Squamous cell carcinoma (SQC) [International Classification of Diseases for Oncology, Third Edition (ICD-O-3)]: 8051-2, 8070-6, 8078, 8083-4, 8090, 8094, 8120, 8123), ADC (8015, 8050, 8140-1, 8143-5, 8147, 8190, 8201, 8211, 8250-5, 8260, 8290, 8310, 8320, 8323, 8333, 8401, 8440, 8470-1, 8480-1, 8490, 8503, 8507, 8550, 8570-2, 8574, 8576), small cell carcinoma (SMC) (8002, 8041-5), large cell carcinoma (LAC; 8012-4, 8021, 8034, 8082), unspecified malignant neoplasm (UMN; 8000-1, 8010-1, 8020, 8230, 8046), and other specified malignant neoplasm (OMN; 8003-4, 8022, 8030-3, 8035, 8200, 82401, 8243-6, 8249, 8430, 8525, 8560, 8562, 8575)
Summary
Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer deaths in China [1]. It is showed that 85%−90% of lung cancer is attributable to smoking [3,4], but the incidence varies sharply between males and females because of differences in the prevalence of smoking and other risk factors [5]. In China, the incidence of lung cancer has leveled off among males, but it continues to increase among females, like in many other countries in the world [1]. This difference in trend among males and females can be attributed to changes in the prevalence of smoking and differences in the distribution of histological types between the sexes [7,10]. In recent years, monitoring data from many countries have shown that the incidence of ADC among females is increasing rapidly, a fact that has aroused the attention of many research groups [4,13]
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