Tianjin Cancer Registry Research Articles

The incidence of lung cancer by histological type: a population-based study in Tianjin, China during 1981-2005.

Lung cancer remains the leading cause of cancer deaths worldwide. The aim of this study was to examine the trend in the incidence of lung cancer, validated by histology in Tianjin, the third largest municipal city in China, during the period from 1981 to 2005. New lung cancer cases, crude incidence rates and age-adjusted rates by histological type were analysed using the data from the Tianjin Cancer Registry, which covers a population of 4 million urban residents. The most common histological types of lung cancer were squamous cell carcinoma (SQCC) in men and adenocarcinoma (ADC) in women. During the 25-year period, the constitutive pattern of the histological types changed gradually, ADC increased by 31.4%, but SQCC decreased by 25.6% among women. For SQCC, ADC or small cell carcinoma (SMCC), both the new cases and crude incidences per year increased among men and women. However, the age-adjusted incidences of all types of lung cancer showed an initial increase, which then levelled off or declined in recent years. The birth-cohort incidence analyses revealed that SQCC declined sharply, while ADC still increased among the younger age groups. The incidences of lung cancer by histological type changed during the 25-year period in Tianjin. Tailored strategies on prevention and control should be developed to meet the needs for various populations.

Trend analysis of the incidence of prostate cancer in Tianjin between 1981 and 2004

To analyze the trend of the incidence of prostate cancer in urban Tianjin area between 1981 and 2004 so as to provide scientific rationales for the prevention and control of prostate cancer. The data of prostate cancer cases were provided by the Tianjin Cancer Registry. The SAS system V9 was used to calculate the crude incidence, age-adjusted incidence and age specific incidence of prostate cancer in Tianjin between 1981 and 2004. And the Join point 3.0 software was used to analyze secular trends. Between 1981 and 2004, a total of 1060 prostate cancer cases were diagnosed in Tianjin. And the age-adjusted incidence rate was 2.84/100 000 in 2004. The incidence of prostate cancer showed 3 incremental stages during the 24-year period at an annual average of 4.02%. An aging trend was observed for prostate cancer patients. The elder patients had a faster increment in incidence. Specifically, it increased annually at 4.63% for age group 65 - 74 year versus 5.18% for age group 75 years or more. Despite a low incidence of prostate cancer in Tianjin, it is increasing at a fast rate. The prevention and control of prostate cancer should be strengthened.

Epidemiological trend of gastric cancer in Tianjin, 1981-2002

To explore the secular trend in incidence and mortality rate of gastric cancer in Tianjin and to provide evidence and reference for making prevention and control strategy for gastric cancer. Data derived from Tianjin cancer registry system were analyzed by descriptive epidemiological method and Joinpoint model. A total of 17990 gastric cancer cases reported in Tianjin from 1981 to 2002, including 12755 males and 5235 females were studied. The annual percent change (APC) of crude incidence rate for males and females was -0.92% (Z = -3.85, P = 0.001) and -0.79% (Z = -2.67, P = 0.015), while the APC of standard incidence rate was -3.55% (Z = -13.52, P = 0.000) and -3.47% (Z = -12.85, P = 0.000). There was a descending trend of incidence rate in males and females above 45-years-old, however, in male under 45 years it showed an increased trend and in females it kept stable. The APC of crude mortality rate was -1.66% ( Z = -5.79, P = 0.000) for males and -1.84% (Z = -6.02,P = 0.000) for females, while the APC of standard mortality rate was -4.60% ( Z = -15.79, P = 0.000) for females and -5.36% ( Z = -8.28, P = 0.000) for males during 1989-2002. Mortality and incidence ratio also indicated a downward trend. Despite its declining trend in Tianjin, gastric cancer still remains an important public health problem in facing of the aging society and many risk factors.

A cancer incidence survey in Tianjin: the third largest city in China—between 1981 and 2000

During the past three decades, the social/natural environment and lifestyle of people in China have undergone a marked transformation to westernization. However, age-standardized cancer rates have not been determined to any great extent in China. In this study, we tracked the cancer incidence between 1981 and 2000 in Tianjin, to identify the changes in incidence associated with social and economic changes. Cancer incidence data were collected by the Tianjin Cancer Registry. Sex, age, and organ site-specific incidence trends were analyzed by the "join-point regression" method. Overall crude cancer incidence increased, but the age-standardized incidence slightly decreased during the study period. The incidence of lung cancer increased between 1981 and 1996 but decreased between 1996 and 2000. The incidences of uterine, esophageal, stomach, and liver cancers decreased. However, the incidences of colorectal, pancreatic, breast, ovarian, and prostate cancers all increased during the study period. There was an aging-related increase in the overall crude cancer incidence and an alteration in the distribution of cancer types in Tianjin. The incidences of cancer types that are more prevalent in developed countries appeared to increase in China, whereas the incidences of cancer types that are more prevalent in developing countries appeared to decline.

Twenty-year secular changes in sex specific lung cancer incidence rates in an urban Chinese population

The objective of this study was to describe trends in the incidence rates of primary lung cancer in a geographically defined Chinese population. Primary lung cancer cases (N=40,022) diagnosed between 1981 and 2000 were identified by the Tianjin Cancer Registry. Age-specific and age-adjusted incidence rates to the world standard population were examined in both males and females. Age-period-cohort (APC) model and Poisson regression were used to assess the cohort effects and incidence trends. Crude and age-adjusted incidence rates in the study period were: 66.2/100,000 and 45.2/100,000 in males; and 47.7/100,000 and 28.2/100,000 in females, respectively. The major birth cohort effect can be described as for those born before 1940, in every age group lung cancer incidence rate increased as the birth years advanced. For those born after 1940, age specific incidence rates decreased as the birth years advanced. Results from the Poisson regression analyses suggested a statistically significant increasing trend of incidence rates of lung cancer from 1981 to 1990 and changed little afterwards. Through first 10 years of the study period between 1981 and 2000, lung cancer incidence rates increased in both males and females. While the study results suggest that the age-adjusted incidence rates may have reached their peak and may even decline, as the Chinese population ages, and smoking prevalence remains high, the number of new lung cancer cases will continue to increase and overall burden of lung cancer will remain high.

Thyroid carcinoma incidence and mortality analysis during 1981–2001 in Tianjin, China

To describe the long-term incidence and mortality trends of thyroid carcinoma and relate them to potential risk factors. All of the cases were from The Tianjin Cancer Registry. Numbers in each age-sex specific population for the six urban districts were obtained from the Tianjin Police Head Office. Descriptive epidemiological methods were used to study the incidence rates of thyroid cancer. Age-sex specific incidence rates were calculated and plotted. The incidence and mortality rate was compared from 1981 to 2001 using the χ 2 trend test. The average incidence rate and mortality was compared using the χ 2 test. Age at diagnosis was compared with t-test. All statistical analyses were carried out using SAS 8.1 for windows. A total of 1,318 cases from thyroid cancer were identified in Tianjin between 1981 and 2001, 352 males and 966 females respectively. The incidence rates have increased from 0.87/100,000 in 1981 to 2.54/100,000 in 2001, up 193%. Females had consistently higher incidence rates than males across all age groups during this period ( χ 2 = 294.429, p < 0.001). While the observed incidence increases were significant in both males and females, the magnitude of incidence increase was greater in females with the incidence ratios between males and females changing from 1:2.7 in 1981 to 1:4.6 in 2001. The results also suggest age-gender interactions. Male incidence rates increased gradually with increasing age and peeked around 60 years of age. However, the incidence rates in females climbed steeply after age 25 and reached its highest in the 35∼50 ages. The average mortality rate was 0.37/100,000. The mortality rates were also found to be higher in older age groups in both females and males. Although the incidence trend increased with time, the mortality trend changed a little. The significant increase in thyroid carcinoma incidence during the last 21 years reported in this study suggests that changes in environmental factors may have played an important role. Further epidemiological investigations are warranted.

Changes in incidence rates of cervical cancer in a geographically defined Chinese population and their implications in screening and education programs

Purpose To describe trends in the incidence rates of primary cervical cancer in a geographically defined Chinese population. To link the changes in cervical incidence patterns with efficient screening and targeted educational strategies. Methods Primary liver cancer cases (N = 2594) were diagnosed between 1981 and 2000 and identified by the Tianjin Cancer Registry. Age-adjusted and age-specific incidence rates were examined. Poisson regression was employed to assess the incidence rate trends. All statistical analyses were conducted using the statistical software package SAS version 8.0. Results Crude and age-adjusted incidence rates in the study period were: 6.4/100,000 and 3.8/100,000, respectively. There were remarkable declining trends in incidence rates. The crude and age-adjusted incidence rates declined from 13.8/100,000 and 10.3/100,000 in 1981 to 3.3/100,000 and 2.0/100,000 in 2000. However, the changes in incidence rates were not consistent across age groups. In general, those aged 40 and older had contributed the most observed incidence decline. Contrary to the incidence patterns in people aged 40 and older, incidence rates in those aged 20–39 years and younger increased during the study period. While the results from Poisson regression analyses suggest overall significant trends of declining incidence rates in cervical cancer, there seemed to be a small upward tail toward the end of the study period. Conclusion The findings also indicated two worrisome aspects. First, the incidence rates seemed to increase in younger women; second, there seemed to be a rebound in incidence rates toward the end of the study period. The findings highlight the importance of targeted education toward high-risk population and shed light toward setting up more efficient screening strategies.

Twenty-year trend in colon cancer incidence in Tianjin, China

Purpose To describe and analyze the incidence trend of colon cancer in Tianjin, China from 1981 to 2000. Methods The primary data concerning cancer incidence was provided by Tianjin Cancer Registry (TCR). Among all the colon cancer cases reported, 68% were histologically confirmed, another 24% were diagnosed by clinical examination, and the last 8% were diagnosed by clinical symptoms. Cases in this study were constant inhabitants in urban Tianjin. All cancer cases were coded according to ICD-9. ICD code 153 represents colon cancer. The coding system remained unchanged during the 20 years. Incidence rates were calculated by five-year age-group as well as sex and year of diagnosis. Results During the years 1981–2000, the total number of colon cancer cases ascertained in urban Tianjin was 4954, including 2547 males and 2407 females. 67.9% of colon cancer cases occurred in the age group 55–79 and age specific incidence rate reached its peak in the age group 75–79. The mean incidence rate of colon cancer during the 20 years was 7.01/100,000 and this rate had been increasing constantly from 1981 to 2000. The average age at diagnosis was 62.4 years. An ascending trend was observed in the mean age at diagnosis of colon cancer from 1981 through 2000. However, as for the sex ratio, there was no clear trend exhibited. Conclusion The incidence trend of colon cancer during 1981–2000 in Tianjin increased. As there were no known particular risk factors seemed to be responsible for the observed increase, further research is warranted.

Has lung cancer incidence rate reached its peak in China? Secular changes in lung cancer incidence rates based on an urban Chinese population

Purpose The objective of this study was to describe trends in the incidence rates from primary lung cancer in a geographically defined Chinese population. Methods Primary lung cancer cases (N = 39,731) diagnosed between 1981 and 2000 were identified by the Tianjin Cancer Registry. Age-adjusted to the world standard population and age- specific incidence rates were examined in both males and females. Changes in incidence rates over time were also examined by birth cohort. Poisson regression was used to assess the incidence trends. Results Crude and age-adjusted incidence rates in the study period were: 66.2/100,000 and 45.2/100,000 in males; and 47.7/100,000 and 28.2/100,000 in females, respectively. Birth cohort was a significant factor affecting the incidence rates of lung cancer. For those born before the year 1930, lung cancer incidence rates increased as the birth years advanced; whereas for those born after 1930, age specific incidence rates decreased as the birth years advanced. Results from the Poisson regression analyses suggested a statistically significantly increasing trend of incidence rates of lung cancer between 1981 and 2000. However, much of the increase in age-adjusted incidence rates occurred between 1981 and 1990. Unlike many previous findings and projections, the findings from this research suggest the age-adjusted incidence rate has stabilized in recent years. Conclusion Through most of the study period, lung cancer incidence rates increased in both males and females. While the study results suggest that the age-adjusted incidence rates may have reached their peaks, as the Chinese population ages and smoking prevalence remains high, the overall burden of lung cancer is expected to grow.

An analysis: Colon cancer mortality in Tianjin, China, from 1981 to 2000

To analyze the data from Tianjin Cancer Registry of mortality due to colon cancer from 1981 to 2000 in Tianjin, China. Tumors diagnosed in this study were coded according to ICD-9. Mortality rates were calculated by sex and calendar year of diagnosis. Seventy point four percent of colon cancer deaths occurred in the age group of 55-79 years and the mortality rate reached its peak in the age group of 75-80 years. The average age at death was 64.10 years. An ascending trend was observed in the mean age of death due to colon cancer from 1981 through 2000. However, as for the sex ratio, there was no clear trend exhibited. During 1981-2000, the total number of deaths was 2147, 1041 males and 1106 females. The mean mortality rate of colon cancer was 3.04/100,000. The mortality caused by colon cancer ascended from 1981 to 2000. The epidemic trend of colon cancer in Tianjin and its risk factors and prevention should be studied further.

Twenty-year trends of primary liver cancer incidence rates in an urban Chinese population.

The objective of this study was to describe trends in the incidence rates of primary liver cancer in a geographically defined Chinese population. Primary liver cancer cases (N=13 685) were diagnosed between 1981 and 2000 and identified by the Tianjin Cancer Registry. Age-adjusted and age-specific incidence rates were examined in both males and females. Poisson regression was employed to assess the incidence rate trends. Crude and age-adjusted incidence rates in the study period were: 27.4/100 000 and 16.4/100 000 in males and 11.5/100 000 and 6.4/100 000 in females, respectively. While the results from Poisson regression analyses suggest statistically significant trends of declining incidence rates of primary liver cancer overall, trends were not consistent across age and sex groups. The decline in incidence was observed, for the most part, in the 40-69 age group, with a greater decrease in males. Our findings provide a new evidence of a downward trend in incidence rates of this disease in China for a period of 20 years. As the observed decline is relatively small and inconsistent across sex and age groups, a continued epidemiological observation on this condition is required.

Changes in survival patterns in urban Chinese patients with liver cancer.

To examine the survival patterns and determinants of primary liver cancer in a geographically defined Chinese population. Primary liver cancer cases (n=13 685) diagnosed between 1981 and 2000 were identified by the Tianjin Cancer Registry. Age-adjusted and age-specific incidence rates were examined in both males and females. Proportional hazards (Cox) regression was utilized to explore the effects of time of diagnosis, sex, age, occupation, residence, and hospital of diagnosis on survival. Crude and age-adjusted incidence rates in the study period were: 27.4/100 000 and 26.3/100 000 in males; and 11.5/100 000 and 10.4/100 000 in females, respectively. Cox regression analyses indicated that there was a significant improvement in survival rates over time. Industrial workers and older people had relatively poor survival rates. The hospital in which the liver cancer was diagnosed was a statistically significant predictor of survival; patients diagnosed in city hospitals were more likely to have better survival than those diagnosed in community/district hospitals. Patients diagnosed in recent years appeared to have a better outcome than those diagnosed in early times. There were also significant survival disparities with respect to occupation and hospital of diagnosis, which suggest that socioeconomic status may play an important role in determining prognosis.