Cancer survival in China, 2003–2005: A population-based study
Hongmei Zeng
National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China
H.Z. and R.Z. contributed equally to the study.
Search for more papers by this authorRongshou Zheng
National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China
H.Z. and R.Z. contributed equally to the study.
Search for more papers by this authorYuming Guo
School of Population Health, University of Queensland, Brisbane, Australia
Search for more papers by this authorSiwei Zhang
National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China
Search for more papers by this authorXiaonong Zou
National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China
Search for more papers by this authorNing Wang
Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital and Institute, Beijing, China
Search for more papers by this authorLimei Zhang
Dalian Cancer Registry, Dalian Center for Disease Control and Prevention, Liaoning, China
Search for more papers by this authorJingao Tang
Haimen Cancer Registry, Haimen Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorJianguo Chen
Qidong Cancer Registry, Qidong Liver Cancer Institute, Jiangsu, China
Search for more papers by this authorKuangrong Wei
Zhongshan Cancer Registry, Zhongshan People's Hospital, Guangdong, China
Search for more papers by this authorSuqin Huang
Taixing Cancer Registry, Taixing Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorJian Wang
Jianhu Cancer Registry, Jianhu Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorLiang Yu
Linzhou Cancer Registry, Linzhou Cancer Hospital, Henan, China
Search for more papers by this authorDeli Zhao
Feicheng Cancer Registry, Feicheng People's Hospital, Shandong, China
Search for more papers by this authorGuohui Song
Cixian Cancer Registry, Cixian Institute for Cancer Prevention and Control, Hebei, China
Search for more papers by this authorJianshun Chen
Changle Cancer Registry, Changle Institute for Cancer Prevention and Control, Fujian, China
Search for more papers by this authorYongzhou Shen
Haining Cancer Registry, Haining Institute for Cancer Prevention and Control, Zhejiang, China
Search for more papers by this authorXiaoping Yang
Jintan Cancer Registry, Jintan Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorXiaoping Gu
Dafeng Cancer Registry, Dafeng Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorFeng Jin
Ganyu Cancer Registry, Ganyu Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorQilong Li
Jiashan Cancer Registry, Jiashan Institute for Cancer Prevention and Control, Zhejiang, China
Search for more papers by this authorYanhua Li
Sihui Cancer Registry, Sihui Institute for Cancer Prevention and Control, Guangdong, China
Search for more papers by this authorHengming Ge
Donghai Cancer Registry, Donghai Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorFengdong Zhu
Guanyun Cancer Registry, Guanyun Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorJianmei Dong
Lianyungang Cancer Registry, Lianyungang Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorGuoping Guo
Yangzhong Cancer Registry, Yangzhong Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorMing Wu
Jiangsu Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorLingbin Du
Zhejiang Office for Cancer Prevention and Control, Zhejiang Cancer Institute, Zhejiang, China
Search for more papers by this authorXibin Sun
Henan Office for Cancer Prevention and Control, Henan Cancer Hospital, Henan, China
Search for more papers by this authorYutong He
Hebei Office for Cancer Prevention and Control, Fourth Hospital of Hebei Medical University, Hebei, China
Search for more papers by this authorMichel P Coleman
Cancer Research UK Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
Search for more papers by this authorPeter Baade
Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia
P.B., W.C. and X.Q.Y. (senior authors) contributed equally to the study.
Search for more papers by this authorCorresponding Author
Wanqing Chen
National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China
P.B., W.C. and X.Q.Y. (senior authors) contributed equally to the study.
Correspondence to: Wanqing Chen, National Office for Cancer Prevention and Control, National Cancer Center, Beijing 100021, China, Tel.: +86 10 8778 7039, Fax: +86 10 67718227, E-mail: [email protected]Search for more papers by this authorXue Qin Yu
Cancer Research Division, Cancer Council New South Wales, Sydney, Australia
P.B., W.C. and X.Q.Y. (senior authors) contributed equally to the study.
Search for more papers by this authorHongmei Zeng
National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China
H.Z. and R.Z. contributed equally to the study.
Search for more papers by this authorRongshou Zheng
National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China
H.Z. and R.Z. contributed equally to the study.
Search for more papers by this authorYuming Guo
School of Population Health, University of Queensland, Brisbane, Australia
Search for more papers by this authorSiwei Zhang
National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China
Search for more papers by this authorXiaonong Zou
National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China
Search for more papers by this authorNing Wang
Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital and Institute, Beijing, China
Search for more papers by this authorLimei Zhang
Dalian Cancer Registry, Dalian Center for Disease Control and Prevention, Liaoning, China
Search for more papers by this authorJingao Tang
Haimen Cancer Registry, Haimen Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorJianguo Chen
Qidong Cancer Registry, Qidong Liver Cancer Institute, Jiangsu, China
Search for more papers by this authorKuangrong Wei
Zhongshan Cancer Registry, Zhongshan People's Hospital, Guangdong, China
Search for more papers by this authorSuqin Huang
Taixing Cancer Registry, Taixing Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorJian Wang
Jianhu Cancer Registry, Jianhu Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorLiang Yu
Linzhou Cancer Registry, Linzhou Cancer Hospital, Henan, China
Search for more papers by this authorDeli Zhao
Feicheng Cancer Registry, Feicheng People's Hospital, Shandong, China
Search for more papers by this authorGuohui Song
Cixian Cancer Registry, Cixian Institute for Cancer Prevention and Control, Hebei, China
Search for more papers by this authorJianshun Chen
Changle Cancer Registry, Changle Institute for Cancer Prevention and Control, Fujian, China
Search for more papers by this authorYongzhou Shen
Haining Cancer Registry, Haining Institute for Cancer Prevention and Control, Zhejiang, China
Search for more papers by this authorXiaoping Yang
Jintan Cancer Registry, Jintan Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorXiaoping Gu
Dafeng Cancer Registry, Dafeng Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorFeng Jin
Ganyu Cancer Registry, Ganyu Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorQilong Li
Jiashan Cancer Registry, Jiashan Institute for Cancer Prevention and Control, Zhejiang, China
Search for more papers by this authorYanhua Li
Sihui Cancer Registry, Sihui Institute for Cancer Prevention and Control, Guangdong, China
Search for more papers by this authorHengming Ge
Donghai Cancer Registry, Donghai Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorFengdong Zhu
Guanyun Cancer Registry, Guanyun Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorJianmei Dong
Lianyungang Cancer Registry, Lianyungang Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorGuoping Guo
Yangzhong Cancer Registry, Yangzhong Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorMing Wu
Jiangsu Center for Disease Control and Prevention, Jiangsu, China
Search for more papers by this authorLingbin Du
Zhejiang Office for Cancer Prevention and Control, Zhejiang Cancer Institute, Zhejiang, China
Search for more papers by this authorXibin Sun
Henan Office for Cancer Prevention and Control, Henan Cancer Hospital, Henan, China
Search for more papers by this authorYutong He
Hebei Office for Cancer Prevention and Control, Fourth Hospital of Hebei Medical University, Hebei, China
Search for more papers by this authorMichel P Coleman
Cancer Research UK Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
Search for more papers by this authorPeter Baade
Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia
P.B., W.C. and X.Q.Y. (senior authors) contributed equally to the study.
Search for more papers by this authorCorresponding Author
Wanqing Chen
National Office for Cancer Prevention and Control, National Cancer Center, Beijing, China
P.B., W.C. and X.Q.Y. (senior authors) contributed equally to the study.
Correspondence to: Wanqing Chen, National Office for Cancer Prevention and Control, National Cancer Center, Beijing 100021, China, Tel.: +86 10 8778 7039, Fax: +86 10 67718227, E-mail: [email protected]Search for more papers by this authorXue Qin Yu
Cancer Research Division, Cancer Council New South Wales, Sydney, Australia
P.B., W.C. and X.Q.Y. (senior authors) contributed equally to the study.
Search for more papers by this authorAbstract
Limited population-based cancer registry data available in China until now has hampered efforts to inform cancer control policy. Following extensive efforts to improve the systematic cancer surveillance in this country, we report on the largest pooled analysis of cancer survival data in China to date. Of 21 population-based cancer registries, data from 17 registries (n = 138,852 cancer records) were included in the final analysis. Cases were diagnosed in 2003–2005 and followed until the end of 2010. Age-standardized relative survival was calculated using region-specific life tables for all cancers combined and 26 individual cancers. Estimates were further stratified by sex and geographical area. The age-standardized 5-year relative survival for all cancers was 30.9% (95% confidence intervals: 30.6%-31.2%). Female breast cancer had high survival (73.0%) followed by cancers of the colorectum (47.2%), stomach (27.4%), esophagus (20.9%), with lung and liver cancer having poor survival (16.1% and 10.1%), respectively. Survival for women was generally higher than for men. Survival for rural patients was about half that of their urban counterparts for all cancers combined (21.8% vs. 39.5%); the pattern was similar for individual major cancers except esophageal cancer. The poor population survival rates in China emphasize the urgent need for government policy changes and investment to improve health services. While the causes for the striking urban-rural disparities observed are not fully understood, increasing access of health service in rural areas and providing basic health-care to the disadvantaged populations will be essential for reducing this disparity in the future.
Abstract
What's new?
Because it's difficult to create good public-health policies without good population data, China has recently made efforts to improve its systematic recording of cancer data. This paper reports the largest pooled analysis of survival data in China, the first to include data from a wide range of geographical areas. They report the various survival rates for different cancers by age, gender, and locality. The most striking finding was that those living in rural residents had far lower survival rates than urban residents. This finding may prompt efforts to improve availability of cancer prevention and treatment in rural areas of China.
References
- 1 Chen Z. The Third National Retrospective Sampling Survey on Causes of Death.ed. Beijing: Peking Union Medical College Press, 2008.
- 2 Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, et al. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol 2014; 15: 489–538.
- 3 Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127: 2893–917.
- 4 Cancer Registry of Norway. Survival of cancer patients: Cases diagnosed in Norway 1968–1976ed. Oslo: Norwegian Cancer Society, 1980.
- 5 Black RJ, Sharp L, Kendrick SW. Trends in cancer survival in Scotland 1968-90ed.: Common Services Agency for the Scottish Health Service, Information & Statistics Division, Edinburgh, 1993.
- 6 Cutler SJ. International symposium on end results of cancer therapy. Computation of survival rates. Natl Cancer Inst Monogr 1964; 15: 381–5.
- 7 Kachuri L, De P, Ellison LF, Semenciw R. Cancer incidence, mortality and survival trends in Canada, 1970–2007. Chronic Dis Inj Can 2013; 33: 69–80.
- 8 Taylor R, Davis P, Boyages J. Long-term survival of women with breast cancer in New South Wales. Eur J Cancer 2003; 39: 215–22.
- 9 Coleman MP, Quaresma M, Berrino F, et al. Cancer survival in five continents: a worldwide population-based study (CONCORD). Lancet Oncol 2008; 9: 730–56.
- 10 De Angelis R, Sant M, Coleman MP, et al. Cancer survival in Europe 1999–2007 by country and age: results of EUROCARE-5-a population-based study. Lancet Oncol 2014; 15: 23–34.
- 11 Wang QJ, Zhu WX, Xing XM. Analysis of the incidence and survival of female breast cancer in Beijing during the last 20 years. Zhonghua Zhong Liu Za Zhi 2006; 28: 208–10.
- 12 Sankaranarayanan R, Swaminathan R, Brenner H, et al. Cancer survival in Africa, Asia, and Central America: a population-based study. Lancet Oncol 2010; 11: 165–73.
- 13 Ferlay J, Burkhard C, Whelan S, Parkin DM. Check and conversion programs for cancer registries. (IARC/IACR Tools for Cancer Registries). IARC Technical Report No. 42, 2005.
- 14 Ederer F, Heise H. Instructions to IBM 650 programmers in processing survival computation, technical, end results evaluation sectioned. Bethesda, MD: National Cancer Institute, 1959.
- 15 Elandt-Johnson RC, Johnson NL. Survival models and data analysis (Wiley series in probability and mathematical statistics). Indianapolis: Wiley, 1980.
- 16 Micheli A, Baili P, Quinn M, et al. Life expectancy and cancer survival in the EUROCARE-3 cancer registry areas. Ann Oncol 2003; 14(Suppl 5): v28–40.
- 17 Greenwood M. The natural duration of cancer.ed. London: HMSO, 1926.
- 18 Corazziari I, Quinn M, Capocaccia R. Standard cancer patient population for age standardising survival ratios. Eur J Cancer 2004; 40: 2307–16.
- 19 National Bureau of Statistics of the People's Republic of China. Beijing, 2014. Available at http://www.stats.gov.cn/tjsj/tjbz/ (accessed on April 1, 2014).
- 20 Dickman PW, Sloggett A, Hills M, Hakulinen T. Regression models for relative survival. Stat Med 2004; 23: 51–64.
- 21 Dickman P, Coviello E, Hills M. Estimating and modeling relative survival. Stata J 2012;2012: 1–23.
- 22 Australian Institute of Health and Welfare. Cancer Survival and Prevalence in Australia: Period Estimates from 1982 to 2010ed. Canberra: AIHW, 2012.
- 23 Howlader N, Noone A, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2010. Bethesda: National Cancer Institute, 2013.
- 24 Autier P, Boniol M, Hery C, et al. Cancer survival statistics should be viewed with caution. Lancet Oncol 2007; 8: 1050–2; author reply 3–4.
- 25 Gatta G, Capocaccia R, Sant M, et al. Understanding variations in survival for colorectal cancer in Europe: a EUROCARE high resolution study. Gut 2000; 47: 533–8.
- 26 Fan L, Strasser-Weippl K, Li JJ, et al. Breast cancer in China. Lancet Oncol 2014; 15: e279–89.
- 27 Anand S, Fan VY, Zhang J, et al. China's human resources for health: quantity, quality, and distribution. Lancet 2008; 372: 1774–81.
- 28 Wang G, Xu H, Jiang M. Evaluation on comprehensive quality of 456 doctors in township hospitals. J Health Resour 2003; 6: 72–4.
- 29 Liu M, Zhang Q, Lu M, et al. Rural and urban disparity in health services utilization in China. Med Care 2007; 45: 767–74.
- 30 Chen W, Armstrong BK, Zheng R, et al. Cancer burden in China: a Bayesian approach. BMC Cancer 2013; 13: 458.
- 31 Thun MJ, Carter BD, Feskanich D, et al. 50-year trends in smoking-related mortality in the United States. N Engl J Med 2013; 368: 351–64.
- 32 Shepard CW, Simard EP, Finelli L, et al. Hepatitis B virus infection: epidemiology and vaccination. Epidemiol Rev 2006; 28: 112–25.
- 33 Li C, Yu X, Butler JR, et al. Moving towards universal health insurance in China: performance, issues and lessons from Thailand. Soc Sci Med 2011; 73: 359–66.
- 34 Sankaranarayanan R, Black RJ, Swaminathan R, Parkin DM. An overview of cancer survival in developing countries. IARC Sci Publ 1998: 135–73.
- 35 Sankaranarayanan R, Swaminathan R, Jayant K, Brenner H. An overview of cancer survival in Africa, Asia, the Caribbean and Central America: the case for investment in cancer health services. IARC Sci Publ 2011: 257–91.
- 36 Berrino F. The EUROCARE Study: strengths, limitations and perspectives of population-based, comparative survival studies. Ann Oncol 2003; 14(Suppl 5): v9–13.
- 37 Brenner H, Hakulinen T. Implications of incomplete registration of deaths on long-term survival estimates from population-based cancer registries. Int J Cancer 2009; 125: 432–7.
- 38 Yang G, Hu J, Rao KQ, et al. Mortality registration and surveillance in China: history, current situation and challenges. Popul Health Metr 2005; 3: 3.
- 39 Yang L, Wang N, Zhu WX, et al. The analysis of the active follow-up study of registered cancer patients between 2002 and 2005 in urban areas of Beijing. Zhonghua Yu Fang Yi Xue Za Zhi 2012; 46: 604–6.
- 40 Merrill RM, Dearden KA. How representative are the surveillance, epidemiology, and end results (SEER) program cancer data of the United States? Cancer Causes Control 2004; 15: 1027–34.
- 41 Allemani C, Sant M, Weir HK, et al. Breast cancer survival in the US and Europe: a CONCORD high-resolution study. Int J Cancer 2013; 132: 1170–81.
- 42 Walters S, Maringe C, Butler J, et al. Breast cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK, 2000–2007: a population-based study. Br J Cancer 2013; 108: 1195–208.
Citing Literature
