With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China's massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high-quality data from an additional number of population-based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population-based cancer registries (2009-2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000-2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age-standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year; P = .1), whereas they increased significantly (+2.2% per year; P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (-1.4% per year; P < .05) and females (-1.1% per year; P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.
National Key R&D Program of China, PUMC Youth Fund and the Fundamental Research Funds for the Central Universities, and Major State Basic Innovation Program of the Chinese Academy of Medical Sciences.
This review presents the latest available international data for lung cancer incidence, mortality and survival, emphasizing the established causal relationship between smoking and lung cancer. In 2002, it was estimated that 1.35 million people throughout the world were diagnosed with lung cancer, and 1.18 million died of lung cancer-more than for any other type of cancer. There are some key differences in the epidemiology of lung cancer between more developed and less developed countries. In more developed countries, incidence and mortality rates are generally declining among males and are starting to plateau for females, reflecting previous trends in smoking prevalence. In contrast, there are some populations in less developed countries where increasing lung cancer rates are predicted to continue, due to endemic use of tobacco. A higher proportion of lung cancer cases are attributable to nonsmoking causes within less developed countries, particularly among women. Worldwide, the majority of lung cancer patients are diagnosed after the disease has progressed to a more advanced stage. Despite advances in chemotherapy, prognosis for lung cancer patients remains poor, with 5-year relative survival less than 14% among males and less than 18% among females in most countries. Given the increasing incidence of lung cancer in less developed countries and the current lack of effective treatment for advanced lung cancers, these results highlight the need for ongoing global tobacco reform to reduce the international burden of lung cancer.
This paper presents the latest international descriptive epidemiological data for invasive breast cancer among women, including incidence, survival and mortality, as well as information on mammographic screening programs. Almost 1.4 million women were diagnosed with breast cancer worldwide in 2008 and approximately 459,000 deaths were recorded. Incidence rates were much higher in more developed countries compared to less developed countries (71.7/100,000 and 29.3/100,000 respectively, adjusted to the World 2000 Standard Population) whereas the corresponding mortality rates were 17.1/100,000 and 11.8/100,000. Five-year relative survival estimates range from 12% in parts of Africa to almost 90% in the United States, Australia and Canada, with the differential linked to a combination of early detection, access to treatment services and cultural barriers. Observed improvements in breast cancer survival in more developed parts of the world over recent decades have been attributed to the introduction of population-based screening using mammography and the systemic use of adjuvant therapies. The future worldwide breast cancer burden will be strongly influenced by large predicted rises in incidence throughout parts of Asia due to an increasingly "westernised" lifestyle. Efforts are underway to reduce the global disparities in survival for women with breast cancer using cost-effective interventions.
Introduction We aim to update global lung cancer epidemiology and describe changing trends and disparities. Methods We presented country-specific incidence and mortality from GLOBOCAN 2012, by region and socioeconomic factors via the Human Development Index (HDI). Between- and within-country incidence by histological type was analyzed from Cancer Incidence in Five Continents Volume X (IARC). Trend analyses including the IARC data, cancer registries, and the WHO Mortality database were conducted using Joinpoint regression. Survival was compared between and within countries, and by histology. Results In 2012, there were 1.82 and 1.59 million new cases and deaths of lung cancer worldwide, respectively. Incidence was highest in very high HDI countries and lowest in low HDI countries (42.2 vs. 7.9/100,000 for males and 21.8 vs. 3.1/100,000 for females, respectively). In most countries with a very high HDI, as male incidence decreased gradually (ranging from −0.3% in Spain to −2.5% in the USA each year), female incidence continued to increase (by 1.4% each year in Australia to 6.1% in recent years in Spain). While histology varied between countries, adenocarcinoma was more common than squamous cell carcinoma, particularly among females (e.g., in Chinese females, the adenocarcinoma-to-squamous cell carcinoma ratio=6.6). Five-year relative survival varied from 2% (Libya) to 30% (Japan), with substantial within-country differences. Conclusion Lung cancer will continue to be a major health problem well through the first half of this century. Preventive strategies, particularly tobacco control, tailored to populations at highest risk are key to reduce the global burden of lung cancer.
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 5 138,852 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
A B S T R A C T PurposeColorectal cancer survivors are at risk for poor health outcomes because of unhealthy lifestyles, but few studies have developed translatable health behavior change interventions. This study aimed to determine the effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes among colorectal cancer survivors. MethodsIn this two-group randomized controlled trial, 410 colorectal cancer survivors were randomly assigned to the health coaching intervention (11 theory-based telephone-delivered health coaching sessions delivered over 6 months focusing on physical activity, weight management, dietary habits, alcohol, and smoking) or usual care. ResultsAt 12 months, significant intervention effects were observed for moderate physical activity (28.5 minutes; P ϭ .003), body mass index (Ϫ0.9 kg/m 2 ; P ϭ .001), energy from total fat (Ϫ7.0%; P ϭ .006), and energy from saturated fat (Ϫ2.8%; P ϭ .016). A significant intervention effect was reported for vegetable intake (0.4 servings per day; P ϭ .001) at 6 months. No significant group differences were found at 6 or 12 months for HRQoL, cancer-related fatigue, fruit, fiber, or alcohol intake, or smoking. ConclusionThe CanChange intervention was effective for improving physical activity, dietary habits, and body mass index in colorectal cancer survivors. The intervention is translatable through existing telephone cancer support and information services in Australia and other countries.
This review outlines current international patterns in prostate cancer incidence and mortality rates and survival, including recent trends and a discussion of the possible impact of prostate-specific antigen (PSA) testing on the observed data. Internationally, prostate cancer is the second most common cancer diagnosed among men (behind lung cancer), and is the sixth most common cause of cancer death among men. Prostate cancer is particularly prevalent in developed countries such as the United States and the Scandinavian countries, with about a six-fold difference between high-incidence and low-incidence countries. Interpretation of trends in incidence and survival are complicated by the increasing impact of PSA testing, particularly in more developed countries. As Western influences become more pronounced in less developed countries, prostate cancer incidence rates in those countries are tending to increase, even though the prevalence of PSA testing is relatively low. Larger proportions of younger men are being diagnosed with prostate cancer and living longer following diagnosis of prostate cancer, which has many implications for health systems. Decreasing mortality rates are becoming widespread among more developed countries, although it is not clear whether this is due to earlier diagnosis (PSA testing), improved treatment, or some combination of these or other factors.
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