Cancer prevention and control: alarming challenges in China

Abstract

China is geographically the third largest country in the world and the most populated low-to-middle-income country. Cancer incidence and mortality rates for some cancers in the USA and European countries have steadily decreased over the last decades, whereas the incidence and mortality of certain cancers in China have been increasing at an alarming speed. Rapid industrialization and urbanization in China have been accompanied by incredible changes in lifestyle and environment combined with an aging population. Mortality caused by lung, colorectal and breast cancers has been steadily increasing, whereas cancer mortality from gastric, esophageal and cervical tumors has tended to decrease. Similar to what has occurred in the United States, unhealthy lifestyles in China, including heavy smoking and poor diet combined with pollution, have contributed to increased cancer risk. China is facing many challenges in cancer treatment and prevention for the general population. The major areas that need to be addressed in the control of cancer in China include cancers associated with environmental pollution, tobacco use, occupational carcinogens, infection, excessive alcohol consumption, dietary deficiencies and obesity. In this perspective, we review the problems in each area and suggest ideas for future directions in cancer research and strategies and actions to reduce the incidence of cancer in China.

Gene–environment interactions and colorectal cancer risk: An umbrella review of systematic reviews and meta‐analyses of observational studies

“…No association indicates evidence for the main environmental effects with p > 0.05. 2 The evidence was classified as highly suggestive (class II) due to the high heterogeneity between the studies. were considered for evaluation.…”

“…Colorectal cancer (CRC) is the third most common cancer worldwide, with 746,000 new cases in men and 614,000 new cases in women . In some low‐to‐middle‐income countries, the incidence of CRC has been increasing partly due to changes in lifestyle and environment combined with aging populations . Thus, it is critical to understand both modifiable and non‐modifiable risk factors for CRC as this may enable more specific prevention strategies and risk assessment, especially in developing countries where CRC screening may not be feasible or affordable…”

“…1 In some low-to-middle-income countries, the incidence of CRC has been increasing partly due to changes in lifestyle and environment combined with aging populations. 2 Thus, it is critical to understand both modifiable and non-modifiable risk factors for CRC as this may enable more specific prevention strategies and risk assessment, especially in developing countries where CRC screening may not be feasible or affordable. 3 CRC risk is determined by a complex interplay of both genetic variants and environmental exposures.…”

The Tsinghua–Lancet Commission on Healthy Cities in China: unlocking the power of cities for a healthy China

“…65 The rise in overall cancer incidence is significant in the more industrially developed east China and larger cities, especially for lung, colorectal, and breast cancer. 66 There were mixed trends in cancer-related mortality: although mortality caused by cancers of the stomach, oesophagus, nasopharynx, and cervix uteri decreased, lung and breast cancer mortality increased between 1987 and 2009. 67 In urban China, the 2015 agestandardised estimate for all-cancer incidence was 192 per 100 000 people and for all-cancer mortality was 110 per 100 000 people.…”

“…The rising incidence of non-communicable diseases and mortality related to these diseases in urban China has been attributed to demographic, environmental, and lifestyle changes caused by economic growth and rapid urbanisation, including ageing popu lation, environ mental pollution, low levels of physical activity, unbalanced diets, smoking, and alcohol consumption. 63,66,75…”