Development of Population-based Cancer Mortality Registration in the North of Viet Nam

Background: Regional cancer distributions provide useful pointers to potential environmental risk factors. Cancerdeath registration data are also basic for checking completeness of population-based registration of cancer incidence.The aim of the present project was to develop population-based cancer mortality registration in various regions inthe North of Viet Nam. Methods: Cancer data were accessed from the database of population-routine-based deathregistration performed by medical workers at commune health stations based on the guidelines of the Ministry ofHealth. All deaths occurring in the communities were registered and the registration process was monthly reviewedfor each fatal case regarding the name, age, sex, address, occupation, date - place - cause of death, and informationconcerning to pre-death medical care during the study period from 1999 to 2005. The list of deaths and residents ofthe study population were carefully cross-checked with other information sources to avoid under or over registration.The study sites were Red River Delta areas and a high-mountain area. The world population structure was used toestimate age-standardized cancer mortality rates per 100,000 (ASR). Results: During 4,330,620 person-years estimatedduring 1999 to 2005, 21,108 deaths were registered. The crude death rate from all causes was 487.4 / 100,000. Amongthem, 4,244 cancers in all sites (2,835 in males and 1,409 in females) were registered, giving mortality rates / 100,000of 134.6 and 63.3 (crude), and 155.7 and 54.3 (ASR), for males and females, respectively. The rate for the highmountainarea was only half (45.5) those in the Red River Delta (95.2-117.4). Male to female ratios were ranked from2.2 to 3.1. Cancer accounted for about 20% of all causes of death. Conclusions: The present findings suggest that inViet Nam, development of reliable population-based cancer mortality registration is feasible and practical.     

Cancer Mortality in a Hanoi Population,Viet Nam, 1996-2005

Background: Hitherto, cancer mortality data have not been available in Viet Nam, so that the real public health ‍problem with this disease has yet to be addressed and recognized in the country with a population of over 80 million ‍in South East Asia. The aim of the present pilot study was to examine cancer mortality in a commune population of ‍Hanoi city, 1996-2005. Methods: Cancer data was accessed from the database of the population-routine-based death ‍registration performed by medical workers at commune health stations based on the guidelines of the Ministry of ‍Health at Hanoi city. All deaths occurring in the community were registered. This registration process was monthly ‍reviewed for each fatal case regarding the name, age, sex, address, occupation, date - place - cause of death, and ‍information concerning to pre - death medical care during the study period from Jan. 1996 to Dec. 2005. The list of ‍death and residents of the study population was carefully cross-checked with other information sources to avoid ‍under- or over-registration. The world population structure was used to estimate Age-standardized cancer mortality ‍rates per 100,000, (ASR). Results: During 60,770 person-years estimated from Jan. 1996 to Dec. 2005, 320 deaths ‍and their causes were registered. Among them, 100 cancer cases of all sites (66 males and 34 females) were included. ‍Cancer mortality rates were 222 and 109 (Crude), 353 and 115 (ASR), for males and females, respectively. For both ‍genders combined, lung cancer was the most common, 27 cases, followed by liver, 26 cases and stomach, with 19. ‍Proportion of death from cancer was about 31% of all causes. Conclusions: The present findings suggest that in Viet ‍Nam, a developing country, cancer is indeed an important public health problem.     

Estimate of the Incidence of Hepatocellular Carcinoma Among Carriers of HBsAg (+) in the General Population of Hanoi,Viet Nam from 1991-93

Background: The estimated number of carriers of HBsAg (+) in the world significantly increased from 120 to 350million from the 1970s to the 1990s . Eighty per cent of liver cancers are estimated to be due to chronic HBV infection.However, only limited data are available regarding liver cancer rates among carriers of HBsAg (+). The aim of thepresent study was to estimate the incidence of liver cancer among carriers of HBsAg (+) in the general population ofHanoi City, Viet Nam.Method: Data were derived from published reports for incidence of liver cancer (population-based cancer registry),the risk of HBV infection for liver cancer (case-control study), and the prevalence of HBV infection (stratified randomsampling of the general population) in the same population of Hanoi City. The Method of Indirect Estimation in aCase Control Study was used in this study.Results: Crude incidence rates per 100,000 were 114 and 37 for carriers of HBsAg (+) in males and females,respectively. The age-standardized incidence rate per 100,000 among carriers of HBsAg (+) for liver cancer was 166in males and 58 in females, (ASR, world population). The annual incidence of liver cancer among carriers of HBsAg(+) was strongly correlated with increased age in both males and females: the estimated value sharply increasedfrom 6 to 655 per 100,000 for persons aged 0-9 and 50+, respectively, in males. Similarly, the estimated incidence ofliver cancer also sharply increased from 8 to 233 per 100,000 for the age groups 10-19 and 50+, respectively, infemales.Conclusion: The present results indicate a high age-dependent incidence of liver cancer among carriers of HBsAg(+) in a general population. These results for Hanoi City, Viet Nam point to the magnitude of the problem andprovide a basis for intervention.     

Cancer incidence in Ho Chi Minh City,Viet Nam, 1995–1996

The results from the population-based cancer registry for the city of Ho Chi Minh in 1995–1996 represent the first information on the incidence of cancer in southern Viet Nam. A total of 4,080 cancer cases in males and 4,338 in females were registered, corresponding to age-standardized incidence rates (ASRs) of 130.9 per 100,000 in men and 100.7 per 100,000 in women. As elsewhere in South East Asia, the principal cancer of men was liver cancer (ASR 25.3), with moderately high rates of lung cancer (ASR 24.6) and stomach cancer (ASR 16.5); cancer of the penis, reportedly very common in early case series from Viet Nam, is now rarely seen. In women, cervical cancer was the dominant malignancy (ASR 26.0) followed by breast cancer (ASR 12.2) and stomach cancer (ASR 7.5). Although there may be some under-registration in these early years of operation, the recorded rates of cervical cancer and liver cancer are already high and suggest that southern Viet Nam would benefit from an effective cervical cancer screening programme, as well as efforts to interrupt the transmission of hepatitis B virus to reduce liver cancer incidence and effective anti-smoking programs. Int. J. Cancer 76:472–479, 1998.© 1998 Wiley-Liss, Inc.     

Incidence and mortality rate of esophageal cancer has decreased during past 40 years in Hebei Province,China

Background

Hebei province is located in North of China with of approximately 6% of whole national population. It is known as a high-risk area for esophageal cancer in China and worldwide. The aim of our study was to estimate the esophageal cancer burden and trend in Hebei Province.

Methods

Eight cancer registries in Hebei Province submitted cancer registry data to the Hebei Provincial Cancer Registry Center. All data were qualified and compiled for cancer statistics in 2011. The pooled data were stratified by gender and age group (0, 1-4, 5-9, 10-14…80+). Incidence and mortality rates were age-standardized to World Segi’s population standard and expressed per 100,000 persons. In addition, proportions and cumulative incidence/mortality rates for esophageal cancer were calculated. Esophageal cancer mortality data during the periods 1973-1975, 1990-1992, and 2004-2005 were extracted from the national death surveys. Mortality and incidence rate data from Cixian and Shexian were obtained from population-based cancer registries in each county.

Results

The estimated number of newly diagnosed esophageal cancer cases and deaths in 2011 in Hebei Province was 24,318 and 18,226, respectively. The crude incidence rate of esophageal cancer was 33.37/100,000 (males, 42.18/100,000 and females, 24.31/100,000). The age-standardized rate by world standard population (ASRW) was 28.09/100,000, ranking third among all cancers. The esophageal cancer mortality rate was 25.01/100,000 (males, 31.40/100,000 and females, 18.45/100,000), ranking third in deaths among all cancers. The mortality rates of esophageal cancer displayed a significant decreasing trend in Hebei Province from 1973-1975 (ASRW =48.69/100,000) to 2004-2005 (ASRW =28.02/100,000), with a decreased rate of 42.45%. In Cixian, the incidence of esophageal cancer decreased from 250.76/100,000 to 106.74/100,000 in males and from 153.86/100,000 to 75.41/100,000 in females, with annual percentage changes (APC) of 2.13 and 2.16, while the mortality rates declined with an APC of 2.46 for males and 3.10 for females from 1988 to 2011. In Shexian, the incidence rate decreased from 116.90/100,000 to 74.12/100,000 in males and from 46.98/100,000 to 40.64/100,000 in females, while the mortality rates declined, with an APC of 4.89 in males from 2003 to 2011.

Conclusions

Although the incidence and mortality rates of esophageal cancer remain high, an obvious decreasing trend has been observed in Hebei Province, as well as in high-risk regions, such as Cixian and Shexian, over the past 40 years.     

Incidence and mortality of colorectal cancer in China, 2011

Objective: Colorectal cancer is the third most common type of cancer and the fourth leading cause of cancer-related death in the world. This article provides the most up-to-date overview of colorectal cancer burden in China.Methods: Totally 234 cancer registries submitted data of 2011 to the National Central Cancer Registry(NCCR). Qualified data from 177 registries was pooled and analyzed. The crude incidence and mortality rates of colorectal cancer were calculated by age, gender and geographic area. The numbers of new cases and deaths were estimated using the 5-year age-specific cancer incidence/mortality rates and the corresponding populations. China census in 2000 and Segi’s world population were applied for age standardized rates.Results: The estimate of new cases diagnosed with colorectal cancer of China in 2011 was 310,244(178,404 for males and 131,840 for females, 195,117 in urban areas and 115,128 in rural areas), accounting for 9.20% of overall new cancer cases. The crude incidence of colorectal cancer ranked fourth in all cancer sites with rate of 23.03/100,000(25.83/100,000 for males and 20.08/100,000 for female, 28.25/100,000 in urban areas and 17.54/100,000 in rural areas). The age-standardized rates by China population and by World population were 16.79/100,000 and 16.52/100,000, respectively. The estimated number of colorectal cancer deaths of China in 2011 was 149,722(86,427 for males and 63,295 for females, 91,682 in urban areas and 58,040 in rural areas), accounting for 7.09% of overall cancer deaths. The crude mortality rate for colorectal cancer ranked fifth leading cause of cancer-related death in all cancer sites with rate of 11.11/100,000(12.51/100,000 for males and 9.64/100,000 for female, 13.27/100,000 in urban areas and 8.84/100,000 in rural areas). The age-standardized rates by China population and by World population for mortality were 7.77/100,000 and 7.66/100,000, respectively. For both of incidence and mortality, the rates of colorectal cancer were much higher in males than in females, and in rural areas than in urban areas. The rate of colorectal cancer increased greatly with age, especially after 40 or 45 years old.Conclusions: Colorectal cancer is a relative common cancer in China, especially for males in urban areas. Targeted prevention and early detection programs should be carried out.     

中国胃癌流行病学现状

  目的  通过对中国人群肿瘤登记数据中胃癌资料进行分析,了解全国胃癌流行现状。  方法  根据全国肿瘤登记中心的数据,评估全国胃癌流行情况及胃癌长期变化趋势。  结果  2012 年中国胃癌新发病例约 42.4 万例,死亡病例约 29.8 万例。2000 年至 2012 年我国城市地区男性与女性胃癌发病率、死亡率保持平稳,农村地区男性呈上升趋势,农村地区女性变化不大,调整年龄后发病率和死亡率均呈下降趋势。2003 年至 2005 年胃癌 5 年相对生存率为 27.4%(95%CI:26.7%～28.1%) 。  结论  胃癌是中国常见的恶性肿瘤,疾病负担严重,农村地区尤为明显,是国家癌症防治的重点。       

2004～2005年西藏自治区恶性肿瘤死因调查分析

[目的]分析西藏自治区2004～2005年恶性肿瘤死亡分布特点和流行趋势.[方法]抽取2004～2005年全国第3次死因回顾调查西藏自治区1市4县恶性肿瘤死亡资料,覆盖总人年数为388 626人年,其中男性188 269人年,女性200 357人年.按性别和地区分别计算粗死亡率、肿瘤死因构成比、年龄别构成比、中国人口标化死亡率、世界人口标化死亡率和肿瘤死因顺位.并与第1次全国死因回顾调查(1973～1975年)资料比较.[结果] 2004～2005年共调查西藏自治区恶性肿瘤死亡病例250例,粗死亡率为64.33/10万,中标率为50.94/10万,世标率为63.70/10万.男性死亡率高于女性死亡率,男性合计粗死亡率为77.55/10万,女性为51.91/10万.男性最常见恶性肿瘤包括胃癌、肝癌、肺癌、食管癌和结直肠癌,前7位合计占男性恶性肿瘤死亡的94.52%;女性最常见恶性肿瘤包括胃癌、肝癌、食管癌、宫颈癌和乳腺癌,前8位合计占女性恶性肿瘤死亡的93.27%.城市和农村地区的死亡癌谱有较大差异,城市地区恶性肿瘤死亡前3位为胃癌、肝癌和肺癌,农村地区死亡前3位为胃癌、肝癌和食管癌.与70年代相比,城市和农村的胃癌、食管癌和结直肠癌粗死亡率水平呈下降趋势,肝癌和肺癌粗死亡率均呈上升趋势.[结论]西藏自治区恶性肿瘤死亡率低于全国和西部地区平均水平,胃癌和肝癌仍然是影响西藏人口最主要的肿瘤死因.     

Changing epidemiology of nasopharyngeal carcinoma in Hong Kong over a 20-year period (1980-99): an encouraging reduction in both incidence and mortality

Epidemiological data from the Hong Kong Cancer Registry for the period 1980-99 were analyzed. Altogether 21,768 new cases of nasopharyngeal carcinoma (NPC) and 8,664 related deaths were registered. In both genders, the peak incidence occurred in the 50-59 years age group, and this age distribution pattern remained similar throughout. The age-standardized incidence rate steadily decreased from 28.5 in 1980-84 to 20.2 in 1995-99 per 100,000 males, and from 11.2-7.8 per 100,000 females, resulting in a total decrease of 29% for males and 30% for females over this 20-year period. The magnitude of total decrease in NPC mortality amounted to 43% and 50%, respectively, as the age-standardized mortality rate steadily decreased from 13.7 in 1980-84 to 7.8 in 1995-99 per 100,000 males, and from 4.5-2.2 per 100,000 females. The age-standardized mortality/incidence ratio also decreased from the peak of 0.48 in 1980-84 to 0.39 in 1995-99 for males, and from 0.40-0.29 for females. Females had significantly lower age-standardized incidence (male/female ratio 2.5-2.6, p < 0.01) and mortality (male/female ratio 3.0-3.5, p< 0.01) throughout the whole period. Furthermore, females had consistently lower mortality/incidence ratio: 0.29 vs. 0.39 in 1995-99. These data are highly suggestive of significant improvement in prevention and control of NPC in Hong Kong. Closer scrutiny of the differences in intrinsic and extrinsic factors between the genders might help to show important factors affecting oncogenesis and prognosis. Possible ways for further reduction of incidence and mortality are discussed.     

Annual report on status of cancer in China, 2011

Objective: The National Central Cancer Registry(NCCR) collected population-based cancer registration data in 2011 from all cancer registries. National cancer incidence and mortality were compiled and cancer incident new cases and cancer deaths were estimated.Methods: In 2014, there were 234 cancer registries submitted cancer incidence and deaths occurred in 2011. All datasets were checked and evaluated based on the criteria of data quality from NCCR. Total 177 registries’ data were qualified and compiled for cancer statistics in 2011. The pooled data were stratified by area(urban/rural), gender, age group(0, 1-4, 5-9, 10-14…85+) and cancer type. Cancer incident cases and deaths were estimated using age-specific rates and national population in 2011. All incidence and death rates are age-standardized to the 2000 Chinese standard population and Segi’s population expressed per 100,000 persons.Results: All 177 cancer registries(77 in urban and 100 in rural areas) covered 175,310,169 populations(98,341,507 in urban and 76,968,662 in rural areas). The morphology verified cases(MV%) accounting for 70.14% and 2.44% of incident cases were identified through death certifications only(DCO%) with mortality to incidence ratio of 0.63. The estimates of new cancer incident cases and cancer deaths were 3,372,175 and 2,113,048 in 2011, respectively. The incidence rate was 250.28/100,000(males 277.77/100,000, females 221.37/100,000), and the age-standardized incidence rates by Chinese standard population(ASIRC) and by world standard population(ASIRW) were 186.34/100,000 and 182.76/100,000 with the cumulative incidence rate(0-74 years old) of 21.20%. The cancer incidence and ASIRC in urban areas were 261.38/100,000 and 189.89/100,000 compared to 238.60/100,000 and 182.10/100,000 in rural areas, respectively. The cancer mortality was 156.83/100,000(194.88/100,000 in males and 116.81/100,000 in females), the age-standardized mortality rates by Chinese standard population(ASMRC) and by world standard population(ASMRW) were 112.88/100,000 and 111.82/100,000, and the cumulative mortality rate(0-74 years old) was 12.69%. The cancer mortality and ASMRC were 154.37/100,000 and 108.20/100,000 in urban areas, and 159.42/100,000 and 117.97/100,000 in rural areas, respectively. Cancers of lung, female breast, stomach, liver, colon and rectum, esophageal, cervix, uterus, prostate and ovary were the most common cancers, accounting for about 75% of all cancer new cases. Lung cancer, liver cancer, stomach cancer, esophageal cancer, colorectal cancer, female breast cancer, pancreatic cancer, brain tumor, cervical cancer and leukemia were the leading causes of cancer death, accounting for about 80% of all cancer deaths. The cancer incidence, mortality and spectrum showed difference between urban and rural areas, males and females.Conclusions: The coverage of cancer registration population had a greater increase than that in the last year. The data quality and representativeness are gradually improved. As the basic work of cancer prevention and control, cancer registry is playing an irreplaceable role. The disease burden of cancer is increasing, and the health department has to take effective measures to contain the increased cancer burden in China.     

2014年上海市恶性肿瘤发病和死亡特征分析

背景与目的：恶性肿瘤已成为严重威胁上海市居民健康的重大公共卫生问题。该研究旨在描述和分析2014年上海市恶性肿瘤发病与死亡情况。方法：根据上海市恶性肿瘤病例报告登记系统收集的恶性肿瘤发病资料,按地区、性别分层,分别计算恶性肿瘤发病与死亡粗率、标化率、前10位恶性肿瘤发病与死亡顺位和构成等,应用Joinpoint统计软件分析2002—2014年上海市恶性肿瘤发病和死亡趋势,估算总体和分阶段的年度变化百分比（annual percentage change,APC）。采用Segi’s世界标准人口年龄构成计算标化率。结果：2014年上海市共报告恶性肿瘤新发病例68 541例,死亡病例37 242例。病理学诊断比例为79.49%,只有死亡医学证明书比例为0.04%,死亡发病比为0.54。上海市恶性肿瘤粗发病率为477.79/10万,标化发病率为223.57/10万,男性标化发病率低于女性,市区低于郊区。恶性肿瘤发病在40岁以后快速上升,在80~84岁年龄组达到高峰。全市发病前10位恶性肿瘤依次为肺癌、结直肠癌、甲状腺癌、胃癌、乳腺癌、肝癌、前列腺癌、胰腺癌、脑和中枢神经系统肿瘤以及膀胱癌,前10位恶性肿瘤占全部恶性肿瘤发病的75.89%。全市恶性肿瘤粗死亡率为259.61/10万,标化死亡率为95.73/10万,男性标化死亡率高于女性,市区和郊区基本持平。死亡率在45岁以后快速上升,在≥85岁年龄组达到高峰。死亡前10位恶性肿瘤依次为肺癌、结直肠癌、胃癌、肝癌、胰腺癌、乳腺癌、食管癌、胆囊癌、前列腺癌以及脑和中枢神经系统肿瘤,前10位恶性肿瘤占全部恶性肿瘤死亡的78.12%。2002—2014年,上海市女性所有部位的恶性肿瘤标化发病率呈明显上升趋势（APC为2.17%,P<0.001）,男性标化发病率则较为稳定。男性和女性所有部位的恶性肿瘤标化死亡率均呈明显下降趋势（APC分别为-0.82%和-0.76%,P<0.05）。结论：肺癌、消化系统恶性肿瘤、甲状腺癌和女性乳腺癌是威胁上海市居民健康的主要恶性肿瘤,仍是肿瘤防治工作的重点。同时,2002—2014年女性恶性肿瘤发病率有上升趋势,男性和女性恶性肿瘤死亡率均持续下降。     

The incidences and mortalities of major cancers in China, 2009

In 2012, the National Central Cancer Registry (NCCR) of China collected cancer registration information for the year 2009 from local cancer registries and analyzed it to describe the incidences and mortalities of cancers in China. Based on the data quality criteria from NCCR, data from 104 registries covering 85,470,522 people (57,489,009 in urban areas and 27,981,513 in rural areas) were checked and evaluated. The data from 72 registries were qualified and accepted for the cancer registry annual report in 2012. The total cancer incident cases and cancer deaths were 244,366 and 154,310, respectively. The morphologically verified cases accounted for 67.23%, and 3.14% of the incident cases only had information from death certifications. The crude incidence in the Chinese cancer registration areas was 285.91/ 100,000 (317.97/100,000 in males and 253.09/100,000 in females). The age-standardized rates for incidences based on the Chinese standard population (ASRIC) and the world standard population (ASRIW) were 146.87/100,000 and 191.72/100,000, respectively, with a cumulative incidence of 22.08%. The cancer mortality in the Chinese cancer registration areas was 180.54/100,000 (224.20/100,000 in males and 135.85/100,000 in females). The age-standardized rates for mortalities based on the Chinese standard population (ASRMC) and the world standard population (ASRMW) were 85.06/100,000 and 115.65/100,000, respectively, and the cumulative mortality was 12.94% . Lung cancer, gastric cancer, colorectal cancer, liver cancer, esophageal cancer, pancreatic cancer, encephaloma, lymphoma, female breast cancer, and cervical cancer were the most common cancers, accounting for 75% of all cancer cases. Lung cancer, gastric cancer, liver cancer, esophageal cancer, colorectal cancer, pancreatic cancer, breast cancer, encephaloma, leukemia, and lymphoma accounted for 80% of all cancer deaths. The cancer registration's population coverage has been increasing, and its data quality is improving. As the basis of the cancer control program, the cancer registry plays an important role in directing anticancer strategies in the medium and long term. Because cancer burdens are different in urban and rural areas in China, prevention and control efforts should be based on practical situations.     

The incidences and mortalities of major cancers in China, 2010

To estimate the cancer incidences and mortalities in China in 2010, the National Central Cancer Registry （NCCR） of China evaluated data for the year of 2010 from 145 qualified cancer registries covering 158,403,248 people （92,433,739 in urban areas and 65,969,509 in rural areas）. The estimates of new cancer cases and cancer deaths were 3,093,039 and 1,956,622 in 2010, respectively. The percentage of morphologically verified cases were 67.11%; 2.99% of incident cases were identified through death certification only, with the mortality to incidence ratio of 0.61. The crude incidence was 235.23/100,000 （268.65/100,000 in males and 200.21/100,000 in females）. The age-standardized rates by Chinese standard population （ASR China） and by world standard population （ASR world） were 184.58/100,000 and 181.49/100,000, respectively, with a cumulative incidence （0-74 years old） of 21.11%. The crude cancer mortality was 148.81/100,000 （186.37/100,000 in males and 109.42/100,000 in females）. The ASR China and ASR world were 113.92/100,000 and 112.86/100,000, respectively, with a cumulative mortality of 12.78%. Lung, breast, gastric, liver, esophageal, colorectal, and cervical cancers were the most common cancers. Lung, liver, gastric, esophageal, colorectal, breast, and pancreatic cancers were the leading causes of cancer deaths. The coverage of cancer registration has rapidly increased in China in recent years and may reflect more accurate cancer burdens among populations living in different areas. Given the increasing cancer burden in the past decades, China should strengthen its cancer prevention and control.     

Annual report on status of cancer in China,2010简

Objective：Population-based cancer registration data in 2010 were collected,evaluated and analyzed by the National Central Cancer Registry （NCCR） of China.Cancer incident new cases and cancer deaths were estimated.Methods：There wvere 219 cancer registries submitted cancer incidence and death data in 2010.All data were checked and evaluated on basis of the criteria of data quality from NCCR.Total 145 registries＇ data were qualified and accepted for cancer statistics in 2010.Pooled data were stratified by urban/rural,area,sex,age group and cancer site.Cancer incident cases and deaths were estimated using age-specific rates and national population.The top ten common cancers in different groups,proportion and cumulative rate were also calculated.Chinese census in 2000 and Segi＇s population were used for age-standardized incidence/ mortality rates.Results：All 145 cancer registries （63 in urban and 82 in rural） covered a total of 158,403,248 population （92,433,739 in urban and 65,969,509 in rural areas）.The estimates of new cancer incident cases and cancer deaths were 3,093,039 and 1,956,622 in 2010,respectively.The morphology verified cases （MV％） accounted for 67.11％ and 2.99％ of incident cases were identified through death certifications only （DCO％） with mortality to incidence ratio （M/I） of 0.61.The crude incidence rate was 235.23/100,000 （268.65/100,000 in males,200.21/100,000 in females）,age-standardized incidence rates by Chinese standard population （ASIRC,2000） and by world standard population （ASIRW） were 184.58/100,000 and 181.49/100,000 with the cumulative incidence rate （0-74 years old） of 21.l 1％.The cancer incidence and ASIRC were 256.41/100,000 and 187.53/100,000 in urban areas whereas in rural areas,they were 213.71/100,000 and 181.10/100,000,respectively.The crude cancer mortality in China was 148.81/100,000 （186.37/100,000 in males and 109.42/100,000 in females）,age-standardized incidence rates by Chinese standard population （ASMRC,2000） and by world standard population （ASMRW） were 113.92/100,000 and 112.86/100,000,and the cumulative incidence rate （0-74 years old） was 12.78％.The cancer mortality and ASMRC were 156.14/100,000 and 109.21/100,000 in urban areas,whereas in rural areas,they were 141.35/100,000 and 119.00/100,000 respectively.Lung cancer,gastric cancer,colorectal cancer,liver cancer,esophageal cancer,pancreas cancer,encephaloma,lymphoma,female breast cancer and cervical cancer,were the most common cancers,accounting for 75％ of all cancer cases in urban and rural areas.Lung cancer,gastric cancer,liver cancer,esophageal cancer,colorectal cancer,pancreatic cancer,breast cancer,encephaloma,leukemia and lymphoma accounted for 80％ of all cancer deaths.Conclusions：The coverage of cancer registration population had a rapid increase and could reflect cancer burden in each area and population.As the basis of cancer control program,cancer registry plays an irreplaceable role in cancer epidemic surveillance,evaluation of cancer control programs and making anticancer strategy.China is facing serious cancer burden and prevention and control should be enhanced.     

National cancer incidence and mortality in China, 2012

Background

Population-based cancer registration data in 2012 from all available cancer registries were collected by the National Central Cancer Registry (NCCR). NCCR estimated the numbers of new cancer cases and cancer deaths in China with compiled cancer incidence and mortality rates.

Methods

In 2015, there were 261 cancer registries submitted cancer incidence and deaths occurred in 2012. All the data were checked and evaluated based on the NCCR criteria of data quality. Qualified data from 193 registries were used for cancer statistics analysis as national estimation. The pooled data were stratified by area (urban/rural), gender, age group [0, 1–4, 5–9, 10–14, …, 85+] and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding national population in 2012. The Chinese census data in 2000 and Segi’s population were applied for age-standardized rates. All the rates were expressed per 100,000 person-year.

Results

Qualified 193 cancer registries (74 urban and 119 rural registries) covered 198,060,406 populations (100,450,109 in urban and 97,610,297 in rural areas). The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 69.13% and 2.38%, respectively, and the mortality to incidence rate ratio (M/I) was 0.62. A total of 3,586,200 new cancer cases and 2,186,600 cancer deaths were estimated in China in 2012. The incidence rate was 264.85/100,000 (289.30/100,000 in males, 239.15/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 191.89/100,000 and 187.83/100,000 with the cumulative incidence rate (0–74 age years old) of 21.82%. The cancer incidence, ASIRC and ASIRW in urban areas were 277.17/100,000, 195.56/100,000 and 190.88/100,000 compared to 251.20/100,000, 187.10/100,000 and 183.91/100,000 in rural areas, respectively. The cancer mortality was 161.49/100,000 (198.99/100,000 in males, 122.06/100,000 in females), the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 112.34/100,000 and 111.25/100,000, and the cumulative mortality rate (0–74 years old) was 12.61%. The cancer mortality, ASMRC and ASMRW were 159.00/100,000, 107.231/100,000 and 106.13/100,000 in urban areas, 164.24/100,000, 118.22/100,000 and 117.06/100,000 in rural areas, respectively. Cancers of lung, stomach, liver, colorectum, esophagus, female breast, thyroid cervix, brain tumor and pancreas were the most common cancers, accounting for about 77.4% of all cancer new cases. Lung cancer, liver cancer, stomach cancer, esophageal cancer, colorectal cancer, pancreatic cancer, female breast cancer, brain tumor, leukemia and lymphoma were the leading causes of cancer death, accounting for about 84.5% of all cancer deaths. The cancer spectrum showed difference between urban and rural, males and females both in incidence and mortality rates.

Conclusions

Cancer surveillance information in China is making great progress with the increasing number of cancer registries, population coverage and the improving data quality. Cancer registration plays a fundamental role in cancer control by providing basic information on population-based cancer incidence, mortality, survival and time trend. The disease burden of cancer is serious in China, so that, cancer prevention and control, including health education, health promotion, cancer screening and cancer care services in China, should be enhanced.     

Cancer mortality in Italy, 1997: quantifying the fall in rates in women and men.

AIMS AND BACKGROUND: To update data and statistics on cancer death certification in Italy to 1997. METHODS: Data and statistics for 1997 subdivided into 31 cancer sites are presented.Trends in age-standardized rates for major cancer sites are plotted from 1955 to 1997. RESULTS: The age-standardized (world standard) death certification rates from all neoplasms steadily declined from the peak of 199.2/100,000 males in 1988 to 174.7 in 1997 and for females from 102.5 to 93.0. The decline was larger in truncated rates, by about 26% for males since 1983 and by 24% for females since the top rate of the early 1960's. A major component of the favorable trend in males was lung cancer, which showed a 16% decline from the peak of 1987-88, to reach 50.6/100,000 in 1997, corresponding to about 5,000 avoided deaths. The decline in lung cancer was about 34% at age 35 to 64. For females, in contrast, both the absolute number of lung cancer deaths and the age-standardized rate of 7.9/100,000 were among the highest values ever registered, reflecting the different pattern of spread of the tobacco-related lung cancer epidemic in the two sexes. Intestinal cancer rates were stable for males but declined by approximately 10% for females, mostly in middle age, as did breast cancer mortality. Among neoplasms showing favorable trends, there were other tobacco-related neoplasms in men, plus the continuing fall in stomach and cervix uteri. Upward trends were observed for non Hodgkin's lymphomas. CONCLUSIONS: The fall in cancer mortality observed over the last decade in Italy is attributable to a decline in lung and other tobacco-related neoplasms in males, together with a persistent fall in stomach and uterine (cervical) cancer. In women, there were also recent falls in intestinal and breast cancer rates, and declines in both sexes in rarer neoplasms influenced by therapeutic advancements.     

Anti-smoking Initiative and Decline in Incidence Rates of Lung Cancer in Viet Nam

Viet Nam had the highest reported male smoking prevalence rate (72.8-74.3%) in the world in the 1990s. Productionof tobacco products was about 0.44 kg or 600 cigarettes per capita per year in 1994 for domestic use. Populationattributablerisk per cent of lung cancer due to smoking was about 69.7%. Males in the south have a lower reportedsmoking prevalence rate (OR = 0.7) and a significant lower incidence rate of lung cancer, age-standardized-incidencerateper 100,000 (ASR): 33.1 vs 24.6 when compared to males in the north. Incidence rates of lung cancer significantlydeclined in Hanoi (ASR 34.9 –33.1 and 6.3 – 5.8) and Ho Chi Minh City (ASR 24.6 – 23.7 and 6.8 – 5.6) between 1991-1997 and at the national level between 1990-2000 (ASR 30.4 – 30.1 and 6.7 – 6.6) in males and females, respectively.This decline in incidence rate of lung cancer resulted from the great achievements of the National Tobacco ControlProgram over about a 10-year period from 1989 to help people stop smoking. The present finding should stimulatefurther primary cancer prevention efforts in developing countries, including Viet Nam. It also suggests that themethod applied to translate scientific evidence of smoking harm to people and into health policy, is a useful tool todrive people’s attitude to stop smoking and remove its human carcinogens from our society.     

Pancreatic cancer incidence and mortality patterns in China, 2011

Objective

The National Central Cancer Registry (NCCR) collected population-based cancer registration data in 2011 from all cancer registries in China. The incidence and mortality rates for pancreatic cancer were compiled and pancreatic cancer incident new cases and deaths were estimated.

Methods

A total of 234 cancer registries submitted cancer data to NCCR. Data from 177 cancer registries were qualified and compiled for cancer statistics in 2011. Pancreatic cancer cases were extracted and analyzed from the national database. The pooled data were stratified by area (urban/rural), gender and age group (0, 1-4, 5-9, 10-14…85+). Pancreatic cancer incident cases and deaths were estimated using age-specific rates and national population in 2010. The national census in 2000 and Segi’s population were used for age-standardized rates.

Results

All 177 cancer registries (77 in urban and 100 in rural areas) covered 175,310,169 populations (98,341,507 in urban and 76,968,662 in rural areas). The morphology verified pancreatic cancer cases (MV%) accounting for 40.52% and 4.33% of pancreatic cancer incident cases were identified through death certifications only (DCO%) with mortality to incidence ratio (M/I) of 0.91. The estimated number of newly diagnosed pancreatic cancer cases and deaths were 80,344 and 72,723 in 2011, respectively. The crude incidence rate was 5.96/100,000 (males 6.57/100,000, females 5.32/100,000). The age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 4.27/100,000 and 4.23/100,000 respectively, ranking 10^th among all cancers. Pancreatic cancer incidence rate and ASIRC were 7.03/100,000 and 4.94/100,000 in urban areas whereas they were 4.84/100,000 and 3.56/100,000 in rural areas. The incidence rate of pancreatic cancer of 33 cancer registries increased from 3.24/100,000 in 2003 to 3.59/100,000 in 2011 with an annual percentage change (APC) of 1.44. The pancreatic cancer mortality rate was 5.40/100,000 (males 5.88/100,000, females 4.89/100,000), ranking 6^th among all cancers. The age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 3.81/100 000 and 3.79/100 000. The pancreatic cancer mortality and ASMRC were 6.47/100,000 and 4.48/100,000 in urban areas, and 4.27/100,000 and 3.08/100,000 in rural areas, respectively. The mortality rates of pancreatic cancer showed an approximately 1.14-fold increase, from 2.85/100,000 in 2003 to 3.26/100,000 in 2011, with an APC of 1.68.

Conclusions

The burden of pancreatic cancer is increasing in China. Identification of high-risk population and adequate treatment and prevention are important.