Lung cancer burden has increased during the last 40 years in Hebei Province, China

Reproductive factors and risk of lung cancer among 300,000 Chinese female never-smokers: evidence from the China Kadoorie Biobank study

BACKGROUND

Lung cancer is the leading cause of cancer mortality among Chinese females despite the low smoking prevalence among this population. This study assessed the roles of reproductive factors in lung cancer development among Chinese female never-smokers.

METHODS

The prospective China Kadoorie Biobank (CKB) recruited over 0.5 million Chinese adults (0.3 million females) from 10 geographical areas in China in 2004-2008 when information on socio-demographic/lifestyle/environmental factors, physical measurements, medical history, and reproductive history collected through interviewer-administered questionnaires. Cox proportional hazard regression was used to estimate adjusted hazard ratios (HRs) of lung cancer by reproductive factors. Subgroup analyses by menopausal status, birth year, and geographical region were performed.

RESULTS

During a median follow-up of 11 years, 2,284 incident lung cancers occurred among 282,558 female never-smokers. Ever oral contraceptive use was associated with a higher risk of lung cancer (HR = 1.16, 95% CI: 1.02-1.33) with a significant increasing trend associated with longer duration of use (p-trend = 0.03). Longer average breastfeeding duration per child was associated with a decreased risk (0.86, 0.78-0.95) for > 12 months compared with those who breastfed for 7-12 months. No statistically significant association was detected between other reproductive factors and lung cancer risk.

CONCLUSION

Oral contraceptive use was associated with an increased risk of lung cancer in Chinese female never-smokers. Further studies are needed to assess lung cancer risk related to different types of oral contraceptives in similar populations.

[Analysis on the Incidence and Economic Burden of Patients with Lung Cancer]

BACKGROUND

The previous study has indicated that lung cancer has a high incidence and mortality in China, and has caused a large economic burden. The purpose of this study was to analyze the incidence and economic burden of lung cancer by analyzing the information on the home page of discharge history of lung cancer patients in Hebei Tumor Hospital, and to provide scientific basis for the prevention and treatment of lung cancer.

METHODS

The information of all of the discharges, new cases, surgical patients, age, gender, length of stay and hospitalization cost of lung cancer patients in Hebei Tumor Hospital from January 2012 to December 2019 were retrieved based on the medical record management system, and the incidence trend, gender and age distribution as well as the economic burden of the disease were statistically described.

RESULTS

The number of new cases of lung cancer increased year by year, from 2,235 cases in 2012 to 5,012 cases in 2019. The number of males always outnumbered females, but the gender ratio decreased year by year, from 2.25 in 2012 to 1.56 in 2019. Among new cases of lung cancer, the proportion of surgical treatment increased year by year, from 28.14% in 2012 to 44.83% in 2019. Except for 2012, the proportion of surgical operations in female patients was higher than that in male patients from 2013 to 2019. The proportion of surgical operations in male and female patients was 23.52% and 28.07% in 2013, and 36.14% and 58.37% in 2019, respectively. The median age at the onset of lung cancer has increased year by year, from 61 years old in 2012 to 63 years old in 2019. The median age of onset in all lung cancer patients was higher in males than in females. The number of new lung cancer patients and surgical patients both showed an increasing trend with the increase of age, and both reached the maximum value in the age group of 60-69 years old. With the increase of age, the number of patients gradually decreased. The median length of hospital stay for all discharged lung cancer patients or surgical patients decreased year by year, from 10 d and 19 d in 2012 to 8 d and 17 d in 2019, respectively, while the median hospitalization cost increased year by year. It increased from 10,611.46 yuan and 38,750.13 yuan in 2012 to 17,187.15 yuan and 84,030.16 yuan in 2019, respectively.

CONCLUSIONS

Lung cancer is still one of the main cancers endangering the health of Chinese residents. The incidence of lung cancer is increasing year by year, and the distribution of gender and age has certain characteristics. In order to reduce the number of cases and the economic burden, effective prevention and control measures should be formulated and medical reform should be strengthened.

Epidemiology and prognosis in young lung cancer patients aged under 45 years old in northern China

To explore the epidemiological characteristics and prognosis of lung cancer in patients aged under 45 years old in northern China. The population-based database about lung cancer cases aged under 45y selected form the Hebei Provincial Cancer Registry Center from 2010-2015. Mortality data of young death from 1973 to 1975, 1990 to 1992, and 2004 to 2005 were extracted from the national retrospective survey of death. Mortality rates were calculated by the mortality database above in this analysis. Consecutive, 954 non-selected younger patients (< 45 years) and 2261 selected older patients (≥ 45 years) with pathologically diagnosed lung cancer treated at the Fourth Hospital of Hebei Medical University were included as the hospital-based database. Epidemiological, treatment outcomes and prognosis status from 2010 to 2017 were documented. A comparison with younger and older patients was also made. Multivariate analysis with young lung cancer patients was calculated by Cox regression model. The younger lung cancer mortality rate tended to slightly increase in Hebei Province, from 1.04 per100 000 in 1973 to 2.01 per 100 000 in 2015, but the PDR tended to decrease over the last 40 years. There were 954 younger and 2261 older lung cancer patients included in the hospital-based database. The proportions of patients who were female (50.84% vs 34.85%), family history of cancer (12.37% vs 6.32%), advanced stage at diagnosis (65.46% vs 60.77%) and adenocarcinoma (65.27% vs 61.11%) were relatively higher in the younger group than in the older group. The median OS were 23.0 months and 27.0 months between younger and older, the OS difference existed between the two groups (P = 0.001). In the younger patients, Cox regression showed that a family history of cancer, symptoms at diagnosis, pathology, stage at diagnosis and surgery were confirmed as independent factors affecting the prognosis. Mortality rates among younger lung cancer patients showed an increasing trend in northern China. The younger account for small but have unique characteristics, with higher proportions of female, family history of cancer, adenocarcinoma and advanced stages than the older group and had a trend of worse OS.

Small cell lung cancer (SCLC) incidence and trends vary by gender, geography, age, and subcategory based on population and hospital cancer registries in Hebei, China (2008-2017)

BACKGROUND

Lung cancer is the leading cause of morbidity and mortality worldwide. Small cell lung cancer (SCLC) has been determined to be the most lethal lung malignancy. Few studies have previously analyzed the epidemiological characteristics of SCLC in China. This study analyzed the epidemiological characteristics of SCLC aiming to provide a reference for the prevention of SCLC in Hebei Province.

METHODS

The epidemiological characteristics of SCLC using lung cancer data based on population and hospital cancer registries in Hebei Province between 2008 and 2017 were analyzed.

RESULTS

The proportion of both population- and hospital-based SCLC cases displayed a significant increasing trend. Moreover, the proportion of males was higher than that for female based on population- and hospital-based cases. The proportion of hospital-based SCLC cases in counties was higher than that in cities, whereas there were no significant regional differences between cities and counties based on population. The proportion of both population- and hospital-based SCLC cases decreased consistently with increasing age. There was a difference between population- and hospital-based distribution of subcategories of SCLC.

CONCLUSIONS

Significant increases in the proportion of both population- and hospital-based SCLC cases over recent years, particularly in males and in patients aged over 55 years, were observed. Research on the pathogenesis of SCLC in these patients and prevention is urgently required.

Trend analysis of lung cancer mortality and years of life lost (YLL) rate from 1999 to 2016 in Tianjin, China: Does the lung cancer burden in rural areas exceed that of urban areas?

BACKGROUND

The aim of this study was to examine the trends in the mortality rate and years of life lost (YLL) rate of lung cancer in Tianjin, China, during the period from 1999 to 2016.

METHODS

Lung cancer death data were obtained from Tianjin residents' all-cause death monitoring system, which covers the whole population of Tianjin. Crude mortality rate, age-standardized mortality rate, truncated rate (35-64 years), YLL and age-standardized YLL rate data were calculated and trends examined.

RESULTS

From 1999 to 2016, a total of 93 358 lung cancer deaths were reported in Tianjin, which accounted for 38.0% of all cancer deaths (93 358/245744). The crude mortality rate of lung cancer had increased 58.5% from 1999 (40.15/100000) to 2016 (63.64/100000), average annual percent change (AACP) = 2.9%, P < 0.01. However, the age-standard YLL rate had decreased to 13.3% in 2016 than in 1999, AACP = -0.8%, P < 0.01, with a stable trend in males (AACP = -0.2%), and noticeable decreasing trend in females (AACP = -1.4%). The lung cancer mortality rate (ASRW) in urban areas was higher than that in rural areas in 1999, with a ratio of 1.99:1. However, it was lower in 2016, with the ratio of 0.98:1. For the truncated rate (35-64 years), it had decreased in urban areas compared with rural areas since the year 2013.

CONCLUSION

Lung cancer remains the most fatal cancer in Tianjin. However, the age-standard YLL rate of lung cancer has decreased considerably accompanied by a decline in smoking rate years ago, especially in women and people living in urban areas. Considerable attention is therefore needed in the rural areas where cases of lung cancer are still rapidly increasing.

Value of immune factors for monitoring risk of lung cancer in patients with interstitial lung disease

Objective

Patients with interstitial lung disease (ILD) are at increased risk of developing lung cancer. We aimed to investigate the clinical significance of serum immune factors in this progression.

Methods

We retrospectively screened a hospital database from January 2012 to December 2016 for patients with lung cancer and ILD. We measured serum levels of C3, C4, IgA, IgG, IgM, C-reactive protein (CRP), ceruloplasmin (CER), and rheumatoid factor in these patients and in healthy controls.

Results

We analyzed data for 262 patients with lung cancer, 220 with ILD, and 57 healthy controls. CER levels were significantly higher in patients with lung cancer (0.35 ± 0.10 g/L) compared with both ILD patients (0.31 ± 0.25 g/L) and healthy individuals (0.25 ± 0.04 g/L). C3 and C4 levels were both significantly higher in healthy individuals compared with patients with lung cancer (C3: 1.70 ± 0.29 vs 1.04 ± 0.26 g/L, C4: 0.27 ± 0.24 vs 0.24 ± 0.09 g/L) and ILD (C3: 1.70 ± 0.29 vs 0.97 ± 0.25 g/L, C4: 0.27 ± 0.24 vs 0.21 ± 0.09 g/L). Optimal scaling analysis demonstrated that lung cancer was closely associated with CRP, CER, C3, and C4.

Conclusions

Increased levels of CRP and CER and decreased levels of C3 and C4 may identify patients with ILD at high risk of developing lung cancer.

The Role of an Array of Routine Clinical Variables to the Occurrence and Severity of Postoperative Pneumonia in Non–Small Cell Lung Cancer Patients

Background and purpose:

Data of an array of preoperative/intraoperative clinical variables may carry significant information for predicting the probability of postoperative pneumonia or chest infection in non–small cell lung cancer (NSCLC) patients. We aimed to investigate the association between those variables and the occurrence of postoperative pneumonia (POP) as well as the severity of POP, based on routine laboratory tests, basic characteristics, and perioperative variables during the in-hospital period.

Methods:

A consecutive series of NSCLC patients undergoing lung cancer lobectomy at our department from January 2014 and December 2015 was used as the target patient group and stratified into 2 groups: pneumonia (POP) and non-pneumonia (N-POP), according to occurrence of pneumonia after lobectomy in 30 days. The POP was classified into 5 severity grades, based on the Clavien-Dindo complication classification system.

Results:

Regarding binary logistic regression analysis for risk factors of POP, the following were found to be the independent risk factors of the occurrence of POP: postoperative predicted forced expiratory volume in 1 second [ppoFEV1%; odds ratio (OR): 0.996, 95% confidence interval (CI): 0.993–0.999; P = 0.021]; Charlson comorbidity index (CCI) score &gt;3 (OR: 2.694, 95% CI: 1.462–4.965; P = 0.001); American Society of Anesthesiologists (ASA)score &gt;3 (OR: 2.066, 95% CI: 1.060–4.029; P = 0.033); postoperative predicted diffusion capacity for carbon monoxide of the lung (ppoDlco%; OR: 0.458, 95% CI: 0.090–0.809; P = 0.014); and neutrophil-lymphocyte ratio (NLR; OR: 2.171, 95% CI: 1.721–2.737; P &lt; 0.001). With regard to risk factors analysis of pneumonia severity via ordinal polytomous logistic regression, the following were the independent risk factors: early stage (OR: 0.626, 95% CI: 0.422–0.929, P = 0.020); CCI score &gt;3 (OR: 1.914, 95% CI: 1.058–3.459, P = 0.032); ppoDlco% (OR: 0.638, 95% CI: 0.445–0.914, P = 0.014); and NLR (OR: 1.218, 95% CI: 1.031–1.436, P = 0.020).

Conclusion:

Among an array of clinical variables in the hospital, major risk factors for POP following LC surgery were ppoFEV1%, ppoDlco%, NLR, ASA score &gt;3, and CCI score&gt;3; meanwhile, ppoDlco%, CCI score&gt;3, NLR, and early tumor stage were the key predictors of POP severity.

Influence of different drug delivery methods for Endostar combined with a gemcitabine/cisplatin regimen in locally advanced or metastatic lung squamous cell carcinoma: A retrospective observational study

Continuous endovenous administration of Endostar (CE) gradually replaced drip intravenous administration of Endostar (DE) in lung squamous cell carcinoma (SCC) treatment presently, but the efficacy and safety of CE and DE which is better in advanced lung SCC are yet unclear. To evaluate the feasibility of CE as an alternative to DE with gemcitabine/cisplatin (GP) chemotherapy. Data were collected from patients admitted with locally advanced or metastatic lung SCC from January 2011 to April 2015, including the patients' characteristics, the therapeutic regimen, the treatment effectiveness, and toxicity. There are 71 patients with pathologically confirmed lung SCC retrospectively assigned to a treatment (CE) group of 48 patients and a control (DE) group of 23 patients. The response of each tumor to the therapy was assessed every 2 cycles by a chest and upper abdomen computed tomography for the comparison of curative effects and adverse reactions. Compared with the DE group, the response rate and disease control rate were noninferior in the CE group. The median progression-free survival and overall survival in the CE and DE groups were no significantly difference (5.5 vs 5.5 months, P = .141; 22.9 vs 14.3 months, P = .053). Increased progression-free survival (PFS) for patients in CE group was observed across 3 subgroups analyzed. There was a 35.7% reduction in the total dose of Endostar per cycle in the CE group compared with that in the DE group. Thus, in combination with GP chemotherapy, CE could be a suitable alternative to DE in locally advanced or metastatic SCC patients, resulting in less hemoptysis, less treatment time, and lower costs.

Fine particulate matter associated mortality burden of lung cancer in Hebei Province, China

BACKGROUND

The association between fine particulate matter (PM_2.5 ) and lung cancer (LC) mortality in China is limited. The Beijing-Tianjin-Hebei region is infamous for serious air pollution. Seven of the top 10 cities with the worst air quality are located in Hebei Province. Thus, we explored the effect of 10 years of PM_2.5 on the LC mortality rate in Hebei Province.

METHODS

We quantified associations between LC mortality and PM_2.5 and estimated the LC mortality burden attributed to PM_2.5 with predicted county level LC deaths in 2014.

RESULTS

The 10-year PM_2.5 LC mortality associations were non-linear, with thresholds of 63 μg/m³ overall, 69 μg/m³ for men, 68 μg/m³ for women, 66 μg/m³ for those aged 30-64 years, and 62 μg/m³ for those aged ≥ 65 years. The relative risks for these groups were 1.09 (95% confidence interval [CI] 1.08-1.10), 1.06 (95% CI 1.03-1.10), 1.20 (95% CI 1.10-1.26), 1.07 (95% CI 1.05-1.11), and 1.10 (95% CI: 1.07-1.13), respectively. There were 2525 (95% CI 2265-2780) LC deaths attributed to 10-year PM_2.5 in 2014, at fractions of 8.3% (95% CI 7.4-9.1%) overall, 5.7% (95% CI 2.8-9.4%) for men, 16.7% (95% CI: 8.3-21.6%) for women, 6.5% (95% CI 4.7-10.3%) for those aged 30-64 years, and 9.1% (95% CI 6.4-11.5%) for those aged ≥ 65 years.

CONCLUSION

Our results suggest that a reduction in the PM_2.5 exposure levels below thresholds would prevent a substantial number of LC deaths in Hebei Province.

Risk factors for pulmonary nodules in north China: A prospective cohort study

OBJECTIVES

Pulmonary nodules have become common incidental findings with the widespread use of computed tomography (CT) technology. Such nodules have the potential to become early lung cancer lesions, so understanding more about factors that may be associated with them is important.

MATERIALS AND METHODS

The present work was based on a large prospective cohort comprising 32,438 participants in Hebei Province (China) between January 2014 and March 2016. Participants aged 40-75 years completed a questionnaire, underwent low-dose CT (LDCT), and were followed up to March 2017. Grouped by the results of LDCT, normal participants and those with pulmonary nodules were included in the data analysis.

RESULTS

In total 7752 subjects were included in this study, of whom 2040 (26.32%) were pulmonary nodule patients. Older age, current smoking status (hazard ratio (HR) = 1.43, 95% confidence interval (95%CI): 1.21, 1.68), exposure to second-hand smoke (SHS) at work (HR = 1.17, 95%CI: 1.01, 1.35), dust exposure (HR = 1.49, 95%CI: 1.06, 2.11), history of lung disease (HR = 1.44, 95%CI: 1.16, 1.77), and family history of cancer (HR = 1.28, 95%CI: 1.12, 1.48) were associated with pulmonary nodules. However, consumption of vegetables (HR = 0.82, 95%CI: 0.68, 0.99), tea (HR = 0.88, 95%CI: 0.78, 0.99) and legumes reduced the risk. Approximately 10.09% and 8.58% of pulmonary nodule incidences were attributed to tobacco smoking and low fruit intake, respectively. An estimated 6.36% and 3.88% of patients with pulmonary nodules attributable to family history of cancer and history of lung disease were detected.

CONCLUSION

The results of this study suggest that age, smoking, SHS, dietary factors, occupational exposures, history of disease and family history of cancer may affect the incidence of pulmonary nodules.

Cancer survival in Cixian of China, 2003-2013: a population-based study

Cixian is one of the high‐risk areas for upper gastrointestinal cancer in China and the world. From 2005, comprehensive population‐based screening for upper gastrointestinal cancers has been conducted in Cixian. The aim of this study was to investigate population‐based cancer survival from 2003 to 2013 and to explore the effect of screening on upper gastrointestinal cancer survival in Cixian. Observed survival was estimated using the life table method. The expected survival from the general population was calculated using all‐cause mortality data from the population of Cixian with the EdererII method. Cixian cancer registry, with a total coverage of 6.88 million person years, recorded 19,628 cancer patients diagnosed during 2003–2013. In Cixian, from 2003 to 2013, there were 19,628 newly cancer cases and 13,984 cancer deaths, with an incidence rate of 285.37/100,000 and mortality rate of 203.31/100,000. The overall five‐year relative cancer survival for patients diagnosed in Cixian in 2003–2013 was 22.53%. The relative survival for all cancers combined in Cixian had an overall upward trend from 2003 to 2013. Among upper gastrointestinal cancer in Cixian, the five‐year relative survival for cardia gastric cancer was highest at 30.42%, followed by oesophageal cancer at 25.37% and noncardia gastric cancer at 18.93%. In 2013, the five‐year relative survival for oesophageal cancer, cardia gastric cancer, and noncardia gastric cancer patients aged 45–69 years was 39.97% (95% CI: 34.52–45.43%), 51.74% (95% CI: 42.09–60.86%), and 37.43% (95% CI: 26.93–48.17%), respectively, the absolute values increasing 14.11%, 16.71%, and 14.92% compared with that in 2003. There is an increasing trend in overall survival for upper gastrointestinal cancer with early screening and treatment of cancer in Cixian.

The prognostic value of neutrophil to lymphocyte and platelet to lymphocyte ratios for patients with lung cancer

As the leading cause of cancer-associated mortality globally among males in 2012, lung cancer is a disease of particular concern. Previously, the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) were revealed to be prognostic factors for various types of cancer, including lung cancer. In the present study, a retrospective review was conducted with patients who were diagnosed with lung cancer between January 1, 2000 and December 31, 2005 in the Fourth Hospital of Hebei Medical University. A total of 695 patients were included, and the optimal cutoffs of the NLR and the PLR were 6.0 and 248.0, respectively. There were statistically significant associations between tumor-node-metastasis (TNM) stage, surgery, metastasis incidence and NLR (P<0.001). The associations between TNM stage, surgery incidence and PLR were also revealed to be statistically significant (P<0.001). Patients in the low NLR group demonstrated longer overall survival (OS) than patients in the high NLR group (819.57 days vs. 629.86 days, P=0.041). The NLR at diagnosis was demonstrated to be an independent prognostic factor for OS. Thus, the NLR may be a promising approach for predicting the prognosis of patients with lung cancer.

Cancer incidence and mortality in Hebei province, 2013

To estimate the numbers of new cancer cases and deaths in Hebei province in 2013 and to investigate the real cancer burden in Hebei province to develop strategies for cancer prevention and control.Data on new cancer cases and deaths in 2013 were collected from 31 population-based cancer registries of Hebei province. All data were checked and evaluated based on data quality criteria from the "Chinese Guideline for Cancer Registration" and "Cancer Incidence in Five Continents Volume IX" by the International Agency for Research on Cancer/International Association of Cancer Registration (IARC/IACR). Qualified data from 21 registries were used for analysis after evaluation. Data analysis was stratified by areas (urban/rural), gender, age group, and cancer type. New cancer cases and deaths in Hebei province were estimated using age-specific rates and the corresponding provincial population. The 10 most common cancers in different groups and the cumulative rates were calculated. The Chinese population census in 2000 and the population of Segi were used for age-standardized incidence/mortality rates.The covered populations included 11, 185,626 people (5,709,393 in males and 5,476,233 in females) from 21 qualified cancer registries, accounting for 15.25% of Hebei provincial population. The major indicators of quality control, that is, the percentage of cases morphologically verified (MV%), percentage of cancer cases identified with a death certificate only (DCO%), and the mortality to incidence rate ratio (M/I), were 75.56%, 3.23%, and 0.65, respectively. In 2013, it was estimated that there were approximately 164,100 newly diagnosed cancer cases and 105,200 cancer deaths in Hebei province. The incidence rate of cancer was 225.36/100,000 (248.03/100,000 in males, 201.73/100,000 in females), and the age-standardized incidence rates by Chinese standard population (ASIRC) and the world standard population (ASIRW) were 182.81/100,000 and 181.36/100,000, respectively. The cancer incidence and ASIRC were 225.49/100,000 and 173.84/100,000 in urban areas and 225.27/100,000 and 189.31/100,000 in rural areas, respectively. The cancer mortality rate was 145.46/100,000 (177.85/100,000 in males and 111.70/100,000 in females). Age-standardized mortality rates by Chinese standard population (ASMRC) and world standard population (ASMRW) were 119.09/100,000 and 118.73/100,000, respectively. The cancer mortality rate in rural areas (152.64/100,000) was higher than that in urban areas (135.71/100,000). The most common cancers were lung cancer, stomach cancer, esophageal cancer, liver cancer, breast cancer, and colorectal cancer. Lung cancer, stomach cancer, liver cancer, esophageal cancer, and colorectal cancer were the major causes of cancer death in Hebei province.The coverage of cancer registration population has rapidly increased and may reveal the cancer burden in Hebei province more comprehensively. The cancer burden in Hebei province is heavy, and prevention and control measures should be enhanced.

Knockdown of Long Noncoding RNA uc.338 by siRNA Inhibits Cellular Migration and Invasion in Human Lung Cancer Cells

Lung cancer remains a critical health concern worldwide. Long noncoding RNAs with ultraconserved elements have recently been implicated in human tumorigenesis. The present study investigated the role of ultraconserved element 338 (uc.338) in the regulation of cell proliferation and metastasis in human lung cancer. Our data showed that the expression of uc.338 in lung cancer was remarkably increased in vivo and in vitro. Depletion of uc.338 with specific siRNA interference retarded the cell proliferative rate in lung cancer cell lines NCI-H929 and H1688. Furthermore, knockdown of uc.338 caused cell cycle arrest in the G₀/G₁ phase in both cell lines. Transwell assays showed that inhibition of uc.338 notably decreased migration and invasion in NCI-H929 and H1688 cells. Moreover, uc.338 depletion decreased the expression of cyclin B1, Cdc25C, Snail, vimentin, and N-cadherin while increasing the protein level of E-cadherin, shown with Western blot analysis. These results suggested the pro-oncogenic potential of uc.338 in lung cancer, which might provide novel clues for the diagnosis and treatment of lung cancer in the clinic.

Estimated cancer incidence and mortality in Hebei province, 2012

OBJECTIVE

This study estimates the numbers of new cancer cases and cancer deaths in Hebei province using incidence and mortality data from 9 population-based cancer registries in 2012.

METHODS

The data of new diagnosed cancer cases and cancer deaths in 2012 were collected from 9 population-based cancer registries of Hebei province in 2015. All the data met the National Central Cancer Registry of China (NCCR) criteria of data quality. The pooled data analysis was stratified by areas (urban/rural), gender, age group (0, 1.4, 5.9, 10.14, …, 85+) and cancer type. New cancer cases and deaths in Hebei province were estimated using age-specific rates and corresponding provincial population in 2012. The 10 most common cancers in different groups and the cumulative rates were calculated. Chinese population census in 2000 and Segi's population were used for age-standardized incidence/mortality rates.

RESULTS

All cancer registries covered 4,986,847 populations, 6.84% of Hebei provincial population (2,098,547 in urban and 2,888,300 in rural areas). The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 76.40% and 4.72%, respectively. The mortality to incidence rate ratio (M/I) was 0.64. In 2012, it is estimated that there were about 187,900 new diagnosed cancer cases and 119,800 cancer deaths in Hebei province. The incidence rate of cancer was 258.12/100,000 (275.75/100,000 in males, 239.78/100,000 in females), and the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 210.65/100,000 and 208.50/100,000, with the cumulative incidence rates (0.74 years old) of 24.46%. The cancer incidence and ASIRC were 256.99/100,000 and 211.32/100,000 in urban areas and 258.94/100,000 and 209.99/100,000 in rural areas, respectively. The cancer mortality rate was 164.63/100,000 (201.85/100,000 in males, 125.92/100,000 in females). Agestandardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 137.30/100,000 and 137.39/100,000 with the cumulative mortality rate (0.74 years old) of 14.58%, respectively. The cancer mortality rate in rural areas (167.16/100,000) was higher than that in urban areas (161.16/100,000). The most common cancers were lung cancer, stomach cancer, breast cancer, esophageal cancer, liver cancer and colorectal cancer, which accounted for 72.31% of all cancer cases. Lung cancer, stomach cancer, liver cancer, esophageal cancer and colorectal cancer were the major causes of cancer death in Hebei province, which accounted for 75.24% of all cancer deaths. The cancer spectrum differs between urban and rural, males and females in both incidence and mortality rates.

CONCLUSIONS

The most common cancers were lung cancer, stomach cancer, esophageal cancer, breast cancer, liver cancer and colorectal cancer in Hebei province.