The Lancet-Oncology: 40 years of change and prevention and control of cancer burden in China from the cancer registration.

For nearly half a century, cancer morbidity and mortality in Chinese groups have been on the riseAt the same time, since its establishment in 1959, the Cancer Registry has been evolving and playing an important role in the Cancer Burden Monitoring and Prevention Programin the latest issue of The Lancet-Oncology, the Director of the National Cancer Center of China and The President of the Oncology Hospital of the Chinese Academy of Medical Sciences, the team of academicians, published an important summary, introduced the development milestones and current situation of China's cancer registration center, and analyzed the changes in the cancer burden in China over the past 40 years from the cancer registration data, as well as its impact on prevention and controlBy introducing key milestones, the research team outlined the rapid development of cancer registration in China1959, China established the first cancer registration center to investigate the high incidence of esophageal cancer in Linzhou, Henan Province1963, China's first urban cancer registration center was established in Shanghai1970s, the first national retrospective survey of cancer mortality in China was completed, covering 96.7% of the country's totalAccording to the report, cancer registration centres have been set up in areas with high mortality rates for specific cancers2002, The National Cancer Registry of China was established to continuously collect and analyze cancer data at the national level2008, China's National Cancer Registration and Follow-up Project was launched, and in 2015, the Measures for the Administration of Tumor Registration were releasedWith the support of a range of policies, the number of cancer registration centres has increased rapidly from 43 in 2008 to 574 in 2019, covering 438 million people (31.5 percent of China's total population), with urban and rural populations accounting for 48 percent and 52 percent, respectivelyat present, all 31 provincial districts in Chinese mainland have been registered with the tumorAll hospitals, medical institutions, and health facilities should submit cancer case records, the Vital Statistics System should provide data on the cause of death in the population, and cross-complement and correlation information through data from various sources, including death monitoring data, insurance records, funeral records, and so onThe development of relevant standards ensures data qualityAll patient information is protected1990-1992 and 2005, the cancer registration team conducted the second and third national cancer mortality survey in China, respectivelyCombined with the monitoring data accumulated over the years by the Oncology Registry, the Herge academician team pointed out in the review that, in general, the cancer burden in China increased from 1973 to 2005, and the trend of changes in the burden of different cancer species was different The proportion of Chinese deaths from cancer increased from 10.1 per cent between 1973 and 1975 to 24.2 per cent in 2015 The overall cancer mortality rate increased from 74.2 per 100,000 to 170.1 per 100,000, but the age-standardized mortality rate has been declining gradually since 1990-1992, from 94.4 per 100,000 to 77.9 per 100,000 in 2015 This suggests that the main reason for the increase in overall cancer mortality is the ageing of the population It is worth noting that the cancer burden in men is growing faster in three indicators the death burden of stomach, esophageal and liver cancer has been high, although the age-standardized mortality rate has decreased significantly, and the overall mortality and age-standardized mortality rates for lung, female breast and colorectal cancer have been on the rise In addition to the aging population, obesity and lack of exercise, widespread smoking and air pollution, and improved control of infection-related diseases may also lead to changes in the characteristics of China's cancer burden, the review said the overall incidence of all cancers has also increased since 2000-2015, with the incidence of age-standardized cancers increasing in women and stabilizing in men The highest types of cancer in men are lung, stomach, liver, colorectal, esophageal and bladder cancer The highest rates for women are breast, lung, colorectal, thyroid, stomach and cervical cancer the five-year survival rate for all cancers in China has also increased, from 30.9 per cent in 2003-2005 to 40.5 per cent in 2012-2015 Pancreatic cancer is still the "king of cancer", with a five-year survival rate of only 7.2% between 2012 and 2015, and a five-year survival rate of thyroid cancer, which is more likely to be "lazy", at 84.3% five-year improvement in survival rates for eight types of cancer, including esophageal, stomach, throat, bone, cervical, uterine, bladder and thyroid cancers The survival rate of highly lethal pancreatic and gallbladder cancers has progressed little the herd of her fellow sons, the cancer registration data play an important role in three areas: assessing the cancer burden and progress in prevention and control in different parts of China; Based on the insights brought about by these data, a series of projects have begun to take place: the National Plan for the Prevention and Control of Cancer (1986-2000) focuses on the prevention and control of cancers with the highest mortality rates, such as stomach cancer, esophageal cancer, liver cancer, lung cancer and colorectal cancer, while ensuring that the cancer registration process covers 5% of China's population; the Three-Year Action Plan for Cancer Prevention and Control in China (2015-2017) further requires that the cancer registration process cover 30% of China's population and promote the mapping of the national cancer in the more recent China Medium- and Long-Term Plan for the Prevention and Control of Chronic Diseases (2017-2025) and the "Healthy China" plan, improving cancer survival rates and reducing premature deaths from chronic diseases, including cancer, are major goals Since 2005, China has launched a number of targeted cancer screening programs, including early diagnosis of cancer in rural areas (esophageal and stomach cancer), Huaihe River basin (main upper gastrointestinal tumors such as esophageal, liver, stomach cancer), early diagnosis of cancer in some urban areas (lung, colorectal, esophageal, stomach, liver and female breast cancer), and early diagnosis of "two cancers" (breast and cervical cancer) screening for women in rural areas Early cancer diagnosis rate of more than 80% in the project area, 90% treatment rate, 46% reduction in cancer mortality among screening population, and nearly 70% reduction in the cost of early-cases treatment compared to the middle and late stages two cases were shared in the review on the causes and prevention of cancer The 1990-2009 National Cancer Registration Data Analysis found that the increased risk of lung cancer was associated with PM2.5 exposure and ozone air pollution, while in Qidong, Jiangsu Province, where liver cancer was high, more than 40 years of tumor registration data laid the foundation for random clinical studies and revealed that hepatitis B vaccine prevention could reduce the risk of liver cancer review notes that the epidemiological shifts in cancer over the past few decades suggest that Chinese mouths are facing the double burden of infection-related and lifestyle-related cancers At the same time, the comprehensive assessment of cancer prevention and control, diagnosis and treatment can not be separated from the continuous and comprehensive coverage of the tumor registration data The Herge team points out that China needs to continue to improve the quality and breadth of cancer registration data, especially in rural areas in the west, compared with the level of cancer registration in some European and American countries, which covers more than 90 percent of the population The burden of cancer is increasingly severe, and tumor registration data is an effective and unique way to understand and evaluate cancer prevention and control .