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Incidence Rates of Four Major Non-Communicable Chronic Diseases in the Chinese Adult Population from 2007 to 2016: A Study Based on a National Commercial Claims Database

Authors Yang Y, Sun X, Wang J, Yang C, Zhang L

Received 15 November 2019

Accepted for publication 29 January 2020

Published 24 February 2020 Volume 2020:12 Pages 215—222


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Henrik Toft Sørensen

Yu Yang, 1, 2,* Xiaoyu Sun, 1, 2,* Jinwei Wang, 3 Chao Yang, 3 Luxia Zhang 1–3

1National Institute of Health Data Science, Peking University, Beijing, People’s Republic of China; 2Center for Data Science in Health and Medicine, Peking University, Beijing, People’s Republic of China; 3Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, National Health Commission of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Luxia Zhang
Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology; Assistant Dean, National Institute of Health Data Science at Peking University, No. 8 Xishiku St, Xicheng District, Beijing 100034, People’s Republic of China
Tel +86-10-83572388
Fax +86-10-66551055

Background: The spread of non-communicable chronic diseases (NCDs) is a global crisis. Understanding the dynamics of NCDs at the population level is crucial to develop prevention strategies as well as to evaluate the effectiveness of intervention. However, studies investigating the incidence rate of NCDs among the general population are limited, especially for developing countries like China. We aim to evaluate the incidence rates of four major NCDs from 2007 to 2016, based on a national commercial claims database in China.
Methods: Cancer, stroke, coronary heart disease (CHD) and end-stage kidney disease (ESKD) accounted for over 90% of claims data were included as major NCDs. The definition of the above diseases followed the guideline of disease definitions of critical illness insurance released by the Insurance Association of China. Age-standardized incidence rates (ASRs) of those major NCDs among subgroups of sex, demographic regions, and China city tiers were reported. The trends of incidence rates were described as annual percent change (APC) as well as average annual percent change (AAPC) and were then examined by joinpoint models.
Results: For the population insured in 2007, the average 10-year ASRs of cancer, CHD, stroke, and ESKD were 221.0, 55.5, 43.5, 11.0 per 100,000 person-years, respectively. For males, the ASRs of cancer, CHD, ESKD continuously increase in the past decade with AAPC of 1.4%, 5.2%, and 3.3%; while the ASRs of stroke were decreased with APC of 3.7% after 2009. For females, the increased ASRs of cancer with AAPC of 4.2% and CHD with AAPC of 2.0%; while decreased trends of ASRs were observed for stroke and ESKD. Patterns of ASRs changing varied between different demographic regions and city tiers.
Conclusion: Commercial claims data could be a valuable data source to evaluate the disease burden for major NCDs in China. The disease burden of severe stroke was decreasing while cancer, CHD and ESKD were still increasing in China. More efforts should be put into control of CHD, especially in the northern part of China.

Keywords: non-communicable chronic diseases, incidence rate, claims database, Asian

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