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Secular Trend of Cancer Death and Incidence in 29 Cancer Groups in China, 1990–2017: A Joinpoint and Age–Period–Cohort Analysis

Authors Liu X, Zhou M, Wang F, Mubarik S, Wang Y, Meng R, Shi F, Wen H, Yu C

Received 29 January 2020

Accepted for publication 2 June 2020

Published 23 July 2020 Volume 2020:12 Pages 6221—6238


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Ahmet Emre Eskazan

Xiaoxue Liu,1 Maigeng Zhou,2 Fang Wang,1 Sumaira Mubarik,1 Yafeng Wang,1 Runtang Meng,1 Fang Shi,1 Haoyu Wen,1 Chuanhua Yu1,3

1Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, People’s Republic of China; 2National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, People’s Republic of China; 3Global Health Institute, Wuhan University, Wuhan 430072, People’s Republic of China

Correspondence: Chuanhua Yu Tel +86-27-6875-8648

Purpose: China has a heavy cancer burden. We aimed to quantitatively estimate the secular trend of cancer mortality and incidence in China.
Methods: We extracted numbers, age-specific and age-standardized rates of 29 cancer groups (from 1990 to 2017) from the Global Burden of Disease (GBD) study in 2017. We estimated rates of major cancer types for annual percent change by Joinpoint regression, and for age, period, and cohort effect by an age–period–cohort model.
Results: In 2017, breast cancer had the highest incidence rate in females. Lung cancer had the highest mortality and incidence rates in males. Although the age-standardized incidence rate of prostate cancer ranked second highest in males, it increased by 112% from 1990 to 2017. Individuals aged over 50 years were at high risk of developing cancer, and the number of deaths at this age accounted for over 89% of all cancers in all age groups. When compared with the global average level, the age-standardized mortality and incidence rates of both liver and esophageal cancers were 2.1 times higher in China, and stomach, lung and nasopharyngeal cancers in China also had high levels (more than 1.5 times higher). During 1990– 2017, most of the 29 cancers exhibited an increasing incidence trend, and Joinpoint regression demonstrated increasing mortality of some major cancers. The period effect indicated that the risk of mortality and incidence due to the main cancers generally increased during 1992– 2017.
Conclusion: Trend analysis provided information on the effects of prevention strategies and targeted interventions on the occurrence of different cancers. Etiological studies need to be conducted on some major cancers in the Chinese population.

Keywords: Chinese burden of cancer, mortality and incidence, trend, Joinpoint analysis, age–period–cohort analysis

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