Page 0088

Lung cancer has become the leading cause of cancer

death in China with a rapidly increasing trend over the

past three decades, especially in urban areas. Smoking

is the predominant risk factor for lung cancer. Also, rapid

modernization and development has resulted in a large

migration from rural areas to cities and a concomitant

increase in urban air pollution (1). Due to the high smoking

prevalence, severe air pollution and ageing population, lung

cancer incidence and mortality in urban China will increase

in future decades. Lung cancer screening plays a key role in

decreasing lung cancer morality and improving the

prognosis of patients, and randomized controlled trials have

confirmed the effect of low dose spiral CT screening (LDCT)

(2). Accordingly, LDCT screening was approved for Medcare

in the United States recently. In urban China, two

government-sponsored screening programmes, including

lung cancer, were initiated in recent years. This article will

give a brief introduction to the lung cancer epidemic, lung

cancer prevention and its control in urban China.

Lung cancer epidemiology in urban China

Incidence and mortality

Lung cancer is the most common cancer and leading cause of

cancer death in both urban and rural areas in China.

According to recent data from a 2010 cancer registry report,

there were 605,946 new cases (19.59% of the total) and

486,555 deaths (24.87% of the total) from lung cancer.

The incidence of lung cancer was 46.08/10

5, and the agestandardized

rate by Chinese standard population (ASR

China) was 35.23/10

5

, while the mortality was 37.00/105, as

well as ASR China was 27.93/105. Both the incidence and

mortality rates in males were approximately twice those in

females.

In urban areas, the incidence of lung cancer was 52.52/10

5

(70.39/105 in males and 33.78/105 in females) and mortality

was 42.23/105 (56.72/105 in males and 27.04/105 in

females), while incidence and mortality in rural areas were

39.54/10

5 and 31.69/10

5 respectively. Correspondingly, the

ASR China for incidence and mortality in urban areas

(36.62/105 and 28.88/105) were both higher than in rural

areas (33.39/10

5 and 26.61/105) (3).

Temporal trends

Lung cancer deaths have increased dramatically in the past

three decades. There were three national cause of death

retrospective surveys conducted by National Health and

Family Planning Commission of the PRC (former MoH) from

1973-1975, 1990-1992 and 2004-2005 respectively. The

data showed the mortality of lung cancer rose from 5.46 to

17.54, up to 30.83 (per 100,000), with the greatest increase

among all cancers of 465% with the ranking for cancer death

moving up from fifth to third, and up to first place (Fig. 1) (4).

LUNG CANCER IN URBAN CHINA

YA-GUANG FAN (LEFT), LUNG CANCER INSTITUTE, TIANJIN MEDICAL UNIVERSITY

GENERAL HOSPITAL, TIANJIN, CHINA; HAO LIANG (MIDDLE), LUNG CANCER INSTITUTE,

SICHUAN UNIVERSITY, HUAXI HOSPITAL, CHENGDU CHINA AND YOULIN QIAO (RIGHT),

CANCER HOSPITAL, CHINESE ACADEMY OF MEDICAL SCIENCES, BEIJING, CHINA

As the result of an ageing population, high smoking prevalence and serious air pollution,

lung cancer in China has increased significantly during the past decades. Notably, the

incidence and mortality of lung cancer are higher in urban China than in rural areas,

however, these differences between urban and rural areas have been decreasing. A great

deal of effort has been made by the government of China to address this, including

tobacco and air pollution control. Although lung cancer survival is better in urban areas

than in rural China, the five-year survival rate of lung cancer patients in urban China is

still as low as 19.5%, whilst most lung cancer cases are diagnosed at an advanced stage

and accordingly lose the opportunity of surgery. Consequently, two government-sponsored

screening programmes including lung cancer have been initiated in recent years, and

Chinese guidelines on the diagnosis and treatment of primary lung cancer have been

issued to standardize the diagnosis and treatment of lung cancer.

DISEASE-SPECIFIC CANCER CONTROL

88 CANCER CONTROL 2015

Index

  1. Page 0001
  2. Page 0002
  3. Page 0003
  4. Page 0004
  5. Page 0005
  6. Page 0006
  7. Page 0007
  8. Page 0008
  9. Page 0009
  10. Page 0010
  11. Page 0011
  12. Page 0012
  13. Page 0013
  14. Page 0014
  15. Page 0015
  16. Page 0016
  17. Page 0017
  18. Page 0018
  19. Page 0019
  20. Page 0020
  21. Page 0021
  22. Page 0022
  23. Page 0023
  24. Page 0024
  25. Page 0025
  26. Page 0026
  27. Page 0027
  28. Page 0028
  29. Page 0029
  30. Page 0030
  31. Page 0031
  32. Page 0032
  33. Page 0033
  34. Page 0034
  35. Page 0035
  36. Page 0036
  37. Page 0037
  38. Page 0038
  39. Page 0039
  40. Page 0040
  41. Page 0041
  42. Page 0042
  43. Page 0043
  44. Page 0044
  45. Page 0045
  46. Page 0046
  47. Page 0047
  48. Page 0048
  49. Page 0049
  50. Page 0050
  51. Page 0051
  52. Page 0052
  53. Page 0053
  54. Page 0054
  55. Page 0055
  56. Page 0056
  57. Page 0057
  58. Page 0058
  59. Page 0059
  60. Page 0060
  61. Page 0061
  62. Page 0062
  63. Page 0063
  64. Page 0064
  65. Page 0065
  66. Page 0066
  67. Page 0067
  68. Page 0068
  69. Page 0069
  70. Page 0070
  71. Page 0071
  72. Page 0072
  73. Page 0073
  74. Page 0074
  75. Page 0075
  76. Page 0076
  77. Page 0077
  78. Page 0078
  79. Page 0079
  80. Page 0080
  81. Page 0081
  82. Page 0082
  83. Page 0083
  84. Page 0084
  85. Page 0085
  86. Page 0086
  87. Page 0087
  88. Page 0088
  89. Page 0089
  90. Page 0090
  91. Page 0091
  92. Page 0092
  93. Page 0093
  94. Page 0094
  95. Page 0095
  96. Page 0096
  97. Page 0097
  98. Page 0098
  99. Page 0099
  100. Page 0100
  101. Page 0101
  102. Page 0102
  103. Page 0103
  104. Page 0104
  105. Page 0105
  106. Page 0106
  107. Page 0107
  108. Page 0108
  109. Page 0109
  110. Page 0110
  111. Page 0111
  112. Page 0112
  113. Page 0113
  114. Page 0114
  115. Page 0115
  116. Page 0116
  117. Page 0117
  118. Page 0118
  119. Page 0119
  120. Page 0120
  121. Page 0121
  122. Page 0122
  123. Page 0123
  124. Page 0124
  125. Page 0125
  126. Page 0126
  127. Page 0127
  128. Page 0128
  129. Page 0129
  130. Page 0130
  131. Page 0131
  132. Page 0132
  133. Page 0133
  134. Page 0134
  135. Page 0135
  136. Page 0136
  137. Page 0137
  138. Page 0138
  139. Page 0139
  140. Page 0140
  141. Page 0141
  142. Page 0142
  143. Page 0143
  144. Page 0144
  145. Page 0145
  146. Page 0146
  147. Page 0147
  148. Page 0148
  149. Page 0149
  150. Page 0150
  151. Page 0151
  152. Page 0152
  153. Page 0153
  154. Page 0154

powered by PageTiger