Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based cancer registries.
Abstract
From 2003 to 2005, standardised 5-year cancer survival in China was much lower than
in developed countries and varied substantially by geographical area. Monitoring population-level
cancer survival is crucial to the understanding of the overall effectiveness of cancer
care. We therefore aimed to investigate survival statistics for people with cancer
in China between 2003 and 2015.We used population-based data from 17 cancer registries
in China. Data for the study population was submitted by the end of July 31, 2016,
with follow-up data on vital status obtained on Dec 31, 2015. We used anonymised,
individual cancer registration records of patients (aged 0-99 years) diagnosed with
primary, invasive cancers from 2003 to 2013. Patients eligible for inclusion had data
for demographic characteristics, date of diagnosis, anatomical site, morphology, behaviour
code, vital status, and last date of contact. We analysed 5-year relative survival
by sex, age, and geographical area, for all cancers combined and 26 different cancer
types, between 2003 and 2015. We stratified survival estimates by calendar period
(2003-05, 2006-08, 2009-11, and 2012-15).There were 678 842 records of patients with
invasive cancer who were diagnosed between 2003 and 2013. Of these records, 659 732
(97·2%) were eligible for inclusion in the final analyses. From 2003-05 to 2012-15,
age-standardised 5-year relative survival increased substantially for all cancers
combined, for both male and female patients, from 30·9% (95% CI 30·6-31·2) to 40·5%
(40·3-40·7). Age-standardised 5-year relative survival also increased for most cancer
types, including cancers of the uterus (average change per calendar period 5·5% [95%
CI 2·5-8·5]), thyroid (5·4% [3·2-7·6]), cervix (4·5% [2·9-6·2]), and bone (3·2% [2·1-4·4]).
In 2012-15, age-standardised 5-year survival for all patients with cancer was higher
in urban areas (46·7%, 95% CI 46·5-47·0) than in rural areas (33·6%, 33·3-33·9), except
for patients with oesophageal or cervical cancer; but improvements in survival were
greater for patients residing in rural areas than in urban areas. Relative survival
decreased with increasing age. The increasing trends in survival were consistent with
the upward trends of medical expenditure of the country during the period studied.There
was a marked overall increase in cancer survival from 2003 to 2015 in the population
covered by these cancer registries in China, possibly reflecting advances in the quality
of cancer care in these areas. The survival gap between urban and rural areas narrowed
over time, although geographical differences in cancer survival remained. Insight
into these trends will help prioritise areas that need increased cancer care.National
Key R&D Program of China, PUMC Youth Fund and the Fundamental Research Funds for the
Central Universities, and Major State Basic Innovation Program of the Chinese Academy
of Medical Sciences.
Type
Journal articleSubject
HumansNeoplasms
Registries
Survival Rate
Adolescent
Adult
Aged
Aged, 80 and over
Middle Aged
Child
Child, Preschool
Infant
Infant, Newborn
China
Female
Male
Young Adult
Cancer Survivors
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https://hdl.handle.net/10161/16698Published Version (Please cite this version)
10.1016/s2214-109x(18)30127-xPublication Info
Zeng, Hongmei; Chen, Wanqing; Zheng, Rongshou; Zhang, Siwei; Ji, John S; Zou, Xiaonong;
... He, Jie (2018). Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based
cancer registries. The Lancet. Global health, 6(5). 10.1016/s2214-109x(18)30127-x. Retrieved from https://hdl.handle.net/10161/16698.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
John Ji
Adjunct Associate Professor in Global Health Research Center at Duke Kunshan University
John S. Ji is an environmental epidemiologist working on healthy aging and climate
change.

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