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Cancer profiles in China and comparisons with the USA: a comprehensive analysis in the incidence, mortality, survival, staging, and attribution to risk factors

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Abstract

China faces a disproportionate cancer burden to the population size and is undergoing a transition in the cancer spectrum. We extracted data in five aspects of cancer incidence, mortality, survival, staging distributions, and attribution to risk factors in China, the USA and worldwide from open-source databases. We conducted a comprehensive secondary analysis of cancer profiles in China in the above aspects, and compared cancer statistics between China and the USA. A total of 4,546,400 new cancer cases and 2,992,600 deaths occurred in China in 2020, accounting for 25.1% and 30.2% of global cases, respectively. Lifestyle-related cancers including lung cancer, colorectal cancer, and breast cancer showed an upward trend and have been the leading cancer types in China. 41.6% of new cancer cases and 49.3% of cancer deaths occurred in digestive-system cancers in China, and the cancers of esophagus, nasopharynx, liver, and stomach in China accounted for over 40% of global cases. Infection-related cancers showed the highest population-attributable fractions among Chinese adults, and most cancers could be attributed to behavioral and metabolic factors. The proportions of stage I for most cancer types were much higher in the USA than in China, except for esophageal cancer (78.2% vs. 41.1%). The 5-year relative survival rates in China have improved substantially during 2000–2014, whereas survival for most cancer types in the USA was significantly higher than in China, except for upper gastrointestinal cancers. Our findings suggest that although substantial progress has been made in cancer control, especially in digestive system cancers in China, there was still a considerable disparity in cancer burden between China and the USA. More robust policies on risk factors and standardized screening practices are urgently warranted to curb the cancer growth and improve the prognosis for cancer patients.

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Acknowledgement

This work was supported by the National Natural Science Foundation of China (82273721), the Jing-jin-ji Special Projects for Basic Research Cooperation (J200017) and the Sanming Project of the Medicine in Shenzhen (SZSM201911015). The views expressed are those of the authors only and do not represent any official position of the National Cancer Center (NCC) of China, Cancer Hospital, Chinese Academy of Medical Sciences (CHCAMS), Chinese Academy of Medical Sciences (CAMS), or Peking Union Medical College (PUMC).

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  1. Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

    Siyi He, Changfa Xia, He Li, Maomao Cao, Fan Yang, Xinxin Yan, Shaoli Zhang, Yi Teng, Qianru Li & Wanqing Chen

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  1. Siyi He
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He, S., Xia, C., Li, H. et al. Cancer profiles in China and comparisons with the USA: a comprehensive analysis in the incidence, mortality, survival, staging, and attribution to risk factors. Sci. China Life Sci. 67, 122–131 (2024). https://doi.org/10.1007/s11427-023-2423-1

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