China saw an estimated 21.6% increase in cancer deaths between 2005 and 2020 to around 2.39 million, according to a new study led by researchers from the Chinese Center for Disease Control and Prevention and Capital Medical University.

The study highlighted large differences between rural and urban areas, as well as between sexes.

Based on data from the National Mortality Surveillance System, a nationally representative survey of mortality in China, the researchers found a 5% increase from 2005 to 2020 in Years of Life Lost (YLL), a measure of premature mortality calculated by subtracting the age at which a person dies from the standard life expectancy.

The researchers attributed the “remarkable increase” in the absolute number of cancer-related deaths and YLLs to population aging, with population growth a secondary factor. Lung cancer, liver cancer, and stomach cancer remain the top three causes of cancer-related deaths.

The number of deaths increased for most cancer types in both rural and urban areas. Age-standardized YLL rates for almost all cancer types in urban areas “decreased significantly,” while in rural areas, YLL rates increased for half of the cancer types.

In urban areas, the study found upticks in YLLs caused by pancreatic cancer and mouth cancer among men, and colon cancer among women.

In rural areas, lung cancer became the leading cause of YLLs for men during this period, displacing liver cancer, and remained the most fatal cancer type for women.

Trends in smoking rates across the country may explain these differences, the researchers suggested, as smoking has slowly declined overall in China but not in rural areas.

The study also found that Chinese men are at higher risk of dying from cancer than women. Possible explanations include lifestyle differences, such as men being much more likely to smoke.

The state’s increased efforts to provide advanced screening for breast and cervical cancer are also credited with lowering mortality and YLL rates for those cancers among women. 

China is becoming more akin to a “high-income country” in its cancer burden, the researchers said. For example, there were increases in the mortality rates of colon and rectum cancer in higher-income provinces — cancers closely linked to signs of economic development such as obesity and alcohol consumption.

In November, the National Health Commission reported a 90% gap between Chinese people’s consumption of fresh fruits and the recommended amount.

Cancer has been the leading cause of death in China since 2010, and the country has a much higher mortality rate than the global average despite having a similar incidence rate.

In 2019, the National Cancer Center of China estimated that the annual cancer treatment costs in the country will exceed 220 billion yuan ($30.8 billion), making it one of the biggest burdens on China’s health system.

The figure is set to increase as China’s population continues to age. According to the National Health Commission, by around 2025, the number of Chinese aged 60 and above will exceed 400 million, or 30% of the total population, compared to 14.2% in 2021.

The government has rolled out several major cancer control and prevention policies in recent years, including more expansive screening and education programs. In 2017, it set a target of increasing the overall cancer five-year survival rate by 10% by 2025.

The researchers called for more policies to combat cancer, including strict tobacco control policies. “Given population aging and increasingly modern lifestyles, our findings suggest that special efforts are needed,” they said.

Editor: Vincent Chow.

(Header image: IC)