Background Cancer remains a major public health issue globally, with a growing burden due to population aging and lifestyle changes. This study provides the estimates of cancer burden in China for 2024. Methods Cancer data of year 2019 from 919 population-based cancer registries across China submitted to the National Cancer Center were selected, with 106 registries providing continuous data from 2010 to 2019 being used to predict the burden of cancer in 2024. The Segi’s world standard population was used to estimate the age-standardized rates. Joinpoint regression analysis was used to evaluate the trends from 2000 to 2019 by calculating the annual percentage changes (APC) and average annual percentage changes (AAPC). Results In 2024, an estimated 5,150,000 new cancer cases and 2,580,000 cancer deaths occurred in China. The age-standardized incidence rate (ASIR) was 207.70 per 100,000 population and the age-standardized mortality rate (ASMR) was 90.90 per 100,000 population. Lung cancer was the most diagnosed cancer, followed by thyroid, colorectal, breast, and liver cancers. Collectively these top five cancers accounted for 59.13 % of all new cases. The leading cause of cancer death was lung cancer, followed by liver cancer, colorectal cancer, stomach cancer, and esophageal cancer, which together comprised of 66.75 % of all cancer deaths. The age-specific incidence rates increased with age for most cancer sites in men, but for cancers of breast, thyroid, ovarian, and cervix in women, the rates increased significantly in young and middle ages. The age-specific mortality rate increased with age and showed a higher level in men than in women. From 2000 to 2019, the ASIR for all cancers combined increased significantly (AAPC = 1.6 %), while the ASMR decreased (AAPC = −1.4 %). Cancers of the esophagus, stomach, and liver showed declining incidence and mortality trends, whereas thyroid, prostate, and cervical cancers exhibited significant increases in incidence. Conclusions The cancer burden in China continued to be substantial, characterized by a coexistence of cancer patterns of both developing and developed countries. The results highlight the necessity for targeted policies within the “Healthy China 2030" initiative to address sex and age disparities, as well as evolving cancer patterns.

PURPOSE:As cancer survivorship increasingly overlaps with chronic disease management, understanding how comorbidity shapes survivors' care experiences is essential. This study aimed to explore how comorbidity influences cancer survivors' experiences of follow-up care and their expectations of primary care within China's evolving health system. METHODS:A multicenter qualitative study using a descriptive phenomenological approach was conducted across 9 community-level sites in Shandong Province, China. Semi-structured, face-to-face interviews were undertaken with 50 adult cancer survivors living with at least one chronic non-cancer comorbidity. Participants were purposively selected from a larger survey sample using maximum variation sampling. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Data collection continued until saturation was achieved. RESULTS:Three overarching themes emerged. First, comorbidity amplified fragmentation across specialist-driven care pathways, placing survivors in the role of self-coordinators and reinforcing the need for a central primary care provider. Second, overlapping symptoms across cancer and chronic conditions generated persistent uncertainty, increasing survivors' demand for interpretive support from primary care. Third, comorbidity reframed survivorship as a long-term, chronic experience, heightening expectations for continuity, emotional support, and assistance with daily-life management. CONCLUSIONS:Comorbidity fundamentally reshapes cancer survivorship care needs, underscoring the importance of integrating oncology follow-up within primary care-based chronic disease management frameworks. IMPLICATIONS FOR CANCER SURVIVORS:Strengthening primary care coordination and continuity may reduce uncertainty, ease self-management burdens, and improve the overall survivorship experience for individuals living with cancer and comorbidity.

Background The “Healthy China 2030” outline aims to reduce premature mortality from major non-communicable diseases by 30% by 2030 compared to the levels in 2015. In China, approximately 2.57 million cancer-related deaths occurred in 2022. Population-based cancer registries are crucial for assessing cancer burdens and guiding policy. The National Cancer Center (NCC) of China regularly collects cancer registry data, ensures quality control and reports the nationwide statistics on cancer mortality in China. Methods Data from 1073 cancer registries in China were submitted to the NCC in 2019. Quality control was conducted based on Chinese and international guidelines. Temporal trends in premature mortality rates from 2010 to 2019 were analyzed using data from 106 continuous cancer registries representing 8.85% of the Chinese population. Descriptive analysis, standardized mortality rates, and Joinpoint Regression were used to examine cancer-related deaths stratified by sex and area. Results In 2019, the premature mortality rate from cancer in China was 6.67%. Lung cancer had the highest premature mortality rate (1.87%), followed by liver cancer (1.15%). In South China, liver cancer had the highest premature mortality rate, while lung cancer led in other regions. Nasopharyngeal cancer had a higher premature mortality rate in South China. From 2010 to 2019, a significant decreasing trend of 1.9% per year was observed in premature cancer mortality, primarily due to declines in esophageal, stomach, and liver cancers. Conclusions Premature cancer mortality remains a significant issue in China, with lung cancer being the leading cause. Traditionally high-incidence digestive tract cancers in China still carried a substantial burden of premature mortality. Throughout the history of cancer prevention and control, there has been a notable decline in overall premature cancer mortality, particularly for cancers of the digestive tract. In the future, it is imperative to develop tailored screening, early diagnosis, and early treatment strategies for different cancers in order to achieve the goal of reducing premature cancer mortality and enhancing the health of the population.

OBJECTIVE:Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related mortality worldwide. This study was aimed at estimating regional and national variations in lifetime CRC risk worldwide. METHODS:CRC data were extracted from GLOBOCAN 2022, including 185 countries, and population and all-cause mortality data were sourced from the United Nations. The world was divided into 20 geographical regions and categorized by Human Development Index (HDI). Lifetime CRC risk was estimated with the life table method, adjusted for multiple primary cancers. RESULTS:In 2022, the lifetime risks of developing and dying from CRC were 2.69% [95% confidence interval (CI): 2.68-2.70] and 1.39% (95% CI: 1.39-1.40), respectively. Men had a higher risk of colon cancer than rectal cancer, and higher CRC risk than women. Lifetime risk varied by region and HDI: regions with very high, high, moderate, and low HDI had incidence risks of 5.17%, 2.75%, 0.72%, and 0.57%, respectively, and mortality risks of 2.48%, 1.50%, 0.44%, and 0.41%, respectively. Australia/New Zealand had the highest incidence risk (7.41%, 95% CI: 7.30-7.52), and Northern Europe the highest mortality risk (3.28%, 95% CI: 3.24-3.32). Risks were stable before 40 years of age, peaked in middle age, and declined after 70 years of age. Temporally, Thailand had the highest increasing trend in lifetime risk, whereas the United States and Austria showed a decreasing trend. CONCLUSIONS:Lifetime CRC risk differs by subtype, sex, HDI, and geography, and residual risk gradually decreases with age. Targeted primary prevention strategies should be implemented in various countries and regions to mitigate CRC burden.

BACKGROUND:The management and outcomes of liver cancer in China have not been well studied. This study aimed to evaluate the management and prognosis of patients with liver cancer in China through a comprehensive multicenter analysis and to compare these findings with data from the United States (US). METHODS:We conducted a retrospective cohort study using data from 13 hospitals across 10 provinces in China, covering patients diagnosed with primary liver cancer between January 2016 and December 2017. We collected data on sociodemographic characteristics, lifestyle factors, stage at diagnosis, and first-line treatment. Patients' survival outcomes were tracked using active and passive follow-up methods until December 2023. Multivariable Cox regression was used to identify prognostic factors. We further compared treatment patterns and prognoses of liver cancer patients between 13 hospitals in China and the Surveillance, Epidemiology, and End Results (SEER) cohort in the US. RESULTS:A total of 4951 patients with liver cancer from China and 18,365 from the Surveillance, Epidemiology, and End Results cohort were analyzed. In the Chinese cohort, commonly used treatments, ranked from highest to lowest, were surgery (37.3%, 1821/4879), interventional therapy (32.1%, 1570/4898), chemotherapy (17.4%, 850/4877), radiofrequency ablation (6.9%, 337/4872), radiotherapy (3.7%, 182/4890), and targeted therapy (2.6%, 127/4875). Surgery rates for patients with liver cancer in stages I to IV were 59.2% (309/522), 58.8% (443/753), 39.0% (328/841), and 18.6% (141/760), respectively. According to the stage at diagnosis, 5-year survival rates for patients in stages I to IV were 48.1% (95% confidence interval [CI]: 44.0-52.6%), 37.8% (95% CI: 34.5-41.4%), 24.0% (95% CI: 21.3-27.0%), and 8.0% (95% CI: 6.2-10.1%), respectively. Compared with the US, China had higher surgery rates and stage-specific survival for patients with liver cancer across all stages. Data from both countries indicated a poor prognosis for liver cancer, with the stage at diagnosis and surgical intervention being key prognostic factors in both China and the US. CONCLUSION:The present findings underscore the urgent need for early diagnosis and curative treatment interventions such as surgery to enhance survival outcomes for patients with liver cancer.

Cancer has become the second leading cause of death, the global cancer burden is rapidly increasing, and there are marked disparities between and within countries worldwide. Population-based cancer registries systematically collect data on cancer patients in defined populations, which play a crucial role in planning and assessing cancer prevention and control strategies. While the development of cancer registration has been marked by increasing standardization of definitions and methods and the electronic processing of data, the advent of artificial intelligence (AI) offers opportunities to further reduce the labor-intensive nature of registry operations, particularly where registry resources are scarce. These include enabling the processing of large datasets, extracting complex or unstructured data patterns to support cancer registration data abstraction, and facilitating data quality and control. The analysis and dissemination of registry data are also increasingly integrating AI methodologies. This paper provides a comprehensive overview of the application of AI in cancer registration. We investigate the challenges associated with integrating AI into existing cancer registry structures, with a particular emphasis on network and computational constraints, uneven resource allocation, and potential biases and limitations within AI systems. We propose a forward-looking AI-enhanced framework for cancer registration, highlighting AI’s potential to optimize efficiency in cancer registration and the use of registry data for cancer control and cancer research.

Background:Tobacco smoking is the most modifiable risk factor significantly contributing to the global cancer burden. Quantification of tobacco smoking-related cancer burden is essential for guiding future cancer prevention and control policy development. Methods:We used smoking prevalence data obtained from national surveys and relative risks for smoking-associated cancers extracted from high-quality published studies to calculate population attributable fractions (PAFs). We then aggregated PAFs and cancer incidence and mortality data from GLOBOCAN 2022 to estimate age-standardized incidence and mortality rates (ASIRs and ASMRs) attributable to smoking. We also compared cancer ASIRs and ASMRs between never-smokers and smokers. Findings:In 2022, estimates indicated that globally, 2,723,853 new cancer cases and 1,800,642 cancer-related deaths among individuals aged 20 years and above could be attributed to tobacco smoking, corresponding to PAFs of 14.76% (95% CI: 11.90%-17.17%) and 18.84% (95% CI: 15.22%-21.88%), respectively. Overall, males demonstrated substantially higher PAFs than females (incidence: 23.52% vs. 5.66%; mortality: 27.93% vs. 7.40%). However, for males, the highest PAF was observed in regions with a high Human Development Index (HDI), whereas for females, it peaked in regions with a very high HDI. Laryngeal exhibited the highest PAFs, followed by lung, bladder, esophageal, and oral cavity & pharyngeal cancers. However, lung cancer accounted for the largest proportion of smoking-related cancer cases (males 43.30%; females 49.97%) and deaths (males 50.04%; females 55.07%) worldwide. In higher-HDI regions, lung cancer contributed to nearly half of the smoking-related cancer burden (ranging from 45.08% to 63.25% across sexes for cases and deaths). Conversely, in lower-HDI regions, the burden was predominantly driven by oral cavity & pharyngeal, esophageal, and cervical cancers. In Eastern Asia, while the ASIRs and ASMRs of lung cancer among smokers were not globally the highest, the ASIRs (males: 39.04 per 100,000; females: 43.67 per 100,000) and ASMRs (males: 28.92 per 100,000; females: 20.86 per 100,000) among never-smokers in this region exceeded those in other geographical areas. Interpretation:Future efforts must therefore integrate aggressive, context-specific tobacco control into the core of cancer prevention strategies while prioritizing research into the unique risk factors driving lung cancer among never-smokers, particularly in high-burden populations such as Asian females. Funding:Capital's Funds for Health Improvement and Research (CFH2024-2G-40214), the CAMS Innovation Fund for Medical Sciences (2021-I2M-1-011), National High Level Hospital Clinical Research Funding (2025-LYZX-R-A03), and 2023 Special Survey on Science and Technology Basic Resources (2023FY100605).

Objective This study aimed to systematically estimate the global incidence levels and distribution characteristics of anatomical subsites of colon cancer across different ages, sexes and geographic regions in 2022. Methods Colon cancer cases in 2022 were obtained from the International Agency for Research on Cancer (IARC)’s GLOBOCAN database. Cases with anatomical subsites of colon cancer were obtained from Volume XII of Cancer Incidence in Five Continents (CI5). Age-standardized incidence rates (ASRs) and the proportional distribution of anatomical subsites were calculated by age group, sex, world region and Human Development Index (HDI). Data from 2003 to 2017 were obtained from CI5 Volumes X, XI, and XII, and temporal trends were analyzed using Joinpoint regression. Results Globally, the ASR for proximal colon cancer was higher than that for distal colon cancer (5.59 vs 5.11 per 100,000 person-years) in all populations. As HDI level increases, the ASRs for all anatomical subsites generally increased among people aged 50 years and above. Sigmoid colon cancer had the highest ASR globally. Appendiceal cancer accounted for over 65% of cases in the 0–14 years age group, but declined sharply with age. More countries had an increasing trend for proximal colon cancer incidence than for distal colon cancer (19 countries vs 13 countries), and the upward trend was more pronounced among individuals aged 0–49 years. Conclusions The global distribution of colon cancer anatomical subsites exhibits age-specific and geographical disparities. The rising incidence of early-onset proximal and distal colon cancers indicates the need for tailored screening strategies and resource allocation.

What is already known about this topic?:Esophageal cancer (EC) consists of two main histological subtypes: esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC), each with distinct epidemiological patterns. Historically, ESCC has been the dominant subtype worldwide, especially in Asian countries. However, in recent decades, the incidence of EAC has been rising rapidly, particularly in European and American countries, reflecting significant shifts in global EC epidemiology. What is added by this report?:This study presents a comprehensive analysis of 25 years of high-quality continuous data on ESCC and EAC incidence trends across 25 countries. It highlights declining ESCC rates in most regions, rising EAC rates in Western nations, pronounced sex differences, and narrowing ESCC-to-EAC ratios. These diverse trends reveal the need to investigate region-specific risk factors and their contributions to the shifting burden of EC globally. What are the implications for public health practice?:The distinct trends of ESCC and EAC call for tailored public health strategies based on regional and histological patterns. Countries experiencing a rising burden of EAC or ESCC can implement targeted risk factor prevention and control measures to address the increasing trends. In clinical practice, a stronger focus on EAC in high-income countries and ESCC in regions, where it remains dominant, can improve early detection and treatment outcomes. Understanding these evolving patterns will aid in designing evidence-based interventions and optimizing resource allocation to reduce the global esophageal cancer burden effectively.

Background: Global disparities exist in the burden of cervical cancer. This study aims to describe and analyze the global epidemiological landscape of cervical cancer in 2022, including recent trends in incidence. Methods: Data from GLOBOCAN 2022 database were used to analyze the incidence and mortality of cervical cancer across 185 countries and regions. We analyzed the age-standardized incidence rates (ASIR) and age-standardized mortality rates (ASMR) of cervical cancer across various geographical regions. The relationship between ASIR, ASMR, mortality to incidence ratio (MIR) and Human Development Index (HDI) was evaluated using the simple linear regression model. Additionally, cervical cancer incidence data from 36 countries between 2003 and 2017 were extracted from the Cancer Incidence in Five Continents (CI5) plus database, and the average annual percent change (AAPC) was calculated using Joinpoint software. Results: In 2022, there were 622,301 cervical cancer cases worldwide, with an ASIR of 14.1 per 100,000. Geographically, the highest ASIR was observed in East Africa (40.4 per 100,000), and the lowest in Western Asia (4.2 per 100,000). Only 11 out of the 185 countries and regions reported an ASIR lower than the World Health Organization’s target as established by the Cervical Cancer Elimination Initiative. There were 348,874 cervical cancer deaths worldwide in 2022, with an ASMR of 7.1 per 100,000. The highest ASMR was in East Africa, followed by Central Africa, and South Africa. There existed negative correlations between HDI and the ASIR, ASMR and MIR of cervical cancer. The disease burden was higher in regions with medium and low HDI compared to the global average, whereas it was lower in regions with very high HDI regions. Among the 36 countries with trend incidence data, seven exhibited significant increases in their ASIRs with AAPCs ranging from 0.9% to 5.9%, while 14 countries demonstrated significant decreases in their ASIRs with AAPCs ranging from −0.8% to −5.9%. Conclusions: Cervical cancer continues to represent a substantial global health burden. The disease burden is marked by clear socioeconomic disparities, underscoring the need to develop and evaluate targeted cervical cancer prevention and control strategies for specific regions.

Inpatient cancer patients often carry the dual burden of the cancer itself and comorbidities, which were recognized as one of the most urgent global public health issues to be addressed. Based on a case study conducted in a tertiary hospital in Shandong Province, this study developed a framework for the extraction of hospital information system data, identification of basic comorbidity characteristics, estimation of the comorbidity burden, and examination of the associations between comorbidity patterns and outcome measures. In the case study, demographic data, diagnostic data, medication data and cost data were extracted from the hospital information system under a stringent inclusion and exclusion process, and the diagnostic data were coded by trained coders with the 10th revision of the International Classification of Diseases (ICD-10). Comorbidities in this study was assessed using the NCI Comorbidity Index, which identifies multiple comorbidities. Rates, numbers, types and severity of comorbidity for inpatient cancer patients together form the characterization of comorbidities. All prevalent conditions in this cohort were included in the cluster analysis. Patient characteristics of each comorbidity cluster were described. Different comorbidity patterns of inpatient cancer patients were identified, and the associations between comorbidity patterns and outcome measures were examined. This framework can be adopted to guide the patient care, hospital administration and medical resource allocation, and has the potential to be applied in various healthcare settings at local, regional, national, and international levels to foster a healthcare environment that is more responsive to the complexities of cancer and its associated conditions. The application of this framework needs to be optimized to overcome a few limitations in data acquisition, data integration, treatment priorities that vary by stage, and ethics and privacy issues.

Supplementary Table 1 shows three major measures of data quality of cancer registries included in this study.

Introduction:This study aims to report the epidemiological trends and provide updated estimates and lifetime risks for breast and cervical cancers among women in Guangdong province. Methods:A Bayesian age-period-cohort model was applied to project incidence and mortality rates for 2023. The adjusted for multiple primaries (AMP) method was used to calculate the lifetime risks of developing and dying from breast and cervical cancer. Joinpoint analysis was employed to describe the temporal trends. Results:The age-standardized incidence rate (ASIR) of female breast cancer increased from 2012 to 2019 in Guangdong province, with a particularly pronounced increase noted in the rural areas. The ASIR for cervical cancer among women aged over 55 increased in both urban and rural areas, whereas a declining trend was observed among women under the age of 55. The age-standardized mortality rates (ASMRs) for both breast cancer and cervical cancer demonstrated upward trends among women aged over 55, while no significant trend in ASMR was found for women under 55 years. In 2023, the estimated incidence rates of breast cancer and cervical cancer would be 50.81/105 (ASIR would be 35.57/105) and 15.31/105 (ASIR would be 10.41/105) respectively, with corresponding mortality rates of 10.78/105 (ASMR would be 7.15/105) and 6.11/105 (ASMR would be 3.93/105) for these cancers. Conclusions:Breast cancer continues to pose a significant threat to women's health in both rural and urban areas of Guangdong, whereas cancer prevention and control programs for cervical cancer have shown positive impacts among the younger population. Greater emphasis should be placed on women aged over 55 to halt the rising mortality rates of both cancers within this population.

Background:The effectiveness of endoscopic screening for upper gastrointestinal (UGI) tract cancers in high-risk areas of China has been well-established. However, the practicality of extending this screening to a wider geographical area remains uncertain. To bridge this gap, we have conducted a hospital-based opportunistic endoscopic screening (OpENS) program for UGI cancers since 2018. Our objectives were to elucidate the implementation process of the OpENS program and assess its effectiveness. Methods:875 hospitals from 710 districts/counties have participated in the OpENS program during 2019-2023. The endoscopic specialists and pathologists participating in the program were mandated to take annual training programs to acquire the fundamentals of screening techniques. Eligible patients who underwent endoscopic examinations were screened for UGI cancers. Patients diagnosed with high-grade intraepithelial neoplasia (HGIN), carcinoma in situ (CIS) and tumors in esophagus or/and stomach were defined as positive cases. Patients with HGIN and CIS were defined as early cases. All hospitals were required to submit screening data via the program's platform, with both the quality of the submitted data and the hospitals' performance being subject to a comprehensive evaluation. The age-standardized incidence rates (ASIRs) for the districts/counties where the participating hospitals were situated were derived from the cancer registry data for the year 2020. Districts/counties with ASIRs for UGI cancers over 22.0/105 were classified as high-risk areas. The positive detection rate (PDR) and early diagnosis rate (EDR) were calculated. Findings:After data cleaning, we included 808 hospitals from 616 districts/counties, with a collective participation of 7,066,892 individuals during 2019-2023. The overall PDR and EDR across all sites were 2.35% and 19.77%. The PDRs and EDRs were 1.02% and 23.18% in esophagus, and were 1.37% and 17.80% in stomach. The PDR was higher among males compared to females (3.59% vs 1.20%), and was increasing with age. The EDR was higher among females compared to males (20.66% vs 19.45%), peaking in the age group of 60-64 years. The PDRs and EDRs were higher in high-risk areas of UGI cancers (p < 0.05). After adjusting for age, sex, province, year of screening, regional UGI cancer incidence level and hospital tier, the hospitals that consecutively participated in the program for five years demonstrated higher PDRs and EDRs when compared to other hospitals (p < 0.05). Among the consecutively participated hospitals, tertiary-level hospitals demonstrated positive associations with the PDRs for both the esophagus and stomach when compared to secondary-level hospitals (p < 0.001). However, the tertiary-level hospitals showed a negative association with the EDR for the esophagus (OR = 0.91, 95% CI: 0.86-0.96, p = 0.001), but exhibited a positive association with the EDR for the stomach (OR = 1.11, 95% CI: 1.05-1.17, p < 0.001). Interpretation:The OpENS program has rapidly expanded across the country. The program has demonstrated high PDRs and EDRs, with hospitals that performed well exhibiting significantly better screening outcomes. Among these well-performed hospitals, secondary-level hospitals can achieve comparable results to tertiary-level hospitals in screening for esophageal lesions, albeit not for stomach lesions. Considering the current hospital capacities in China, the training-guided opportunistic UGI endoscopy screening exhibits significant feasibility and effectiveness across areas with varying level of UGI risks. Funding:CAMS Innovation Fund for Medical Sciences (No. 2021-I2M-1-061, 2021-I2M-1-023).

BACKGROUND:Global disparities in healthcare resources impact diagnosis, treatment, and ongoing supportive care for cancer. As these resource levels can be considered modifiable factors of health inequality on a global scale, we aimed to explore their association with the global cancer burden and quantify the extent of these inequalities. METHODS:Healthcare resource capacity was measured using the universal health coverage (UHC) index and current health expenditure as a percentage of gross domestic product [CHE/GDP (%)]. Cancer data were sourced from the GLOBOCAN database. Variables such as age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and a proxy for 5-year survival (1 - mortality to incidence ratio) were calculated. Absolute and relative inequalities in cancer burden were assessed using the slope index of inequality and concentration index. The association between healthcare resources and cancer burden was further explored by negative binomial regression. Counterfactual simulations quantify inequalities based on healthcare resource levels. RESULTS:Marked absolute and relative inequalities were found in the burden of most cancer types related to the UHC index and the CHE/GDP (%) gradient. Both the absolute and relative burdens of cancer were concentrated in areas with high UHC index and CHE/GDP (%) levels. A significant positive association was found between the ASIR [incidence rate ratio (IRR): 1.77, 95% confidence interval (CI): 1.57-2.00] and survival (IRR: 1.60, 95% CI: 1.48-1.73) with the UHC index. A weaker positive association was found for CHE/GDP (%) with ASIR (IRR: 1.37, 95% CI: 1.20-1.56) and survival (IRR: 1.23, 95% CI: 1.13-1.35). No significant association was found between ASMR and either the UHC index or CHE/GDP (%). An estimated 21% of cancer deaths were associated with the potential to be prevented, with survival rates matching the most advanced nations in each region, and over 31% of cancer deaths were associated with the potential to be prevented, with survival rates matching the most advanced nations worldwide. CONCLUSIONS:Substantial inequalities in the cancer burden related to healthcare resources are apparent worldwide. Allocating healthcare resources at optimal levels can improve survival and reduce cancer-related deaths. These findings emphasize the need for targeted interventions and policies to address inequalities in healthcare resource allocation and ensure equitable access to cancer treatment.

Supplementary Table 3 shows the difference in age-standardized esophageal cancer mortality rates between 90th and 10th percentile counties by province and time period.

BACKGROUND: To analyze the epidemiological characteristics and disease burden of digestive system cancer in Guangdong in 2019, and to provide evidence for prevention and treatment of digestive system cancer. METHODS: Both incidence and mortality data of the five digestive system cancers (esophageal cancer, stomach cancer, colorectal cancer, liver cancer and pancreatic cancer ) used in calculations originated from the cancer registration system of Guangdong Province. Crude incidence rate, mortality rate, age-standardized incidence and mortality rate, 35–64 year-old truncated incidence and mortality rate, 0–64 year-old cumulative incidence and mortality rate, disability adjusted life years (DALY), and cause-eliminated life expectancy were used to estimate the disease burden due to digestive system cancers in Guangdong province in this study. The life expectancy and the cause-eliminated life expectancy were calculated using an abridged life table method in this study. The standard population adopted in this study was the Segi’s world standard population. RESULTS: In 2019, the crude incidence rates and crude mortality rates of digestive system cancers were 82.30/100,000 and 56.53/100,000 respectively in Guangdong Province. The age-standardized incidence rates and age-standardized mortality rates were 59.61/100,000 and 37.27/100,000, respectively. The total DALY and DALY rate of digestive system cancers in Guangdong Province were 1,681,089 person-years and 1,459.42/100,000. After eliminating causes of death from digestive system cancers, the life expectancy increased by 0.83 years, from 84.10 years to 84.93 years in Guangdong Province. In the disease burden of digestive system cancer, the disease burden is higher in males than in females and higher in rural areas compared to urban areas. Among these, colorectal cancer has the highest incidence, liver cancer exhibited the highest mortality, disease burden, and the most significant impact on life expectancy. CONCLUSIONS: Digestive system cancers exhibited a heavy disease burden in Guangdong Province. There were discernible gender and regional disparities in the incidence, mortality, and disease burden associated with five digestive system cancers. Liver cancer and colorectal cancer emerged as the predominant malignancies contributing to the disease burden in Guangdong Province. The vast majority of DALYs were due to YLL, indicating the need to focus resources on disease prevention and early detection. Guangdong Province should implement targeted interventions against modifiable risk factors for colorectal and liver cancers among high-risk populations and in high-incidence regions, thereby reducing the disease burden in the future.

Supplementary Figure 1 shows the geographic distribution and population coverage of 782 counties included in final analyses, along with the population density of China.

OBJECTIVE:Cervical cancer is a growing concern in China, especially among women who reside in rural areas and older women. Understanding age- and region-specific trends in cervical cancer is vital for informing policy and assessing progress toward WHO elimination targets. METHODS:The 2000-2020 data from 22 long-standing registries contributing to the China national cancer registry was analyzed to estimate age-standardized incidence and mortality rates (ASIR and ASMR, respectively). Joinpoint regression yielded an average annual percentage change (AAPC) stratified by age group (<35, 35-64, 65-74, and ≥75 y) and by urban-rural area. The comparative analysis included GLOBOCAN Overtime data from selected Asia-Pacific countries. RESULTS:The ASIR tripled in China between 2000 and 2020 before stabilizing (AAPC = 6.5%), while the ASMR rose steadily (AAPC = 3.9%). The urban incidence declined after 2009 among women <35 y, while rural trends were broadly stable. The ASIR and ASMR increased in urban areas among women 35-64 y of age, while rural areas had a rising ASIR and a stable ASMR, suggesting potential screening effects. In contrast, women ≥65 y of age had a steadily increasing incidence and mortality in rural and urban areas. Australia and Republic of Korea had consistent declines in the ASIRs and ASMRs compared to other Asia-Pacific countries, whereas Japan exhibited rising trends. The Philippines experienced a surge in mortality rates, despite incidence rates remaining stable or declining. CONCLUSIONS:The cervical cancer burden in China has begun to plateau but large disparities persist by age and geography. To achieve elimination of cervical cancer, it is imperative to implement tailored strategies that prioritize the urgent expansion of HPV vaccination programs, the deployment of high-efficacy screening methods, and the universal access to treatment throughout the nation.

Background:Haematologic malignancies accounted for 6.6% of total cancer cases and 7.2% of total cancer-related deaths worldwide in 2022. We implemented a novel approach to estimate the lifetime risk of developing and dying from various types of haematologic malignancies at the global, regional and country-specific perspectives in 2022. Methods:We retrieved incidence and mortality rates for Hodgkin lymphoma (HL), Non-Hodgkin lymphoma (NHL), multiple myeloma (MM) and leukaemia from GLOBOCAN 2022 of 185 countries, along with the national population statistics and all-cause mortality data sourced from the United Nations. For trend analysis, we obtained consecutive cancer registry data spanning from 2003 to 2017 from the Cancer Incidence in Five Continents (CI5) Plus database. After quality control, datasets from 30 countries were included. We used the "adjusted for multiple primaries (AMP)" method to calculate the lifetime risk of incidence (LRI) and mortality (LRM) by cancer type, selected age interval, sex, country and geographic region. Findings:In 2022, the global lifetime risk of incidence (LRI) and mortality (LRM) for all haematologic malignancies was 1.67% and 0.98%, respectively. LRI was highest for NHL, whereas the LRM was highest for leukaemia. On a general level, males exhibited higher LRI and LRM compared to females. Both LRI and LRM increased with higher Human Development Index (HDI) levels. The LRI and LRM for haematologic malignancies were notably high in regions such as Australia/New Zealand, Northen America, as well as Northen, Western and Southern Europe, whereas they were comparatively low in Middle, Western and Eastern Africa. We observed about 5-fold regional disparity in the LRI/LRM ratio for HL, ranging from 1.50 in Middle Africa to 7.67 in Western Europe. Individuals aged 60 and above still faced 71.26% and 78.57% remaining risks for developing and dying from all haematologic malignancies. Among the 185 countries studied, NHL was the haematologic malignancy with the highest LRI in 68.65% of the countries. However, leukaemia had the highest LRM in 58.92% of these countries. MM exhibited the highest LRI and LRM particularly in islands surrounding the Caribbean Sea. Out of 30 countries with eligible consecutive cancer surveillance data, 24 exhibited significant upward trends in LRI of all haematologic malignancies, with AAPCs ranging from 0.5% in USA to 4.3% in Latvia. 25 countries showed significant upward trends in LRM, with AAPCs ranging from 1.0% in USA to 5.5% in Republic of Korea. Interpretation:The global lifetime risks of haematologic malignancies exhibit considerable variations across different world regions, necessitating country-specific and targeted decision-making strategies. In contrast to traditional indicators, the compositive lifetime risks provide intuitive measures with profound public health implications, offering fresh insights into the development of regional disease prevention and control strategies. Funding:CAMS Innovation Funds for Medical Sciences (No. 2021-I2M-1-061, No. 2021-I2M-1-011).