Analysis Of Incidence And Mortality Rates Of Malignant Tumors In Hebei Provincial Cancer Registry Areas In 2013 And Prediction Of Incidence Of Malignant Tumors In High-risk Area

Objective: Cancer has been the leading cause of death in China, which is threatened to human’s health. The National Central Cancer Registry indicated that a total of 3.586 million new cancer cases and 2.187 million cancer deaths were estimated in China in 2012. The incidence and mortality rates of cancers in Hebei province were higher than some areas in China. The earliest population-based registry of Hebei province was established in Cixian which is one of the high-risk areas for esophageal cancer in China and worldwide. It’s important to monitor incidence and mortality rates of cancers and to predict the incidence trends. The data of cancer registries could provide the basic information for cancer prevention, control and reduction of cancers’ incidence and mortality rates. This study aimed to analyze the incidence and mortality rates in Hebei Provincial cancer registry areas. We also extracted the data of esophageal cancers in Cixian to predict the incidence trends.Method: The cancer data which were reported to cancer registries were from local hospitals, community health service centers, the Basic Medical Insurances for Urban Residents, the New-Rural Cooperative Medical System and the Death Surveillance. The data were collected from 21 population-based cancer registries(Baoding city, Qinhuangdao city, Cangzhou city, Shijiazhuang city and Shuangqiao district of Chengde city were cities; Cixian, Shexian, Qianxi county, Wuan county, Zanhuang county, Fengning county, Xinji county, Xingtai county, Zhangbei county, Anguo county, Haixing county, Yanshan county, Neiqiu county, Renxian, Xuanhua county and Shenze county were counties) of Hebei province in 2013. Data were checked and evaluated with MS-Excel, SAS and IARC Tools based on “Guideline for Chinese Cancer Registration” and referring to relevant data quality criterion of IARC/IACR. All cancers were coded by International Classification of Disease for Oncology Third Edition(ICD-O-3) and 10 th Revision(ICD-10). Data of 21 cancer registries met the standard. Incidence and mortality rates stratified by areas(urban/rural), sex, age group and cancer site were analyzed. Incidence and mortality rates, proportions, cumulative rates and truncated age-standardized rates were calculated. Chinese population census in 2000 and Segi’s populations were used for age-standardized incidence/mortality rates. Grey system model GM(1, 1) was used to predict the incidence rates of esophageal cancer in 2014-2018 in Cixian.Results: All cancer registries covered 11183830 populations(5684047 in male and 5499783 in female), accounting for 15.25% of Hebei Provincial population in 2013. The percentage of cases morphologically verified(MV %) and death certificate-only cases(DCO %) were 75.51% and 3.22%, respectively. The mortality to incidence rate ratio(M/I) was 0.63.The total new cancer incidence cases were 25275 in Hebei provincial cancer registry areas in 2013. The crude incidence of cancer was 226.00/105(249.75/105 in male, 201.44/105 in female), and the age-standardized incidence rates by Chinese standard population(ASIRC) and by world standard population(ASIRW) were 166.58/105 and 164.50/105 with the cumulative incidence rate(0-74 age years old) of 19.44%. The crude incidence of cancer in urban areas was 225.74/105, and the ASIRC and the ASIRW were 162.05/105 and 159.46/105. The crude incidence of cancer in rural areas was 226.18/105, and the ASIRC and the ASIRW were 169.18/105 and 167.53/105. Lung, stomach, esophagus, liver and breast cancer were the top five most common cancers for both sexes. The 10 most common cancers accounted for 80.69%.The total deaths were 15916 in Hebei provincial cancer registry areas in 2013. The crude mortality of cancer was 142.31/105(175.47/105 in male, 108.04/105 in female). The age-standardized mortality rates by Chinese standard population(ASMRC) and by world standard population(ASMRW) were 101.86/10/105 and 100.93/105 with the cumulative mortality rate(0-74 age years old) of 11.41%. The crude mortality of cancer in urban areas was 134.19/105 while it was 148.29/105 in rural areas. Lung cancer was the leading cause of cancer death followed by cancers of stomach, liver, esophagus and colorectum. Ten of the leading cause of cancer death accounted for 80.93% of all cancer deaths. In Cixian, the incidence trend of esophagus cancer was decreased. The incidence rates of esophagus cancer for male and female were 77.94/105 and 56.91/105, respectively.Conclusions: The incidence and mortality rates of cancers were 226.00/105 and 142.31/105 in Hebei provincial cancer registry areas in 2013, respectively. The incidence and mortality rates of cancers were higher for male than for female. They were higher in rural areas than in urban areas. The burden of cancers in Hebei province was heavy. The most common cancers were lung cancer, stomach cancer, esophagus cancer, liver cancer, breast cancer and colorectal cancer in Hebei province. The incidence rate of esophagus cancer was decreased in Cixian, but it was higher than the level of China. It’s the key task that strengthening cancers screening, early diagnosis and early treatment for Hebei provincial residents, especially residents in rural areas to reduce morbidity and mortality of the major malignant tumors.