How China battles against increasing cancer death rates with technology

Recently, China initiated a series of research and clinical programs aimed at the early detection and treatment of various types of cancer. Under the direction and support of the National Health Commission and the Ministry of Education, the clinical medicine advanced research institute project looks to establish a big data platform and collect inputs on rare and hard-to-treat diseases so they can be analyzed by research institutions.

Meanwhile, Peking University will lead another initiative known as the China pan-cancer early detection and treatment cohort study, along with 10 other top-tier hospitals, that looks to find reliable tumor markers for diagnosis of various types of cancer, which has become a leading cause of death in the country since 2010, according to official statistics.  

"[We] hope to utilize state-of-the-art technology for early diagnosis, whether it's tumors in the gastrointestinal tract, in the urinary system, or related to obstetrics and gynecology," Qiao Jie, executive vice deputy director of Peking University Health Science Center, told China Media Group. 

"Initiating multiple tumor studies simultaneously, [we] aim to apply advanced methods in diagnosis, treatment, and prevention as early as possible, contributing to their clinical implementation. The goal is to establish world-class innovative research techniques in the overall field of clinical medicine with the ultimate goal of serving the public."

The total number of cancer-related deaths in China increased by 21.6 percent between 2005 and 2020, reaching roughly 2.4 million people, while lung, liver and stomach cancers remained the top three lethal cancer types in the country, according to a study by Chinese scholars published by The Lancet Public Health in December last year. The study, titled "National and subnational trends in cancer burden in China, 2005-20,” aims to assess the changes in cancer burden across China during the period mentioned, using data from the national death rate monitoring system.

The research estimated the mortality rates and years of life lost (YLL) for all cancers and 23 cancer groups in 31 provinces, stratified by age and gender. Using the 2020 Chinese population census as a reference, the study calculated age-standardized death rates and YLL rates. It pointed out that China's cancer burden has gradually approached that of high-income countries in this period, while significant differences between genders, ages and urban-rural areas in terms of cancer death rates have emerged.

The researchers suggested that significant differences in cancer burden between genders may be related to biological differences and environmental factors, including men being more exposed to occupational risks, high societal pressure and unhealthy lifestyles.

The study mentioned that in urban areas, with the exception of prostate cancer in males and multiple myeloma in females, age-standardized death rates and YLL rates for almost all cancer types showed a significant decrease. However, in rural areas, about half of the cancer types had an increase in age-standardized YLL rates.

The researchers believed that these phenomena were influenced by various factors, while differences in risk factors could also play a role, as the smoking rate in rural areas was higher than in urban areas.

"To some extent, the trends in cancer death rates can be explained by changes in relevant risk factors and incidence," the study stated. It further cited an example of how the higher smoking rate among Chinese men contributed to the high lung cancer death rate. From 2007 to 2018, the male smoking rate decreased from 58.4% to 50.8%, and the female smoking rate decreased from 2.2% to 1.9%.

Although the smoking rate was slowly declining, it did not significantly decrease in rural areas of China. Additionally, from 2000 to 2016, the incidence of all cancers in males remained relatively stable, while in females, it increased significantly by 2.3 percent annually, which could also contribute to the increase in cancer death rates.

Changes in the burden of diseases such as colon and rectal cancer and pancreatic cancer in high-income provinces have been noteworthy. Increasing colorectal cancer cases have been associated with economic growth, as they are closely related to lifestyle. The study mentioned that in high-income regions, the increased intake of animal-based foods, obesity and unhealthy habits such as smoking and drinking were important factors in the development of colorectal and pancreatic cancers.

Given the aging population and the increasingly modernized lifestyle, the researchers suggested the need to adjust the national cancer control plan to reduce the burden of trachea, bronchus and lung cancers, as well as other emerging cancers. They emphasized the government's role in promoting cost-effective cancer screening and vaccination programs, implementing strict tobacco control policies and working towards raising awareness of healthy lifestyles through public education.

Graphics by Liu Shaozhen and Liang Qian