Skip to main content
Download PDF

Fatal, non-fatal burden of cancer in the elderly in China, 2005–2016: a nationwide registry-based study

BMC Public Health volume 23, Article number: 877 (2023) Cite this article

Abstract

Background

As populations age, cancer burden becomes increasingly conspicuous. This study quantified the cancer burden of the elderly (≥ 60 years) in China, based on the China Cancer Registry Annual Report to provide epidemiological evidence for cancer prevention and control.

Methods

Data on cancer cases and deaths among the elderly aged ≥ 60 years were collected from the China Cancer Registry Annual Report, 2008–2019. Potential years of life lost (PYLL) and disability-adjusted life years (DALY) were calculated to analyze fatalities and the non-fatal burden. The time trend was analyzed using the Joinpoint model.

Results

From 2005 to 2016, the PYLL rate of cancer in the elderly was stable between 45.34‰ and 47.62‰, but the DALY rate for cancer decreased at an average annual rate of 1.18% (95% CI: 0.84–1.52%). The non-fatal cancer burden in the rural elderly was higher than that of the urban elderly. Lung, gastric, liver, esophageal, and colorectal cancers were the main cancers causing the cancer burden in the elderly, and accounted for 74.3% of DALYs. The DALY rate of lung cancer in females in the 60–64 age group increased (annual percentage change [APC] = 1.14%, 95% CI: 0.10–1.82%). Female breast cancer was one of the top five cancers in the 60–64 age group, with DALY rates that also increased (APC = 2.17%, 95% CI: 1.35–3.01%). With increasing age, the burden of liver cancer decreased, while that of colorectal cancer rose.

Conclusions

From 2005 to 2016, the cancer burden in the elderly in China decreased, mainly reflected in the non-fatal burden. Female breast and liver cancer were a more serious burden in the younger elderly, while colorectal cancer burden was mainly observed in the older elderly.

Peer Review reports

Introduction

Cancer is a significant barrier to improving life expectancy in every country in the world and will become the leading cause of death in most countries this century [1]. According to the World Health Organization (WHO) estimates in 2019, 112 of the 183 countries had cancer as the first or second leading cause of death before the age of 70 and cancer ranked third or fourth in another 23 countries [2]. Previous studies have shown that China accounts for 23.7% of new cancer cases and 30% of worldwide cancer deaths [3].

Serious population aging may bring about a series of social problems, including that concerning the prevention and control of geriatric diseases. By the end of 2019, the elderly population aged ≥ 60 years in China had reached 253 million, accounting for 18.1% of the population, and China had become a “deep aging society” [4]. Studies have found that cancer was the second leading cause of death in elderly (≥ 60 years) in China from 1990 to 2019, following that of circulatory diseases, and the incidence and mortality of cancer in the elderly were 8.18 times and 13.53 times that of middle-aged and young people, respectively [5, 6]. The prevention and control of cancer in the elderly have become an important public health problem in China.

Therefore, the purpose of this study was to provide a reference for the prevention and control of cancer in the elderly in China through the analysis of the current situation and of the trends in the cancer burden among the elderly from 2005 to 2016, based on the national registration, including fatal and non-fatal burden by calculating the potential years of life lost (PYLL) and disability-adjusted life years (DALY).

Materials and methods

Data sources

From the China Cancer Registry Annual Report, 2008–019 [7,8,9,10,11,12,13,14,15,16,17,18] published by the National Central Cancer Registry of China, the morbidity and mortality information of all cancer patients in the elderly aged ≥ 60 years in China from 2005 to 2016 was selected. These reports included cancer at all anatomical sites (ICD-10: C00–97, D32–33, D42–43, D45, D47) [19].

Indicators

PYLL (potential years of life lost)

The formulas for calculating PYLL and PYLL rate (‰) were as follows [20]:

PYLL = ∑ (L-ai) × di.

PYLL rate (‰) = PYLL/n × 1000‰.

In the formula, L is the life expectancy from the sixth national census of China in 2010 [21, 22]; ai is the median of age group i, and the age grouping method in this study is based on the China Cancer Registry Annual Report [7,8,9,10,11,12,13,14,15,16,17,18], ai for the 60–64 age group was 62, the 65–69 age group was 67, the 70–74 age group was 72, the 75–79 age group was 77, the 80–84 age group was 82, and the over 85 age group was 87; di is the number of deaths in age group i; n is the total population aged over 60 in the same period.

The difference between L and ai is used to determine whether premature death has occurred. If the difference is greater than 0, premature death is considered to have occurred. The age thresholds for premature death in this study based on life expectancy adjustments are as follows:

The life expectancy is 77 years, and 72 years for males, 77 years for females; the life expectancy of urban residents is 82 years, and 77 years for males, 82 years for females; the life expectancy of rural residents is 72 years, and 72 years for males, 77 years for females.

DALY (disability-adjusted life years)

The formulas for calculating DALY and DALY rate (‰) were as follows:

DALY = YLL (years of life lost) + YLD (years lived with disability) [23].

DALY rate (‰) = DALY/n × 1000‰.

In the formula, n is the total population aged over 60 in the same period.

YLL = N × DW × Ce(γα)/(β + γ) 2 {e−(β +γ) (L+α) [-(β + γ) (L + α)-1]-e−( β +γ) α[-(β + γ) α-1]}

In the formula, N is the number of deaths; DW is disability weight (death is 1); L is the duration of disability or death due to premature death, The value is 80 years for males and 82.5 years for females; γ is the discount rate, the Global Burden of Disease (GBD) standard value is 0.03; C is the normal number of age-weighted schools, and the GBD standard takes a value of 0.1658; α is the age at which death occurred; β is an age-weighted function parameter, and the GBD standard takes a value of 0.04. Use the DALY calculation template provided by the WHO.

YLD = DW × P [24].

In the formula, P is the prevalence; DW is the disability weight, and the DW value is set at 0.288 [25].

Statistical analysis

Differential analysis of cancer burden characteristics

All the analysis was stratified by different regions (urban/rural), sex (male/ female), age group (60–85 years old according to one age group every 5 years old, and 85 years old and older into one group, a total of 6 groups) and years (2005–2016). It was assumed that the PYLL rate of cancer in the population followed the Poisson distribution, and the Poisson regression was fitted by the SAS statistical software Genmod module. The dependent variable was the PYLL rate, and the independent variables were gender, region, and adjusted age group. After adjusting for age, region, and sex, the regional ratio and sex ratio of the PYLL rate in each age group and their 95% CI were calculated, and the linear regression test ratio trend test was performed [26].

Trend analysis of cancer burden

Time trend analysis was expressed as an annual percentage change (APC) and its 95% CI, calculated using Joinpoint 4.3.1.0 developed by the American Institute for Cancer Research [27]. If the trend is statistically significant, it is indicated by an “increase” or “decrease”. If not, it is indicated as “stable”.

Results

The cancer PYLL in the elderly in China, 2005–2016

The cancer PYLL in different sex

From 2005 to 2016, the cancer PYLL of the elderly in China was 13,473,579 person-years, and the PYLL rate was 46.52‰, which was stable over time (P > 0.05). The cancer PYLL of the elderly males was 4,406,299 person-years, the PYLL rate was 36.52‰ and decreased at an average annual rate of 1.42% (95%CI: 0.91–1.94%) over time. And that of females was 4,495,040 person-years, the PYLL rate was 30.49‰ and decreased at an average annual rate of 0.64% (95%CI: 0.45–0.83%) over time. The male/female PYLL ratio of rural residents was stable, while the ratios of urban and national residents were decreasing from 2005 to 2016 (all P < 0.05). (Tables 1 and 2)

Table 1 The cancer PYLL by sex in the elderly in China, 2005–2016
Full size table
Table 2 The sex ratio (male/female) of cancer PYLL in the elderly in China, 2005–2016
Full size table

The cancer PYLL in different regions

From 2005 to 2016, the cancer PYLL in the elderly in urban areas was 12,175,284 person-years, and the PYLL rate was 66.98‰, which was stable over time (P > 0.05). The cancer PYLL in the elderly in rural areas was 6,409,128 person-years. The PYLL rate was 51.30‰ and decreased at an average annual rate of 3.12% (95%CI:2.42–3.82%). At the same time, the urban /rural ratio of cancer PYLL rate was stable from 2005 to 2016 (P > 0.05). (Tables 3 and 4)

Table 3 The cancer PYLL in the elderly in China, 2005–2016
Full size table
Table 4 The regional ratio (urban/rural) of cancer PYLL in the elderly in China, 2005–2016
Full size table

The sequence of cancer PYLL in the elderly in China, 2005–2016

Sorted by annual average PYLL, lung cancer caused the most PYLL in the elderly in China from 2005 to 2016, with an average annual PYLL of 317,583 person-years, followed by gastric, liver, esophageal, and colorectal cancer. The burden caused by the above five cancers accounted for 71.3% of the total cancer burden. Cancer with the highest PYLL in males was lung cancer, with an average annual PYLL of 108,990 person-years, followed by liver, gastric, esophageal, and colorectal cancer. It accounted for 79.9% of the total PYLL. Cancer with the highest PYLL in females was also lung cancer, with an average annual PYLL of 88,164 person-years, followed by gastric, liver, colorectal, and esophageal cancer. It accounted for 63.1% of the total PYLL. (Fig. 1)

Fig. 1
figure 1

Proportion of PYLL caused by cancers in the elderly in China, 2005–2016 (A. all; B. male; C. female)

Full size image

Annual trend of the top five cancer PYLL rate in the elderly in China, 2005–2016

From 2005 to 2016, in males, among the top five cancer PYLL rates from different age groups, only the PYLL rate of gastric cancer from the 60–64 age group showed a downward trend (APC = -2.65, P < 0.05). In females, the top five cancer PYLL rates in different age groups showed a downward trend over time, except for liver cancer in the 70–74 age group (APC = -0.88%, P > 0.05) and 65–69 age group (APC = -0.44%, P > 0.05); and it should be noted that in the 60–64 age group, the PYLL rates of lung cancer (APC = 0.98%, P < 0.05) and female breast cancer (APC = 2.24%, P < 0.05) showed an upward trend from 2005 to 2016. At the same time, only in the 60–64 age group, the PYLL rate of female breast cancer was fourth place, and in other age groups, it was not in the top five. (Fig. 2)

Fig. 2
figure 2

The APC of the top five cancer PYLL rate in the elderly by age, 2005–2016 (A. male; B. female)

Note ★P < 0.05.

Full size image

The cancer DALY in the elderly in China, 2005–2016

The cancer DALY in different sex

From 2005 to 2016, the cancer DALY of the elderly in China was 25,921,678 person-years, and the DALY rate was 77.10‰, showing a downward trend at an annual rate of 1.18% (95% CI: 0.84–1.52%). The cancer DALY of the elderly males was 15,744,073 person-years, the DALY rate was 97.15‰, and decreased at an average annual rate of 1.04% (95% CI: 0.71–1.37%). And that of females was 10,177,605 person-years, the DALY rate was 58.44‰, and decreased at an average annual rate of 1.57% (95% CI :1.21–1.92%). (Table 5)

Table 5 The cancer DALY in the elderly in China, 2005–2016
Full size table

The cancer DALY in different regions

From 2005 to 2016, the cancer DALY in the elderly in urban areas was 14,431,915 person-years. The DALY rate was 74.88‰ and decreased at an average annual rate of 0.83% (95% CI: 0.40–1.26%). The cancer DALY in the elderly in rural areas was 11,982,525 person-years. The DALY rate was 81.60‰ and decreased at an average annual rate of 3.38% (95% CI: 2.50–4.24%). (Table 6)

Table 6 The cancer DALY in the elderly in China, 2005–2016
Full size table

The sequence of cancer DALY in the elderly in China, 2005–2016

Sorted by annual average DALY, lung cancer caused the most DALY in the elderly in China from 2005 to 2016, with an average annual DALY of 28,454 person-years, followed by gastric, liver, esophageal, and colorectal cancer. The burden caused by the above five cancers accounted for about 74.3% of the total cancer burden. Cancer with the highest DALY in elderly males was lung cancer, with an average annual DALY of 339,038 person-years, followed by gastric, liver, esophageal, and colorectal cancer. It accounted for 78.4% of the total DALY. Cancer with the highest DALY in elderly females was also lung cancer, with an average annual DALY of 74,832 person-years, followed by gastric, colorectal, liver, and esophageal cancer. It accounted for 67.3% of the total DALY. (Fig. 3)

Fig. 3
figure 3

Proportion of DALY caused by cancers in the elderly in China, 2005–2016 (A. all; B. male; C. female)

Full size image

Annual trend of the top five cancer DALY rates in the elderly in China, 2005–2016

In males, from 2005 to 2016, the leading cause of cancer burden in all age groups was lung cancer, and the DALY rate was stable over time (P > 0.05). The DALY rate of gastric cancer showed a downtown trend over time in the 60–64, 70–74 and ≥ 85 age groups, of which the most obvious trend was in the 60–64 age group (APC60–64 = -2.68%, APC70–74 = -2.16%, APC85+ = -2.40%, all P < 0.05). Liver cancer showed a downward trend over time in the 70–74 and the ≥ 85 age group, of which the most obvious trend was in the ≥ 85 age group (APC70–74 = -1.50%, APC85+ = -2.13%, all P < 0.05). The esophageal cancer was stable over time in all age groups (all P > 0.05). Colorectal cancer showed a downtown trend over time only in the 70–74 age group (APC70–74 = -2.45%, P < 0.05).

In females, lung cancer was also the leading cause of cancer burden, and the DALY rate of lung cancer showed a downward trend over time in the 70–74 and 75–79 age groups (APC70–74 = -2.55%, APC75–79 = -0.94%, all P < 0.05). Gastric cancer showed a downward trend over time in all age groups under 85, of which the most obvious trend was in the 60–64 age group (APC60–64 = -3.97%, APC65–69 = -2.62%, APC70–74 = -3.36%, APC80–84 = -2.06%, all P < 0.05). Colorectal cancer showed a downward trend over time in all age groups except for the 80–84 age group (APC65–69 = -2.41%, APC70–74 = -3.22%, APC75–79 = -2.95%, APC85+ = -1.20%, all P < 0.05). Esophageal cancer showed a downward trend over time in the 60–79 age groups, of which the most obvious was in the 60–64 age group (APC60–64 = -6.44%, APC65–69 = -2.81%, APC70–74 = -2.11%, all P < 0.05). And it’s worth noting that, the DALY rate of female breast cancer ranked fourth only in the 60–64 age group and showed an upward trend over time (APC = 2.17%, P < 0.05). The DALY rate of lung cancer also showed an upward trend over time in the 60–64 and ≥ 85 age groups (APC60–64 = 0.96%, APC85+ = 1.80%, all P < 0.05). Colorectal cancer ranked fifth in the 65–69 age group, but in all age groups over 75 years old, colorectal cancer ranked third. (Fig. 4)

Fig. 4
figure 4

The APC of the top five cancer DALY rates in the elderly by age, 2005–2016 (A. male; B. female)

Note ★P < 0.05

Full size image

Discussion

From 2005 to 2016, the PYLL rate of elderly cancer patients in China fluctuated between 45.34‰ and 47.62‰ and was stable over time; the DALY rate fluctuated between 7.43‰ and 82.94‰, decreasing at an average annual rate of 1.18% (95% CI: 0.84–1.52%). This result may indicate that with economic growth, improvement of medical standards, and advancement in cancer research, Chinese awareness regarding the prevention, diagnosis, and treatment of cancer in the elderly has continuously improved, and certain successes have been achieved in the prevention and treatment of cancer’s non-fatal burden.

From 2005 to 2016, both the PYLL and DALY rates of the elderly males were higher than those of females. The PYLL rate of the elderly males increased with time, while that of females decreased; however, for the DALY rate, it was reduced for both males and females, but the rate of the reduction in females was higher than that of males (APCmale = -1.42%, APCfemale = -1.57%). Therefore, the prevention and treatment effect of the cancer burden in elderly males was worse than that of females, especially with respect to fatal cancer burden. Zhang S et al. [28] have shown that males are more likely to be exposed to risk factors, such as smoking, harmful drinking, exposure to dust, and physical inactivity, resulting in a higher incidence of cancer. To effectively reduce the cancer burden in the elderly in China, the prevention and treatment of cancers in elderly males should be the prime focus. We should mobilize relevant departments to educate the public about health, emphasizing the cancer burden in elderly males. To reduce the occurrence and development of cancer requires identifying and controlling the risk factors, such as smoking, harmful drinking, and exposure to dust, but these lifestyle factors need to be initiated early in life to prevent the development of cancer. At present, WHO’s MPOWER package has been implemented in China, but some projects were not enough [29]. In the future, the coverage of health warnings in China needs to be expanded, the tobacco tax should be increased, and smoke-free laws should be improved. The study showed that the non-price measures would reduce the smoking rate in China by 2.7% [29]. The implementation of the above measures may play an important role in optimizing the allocation of health resources and focusing on reducing the cancer burden among the elderly males in China.

The PYLL rate of elderly cancer patients in China was generally stable over time, while the DALY rate was decreasing. Meanwhile, the PYLL rate of the elderly in rural areas was much lower than that in urban areas, but the DALY rate was higher. Our results suggested that the cancer burden of the elderly rural was higher than that of the urban elderly, and the proportion of the non-fatal burden was also higher. In our previous study [30], we found that from 2005 to 2016, the cancer incidence among elderly people in rural areas was significantly higher than that in urban areas. At the same time, compared with urban areas, cancer patients in rural China may have lower disposable income, poor medical insurance treatment, relatively scarce available medical resources, less available medical services, and poor medical awareness [31,32,33], which may lead to them being more likely to miss the best opportunity for treatment. Therefore, rural patients are more likely to have a poor prognosis than urban cancer patients and may have a greater non-fatal burden. Narrowing the wealth gap between rural and urban areas, allocating more medical resources in rural areas, improving the medical awareness of rural patients, and implementing early cancer prevention and control strategies may have a significant impact on effectively reducing the cancer burden of the elderly in China. For example, screening is known to be an effective means of early cancer control. The Japanese government has its citizens regularly screened at appropriate ages for gastric, breast, lung, colorectal and cervical cancer, which has resulted in a five-year survival rate of 68.6%, the highest in the world [34]. At the same time, Britain’s breast cancer mortality rate fell to 55.1% between 1990 and 2013 compared with the 1980s, when breast cancer screening was not implemented, and after the introduction of colorectal cancer screening in 2006, the mortality rate of colorectal cancer in men and women decreased to 88.2% and 92.1%, respectively [35, 36]. Although pilot screening trials for these cancers were conducted in a number of medium-sized and above cities in 2012 in China, even the most extensive coverage for breast cancer screening was less than 50% as of 2019 [37]. So, these screening efforts should be extended to all regions of China, not just some urban areas, to reduce the burden of cancer.

From the perspective of the order of cancer burden and the changing trend in the burden of important cancers, lung, gastric, liver, esophageal, and colorectal cancers were more health-threatening to the elderly in China, of which the PYLL and DALY of elderly males and females ranked first in lung cancer. It can be seen that lung cancer still causes the highest cancer burden in the elderly in China. Regarding PYLL and DALY rates of several other cancers with a high cancer burden, for elderly males, the cancers showed a downward trend or stabilized state over time. Among elderly females, in addition to the PYLL rate of lung cancer in the 60–64 age group, the lung cancer DALY rate in the 60–64 age group and the ≥ 85 age group and the PYLL and DALY rates of female breast cancer in the 60–64 age group increased over time. The remaining cancers showed a downward trend or stabilized over time. Gastric cancer showed a downward trend or stabilized in all age groups in both males and females. In recent years, China has achieved good results in the prevention and treatment of gastric cancer. Previous study have shown excellent diagnosis and treatment of early gastric cancer, the 5-year survival rate has been shown to reach more than 90%, the overall prevention and treatment of gastric cancer is better, and the value of improving early screening of gastric cancer is better appreciated and has increased [38]. To effectively reduce the burden of cancer in the elderly in China, improving early screening of gastric cancer can achieve great benefits. At the same time, for both elderly males and females, with age, the order of the burden of disease caused by liver cancer decreases, which may be related to the more advanced stage of primary liver cancer at a younger age [39]. Britain and America have lower rates of gastric and liver cancer than China, maybe thanks to better control of cancer-related infections such as H. pylori and HBV [40, 41]. Therefore, we should strengthen the control of these cancer-associated infections. As the highest risk factor for gastric cancer, the control of H. pylori should be emphasized. The media should educate the public about the dangers of H. pylori and advocate for regular non-invasive testing for H. pylori (including 13 C-urea breath test, H. pylori fecal antigen test and serological test), and patients with gastritis should be additionally advised to undergo endoscopy. In addition, the Chinese government added HBV vaccination to the planned immunization of newborns in 1992, and provided free vaccination services for newborns in 2002 [42], this may reduce the burden of liver cancer among the elderly in China in the future.

It is worth noting that in the elderly female population, colorectal cancer has increased in the ranking of loss of healthy life caused by cancers with age. In the PYLL ranking, colorectal cancer was not in the top five ranks in the 60–64 age group but ranked fourth in the 70–74 age group. In the DALY ranking, colorectal cancer ranked fifth in the 65–69 age group, and in all age groups over 75 years old, colorectal cancer ranked third as a cancer that affects the life and health of elderly females. Previous literature has shown that Sirota monotherapy is effective in improving the quality of life of elderly patients with advanced colorectal cancer [43, 44]. Moreover, the PYLL and DALY top five-digit cancers in all age groups were the same as the overall top five-digit cancers, but in females aged 60–64 years, both PYLL and DALY for female breast cancer were in fourth place, and both PYLL and DALY rates increased over time. Chen W et al. [45] showed that the prognosis of female breast cancer was better and the survival rate was higher. The prevention and treatment of breast cancer in females under 65 years old and colorectal cancer in females over 65 years old should be the focus of public health work. The increased incidence of breast and colorectal cancer may be related to the increased intake of processed meat, obesity and sedentary lifestyles after economic development [35]. In order to reduce their cancer burden, in addition to increasing their screening sites across the country and strengthening their early prevention, the media should also promote proper lifestyle behaviors, such as reducing the intake of processed meat, promoting exercise and weight control.

Conclusion

In summary, encouraging results have been achieved in preventing and treating cancer in the elderly in China, especially in terms of the burden of non-fatal cancers. However, the cancer burden in rural elderly patients was still higher than that in urban elderly patients, and the non-fatal burden of cancer in rural elderly patients was still more serious. The cancer burden in elderly male patients was higher than that in elderly female patients. In the future, it is necessary to focus on the prevention and treatment of cancers with high burdens such as lung cancer, gastric cancer, esophageal cancer, liver and colorectal cancer (in the elderly population of high age), and breast cancer (in the elderly female of low age). Considering the contribution of these cancers to the burden on the elderly, cancer prevention strategies and policies should be formulated and continuously optimized to make them more targeted and precise. Additionally, the hardware facilities and professional level of staff in primary medical institutions are the keys to the detection of early cancer cases. Ensuring the advanced and perfect hardware equipment of primary medical institutions and strengthening the screening and diagnosis training of primary medical staff are beneficial to the effective prevention and treatment of cancer, and have significance for effectively reducing the cancer burden of the elderly.

Data Availability

All data generated or analyzed during this study are included in this published article and its supplementary information files.

Abbreviations

APC:

Annual percentage change

CI:

Confidence interval

DALY:

Disability-adjusted life years

GBD:

Global Burden of Disease

PYLL:

Potential years of life lost

YLD:

Years lived with disability

YLL:

Years of life lost.

References

  1. Bray F, Laversanne M, Weiderpass E, Soerjomataram I. The ever-increasing importance of cancer as a leading cause of premature death worldwide. Cancer. 2021;127:3029–30.

    Article  PubMed  Google Scholar 

  2. World Health Organization (WHO). Global Health Estimates 2020: Deaths by Cause, Age, Sex, by Country and by Region, 2000–2019. WHO. ; 2020. Accessed December 11, 2020. who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death.

  3. Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M et al. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer [EB/OL]. https://gco.iarc.fr/today.

  4. Xiang X, Wang Y. Chinese population aging status, characteristics, causes and countermeasures. Chin J Gerontol. 2021;41(18):4.

    Google Scholar 

  5. Zhang X, Yan Y, Pang L, Niu Q, Xu S, Xiang H, et al. Disease burden of malignant tumors in the elderly population in China. Chin J Gerontol. 2017;37(21):5.

    Google Scholar 

  6. Ma M, Han Y. Analysis of death causes of the Elderly in different regions of China since 1990. China Health Standard Management. 2021;12(3):4.

    Google Scholar 

  7. Zhao P, Chen W. China Cancer Registry Annual Report, 2008. Beijing: Military Medical Science Press; 2009. pp. 19–51.

    Google Scholar 

  8. Zhao P, Chen W. China Cancer Registry Annual Report, 2009. Beijing: Military Medical Science Press; 2010. pp. 16–09.

    Google Scholar 

  9. Zhao P, Chen W. China Cancer Registry Annual Report, 2010. Beijing: Military Medical Science Press; 2011. pp. 16–15.

    Google Scholar 

  10. He J, Zhao P, Chen W. China Cancer Registry Annual Report, 2011. Beijing: Military Medical Science Press; 2012. pp. 16–29.

    Google Scholar 

  11. He J, Zhao P, Chen W. China Cancer Registry Annual Report, 2012; Beijing: Military Medical Science Press; 2013. p.18–153.

  12. He J, Chen W. China Cancer Registry Annual Report, 2013; Beijing: Tsinghua University Press; 2017. p.44–219.

  13. He J, Chen W, China. Cancer Registry Annual Report, 2014; Beijing: Tsinghua University Press; 2017. p. 48–241.

  14. He J, Chen W. China Cancer Registry Annual Report, 2015; Beijing: Tsinghua University Press; 2017. p.52–235.

  15. He J, Chen W, China. Cancer Registry Annual Report, 2016; Beijing: Tsinghua University Press; 2017. p.58–241.

  16. He J, Chen W. China Cancer Registry Annual Report, 2017; Beijing: Tsinghua University Press; 2018. p.45–229.

  17. He J, Chen W. China Cancer Registry Annual Report, 2018; Beijing: Tsinghua University Press; 2019. p.47–231.

  18. He J, Chen W. China Cancer Registry Annual Report, 2019; Beijing: Tsinghua University Press; 2021. p.59–251.

  19. Freyberger H, Schulte-Markwort E, Dilling H. WHO Crosswalk for the Tenth Revision of the International Classification of Diseases, Chapter V (F): ICD-10 vs. ICD-9. Fortschr Neuro Psyc 1993(4); 61:109–27.

  20. Yan Y, Chen Y, Jia H, Liu J, Ding Y, Wang H, et al. Patterns of life lost to cancers with high risk of death in China. Int J Environ Res Public Health. 2019;16(12):2175.

    Article  PubMed  PubMed Central  Google Scholar 

  21. National Statistical Bureau of the People’s Republic of China. Main Data Bulletin of the Sixth National Population Census 2010 (No. 1). Chin. J Fam Plan. 2011;54:511–2.

    Google Scholar 

  22. Shu XY, Wen Y, Zong ZH, Zhou J, Sociology SO, University N. Indirect estimation and evaluation of China’s average life expectancy. Popul J. 2014;5:7.

    Google Scholar 

  23. Devleesschauwer B, Haveetlaar AH, Maertens de Noordhout C, Haagsma JA, Praet N, Dorny P, et al. DALY calculation in practice: a stepwise approach. Int J Public Health. 2014;59(3):571–4.

    Article  PubMed  Google Scholar 

  24. World Health Organization. (2020, December). " WHO methods and data sources for global burden of disease estimates 2000–2019.“ Retrieved from Global health estimates: Leading causes of DALYs (who.int).

  25. Lei SY, Zheng RS, Wei WW. Progress on disability weights in the disease burden of cancer. Zhonghua Zhong Liu Za Zhi. 2021;43(7):756–61.

    CAS  PubMed  Google Scholar 

  26. Han R, Zheng R, Zhang S, Wu M, Chen W. Trend analysis on the differences of Lung Cancer incidence between gender, Area and average age in China during 1989–2008. Chin J Oncol. 2013;16(9):445–51.

    Google Scholar 

  27. Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med. 2000;19(3):335–51.

    Article  CAS  PubMed  Google Scholar 

  28. Zhang S, Shen C, Zhang H, Pang S, Jiang G, Wang D. Incidence, Mortality and Disease Burden of Cancer in Tianjin, 2014.China cancer. 2019; 28(3): 167–74.

  29. Goodchild M, Zheng R. Tobacco control and healthy China 2030. Tob Control. 2019;28(4):409–13.

    Article  PubMed  Google Scholar 

  30. Guo H, Lin K, Yang K, Ma Z, Cao M, Hu Y, et al. Trends of cancer incidence among chinese older adults from 2005 to 2016: a log-linear regression and age-period-cohort analysis. Front Public Health. 2022;10:1023276.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Zhao Y, Tang S, Mao W, Akinyemiju T. Socio-Economic and Rural-Urban differences in Healthcare and Catastrophic Health Expenditure among Cancer Patients in China: analysis of the China Health and Retirement Longitudinal Study. Front Public Health. 2022;9:779285.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Wang H, Hua X, Yao N, Zhang N, Wang J, Anderson R, et al. The Urban-Rural Disparities and Associated factors of Health Care utilization among Cancer Patients in China. Front Public Health. 2022;10:842837.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115–32.

    Article  PubMed  Google Scholar 

  34. National Cancer Center. Latest Cancer Statistics: National Cancer Center Cancer Statistics. https://ganjoho.jp/reg_stat/statistics/stat/summary.html. 2021 (accessed 2023-4-1).

  35. Feng RM, Zong YN, Cao SM, Xu RH. Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics? Cancer Commun (Lond). 2019 Apr 29;39(1):22.

  36. Basu P, Ponti A, Anttila A, Ronco G, Senore C, Vale DB, et al. Status of implementation and organization of cancer screening in the European Union Member States-Summary results from the second european screening report. Int J Cancer. 2018;142(1):44–56.

    Article  CAS  PubMed  Google Scholar 

  37. Sun L, Legood R, Sadique Z, Dos-Santos-Silva I, Yang L. Cost-effectiveness of risk-based breast cancer screening programme, China. Bull World Health Organ. 2018 Aug 1;96(8):568–577.

  38. Miyahara R, Niwa Y, Matsuura T, Maeda O, Ando T, Ohmiya N, et al. Prevalence and prognosis of gastric cancer detected by screening in a large japanese population: data from a single institute over 30 years. J Gastroenterol Hepatol. 2007;22:1435–42.

    Article  PubMed  Google Scholar 

  39. Chan AC, Poon RT, Ng KK, Lo CM, Fan ST, Wong J. Changing paradigm in the management of hepatocellular carcinoma improves the survival benefit of early detection by screening. Ann Surg. 2008;247:666–73.

    Article  PubMed  Google Scholar 

  40. Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, et al. Global prevalence of Helicobacter pylori infection: systematic review and Meta-analysis. Gastroenterology. 2017;153(2):420–9.

    Article  PubMed  Google Scholar 

  41. Polaris Observatory Collaborators. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study. Lancet Gastroenterol Hepatol. 2018;3(6):383–403.

    Article  Google Scholar 

  42. Shi JF, Cao M, Wang Y, Bai FZ, Lei L, Peng J, et al. Is it possible to halve the incidence of liver cancer in China by 2050? Int J Cancer. 2021;148(5):1051–65.

    Article  CAS  PubMed  Google Scholar 

  43. Takenami T, Tsujinaka S, Takahashi J, Tamaki S, Maemoto R, Fukuda R et al. Efficacy of Neoadjuvant Chemotherapy with Capecitabine plus Oxaliplatin in the Treatment of Locally Advanced Sigmoid Colon Cancer Invading the Urinary Bladder: A Report of Three Cases. Case Rep Surg. 2019; 2019: 8129358.

  44. Schmoll HJ, Tabernero J, Maroun J, de Braud F, Price T, Van Cutsem E, et al. Capecitabine Plus Oxaliplatin compared with Fluorouracil/Folinic acid as adjuvant therapy for stage III Colon cancer: final results of the NO16968 Randomized Controlled Phase III Trial. J Clin Oncol. 2015;33:3733–40.

    Article  CAS  PubMed  Google Scholar 

  45. Chen W, Zheng S. Incidence, mortality and survival analysis of breast cancer in China. Chin J Clin Oncol. 2015;13:668–74.

    Google Scholar 

Download references

Acknowledgements

The authors gratefully acknowledge the financial support from the Shihezi University High-level Talent Project (RCZK2021B28), the self-funded project of Shihezi University (ZZZC202125), and the Shihezi Science and Technology Research Project of the 8th Division of Xinjiang Production and Construction Corps under the project (2018YL11). The authors gratefully acknowledge Jing-Jie Luan for her help with the data analysis.

Funding

Shihezi University High-level Talent Project (RCZK2021B28).

Self-funded Project of ShiHezi University (ZZZC202125).

Technology Research Project of the 8th Division of Xinjiang Production and Construction Corps under the project (2018YL11).

Author information

Author notes

  1. Zhen-Rong Ma and Kang-Qian Lin contributed equally to this work.

Authors and Affiliations

  1. Department of Preventive Medicine, Medical College, Shihezi University, 129 Bei Er Road, Shihezi, 832002, China

    Zhen-Rong Ma, Kang-Qian Lin, Hong Guo, Kai-Yue Yang, Miao Cao, Xi Song, Yun-Hua Hu & Yi-Zhong Yan

  2. Shihezi Municipal Center for Disease Control and Prevention, Shihezi, 832002, China

    Huai-Miao Jia

  3. Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public Health Security of The Xinjiang Production and Construction Corps, Xinjiang Production and Construction Corps, Shihezi, China

    Huai-Miao Jia, Yun-Hua Hu & Yi-Zhong Yan

Authors
  1. Zhen-Rong Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kang-Qian Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hong Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kai-Yue Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Miao Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xi Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Huai-Miao Jia
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yun-Hua Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yi-Zhong Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Ma ZR, Lin KQ designed the study, analyzed the data, conducted visual processing on the data, as well as drafted and revised the manuscript; Guo H, Yang KY analyzed the data and conducted visual processing on the data; Cao M, Song X, Jia HM sorted and analyzed the data; Yan YZ and Hu YH conceptualized and designed the study, critically revised the literature and obtained funding. All authors reviewed the manuscript.

Corresponding author

Correspondence to Yi-Zhong Yan.

Ethics declarations

Ethics approval and consent to participate

This study did not conduct data collection, and just analyzed the existing morbidity and mortality information extracted from the China Cancer Registry Annual Report, 2008–2019 published by the National Central Cancer Registry of China. The cases’ basic information is not identifiable in this database, and there is no information such as biological samples of the cases involved. No administrative permissions were required to access and use the dataset in this study. All methods are implemented in accordance with the relevant guidelines and provisions of the Declaration of Helsinki. So, it is not applicable for ethics approval and consent to participate.

Consent for publication

Not applicable.

Competing interests

The authors declare no conflicts of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ma, ZR., Lin, KQ., Guo, H. et al. Fatal, non-fatal burden of cancer in the elderly in China, 2005–2016: a nationwide registry-based study. BMC Public Health 23, 877 (2023). https://doi.org/10.1186/s12889-023-15686-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12889-023-15686-9

Keywords

BMC Public Health

ISSN: 1471-2458

Contact us