“Cancer High Incidence Map” for provinces across the country is here

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The order of the incidence of 15 major malignant tumors in 31 provinces (autonomous regions and municipalities) in China in 2016 (the numbers in the figure represent the order of the incidence of each cancer type in the corresponding province).Image source: Chinese Journal of Oncology

April 15-21, 2023 is the 29th National Cancer Prevention and Control Awareness Week, and the theme of this year’s Awareness Week is “Comprehensive Actions for Cancer Prevention and Control – Whole Group, Whole Cycle, and Whole Society”.

Nasopharyngeal carcinoma has a relatively high incidence in Guangdong and Guangxi; thyroid cancer has a high incidence in Tianjin and Zhejiang; prostate cancer has a high incidence in more economically developed areas…Recently, the National Cancer Center and the Cancer Hospital of the Chinese Academy of Medical Sciences published the latest update on my country’s cancer in the “Chinese Journal of Oncology”. The data on the prevalence of malignant tumors, and for the first time published the prevalence of major cancer spectrum in each province. What is the current prevalence of malignant tumors in my country? What are the differences in the high incidence types of cancer in different regions? What are the common cancers? Relevant experts gave answers.

Lung cancer ranks first in the incidence of malignant tumors in my country

Due to the time required for national data collection, collation and verification, cancer data reporting is usually delayed. As of August 31, 2019, the National Cancer Center has received 2016 tumor registration data submitted by 682 registries in 31 provinces (autonomous regions and municipalities) across the country, including 251 prefecture-level and above cities and 431 counties and county-level cities. to estimate the epidemiological characteristics of malignant tumors in China in 2016. In the end, the “2016 China Malignant Tumor Epidemic Situation Analysis” (hereinafter referred to as the “report”) included 487 registries that met data quality control standards, covering a total of 380 million people, including 192 million urban population and 188 million rural population .

The report shows that in terms of the number of cases, lung cancer ranks first in the incidence of malignant tumors in my country. In 2016, there were about 828,100 new cases of lung cancer in my country, which is twice the number of colorectal cancer (408,000 cases), which ranked second. Gastric cancer, liver cancer, and female breast cancer rank 3rd to 5th, respectively, with an incidence of more than 300,000 cases. The first five malignant tumors accounted for 57.27% of all new cases. Ranked 6th to 10th are esophageal cancer, thyroid cancer, cervical cancer, brain tumor, and pancreatic cancer, each with over 100,000 cases. Digestive tract tumors such as esophageal cancer, gastric cancer and liver cancer, although still at a relatively high incidence level, have shown a trend of rapid decline.

From the statistical point of view, there are some differences in the main prevalent cancers in different provinces. Among the 31 provinces (autonomous regions and municipalities directly under the Central Government) in the country, the incidence of lung cancer ranks first in all areas except the Tibet Autonomous Region, Gansu Province and Qinghai Province; nasopharyngeal carcinoma ranks 20th in the incidence of malignant tumors in the country in Guangdong Province, Guangxi Zhuang Autonomous Region, Hainan Province, Jiangxi Province, and Guizhou Province all rank in the top 10; thyroid cancer ranks seventh in the country, but it has risen to 1 in Tianjin, Zhejiang Province, and Xinjiang Uygur Autonomous Region. No. 2; the incidence of esophageal cancer in Beijing, Tianjin, Shanghai, and Guangdong Province is relatively low, ranking around No. 15; prostate cancer occurs more frequently in areas with higher socio-economic development, such as Beijing, Shanghai City, Jiangsu Province, Zhejiang Province, etc.

There are also significant differences in the structure of the cancer spectrum between urban and rural areas, as shown by the high incidence of breast cancer, colorectal cancer and other malignant tumors in urban areas, and the high incidence of digestive system tumors such as esophageal cancer, gastric cancer, and liver cancer in rural areas. The report pointed out that my country’s current cancer spectrum structure is a situation where cancer spectrums in developed countries and cancer spectrums in developing countries coexist. In relatively developed areas, lung cancer, colorectal cancer, breast cancer, thyroid cancer, and prostate cancer are the main high incidences, but in areas with relatively backward social economy, there are still high incidences of digestive tract tumors such as gastric cancer, esophageal cancer, and liver cancer. , accompanied by colorectal cancer, breast cancer and other top conditions.

　　Smoking is a major risk factor for lung cancer

“Lung cancer not only ranks first in the incidence and death of malignant tumors in my country, but also one of the cancers with the highest morbidity and mortality in the world.” said Liu Wei, Chief Physician of the Department of Oncology, Beijing Chest Hospital Affiliated to Capital Medical University, “Lung cancer It is a relatively open organ, and it is a ‘window’ for the human body to communicate with the outside world, so it is greatly affected by external harmful substances.”

“The pathogenic factors of lung cancer are relatively complicated. Smoking is the main risk factor for lung cancer. More than 80% of the patients who die from lung cancer are caused by smoking or passive smoking. We often say that three ’20’ are very important-smoking for 20 years People above the age of 20 who started smoking before the age of 20 and those who smoked more than 20 cigarettes a day, as long as they meet any of the above three items, they are prone to lung cancer.” Liu Wei said, clinically, the number of cigarettes smoked per day multiplied by the number of years of smoking is called The smoking index of lung cancer, if a person smokes an average of 20 cigarettes a day and has a smoking history of 20 years, then the smoking index of this person is 400. If a person’s smoking index is greater than 400, the probability of developing lung cancer is 7-20 times that of a non-smoker. In other words, people with a smoking index greater than 400 belong to the high-risk group of lung cancer.

The “China Smoking Hazards to Health Report 2020” released by the National Health and Medical Commission shows that from 2007 to 2017, the smoking rate of people over the age of 15 in the world dropped to 19.2%, but in 2018, the smoking rate of people over the age of 15 in China was 26.6%, and the smoking rate of men More than 50.5%.

“Studies have found that the earlier you quit smoking, the greater your health benefits and the greater your life expectancy.” Liu Wei said that the lung cancer mortality rate of smokers who quit smoking for 5 years is lower than that of ordinary smokers (1 pack per day), or close to that of non-smokers mortality rate. After 10 years of quitting smoking, the incidence of lung cancer drops to the average level of non-smokers. Therefore, smoking control and smoking cessation are one of the most effective and active ways to prevent lung cancer.

Liu? introduction, radon gas exposure is the second largest risk factor for lung cancer, but also one of the main carcinogens announced by the World Health Organization. In addition, risk factors for lung cancer include: family history and genetic factors, long-term exposure to second-hand smoke, asbestos, certain special metals (such as arsenic, chromium, cadmium, etc.), certain organic substances, radiation, air pollution, kitchen fume, automobile Exhaust etc.

“To prevent lung cancer, we must also pay attention to the air quality around us.” Liu Wei said, suggesting that everyone pay attention to the daily air quality broadcast. For example, in weather with severe air pollution, it is necessary to reduce the time spent outdoors, and to wear a particle protective mask when traveling. At the same time, we must pay more attention to indoor pollution, do a good job in green home decoration, pay attention to indoor ventilation, and choose indoor air purification devices to effectively absorb harmful particles in the room, reduce pollution, improve cardiopulmonary function, and promote health.

　Why are the types of high-incidence cancer different in different provinces

“Our country has a vast territory, and there are great differences in climate, environment, eating habits, and lifestyles between regions, so different regions have different types of high-incidence cancer.” Liu Wei said, for example, the incidence of gastric cancer is higher than that of malignant tumors in Gansu Province and Qinghai Province. Ranked first in the middle, “In addition to genetic factors, the occurrence of gastric cancer and esophageal cancer is mainly related to eating habits, such as overeating, hard food, cold food, spicy food, pickled food, etc., which are easy to irritate the gastric mucosa or Esophageal mucosa, leading to irreversible mutations in epithelial cells that eventually develop into cancer.”

In areas with high socioeconomic development, such as Beijing, Shanghai, Jiangsu Province, Zhejiang Province, etc., the incidence of colorectal cancer and prostate cancer is relatively high. “Colorectal cancer and prostate cancer are also called ‘rich cancers’, and they are more common in European and American countries.” Liu Wei said that with the improvement of living conditions, the diet structure of residents in some areas is gradually inclined to high-fat diet, high-energy diet Diet, which can easily lead to a high incidence of colorectal cancer, prostate cancer and other cancers, especially in areas with relatively good economic conditions, the incidence of which will be relatively high.

There are certain differences in the incidence of cancer among different genders. According to the report, lung cancer ranks first among men, followed by liver, stomach, colorectal, and esophageal cancers; among women, breast cancer ranks first, followed by lung, colorectal, thyroid, and stomach cancers. In the past 10 years, the incidence of thyroid cancer in the female population has increased by more than 20% every year, which may be related to the current level of diagnosis and treatment of malignant tumors and the improvement of residents’ health awareness. However, the mortality rate of thyroid cancer has maintained a relatively low increase in the past 10 years, with an annual increase of about 1.6%, indicating that the current increase in incidence may be related to overdiagnosis.

“Most thyroid cancer develops slowly and has a good prognosis, so it is called ‘lazy cancer’.” Liu Wei introduced, but there are still a small number of highly deteriorating types that are not easy to be accurately identified. While avoiding overtreatment, it is also recommended Patients diagnosed with thyroid cancer should consult specialist physicians in regular large hospitals, and choose appropriate treatment methods according to the doctor’s advice.

“For women, in addition to regular physical examinations and not using exogenous estrogen indiscriminately, they should also pay attention to maintaining a peaceful and happy mood.” Liu Wei emphasized that breast cancer, thyroid cancer and other high-incidence tumors in women are related to bad emotions, and cancer prevention First of all, you need to maintain a happy mood and a peaceful mind at ordinary times. You should not be frequently depressed or angry. At the same time, pay attention to exercise and strengthen your own immunity.

“The World Health Organization proposes that 1/3 of cancers can be completely prevented; 1/3 of cancers can be cured through early detection; 1/3 of cancers can use existing medical measures to prolong life, relieve pain, and improve quality of life.” Liu Wei said, “reasonable diet, moderate exercise, smoking cessation, alcohol restriction, and psychological balance can effectively reduce the occurrence of cancer. If we can maintain a healthy lifestyle, insist on regular physical examinations, and deal with precancerous lesions in time, many malignant tumors can be prevented. controllable.”

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