Comparison of current incidence, mortality and trends of cancers in China and the United States_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Qi ¹ , LAI Zepeng ¹ , JIANG Juxi ¹ , DENG Kaiwen ¹ , ZENG Ziqian ¹ ,  YAN Huan ² ,  CHEN Weizhong ¹

1. School of Public Health, Chengdu Medical College, Chengdu 610500, P. R. China;
2. Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Traditional Chinese Medicine of Chengdu Medical College, Xindu Hospital of Traditional Chinese Medicine, Xindu, Sichuan 610500, P. R. China;

Corresponding author：

YAN Huan, Email: 17628680@qq.com; CHEN Weizhong, Email: wejone@126.com

Keywords：

cancer; China-United States comparison; epidemic trend; incidence; mortality

DOI：

10.7507/1007-9424.202504082

Video：

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Objective To analyze and compare the incidence, mortality, temporal trends, and cancer spectrum differences between China and the United States (US), providing theoretical support for cancer prevention and control in China. Methods Age standardized incidence rate (ASIR), age standardized mortality rate (ASMR), and cancer site composition were extracted from GLOBOCAN, Cancer Statistics 2025, the China Cancer Registry Annual Report, and other epidemiological sources. Spatial (urban-rural, sex specific) and temporal distributions were described, and average annual growth rate (AAGR) were calculated. Results From 2005 onward, China exhibited a modest rise in ASIR, whereas the US showed a decline (AAGR: 0.58 vs –0.42); nevertheless, China’s overall incidence remained lower (2022 ASIR = 201.61/100 000) than that of the US (303.60/100 000). Both countries experienced decreasing ASMR (AAGR: –1.03 vs –1.72). In both nations, male ASIR and ASMR were higher than female. Since 2005, the top three US cancers had remained prostate (men) or breast (women), lung and colorectal cancer. In China, incidences of lung, colorectal, female breast and thyroid cancers had continued to rise, while stomach and liver cancer incidences had declined yet still rank high among men. Urban ASIR in China exceeded rural rates, whereas rural ASMR was higher than urban counterparts. Conclusions Accelerating population ageing and lifestyle transitions have driven an upward incidence trend in China, accompanied by a shift towards a mixed pattern of traditional and emerging cancer risks. Drawing on US experience, China should intensify tobacco control measures, expand organized screening and early detection programs, implement comprehensive interventions for priority cancers, strengthen primary level capacity and improve treatment access in rural areas, thereby establishing a more effective national cancer prevention and control system.

Citation： LI Qi, LAI Zepeng, JIANG Juxi, DENG Kaiwen, ZENG Ziqian, YAN Huan, CHEN Weizhong. Comparison of current incidence, mortality and trends of cancers in China and the United States. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2025, 32(6): 702-713. doi: 10.7507/1007-9424.202504082 Copy

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8.	张思维, 雷正龙, 李光琳, 等. 中国肿瘤登记地区2005年发病死亡资料分析. 中国肿瘤, 2009, 18(12): 973-979.
9.	张思维, 雷正龙, 李光琳, 等. 中国肿瘤登记地区2006年肿瘤发病和死亡资料分析. 中国肿瘤, 2010, 19(6): 356-365.
10.	陈万青, 张思维, 郑荣寿, 等. 中国肿瘤登记地区2007年肿瘤发病和死亡分析. 中国肿瘤, 2011, 20(3): 162-169.
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17.	陈万青, 孙可欣, 郑荣寿, 等. 2014年中国分地区恶性肿瘤发病和死亡分析. 中国肿瘤, 2018, 27(1): 1-14.
18.	郑荣寿, 孙可欣, 张思维, 等. 2015年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2019, 41(1): 19-28.
19.	郑荣寿, 张思维, 孙可欣, 等. 2016年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2023, 45(3): 212-220.
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23.	Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent, 2024, 4(1): 47-53.
24.	吉雨婷, 刘斯文, 张芸萌, 等. 中美两国恶性肿瘤疾病负担、流行趋势及归因风险因素比较. 中华肿瘤杂志, 2024, 46(7): 646-656.
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26.	常青云, 杜君, 喻达. 中国人口老龄化与癌症防治工作研究进展. 中华肿瘤防治杂志, 2022, 29(16): 1165-1170.
27.	陈伟霖, 黄丽萍, 韩煌煌, 等. 腌制食品摄入联合吸烟、饮酒与食管癌发病关系病例对照研究. 中国公共卫生, 2018, 34(5): 643-646.
28.	Chiang TH, Cheng HC, Chuang SL, et al. Mass screening and eradication of Helicobacter pylori as the policy recommendations for gastric cancer prevention. J Formos Med Assoc, 2022, 121(12): 2378-2392.
29.	Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Prz Gastroenterol, 2019, 14(2): 89-103.
30.	夏阳, 朱庆超, 汪昱, 等. 高脂饮食引发肠道菌群结构改变与结直肠癌发生的相关性研究. 中国全科医学, 2016, 19(20): 2473-2480.
31.	肥胖会增加13类癌症风险. 中国食品学报, 2016, 16(8): 15.
32.	Wen J, Shang W, Ding Y, et al. China’s smoke-free policies in public place and the smoking cessation status of smokers. Tob Use Insights, 2023, 16: 1179173X231171483.
33.	Mittelman SD. The role of diet in cancer prevention and chemotherapy efficacy. Annu Rev Nutr, 2020, 40(1): 273-297.
34.	Chen W, Xia C, Zheng R, et al. Disparities by province, age, and sex in site-specific cancer burden attributable to 23 potentially modifiable risk factors in China: a comparative risk assessment. Lancet Glob Health, 2019, 7(2): e257-e269.
35.	韩玲, 王梦琪, 熊为锋, 等. PM2. 5长期暴露对北京市居民肺癌发病的影响. 环境卫生学杂志, 2022, 12(12): 870-877, 902.
36.	Nagaradona T, Bassig BA, Hosgood D, et al. Overall and cause-specific mortality rates among men and women with high exposure to indoor air pollution from the use of smoky and smokeless coal: a cohort study in Xuanwei, China. BMJ Open, 2022, 12(11): e058714. doi: 10.1136/bmjopen-2021-058714.
37.	李继华, 何俊, 阚强波, 等. 基于行政村级的云南省富源县2010–2019年肺癌死亡空间分析. 中国肿瘤, 2021, 30(10): 759-766.
38.	Guy GP Jr, Thomas CC, Thompson T, et al. Vital signs: melanoma incidence and mortality trends and projections - United States, 1982–2030. MMWR Morb Mortal Wkly Rep, 2015, 64(21): 591-596.
39.	Buller DB, Cokkinides V, Hall HI, et al. Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: review from national surveys and case studies of 3 states. J Am Acad Dermatol, 2011, 65(5 Suppl 1): S114-S123.
40.	Zhang M, Bao H, Zhang X, et al. Breast cancer screening coverage - China, 2018–2019. China CDC Wkly, 2023, 5(15): 321-326.
41.	Zeng H, Ran X, An L, et al. Disparities in stage at diagnosis for five common cancers in China: a multicentre, hospital-based, observational study. Lancet Public Health, 2021, 6(12): e877-e887.
42.	Zhu D, Shi X, Nicholas S, et al. Estimated annual prevalence, medical service utilization and direct costs of lung cancer in urban China. Cancer Med, 2021, 10(8): 2914-2923.
43.	Siddappa Malleshappa SK, Giri S, Patel S, et al. Overall survival based on oncologist density in the United States: a retrospective cohort study. PLoS One, 2021, 16(5): e0250894. doi: 10.1371/journal.pone.0250894.
44.	Li X, Krumholz HM, Yip W, et al. Quality of primary health care in China: challenges and recommendations. Lancet, 2020, 395(10239): 1802-1812.
45.	Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet, 2018, 391(10125): 1023-1075.
46.	Wender R, Wolf AMD. Increasing cancer screening rates in primary care. Med Clin North Am, 2020, 104(6): 971-987.
47.	Espina C, Soerjomataram I, Forman D, et al. Cancer prevention policy in the EU: best practices are now well recognised; no reason for countries to lag behind. J Cancer Policy, 2018, 18: 40-51.
48.	Xia C, Basu P, Kramer BS, et al. Cancer screening in China: a steep road from evidence to implementation. Lancet Public Health, 2023, 8(12): e996-e1005.
49.	Štor Z, Blagus R, Tropea A, et al. Net survival of patients with colorectal cancer: a comparison of two periods. Updates Surg, 2019, 71(4): 687-694.
50.	Edwards BK, Ward E, Kohler BA, et al. Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer, 2010, 116(3): 544-573.

1. Qi J, Li M, Wang L, et al. National and subnational trends in cancer burden in China, 2005-20: an analysis of national mortality surveillance data. Lancet Public Health, 2023, 8(12): e943-e955.
2. 蔡红霞, 刘潇霞, 张文彬. 2011–2016年中国恶性肿瘤发病和死亡趋势分析及GM(1, 1)模型预测. 现代肿瘤医学, 2023, 31(5): 931-936.
3. 郑荣寿, 陈茹, 韩冰峰, 等. 2022年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2024, 46(3): 221-231.
4. 徐睿锋, 王泓睿, 车云, 等. 中美癌症流行特征及长期趋势研究. 中国胸心血管外科临床杂志, 2025.
5. International Agency for Research on Cancer. Global cancer observatory. [2025-04-07]. https://gco.iarc.fr/.
6. Siegel RL, Kratzer TB, Giaquinto AN, et al. Cancer statistics, 2025. CA Cancer J Clin, 2025, 75(1): 10-45.
7. 陈万青. 2004-2005年中国恶性肿瘤发病与死亡的估计. 中华肿瘤杂志, 2009, 31(9): 664-668.
8. 张思维, 雷正龙, 李光琳, 等. 中国肿瘤登记地区2005年发病死亡资料分析. 中国肿瘤, 2009, 18(12): 973-979.
9. 张思维, 雷正龙, 李光琳, 等. 中国肿瘤登记地区2006年肿瘤发病和死亡资料分析. 中国肿瘤, 2010, 19(6): 356-365.
10. 陈万青, 张思维, 郑荣寿, 等. 中国肿瘤登记地区2007年肿瘤发病和死亡分析. 中国肿瘤, 2011, 20(3): 162-169.
11. 郑荣寿, 张思维, 吴良有, 等. 中国肿瘤登记地区2008年恶性肿瘤发病和死亡分析. 中国肿瘤, 2012, 21(1): 1-12.
12. 陈万青, 张思维, 郑荣寿, 等. 中国2009年恶性肿瘤发病和死亡分析. 中国肿瘤, 2013, 22(1): 2-12.
13. Chen W, Zheng R, Zhang S, et al. Report of cancer incidence and mortality in China, 2010. Ann Transl Med, 2014, 2(7): 61.
14. 陈万青, 郑荣寿, 曾红梅, 等. 2011年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 2015, 24(1): 1-10.
15. 陈万青, 郑荣寿, 张思维, 等. 2012年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 2016, 25(1): 1-8.
16. 陈万青, 郑荣寿, 张思维, 等. 2013年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 2017, 26(1): 1-7.
17. 陈万青, 孙可欣, 郑荣寿, 等. 2014年中国分地区恶性肿瘤发病和死亡分析. 中国肿瘤, 2018, 27(1): 1-14.
18. 郑荣寿, 孙可欣, 张思维, 等. 2015年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2019, 41(1): 19-28.
19. 郑荣寿, 张思维, 孙可欣, 等. 2016年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2023, 45(3): 212-220.
20. 国家癌症中心. 2020中国肿瘤登记年报. 北京: 人民卫生出版社, 2022: 66-76.
21. 国家癌症中心. 2021中国肿瘤登记年报. 北京: 人民卫生出版社, 2023: 68-78.
22. 王少明, 郑荣寿, 韩冰峰, 等. 2022年中国人群恶性肿瘤发病与死亡年龄特征分析. 中国肿瘤, 2024, 33(3): 165-174.
23. Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent, 2024, 4(1): 47-53.
24. 吉雨婷, 刘斯文, 张芸萌, 等. 中美两国恶性肿瘤疾病负担、流行趋势及归因风险因素比较. 中华肿瘤杂志, 2024, 46(7): 646-656.
25. 由金玲, 徐晓慧, 林琳, 等. 基于GBD数据分析1990年和2019年中国人群癌谱差异. 中国肿瘤, 2024, 33(1): 36-43.
26. 常青云, 杜君, 喻达. 中国人口老龄化与癌症防治工作研究进展. 中华肿瘤防治杂志, 2022, 29(16): 1165-1170.
27. 陈伟霖, 黄丽萍, 韩煌煌, 等. 腌制食品摄入联合吸烟、饮酒与食管癌发病关系病例对照研究. 中国公共卫生, 2018, 34(5): 643-646.
28. Chiang TH, Cheng HC, Chuang SL, et al. Mass screening and eradication of Helicobacter pylori as the policy recommendations for gastric cancer prevention. J Formos Med Assoc, 2022, 121(12): 2378-2392.
29. Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Prz Gastroenterol, 2019, 14(2): 89-103.
30. 夏阳, 朱庆超, 汪昱, 等. 高脂饮食引发肠道菌群结构改变与结直肠癌发生的相关性研究. 中国全科医学, 2016, 19(20): 2473-2480.
31. 肥胖会增加13类癌症风险. 中国食品学报, 2016, 16(8): 15.
32. Wen J, Shang W, Ding Y, et al. China’s smoke-free policies in public place and the smoking cessation status of smokers. Tob Use Insights, 2023, 16: 1179173X231171483.
33. Mittelman SD. The role of diet in cancer prevention and chemotherapy efficacy. Annu Rev Nutr, 2020, 40(1): 273-297.
34. Chen W, Xia C, Zheng R, et al. Disparities by province, age, and sex in site-specific cancer burden attributable to 23 potentially modifiable risk factors in China: a comparative risk assessment. Lancet Glob Health, 2019, 7(2): e257-e269.
35. 韩玲, 王梦琪, 熊为锋, 等. PM2. 5长期暴露对北京市居民肺癌发病的影响. 环境卫生学杂志, 2022, 12(12): 870-877, 902.
36. Nagaradona T, Bassig BA, Hosgood D, et al. Overall and cause-specific mortality rates among men and women with high exposure to indoor air pollution from the use of smoky and smokeless coal: a cohort study in Xuanwei, China. BMJ Open, 2022, 12(11): e058714. doi: 10.1136/bmjopen-2021-058714.
37. 李继华, 何俊, 阚强波, 等. 基于行政村级的云南省富源县2010–2019年肺癌死亡空间分析. 中国肿瘤, 2021, 30(10): 759-766.
38. Guy GP Jr, Thomas CC, Thompson T, et al. Vital signs: melanoma incidence and mortality trends and projections - United States, 1982–2030. MMWR Morb Mortal Wkly Rep, 2015, 64(21): 591-596.
39. Buller DB, Cokkinides V, Hall HI, et al. Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: review from national surveys and case studies of 3 states. J Am Acad Dermatol, 2011, 65(5 Suppl 1): S114-S123.
40. Zhang M, Bao H, Zhang X, et al. Breast cancer screening coverage - China, 2018–2019. China CDC Wkly, 2023, 5(15): 321-326.
41. Zeng H, Ran X, An L, et al. Disparities in stage at diagnosis for five common cancers in China: a multicentre, hospital-based, observational study. Lancet Public Health, 2021, 6(12): e877-e887.
42. Zhu D, Shi X, Nicholas S, et al. Estimated annual prevalence, medical service utilization and direct costs of lung cancer in urban China. Cancer Med, 2021, 10(8): 2914-2923.
43. Siddappa Malleshappa SK, Giri S, Patel S, et al. Overall survival based on oncologist density in the United States: a retrospective cohort study. PLoS One, 2021, 16(5): e0250894. doi: 10.1371/journal.pone.0250894.
44. Li X, Krumholz HM, Yip W, et al. Quality of primary health care in China: challenges and recommendations. Lancet, 2020, 395(10239): 1802-1812.
45. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet, 2018, 391(10125): 1023-1075.
46. Wender R, Wolf AMD. Increasing cancer screening rates in primary care. Med Clin North Am, 2020, 104(6): 971-987.
47. Espina C, Soerjomataram I, Forman D, et al. Cancer prevention policy in the EU: best practices are now well recognised; no reason for countries to lag behind. J Cancer Policy, 2018, 18: 40-51.
48. Xia C, Basu P, Kramer BS, et al. Cancer screening in China: a steep road from evidence to implementation. Lancet Public Health, 2023, 8(12): e996-e1005.
49. Štor Z, Blagus R, Tropea A, et al. Net survival of patients with colorectal cancer: a comparison of two periods. Updates Surg, 2019, 71(4): 687-694.
50. Edwards BK, Ward E, Kohler BA, et al. Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer, 2010, 116(3): 544-573.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of current incidence, mortality and trends of cancers in China and the United States

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