2009년부터 2021년까지 중국 도시 및 농촌 지역의 자궁경부암 및 유방암에 대한 연령별 국가 사망률 추세: 인구 기반 분석

  • role: Contribute equally, First author同等贡献者, 第一作者
  • Affiliation:

    Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China

Meng-Long Li1,  
  • role: Contribute equally同等贡献者
  • Affiliation:

    National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing 100050, China

Jin-Lei Qi2,  
  • role: Contribute equally同等贡献者
  • Affiliation:

    Department of Pathology, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China

Ya-Qi Ma3,  
  • Affiliation:

    Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China

Wen Shu1,  
  • Affiliation:

    Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China

Hui-Di Xiao1,  
  • Affiliation:

    National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing 100050, China

Li-Jun Wang2,  
  • Affiliation:

    National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing 100050, China

Peng Yin2,  
  • Affiliation:

    National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing 100050, China

Hao-Yan Guo2,  
  • Affiliation:

    Yale School of Public Health, Yale University, New Haven, CT 06510-3201, USA

Sten H. Vermund4,  
  • role: Corresponding author通信作者
  • Affiliation:

    National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing 100050, China

  • Email:zhoumaigeng@ncncd.chinacdc.cn
  • Introduction:* zhoumaigeng@ncncd.chinacdc.cn
Mai-Geng Zhou2*,  
  • role: Corresponding author通信作者
  • Affiliation:

    Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China

    UNESCO Chair on Global Health and Education, Peking University, Beijing 100083, China

    Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China

  • Email:huyifei@yahoo.com
  • Introduction:huyifei@yahoo.com
Yi-Fei Hu156*

추상적인

Background:Cervical and breast cancers are among the top 4 leading causes of cancer-related mortality in women. This study aimed to examine age-specific temporal trends in mortality for cervical and breast cancers in urban and rural areas of China from 2009 to 2021.Methods:Age-specific mortality data for cervical and breast cancers among Chinese women aged 20–84 years were obtained from China’s National Disease Surveillance Points system spanning the years 2009 to 2021. Negative binomial regression models were utilized to assess urban-rural differences in mortality rate ratios, while Joinpoint models with estimated average annual percent changes (AAPC) and slopes were employed to compare temporal trends and the acceleration of mortality rates within different age groups.Results:From 2009 to 2021, there was a relative increase in age-specific mortality associated with the two cancers observed in rural areas compared with urban areas. A rising trend in the screening age of 35–64 [AAPC: 4.0%, 95% confidence interval (CI) 0.5–7.6, P=0.026] for cervical cancer was noted in rural areas, while a stable trend (AAPC: –0.7%, 95% CI –5.8 to 4.6, P=0.780) was observed in urban areas. As for breast cancer, a stable trend (AAPC: 0.3%, 95% CI –0.3 to 0.9, P=0.280) was observed in rural areas compared to a decreasing trend (AAPC: –2.7%, 95% CI –4.6 to –0.7, P=0.007) in urban areas. Urban-rural differences in mortality rates increased over time for cervical cancer but decreased for breast cancer. Mortality trends for both cervical and breast cancers showed an increase with age across 4 segments, with the most significant surge in mortality observed among the 35–54 age group across urban and rural areas, periods, and regions in China.Conclusions:Special attention should be given to women aged 35–54 years due to mortality trends and rural–urban disparities. Focusing on vulnerable age groups and addressing rural–urban differences in the delivery of cancer control programs can enhance resource efficiency and promote health equity.

키워드

cervical cancer;Breast cancer;Age-specific mortality;Trend;Urban–rural difference;Joinpoint model;China

References

  1. 1..
    Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–63.
  2. 2..
    Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.
  3. 3..
    WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention. 2nd ed. Geneva: World Health Organization; 2021.
  4. 4..
    Qiu H, Cao S, Xu R. Cancer incidence, mortality, and burden in China: a timetrend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020. Cancer Commun (Lond). 2021;41(10):1037–48.
  5. 5..
    Qi J, Li M, Wang L, Hu Y, Liu W, Long Z, 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):e943–55.
  6. 6..
    Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: World Health Organization; 2020.
  7. 7..
    Duggan C, Trapani D, Ilbawi AM, Fidarova E, Laversanne M, Curigliano G, et al. National health system characteristics, breast cancer stage at diagnosis, and breast cancer mortality: a population-based analysis. Lancet Oncol. 2021;22(11):1632–42.
  8. 8..
    Zhao F, Qiao Y. Cervical cancer prevention in China: a key to cancer control. Lancet. 2019;393(10175):969–70.
  9. 9..
    Ministry of Health of the People’s Republic of China; All-China Women’s Federation. “Two Cancers” screening program for rural women. Available online: (accessed 1 June 2024).
  10. 10..
    National Health and Family Planning Commission of the People’s Republic of China; Ministry of Finance of the People’s Republic of China; All-China Women’s Federation. “Two Cancers” screening program for rural women (2015 Revision). Available online: (accessed 1 June 2024).
  11. 11..
    National Health Commission of the People’s Republic of China. Cervical cancer screening program and breast cancer screening program. Available online: (accessed 1 June 2024).
  12. 12..
    Bao H, Wang L, Brown M, Zhang M, Hunt K, Di J, et al. A nationally quasi-experimental study to assess the impact of partial organized breast and cervical cancer screening programme on participation and inequalities. BMC Cancer. 2020;20(1):1191.
  13. 13..
    Zhang M, Zhong Y, Zhao Z, Huang Z, Zhang X, Li C, et al. Cervical cancer screening rates among Chinese women—China, 2015. CCDC Wkly. 2020;2(26):481–6.
  14. 14..
    Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020;8(2):e191–203.
  15. 15..
    Simms KT, Steinberg J, Caruana M, Smith MA, Lew JB, Soerjomataram I, et al. Impact of scaled up human papillomavirus vaccination and cervical screening and the potential for global elimination of cervical cancer in 181 countries, 2020–99: a modelling study. Lancet Oncol. 2019;20(3):394–407.
  16. 16..
    He WQ, Li C. Recent global burden of cervical cancer incidence and mortality, predictors, and temporal trends. Gynecol Oncol. 2021;163(3):583–92.
  17. 17..
    Duan R, Xu K, Huang L, Yuan M, Wang H, Qiao Y, et al. Temporal trends and projection of cancer attributable to human papillomavirus infection in China, 2007–2030. Cancer Epidemiol Biomark Prev. 2022;31(5):1130–6.
  18. 18..
    Fan L, Strasser-Weippl K, Li JJ, St Louis J, Finkelstein DM, Yu KD, et al. Breast cancer in China. Lancet Oncol. 2014;15(7):e279–89.
  19. 19..
    Li X, Zheng R, Li X, Shan H, Wu Q, Wang Y, et al. Trends of incidence rate and age at diagnosis for cervical cancer in China, from 2000 to 2014. Chin J Cancer Res. 2017;29(6):477–86.
  20. 20..
    Pan R, Zhu M, Yu C, Lv J, Guo Y, Bian Z, et al. Cancer incidence and mortality: a cohort study in China, 2008–2013. Int J Cancer. 2017;141(7):1315–23.
  21. 21..
    Liu S, Wu X, Lopez AD, Wang L, Cai Y, Page A, et al. An integrated national mortality surveillance system for death registration and mortality surveillance. China Bull World Health Organ. 2016;94(1):46–57.
  22. 22..
    Yang G, Hu J, Rao KQ, Ma J, Rao C, Lopez AD. Mortality registration and surveillance in China: history, current situation and challenges. Popul Health Metr. 2005;3(1):3.
  23. 23..
    Qi J, Zhang D, Zhang X, Takana T, Pan Y, Yin P, et al. Short- and medium-term impacts of strict anti-contagion policies on non-COVID-19 mortality in China. Nat Hum Behav. 2022;6(1):55–63.
  24. 24..
    Liu J, Zhang L, Yan Y, Zhou Y, Yin P, Qi J, et al. Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries. BMJ. 2021;372:n415.
  25. 25..
    Liu W, Liu J, Song Y, Wang X, Zhou M, Wang L, et al. Mortality of lymphoma and myeloma in China, 2004–2017: an observational study. J Hematol Oncol. 2019;12(1):22.
  26. 26..
    Zhao Z, Wang L, Li Y, Jiang Y, Zhang M, Huang Z, et al. Provincial representativeness assessment of China Non-communicable and Chronic Disease Risk Factor Surveillance System in 2013. Chin J Prev Med. 2018;52(2):165–9.
  27. 27..
    National Cancer Institute. Joinpoint trend analysis software-method and parameters tab. Available online: (accessed 1 June 2024).
  28. 28..
    Modeling rates and estimating rates and rate ratios (with confidence intervals). Available online: (accessed 1 June 2024).
  29. 29..
    National Health Commission of the People’s Republic of China. China health statistics yearbook (2018). Available online: (accessed 1 June 2024).
  30. 30..
    Wen X, Wen D, Yang Y, Chen Y, Akazawa K, Liu Y, et al. Urban-rural disparity in cervical cancer in China and feasible interventions for tackling the rural excess. Medicine (Baltimore). 2019;98(1):e13907.
  31. 31..
    Li Y, Ma L, Yang C, Chen Z, Zhao Y, Dang L, et al. A study on service capacity of primary medical and health institutions for cervical cancer screening in urban and rural areas in China. Chin J Cancer Res. 2019;31(5):838–48.
  32. 32..
    Yue X, Gong X, Li J, Teng F, Jiang N, Men P, et al. Epidemiological features of condyloma acuminatum in national sexually transmitted disease surveillance sites in China from 2008 to 2016. Chin J Dermatol. 2017;50(5):321–5.
  33. 33..
    An J, Zhou K, Li M, Li X. Assessing the relationship between body image and quality of life among rural and urban breast cancer survivors in China. BMC Womens Health. 2022;22(1):61.
  34. 34..
    Fei X, Wu J, Kong Z, Christakos G. Urban-rural disparity of breast cancer and socioeconomic risk factors in China. PLoS One. 2015;10(2):e0117572.
  35. 35..
    Yang L, Sun TT, Wang N. The incidence and mortality trends of female breast cancer in Beijing, China: between 2004 and 2008. Chin J Prev Med. 2012;46(11):1009–14.

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