Search

Objective: To provide the most up-to-date data on the burden of malignant mesothelioma (MM) and the projections through 2029 in China. Methods: Data on patients diagnosed with MM from China during 1990–2019 were obtained from the Global Burden of Disease (GBD) 2019 database, including annual cases and deaths data and age-standardized rates of incidence, mortality, and disability-adjusted life-years (DALYs) associated with MM among different age groups. Temporal trends during 1990–2019 were analyzed by the Joinpoint regression models using 95% confidence interval (CI), while the projections through 2029 were calculated by the Bayesian age-period-cohort model. Data on the production and consumption of asbestos in China were obtained from the United States Geological Survey on Mineral Commodity Summaries during 1996–2023. Results: We observed a significant elevation in incident new cases and deaths over the last 3 decades, increasing from 1193 in 1990 to 2815 in 2019 for incident cases and from 1134 in 1990 to 2773 in 2019 for death cases. We found a roughly 6% increase in the proportion of incident cases for those aged >70 years (30% in 2019 versus 24% in 1990), while for the proportion of deaths similar elevation for those aged >70 years was found. Additionally, men had significantly higher DALYs due to MM across age groups compared with women. Asbestos consumption in China dramatically dropped since 2012 and reached the bottom in 2017 with 230 kilotons. By 2029, the projected age-standardized rate for incidence and mortality is expected to reach 1.2 per million for both. Conclusion: We found, for the first time using GBD data on the Chinese population, that the burden of MM has been significantly increasing in China over the last three decades and will continue to increase in the upcoming decade, suggesting an urgent need for a complete ban on chrysotile asbestos in China.

Objective: To analyze the impact of global population aging on cancer epidemiology, with a focus on the incidence and mortality rates among individuals aged 60 years and above. Methods: We utilized open-source data, retrieving population age estimates from the United Nations Population Division website. The GLOBOCAN 2020 database provided estimates for cancer cases and deaths in 2020 and 2040, while the Global Burden of Disease 2019 database supplied estimates of new cancer cases worldwide from 2000 to 2019. Inclusion criteria considered individuals aged 60 years and over, focusing on the top five deadliest cancers. The cohort-component method was employed for population prediction, with age-specific incidence and mortality rates estimated for 2020 used to forecast the cancer burden. Results: In 2021, the global population aged over 60 years accounted for 13.7%, with Europe/North America and Australia/New Zealand having the highest proportions. The older population is predicted to reach 19.2% by 2040. In 2020, of the 19.3 million new cancer cases worldwide, 64% occurred in individuals aged 60 and above, contributing to 71.3% of cancer-related deaths. The five most common cancer sites were the lung, colorectum, prostate, breast, and stomach. Cancer incidence and deaths are projected to rise significantly among older individuals, reaching 20.7 million new cases and 12.7 million deaths by 2040. Older age, tobacco use, dietary factors, alcohol consumption, and high body mass index (BMI) were identified as major risk factors for various cancers in this demographic. Conclusions: This study reveals a significant rise in cancer incidence and mortality among the elderly due to global population aging. The urgency for targeted interventions in cancer prevention, screening, and treatment for older individuals is emphasized. Despite acknowledged limitations, these findings contribute valuable insights to inform strategies for managing cancer in the elderly amidst evolving demographic trends.

Objective: The burden of gastric cancer (GC) across different age groups needs updating. We determined the GC global, regional, and national burden profiles and changes in incidence for 3 sequential 5-year intervals from 2003 to 2017. Methods: The latest incidence and mortality estimates of GC from 185 countries and regions were extracted from the GLOBOCAN 2022 database. The 5-year interval age-standardised incidence rates (ASIRs) were evaluated using cancer registry data from volumes X–XII of the Cancer Incidence in Five Continents (CI5). Correlation analysis was used to evaluate the relationship between ASIR or the age-standardised mortality rate (ASMR) and the Human Development Index (HDI). Results: There was an estimated global 968,000 new GC cases and 660,000 deaths in 2022, with male predominance. GC ASIRs and ASMRs were 9.2 and 6.1 per 100,000 persons, respectively. East Asia had the highest burden, with 53.8% of cases and 48.2% of deaths among all geographic regions. There was a significant correlation between ASIR and HDI. Over three 5-year intervals from 2003 to 2017, the incidence of GC notably decreased in most countries but peaked at 2008–2012 in New Zealand, Turkey, and South Africa. Several countries in Europe, Oceania, and America suggest an increasingly concerning trend among younger individuals, especially females. Conclusions: GC is a significant health issue, especially among males and in geographic regions with an HDI, such as eastern Asia. While the incidence of GC is decreasing in many countries due to prevention efforts and improved treatments, a rising trend persists among younger individuals. Comprehensive prevention strategies tailored to different age patterns are clearly needed.

BackgroundThe nationwide HUN-CANCER EPI study examined cancer incidence and mortality rates in Hungary from 2011 to 2019.MethodsUsing data from the National Health Insurance Fund (NHIF) and Hungarian Central Statistical Office (HCSO), our retrospective study analyzed newly diagnosed malignancies between Jan 1, 2011, and Dec 31, 2019. Age-standardized incidence and mortality rates were calculated for all and for different tumor types using both the 1976 and 2013 European Standard Populations (ESP).FindingsThe number of newly diagnosed cancer cases decreased from 60,554 to 56,675 between 2011–2019. Age-standardized incidence rates were much lower in 2018, than previously estimated (475.5 vs. 580.5/100,000 person-years [PYs] in males and 383.6 vs. 438.5/100,000 PYs in females; ESP 1976). All-site cancer incidence showed a mean annual decrease of 1.9% (95% CI: 2.4%-1.4%) in men and 1.0% (95% CI:1.42%-0.66%) in women, parallel to mortality trends (-1.6% in males and -0.6% in females; ESP 2013). In 2018, the highest age-standardized incidence rates were found for lung (88.3), colorectal (82.2), and prostate cancer (62.3) in men, and breast (104.6), lung (47.7), and colorectal cancer (45.8) in women. The most significant decreases in incidence rates were observed for stomach (4.7%), laryngeal (4.4%), and gallbladder cancers (3.5%), with parallel decreases in mortality rates (3.9%, 2.7% and 3.2%, respectively).InterpretationWe found a lower incidence of newly diagnosed cancer cases for Hungary compared to previous estimates, and decreasing trends in cancer incidence and mortality, in line with global findings and the declining prevalence of smoking.

Background. A key requirement of community outreach and engagement offices within National Cancer Institute-designated cancer centers is to conduct a comprehensive examination of their catchment area’s population, cancer burden, and assets. To accomplish this task, we describe the plan for implementing our initiative, the Cancer Health Assets and Needs Assessment (CHANA). CHANA compiles, into a single source, up-to-date data that describes the cancer landscape of North Carolina’s 100 counties.Methods. CHANA utilized a three phased approach: (1) compiling existing data from publicly available sources; (2) analyzing novel data source, which links state cancer registry, multi-payer insurance claims, and area-level contextual data; and (3) conducting surveys of the general public and cancer survivors and key informant interviews with cancer-related community organizations to understand their priorities and resources. These multifaceted data resources are curated and compiled into three key dissemination products: a summary report, county-level profile reports, and interactive online data dashboards.Discussion. Through data-driven efforts like CHANA, cancer centers and the communities they serve can better understand gaps in care and information needs, opportunities, and resources to improve health outcomes, and priorities for new research and programmatic endeavors focused on prevention, healthcare access, equity, and quality.

IntroductionSub-Saharan Africa (SSA) is plagued by myriads of diseases, mostly infectious; but cancer disease burden is rising among non-communicable diseases. Nigeria has a high burden of cancer, however its remote underserved culturally-conserved populations have been understudied, a gap this study sought to fill.MethodsThis was a cross-sectional multi-institutional descriptive study of histologically diagnosed cancers over a four-year period (January 2019-December 2022) archived in the Departments of Pathology and Cancer Registries of six tertiary hospitals in the northeast of Nigeria. Data obtained included age at diagnosis, gender, tumor site and available cancer care infrastructure. Population data of the study region and its demographics was obtained from the National Population Commission and used to calculate incident rates for the population studied.ResultsA total of 4,681 incident cancer cases from 2,770 females and 1,911 males were identified. The median age at diagnosis for females was 45 years (range 1–95yrs), and 56 years (range 1–99yrs) for males. Observed age-specific incidence rates (ASR) increased steadily for both genders reaching peaks in the age group 80 years and above with the highest ASR seen among males (321/100,000 persons) compared to females (215.5/100,000 persons). Breast, cervical, prostatic, colorectal and skin cancers were the five most common incident cancers. In females, breast, cervical, skin, ovarian and colorectal cancers were the top five malignancies; while prostate, haematolymphoid, skin, colorectal and urinary bladder cancers predominated in men.ConclusionRemote SSA communities are witnessing rising cancer disease burden. Proactive control programs inclusive of advocacy, vaccination, screening, and improved diagnostics are needed.

Background: This study aims to define the financial burden experienced by Slovenian cancer patients, including both objective financial consequences and subjective financial worries resulting from their disease and treatment. Additionally, we investigate the impact of financial toxicity (FT) on quality of life (QoL). Prior to this study, no research had been conducted on this topic in Slovenia. Aim: The objective of this study was to evaluate the financial burden experienced by cancer patients in Slovenia, its impact on their QoL, and to test the effectiveness of existing tools for assessing FT and QoL. Methods: A survey methodology was employed to measure FT. We developed our own questionnaire to assess FT, and the internationally validated FACIT-COST and EORTC QLQ-C30 questionnaires were used. The study was prospective and cross-sectional and was held at the Institute of Oncology Ljubljana from June to October 2023. Results: We analysed 590 valid surveys. Based on the FACIT- -COST questionnaire, we found that the majority of surveyed patients (53.7%) had no FT, and 42.9% of surveyed patients mostly had mild to moderate FT. The low FT among Slovenian cancer patients was also confirmed by the EORTC QLQ-C30 questionnaire and our own questionnaire. The majority of patients (85.1%) estimated that they did not incur any major costs due to their disease and treatment. Based on the FACIT-COST and the EORTC QLQ-C30 indicator for financial burden, we found that the risk groups for increased FT were mainly patients with a lower net household income (p ≤ 0.001), younger patients (p < 0.001), breast cancer patients (p = 0.016), working patients (p < 0.001) and patients undergoing active oncological treatment (p = 0.039). In our own questionnaire, a lower level of education (p ≤ 0.001), a rural environment (p = 0.033) and the type of health insurance (p = 0.006) also proved to be important for FT. The effect of religion on FT is not associated with higher FT based on our own questionnaire, as shown by the FACIT-COST and EORTC QLQ-C30 questionnaires. We also confirmed the effect of lower income on poorer QoL. Other parameters influencing QoL are: a very low or very high level of education, head and neck cancer and treatment activity. Conclusions: In Slovenia, the majority of cancer patients do not suffer from FT, and 42.9% have mild to moderate FT. FT is statistically significantly associated with income level, age, type of cancer, employment status, oncological treatment activity, education level, rural environment and type of health insurance. Higher FT is associated with poorer QoL. It is also associated with income level, education level, cancer type and oncological treatment activity.

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.

Abstract Background and purpose Cancer has become one of the major killers of humanity due to the number of people over the age of 75 increasing with population ageing. The aim of this study was to analyse the incidence and mortality rates in people over 75 of 29 cancer types in 204 countries and regions, as well as the trends from 1990 to 2019. Methods Twenty-nine cancer types were collected from the Global Burden of Disease (GBD) 2019 database( https://vizhub.healthdata.org/gbd-results/ ). We collected global cancer data for 2019 in terms of sex, age, sociodemographic index (SDI), region, etc. The estimated annual percentage change (EAPC) was calculated to assess the trend of the cancer incidence and mortality rate from 1990 to 2019. Results In 2019, the number of new cancer cases and deaths among people 75 and older was almost 3 and 4.5 times that of 1990, respectively. From 1990 to 2019, there was a slow rise in incidence and a slight decline in mortality. There were significant differences in the cancer burden based on sex, age, region, and SDI. The cancer burden in men was higher than in women. In addition, the cancer burden varied from region to region. The highest cancer burden occurred in high-income North America. In addition, the higher the SDI was, the greater the burden of cancer. The incidence of cancer in high SDI was approximately seven times that of low SDI, and the trend of increase in high SDI was obvious. However, the trend of mortality in high SDI was decreasing, while it was increasing in low SDI. Conclusions The present study focused on the cancer burden in adults over 75 years old. The findings in the study could serve as the basis for an analysis of the types of cancers that are most prevalent in different regions. This is beneficial for strategies of prevention and treatment according to the characteristics of different countries and regions to reduce the burden of cancer in older adults.

Abstract Background A stronger spatial clustering of cancer burden indicates stronger environmental and human behavioral effects. However, which common cancers in China have stronger spatial clustering and knowledge gaps regarding the environmental and human behavioral effects have yet to be investigated. This study aimed to compare the spatial clustering degree and hotspot patterns of 11 common cancers in mainland China and discuss the potential environmental and behavioral risks underlying the patterns. Methods Cancer incidence data recorded at 339 registries in 2014 was obtained from the “China Cancer Registry Annual Report 2017”. We calculated the spatial clustering degree of the common cancers using the global Moran’s Index and identified the hotspot patterns using the hotspot analysis. Results We found that esophagus, stomach and liver cancer have a significantly higher spatial clustering degree ( $$p

Cancer has become the most common cause of death in China. Owing to rapid economic development, improved livelihood, and shifts in risk factors, cancer epidemiology has experienced substantial changes during the past several decades. In this review, we aim to describe the current cancer epidemiology of the main types of cancer in China, report major risk factors associated with cancer development, and summarize the contributions of the Chinese government to controlling the cancer burden. A total of 4,064,000 new cases were diagnosed in China in 2016. The most frequent types are lung cancer (828,100; 20.4%), colorectal cancer (408,000; 10.0%), and gastric cancer (396,500; 9.8%). Lung (657,000; 27.2%), liver (336,400, 13.9%), and stomach (288,500; 12.0%) cancers are the 3 most deadly cancers in the general population. The 5-year survival rate for cancer has dramatically increased in recent decades. However, liver and particularly pancreatic cancers still have the poorest prognosis. The main modifiable risk factors associated with cancer development include infectious agents, smoking, alcohol consumption, obesity, unhealthful dietary habits, and inadequate physical activity. The Chinese government has made unremitting efforts to decrease the cancer burden, including cancer education and investment in cancer screening programs.

BackgroundThere is a lack of in-depth analysis regarding the disease burden of childhood cancer in China. Indeed, this is the first time the topic has been addressed in detail. Drawing on population-based data for the past 30 years, this study systematically analyzes the composition and long-term trend of this disease burden in China.MethodsGBD 2019 contained population-based data from 1990 to 2019 and was prepared using Microsoft Excel 2016. We used AAPC and ARIMA models for trend analysis and prediction formulation.ResultsIn 2019, there were 45,601 new cases, 9,156 cancer deaths, and 782,530 DALYs in China. From 1990 to 2019, leukemia, together with brain and CNS cancer, invariably ranked highest in terms of new cases, cancer deaths, and DALYs. Leukemia accounted for more than 50%, but decreased over time. By contrast, the proportions for brain and CNS cancer increased. There were significant decreases in the overall incidence, mortality, and DALY rates in China, but these were still higher than the corresponding global average levels. Considering all types of childhood cancer, the incidence rate of testicular cancer showed the biggest increase, and the mortality and DALY rates of leukemia showed the largest decrease. In terms of different age groups, the overall incidence rate of childhood cancers increased in 0 to 4 age group, but it decreased in 5 to 14 age groups. The overall mortality and DALY rates of childhood cancers decreased in all four age groups. Over the next 10 years, the overall incidence rate of childhood cancer will increase, but the overall mortality and DALY rates will decrease. The increase in malignant skin melanoma will comprise the largest rise in the incidence, while the decrease for leukemia will be the largest fall in the incidence, cancer deaths, and DALYs.ConclusionThe disease burden of all childhood cancers in China remains highly serious, especially for certain types of cancer and certain age groups. China should focus more emphatically on the incidence of childhood cancer in future, and it must consistently strengthen investment in the relevant research and medical resources to reduce the disease burden in this field.

Abstract Background The burden of cancer in Sri Lanka is on the rise. The overall incidence of cancer in Sri Lanka has doubled over the past 25 years with a parallel rise in cancer-related mortality. Cancer has become the second commonest cause of hospital mortality in Sri Lanka. In this review, we aim to provide an overview of the current status and future direction of cancer care in Sri Lanka. Main body In Sri Lanka, cancer services are predominantly provided by the state sector free of charge to the general public. With the establishment of national cancer policy on cancer prevention and control, there has been a commendable improvement in the cancer services provided island-wide. An increasing number of breast, oropharyngeal, thyroid, oesophageal, colorectal, lung, and gastric cancers are being diagnosed and treated annually. Primary prevention measures include restrictions in tobacco and HPV vaccination. Screening programs for selected cancers such as breast, oral and cervical cancers are delivered. Medical oncology units with facilities for systemic therapy and adequately supported by surgical, pathology, and radiology departments have been established in each district general hospital island-wide. Although the current progress is commendable, future changes are necessary to overcome the current limitations and to cater the ever increasing burden of cancer. Measures are necessary to enhance the coverage of Sri Lanka Cancer Registry. Timely high-quality research and audits are essential. Community participation in planning strategies for cancer prevention and treatment is minimal. Community-based palliative care facilities and radiation and other systemic therapy should be made available in all provinces. A culture of multi-disciplinary care with proper referral pathways would help to improve the current setting. Conclusion In conclusion, Sri Lanka has a reasonably balanced and continuously expanding program for prevention, screening, and treatment of cancers. Emphasis on preventive strategies related to reducing tobacco smoking, chewing betel, and obesity, making cancers a notifiable disease, involving the community in planning cancer care and prevention strategies, conducting research to evaluate cost-effectiveness of existing treatment and increasing radiotherapy facilities would further improve the cancer services in Sri Lanka.

The aim of our study was to describe the survival of Slovenian cancer patients diagnosed in the last twenty years. An insight is given into the improvement made in different cancer types, population groups and prognostic factors.

BackgroundUnderstanding the epidemiological characteristics of various cancers can optimize the prevention and control strategies in the national cancer control plan. This study aimed to report the burden differences, pattern trend, and potential risk factors of all neoplasm types in China in recent 30 years, and further compared with top economies in the world.MethodsThe disability-adjusted life-years (DALYs) and age-standardized DALY rate (ASDR) of all neoplasms with the attributable risk factors from 1990 to 2019 in China, Japan, European Union, USA, and the world were extracted from the Global Burden of Disease Study 2019. The temporal trend analysis was estimated using the joinpoint regression model.ResultsIn 2019, about 251.4 million DALYs worldwide were caused by all neoplasms, and nearly 26.9% (67.5 million DALYs) occurred in China with the ASDR in 2019 of 342.09/10 000, which was higher than European Union (334.25/10 000), USA (322.94/10 000), and Japan (250.36/10 000). Although the cancer burden of the colorectum, non-Hodgkin lymphoma, oral cavity, ovary, and kidney in China was lower than in Japan, European Union and USA, the corresponding ASDR gradually increased in China over the past 30 years, but declined in the three developed areas. Around 46.29% of overall neoplasms DALYs in China in 2019 were attributed to 22 identified risk factors, and the specific risk attributable-fraction for several neoplasm types varied greatly in these regions.ConclusionThe ASDR of cancers of the lung, colorectum, pancreas, non-Hodgkin lymphoma, oral cavity, ovary, kidney, and chronic lymphoid leukemia increased in China compared to 30 years ago. With the population aging and the social transformation in China, the increasing burden of neoplasms and the changing spectrum of neoplasms suggest that effective comprehensive prevention and treatment measures should be adopted to reduce the burden, including public health education, strict tobacco-control policy, healthier lifestyles, along with expanding vaccination programs and early cancer screening.

ObjectiveCancer incidence and mortality rates in Africa are increasing, yet their geographic distribution and determinants are incompletely characterized. The present study aims to establish the spatial epidemiology of cancer burden in Africa and delineate the association between cancer burden and the country-level socioeconomic status. The study also examines the forecasts of the cancer burden for 2040 and evaluates infrastructure availability across all African countries.MethodsThe estimates of age, sex, and country-specific incidence and mortality of 34 neoplasms in 54 African countries, were procured from GLOBOCAN 2020. Mortality-to-incidence ratio (MIR) was employed as a proxy indicator of 5-year survival rates, and the socioeconomic development of each country was measured using its human development index (HDI). We regressed age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and MIR on HDI using linear regression model to determine the relationship between cancer burden and HDI. Maps were generated for each cancer group for each country in Africa. The data about the cancer infrastructure of African countries were extracted from the WHO Cancer Country Profiles.ResultsIn Africa, an estimated 1.1 million new cases [95% uncertainty intervals (UIs) 1.0 – 1.3 million] and 711,429 [611,604 – 827,547] deaths occurred due to neoplasms in 2020. The ASIR was estimated to be 132.1/100,000, varying from 78.4/100,000 (Niger) to 212.5/100,000 (La Réunion) in 2020. The ASMR was 88.8/100,000 in Africa, ranging from 56.6/100,000 in the Republic of the Congo to 139.4/100,000 in Zimbabwe. The MIR of all cancer combined was 0.64 in Africa, varying from 0.49 in Mauritius to 0.78 in The Gambia. HDI had a significant negative correlation with MIR of all cancer groups combined and main cancer groups (prostate, breast, cervical and colorectal). HDI explained 75% of the variation in overall 5-year cancer survival (MIR). By 2040, the burden of all neoplasms combined is forecasted to increase to 2.1 million new cases and 1.4 million deaths in Africa.ConclusionHigh cancer mortality rates in Africa demand a holistic approach toward cancer control and management, including, but not limited to, boosting cancer awareness, adopting primary and secondary prevention, mitigating risk factors, improving cancer infrastructure and timely treatment.

Abstract Background and Aims Interventions that significantly reduce dietary sodium intake are anticipated to decrease gastric cancer (GCa) burden. However, the optimal restriction strategies remain unknown at present. This study aims to understand where and to what extent policies modifying sodium consumption change the distribution of GCa burden, and the effects of potential salt reduction strategies in China. Methods The synthetic population in this microscopic simulation study is close to reality. We incorporated estimates of dietary patterns and GCa risk into the model of excess salt consumption. These estimates and simulated population were obtained from the China Health and Nutrition Survey, Global Burden of Disease Project, and the sixth census of China's National Bureau of Statistics, respectively. Results In the no intervention scenario, we estimated that disease burdens due to excess sodium intake would be at 472.9 million disability‐adjusted life years (DALYs) nationally between 2010 and 2030 (95% credible interval [CrI]: 371.1–567.7). The GCa burden caused by high sodium is projected to have a disproportionate impact on the central and southern provinces of China (9.2 and 4.5 million DALYs, respectively). Implementing a cooking salt substitute strategy would be expected to avoid a larger portion of GCa burden (about 67.2%, 95% CrI: 66.8%–67.6%) than the salt‐restriction spoon program (about 16.7%, 95% CrI: 16.1%–17.4%). Conclusion Dietary salt reduction policy is very powerfully effective in reducing the GCa burden overall. It is expected that proposed salt substitutes are more effective than traditional salt‐restriction spoons to avoid increased inequality.

As the most populous country in the world, China has made strides in health promotion in the past few decades. With the aging population, the burden of cancer in China continues to grow. Changes in risk factors for cancer, especially diet, obesity, diabetes, and air pollution, continue to fuel the shift of cancer transition in China. The burden of upper gastrointestinal cancer in China is decreasing, but still heavy. The rising burden of colorectal, prostate, and breast cancers is also significant. Lung cancer became the top cause of cancer-related deaths, together with smoking as the most important contributor to cancer deaths. The Chinese government has taken several approaches to control cancer and cancer-related risk factors. Many achievements have been made, but some challenges remain. Health China 2030 is ambitious and depicts a bright vision of the future for cancer control in China. The decrease in the cancer burden in China will require cross-sector collaboration and coordinated efforts on primary and secondary preventions by governments, public health organizations, and individuals. In this review, we describe the trends of cancer burden and discuss cancer-related risk factors in China, identifying strategies to reduce the burden of cancer in China.

Background: Gynecologic cancers (GCs) are among the leading causes of morbidity and mortality in females worldwide. Estimating the cancer burden is invaluable to set up priorities for research funding allocations, cancer control policies, and prevention strategies. The International Agency for Research on Cancer (IARC) has recently released the latest estimates on the prevalence, incidence, and mortality for 36 types of cancer and all cancer sites combined in 185 countries in 2020. Methods: We obtained data on the incidence, mortality, and prevalence of GCs in the Iranian female population from the GLOBOCAN 2020 database presented by the IARC, compared the burden with the previous reports presented in 2012 and 2018, and provided the estimates for 2040. In addition, we compared the burden to that of the WHO Eastern Mediterranean Region (EMRO) and the world. Results: There has been a slight increase in the incidence of GCs in recent years after stable rates for a couple of decades. The growing availability of incidence rates from population-based cancer registries (PBCRs) and mortality rates from vital statistics offices in Iran may account for the increasing trend. Conclusions: Cancer awareness campaigns and high-quality prevention programs may result in better GC prevention among women.

Abstract Background In this study, we aimed to assess health research funding allocation in South Korea by analysing the relationship between government funding and disease burden in South Korea, specifically focusing on cancers. Methods The relationship between research funding and the cancer burden, measured in disability-adjusted life-years (DALYs), was analysed using a linear regression method over a 10-year interval. Funding information on 25 types of cancer was obtained from the National Science and Technology Information Service portal in South Korea. Measures of cancer burden were obtained from Global Burden of Disease studies. The funding predictions were derived from regression analysis and compared with actual funding allocations. In addition, we evaluated how the funding distribution reflected long-term changes in the burden and the burden specific to South Korea compared with global values. Results Korean funding in four periods, 2005–2007, 2008–2010, 2011–2013 and 2015–2017, were associated with the cancer burden in 2003, 2006, 2009 and 2013, respectively. For DALYs, the correlation coefficients were 0.79 and 0.82 in 2003 and 2013, respectively, which were higher than the values from other countries. However, the changes in DALYs (1990–2006) were not associated with the funding changes (from 2005 to 2007 to 2015–2017). In addition, the value differences between Korean and global DALYs were not associated with Korean government research funding. Conclusions Although research funding was associated with the cancer burden in South Korea during the last decade, the distribution of research funds did not appropriately reflect the changes in burden nor the differences between the South Korean and global burden levels. The policy-makers involved in health research budgeting should consider not only the absolute burden values for singular years but also the long-term changes in burden and the country-specific burden when they prioritise public research projects.

Background: Long-term exposure to PM2.5 has been linked to cancer incidence and mortality. However, it was unknown whether there was an association with cancer hospitalizations. Methods: Data on cancer hospitalizations and annual PM2.5 concentrations were collected from 1,814 Brazilian cities during 2002–2015. A difference-in-difference approach with quasi-Poisson regression was applied to examine State-specific associations. The State-specific associations were pooled at a national level using random-effect meta-analyses. PM2.5 attributable burden were estimated for cancer hospitalization admissions, inpatient days and costs. Results: We included 5,102,358 cancer hospitalizations (53.8% female). The mean annual concentration of PM2.5 was 7.0 μg/m3 (standard deviation: 4.0 μg/m3). With each 1 μg/m3 increase in two-year-average (current year and previous one year) concentrations of PM2.5, the relative risks (RR) of hospitalization were 1.04 (95% confidence interval [CI]: 1.02 to 1.07) for all-site cancers from 2002 to 2015 without sex and age differences. We estimated that 33.82% (95%CI: 14.97% to 47.84%) of total cancer hospitalizations could be attributed to PM2.5 exposure in Brazil during the study time. For every 100,000 population, 1,190 (95%CI: 527 to 1,836) cancer hospitalizations, 8,191 (95%CI: 3,627 to 11,587) inpatient days and US$788,775 (95%CI: $349,272 to $1,115,825) cost were attributable to PM2.5 exposure. Conclusions: Long-term exposure to ambient PM2.5 was positively associated with hospitalization for many cancer types in Brazil. Inpatient days and cost would be saved if the annual PM2.5 exposure was reduced.

Baohua Liu,1,2,* Xinxin Lao,3,* Yang Feng,4,* Jiazhuo Liu,5 Mingli Jiao,1 Miaomiao Zhao,1 Jiahui Wang,1 Xin Zhang,1 Jingjing Liu,1 Xinye Qi,1 Huan Liu,1 Ruohui Chen,1 Qunhong Wu,1 Yanhua Hao11Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People’s Republic of China; 2Harbin Center for Disease Control and Prevention, Harbin, Heilongjiang, People’s Republic of China; 3Educational Administration Section, General Hospital of Heilongjiang Farms & Land Reclamation Administration, Harbin, Heilongjiang, People’s Republic of China; 4Network Communication Section, Heilongjiang Third Hospital, Beian, Heilongjiang, People’s Republic of China; 5Second Project Section, Project Fund Supervision Service Center of Heilongjiang Health and Family Planning Commission, Harbin, Heilongjiang, People’s Republic of China*These authors contributed equally to this work Purpose: The burden of cancer impacts many of the world’s top concerns, but little information is published about the characteristics of cancer prevalence in the poor population.Materials and methods: Data on cancer prevalence were obtained from the Health Poverty Alleviation Information System of Heilongjiang province. Prevalence was defined as all living cancer cases on October 1, 2018. Geographical area, cancer site, sex, age, educational level, and time since diagnosis were investigated.Results: There were 10,529 cancer cases among 624,869 poor rural people in Heilongjiang up to October 1, 2018, and 77% of them did not have labor ability. Females accounted for 53.4%. The top five common cancers were lung, breast, colorectal, stomach, and liver cancer. There were distinct regional, sex, and age distribution differences in cancers. The prevalence rate for overall cancers was 1,685.0 per 100,000 people, which was much higher than that of the national level. Cancer prevalence peaked at an earlier age group (65–69 year). The 5-year cancer prevalence was 80.1% of the total cases.Conclusion: Cancer imposes significant health and financial burdens in the rural poor. This study presents total and partial prevalence for the first time using actual dates from a large poor population in China, providing valuable information for tailored cancer prevention and control, quantifying the cancer burden and identifying priorities for poverty alleviation plans.Keywords: cancer burden, prevalence, rural, poverty-stricken population

The burden of cancer is increasing worldwide, and Europe is no exception in this regard. Cancer incidence rate for men in 2018, excluding nonmelanoma skin cancers, averaged over the 40 UN‐defined European countries has been estimated as 436/100 000. For women, the estimated incidence rate is 332.6/100 000. Although mortality rates are declining in most European countries, the total number of cancer deaths continues to rise due to an increase in the number of older people in the age range when the cancer typically occurs. The increase in incident cases and cancer deaths increases the pressure on healthcare infrastructure and related costs, thus presenting a challenge to health service sustainability in countries. In the general population, there remains a perception of an ever‐increasing cancer risk. Hence, treatment alone is not a solution to address the cancer burden. At the same time, recent estimates of preventable fractions of cancer suggest that about half of all cancer cases could be prevented through rigorous implementation of successful prevention measures, among other actions, by following the cancer prevention recommendations of the European Code against Cancer. Smoking alone explains almost half of all preventable cancers, and the scattered way of implementing tobacco control in Europe with still increasing numbers of lung cancers in women demonstrates the gap between prevention potential and effectively implemented prevention. Cancer prevention clearly needs more resources, stronger support from decision‐makers and society, and a solid network to better speak with one voice. The newly established ‘Cancer Prevention Europe’ (Forman et al., ) offers promising opportunities for the latter.

Otília Menyhárt,1,2 János T Fekete,2 Balázs Győrffy1,2 1MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Budapest, Hungary; 22nd Department of Pediatrics, Semmelweis University, Budapest, Hungary Background: Population aging is a common demographic pattern in developed countries, and aging increases the risk of cancer. The disproportionately high cancer burden, as a consequence, is especially pronounced in Central and Eastern European countries, including Hungary. Methods: We summarized current and projected future cancer incidences and mortalities utilizing data from the last two decades. Predictions are based on cancer incidence and mortality collected between 1996 and 2015 in Hungary. In addition to the crude rates, data were age standardized to the European standard population (ESP) of 2013, ESP of 1976, and local census of 2011.Results: The lifetime probability of developing cancer and cancer-related mortality has already reached 56.9% and 27.6% in men, respectively, and 51.9% and 21.7% in women. Between 2016 and 2030, the total population is expected to shrink by 6%, while the number of 60-year olds and above will grow by 18%. This will lead to a 35% increase in cancer incidence and 30% increase in cancer death among 65–85-year olds. Joinpoint regression identified the period 2007–2015 as starting point for this coming increase in new cases. In women, lung and breast cancer will increase yearly by 1.9% and 1.7%, respectively, between 2016 and 2030, while in men, the prostate and colorectal cancer rates will increase yearly by 3.6% and 2.1%.Conclusion: In the aging population of Hungary, cancer incidence will increase considerably over previous projections. Although a large portion of the most rapidly rising cancers are avoidable by implementing public health programs, a substantial portion remains inevitably incurable. Keywords: cancer, biostatistics, aging, lung cancer, colon cancer, breast cancer, prostate cancer

Abstract Objective Colorectal cancer (CRC) burden is increasing in the south Asian region due to the changing socio-economic landscape and population demographics. There is a lack of robust high quality data from this region in order to evaluate the disease pattern and comparison. Using generalized linear models assuming Poisson distribution and model fitting, authors describe the variation in the landscape of CRC burden along time since 1997 at a regional tertiary care center in Sri Lanka. Results Analyzing 679 patients, it is observed that both colon and rectal cancers have significantly increased over time (pre 2000—61, 2000 to 2004—178, 2005 to 2009—190, 2010 to 2014–250; P

India has a rapidly growing population inflicted with cancer diagnosis. From an estimated incidence of 1.45 million cases in 2016, the cancer incidence is expected to reach 1.75 million cases in 2020. With the limitation of facilities for cancer treatment, the only effective way to tackle the rising and humongous cancer burden is focusing on preventable cancer cases. Approximately, 70% of the Indian cancers (40% tobacco related, 20% infection related and 10% others) are caused by potentially modifiable and preventable risk factors. We review these factors with special emphasis on the Indian scenario. The results may help in designing preventive strategies for a wider application.

The aim of our study was to describe cancer burden and time trends of all cancers combined, the most frequent as well as the rare cancers in Slovenia.

Background: Some infectious agents have been shown to be human carcinogens. The current study focused on estimation of cancer burden attributable to infection in different regions of Asia. Methods: By systematically reviewing previous studies of the infection prevalence data of 13 countries in Asia and relative risks of specific cancers, we calculated the population attributable fraction of carcinogenic infections. Using data from GLOBOCAN 2012, the overall country-specific and gender-specific number of new cancer cases and deaths resulting from infection were estimated. Results: Across 13 principal Asian countries, the average prevalence and range was 6.6% (0.5% in Japanese women to 15.0% in Vietnamese men) for hepatitis B virus (HBV), 2.6% (0.3% in Iran to 5.1% in Saudi Arabia) for hepatitis C virus (HCV), 7.9% (2.8% in Pakistan to 17.7% in China) for human papillomavirus (HPV), and 61.8% (12.8% in Indonesia to 91.7% in Bangladesh) for Helicobacter pylori (HP). The estimated total number of cancer cases and deaths caused by infection in these 13 countries were 1 212 026 (19.6% of all new cancer cases) and 908 549 (22.0% of all deaths from cancer). The fractions of cancer incidence attributable to infection were 19.7% and 19.5% in men and women, respectively. The percentages of cancer deaths attributable to infection were 21.9% and 22.1% in men and women, respectively. Among the main infectious agents, HP was responsible for 31.5% of infection-related cancer cases and 32.8% of infection-related cancer deaths, followed by HBV (28.6% of new cases and 23.8% of deaths), HPV (22.0% of new cases and 27.3% of deaths), and HCV (12.2% of new cases and 10.6% of deaths). Conclusions: Approximately one quarter of all cancer cases and deaths were infection-associated in Asia, which could be effectively prevented if appropriate long-term controls of infectious agents were applied.

This manuscript captures the discussion and recommendations that came out of a special Afro Asian symposium involving 13 countries. Unmet needs and cost-effective solutions with special emphasis on training form the backbone of practical next steps.