Objective: Colorectal cancer (CRC) is one of the most common cancers and the major cause of cancer death in China. The aim of this study was to estimate the burden of CRC in China. Materials and methods: Data from the National Cancer Center (NCC) of China was used and stratified by area (urban/rural), sex (male/female) for analyzing the age-specific incidence and mortality rates. Time trend of colorectal cancer was calculated based on the 22 high-quality cancer registries in China. National new cases and deaths of colorectal cancer were estimated using age-specific rates multiplied by the corresponding national population in 2014. The Chinese population in 2000 and Segi's world population were used to calculate age-standardized rates of colorectal cancer in China. Results: Overall, 370,400 new colorectal cancer cases and 179,600 deaths were estimated in China in 2014, with about 214,100 new cases in men and 156,300 in women. Meanwhile, 104,000 deaths cases of colorectal cancer were men and 75,600 deaths were women, which accounted for 9.74％ and 7.82％ of all cancer incidence and deaths in China, separately. Relatively higher incidence and mortality was observed in urban areas of China. And the Eastern areas of China showed the highest incidence and mortality. The age-standardized incidence and mortality rate of colorectal cancer has increased by about 1.9％ per year for incidence and about 0.9％ per year for mortality rate from 2000 to 2014. Conclusion: With gradually higher incidence and mortality rate in the past 15 years, colorectal cancer became a major challenge to China's public health. Effective control strategies are needed in China.

Objective: To analyze the associations between molecular subtypes and overall breast cancer survival among premenopausal and postmenopausal breast cancer in Beijing, and to provide basic information for breast cancer clinical researches and control. Methods: All the resident patients diagnosed with breast cancer in four well-established hospitals were retrieved from Beijing cancer registry, related information, such as TNM stages, receptor status, histological grade, height, weight, were collected by case extraction. Cancer registration information and population-based follow-up information were used to acquire survival outcome. All the patients were followed up until 31 December 2015, 4 531 cases with invasive, primary breast were included in the final analysis. All the cases were classified into Luminal and non-Luminal according to receptor status. Five-year survival rates of the two subtypes were estimated by the life-table method. Multivariable Cox proportional hazards models were employed to evaluate the associations between molecular subtypes and breast cancer survival. Results: Of all the 4 531 patients, premenopausal patients accounted for 44.5% (2 017 cases) and postmenopausal patients accounted for 55.5% (2 514 cases). 643 cases died during the study period. Overall five-year survival was 89.5% (95%CI: 88.6%-90.4%), for premenopausal and postmenopausal patients, they were 92.1% (95%CI: 90.9%-93.3%), and 87.5% (95%CI: 86.2%-88.8%), respectively. Among all the patients, 3 730 patients had molecular subtype, 76.7% (2 861 cases) were Luminal breast cancer, and 23.3% (869 cases) were non-Luminal breast cancer. Five-year survival rates for Luminal and non-Luminal were 91.8% (95%CI: 90.8%-92.8%), and 83.2% (95%CI: 80.7%-85.7%), respectively. No matter in premenopausal or postmenopausal patients, non-Luminal breast cancer had significantly higher risk of death compared to Luminal breast cancer (premenopausal: HR=1.85, 95%CI: 1.26-2.73; premenopausal: HR=1.42, 95%CI: 1.07-1.88). Conclusion For both premenopausal and postmenopausal breast cancer patients, non-Luminal breast cancer had lower five-year survival rates than Luminal breast cancer, which was a risk factor on breast cancer survival.

Objective: To analyze the trend of cancer incidence and age changes among men in cancer registration areas of China from 2000 and 2014. Methods: We select the information of national cancer registry with continuous data from 2000 to 2014, review and organize the monitoring data at the above registries. A total of 22 monitoring registries were included in this study. The covering population of male were about 314 330 648 person years. The information on the incidence of all male prostate cancer patients with C61 was extracted from the International Classification of Diseases-10^th Revision (ICD-10). To understand the incidence of male prostate cancer in each year, the age-standardized rate by Chinese population (ASR), average annual percent change (AAPC), adjusted mean age at onset were calculated. Incidence rates stratified by regions and age groups were also calculated. The linear regression model was employed to analyze the relationship between mean age at onset and year. Results: The prostate cancer incidence in China increased by 11.5% (95%CI: 10.3%-12.7%) from 2000(4.62/100 000) to 2014(21.62/100 000), the age-standardized incidence rate increased by 7.1% (95%CI: 6.0%-8.1%) and the growth of rural was greater than that of urban. The age-specific incidence showed that the incidence rate increased significantly among the age group of 50 years; the incidence rates in men who have the same age but with different birth years showed a significant increase as birth years increased. The adjusted mean age at diagnosis of prostate cancer in cancer registry areas was 74.09 years old in the year of 2000, reduced by 0.13 year old to 72.35 years old in 2014 (β=-0.13, P<0.001). The adjusted mean age at onset declined significantly over time in urban areas (β=-0.13, P<0.001). Conclusion The trend of prostate cancer incidence among men in cancer registry regions generally increased, and the average age at diagnosis declined slightly from 2000 to 2014.

Background::Hepatitis B virus (HBV) infection is the primary cause of hepatocellular carcinoma (HCC) in China. The target population for HCC screening comprises individuals who test positive for hepatitis B surface antigen (HBsAg). However, current data on the prevalence of HBV infection among individuals who are eligible for HCC screening in China are lacking. We aimed to assess the seroepidemiology of HBV infection among Chinese individuals eligible for HCC screening to provide the latest evidence for appropriate HCC screening strategies in China.Methods::Questionnaires including information of sex, age, ethnicity, marital status, educational level, source of drinking water, as well as smoking and alcohol consumption history and serum samples were collected from females aged 45–64 years and males aged 35–64 years in 21 counties from 4 provinces in eastern and central China between 2015 and 2023. Enzyme-linked immunosorbent assay methods were used to detect the serum HBV marker HBsAg.Results::A total of 603,082 individuals were enrolled, and serum samples were collected for analysis from January 1, 2015 to December 31, 2023. The prevalence of HBsAg positive in the study population was 5.23% (31,528/603,082). The prevalence of HBsAg positive was greater in males than in females (5.60% [17,660/315,183] vs 4.82% [13,868/287,899], χ 2 = 187.52, P <0.0001). The elderly participants exhibited a greater prevalence of HBV infection than younger participants (χ 2 = 41.73, P <0.0001). Birth cohort analysis revealed an overall downward trend in HBV prevalence for both males and females. Individuals born in more recent cohorts exhibited a lower prevalence of HBV infection as compared to those born earlier. Conclusions::The current prevalence of HBV infection remains above 5% in populations eligible for HCC screening in China.

Background: Stage at diagnosis and molecular subtype are important clinical factors associated with breast cancer patient survival. However, subgroup survival data from a large study sample are limited in China. To estimate the survival differences among patients with different stages and various subtypes of breast cancer, we conducted a hospital-based multi-center study on breast cancer in Beijing, China. Methods: All resident patients diagnosed with primary, invasive breast cancer between January 1, 2006 and Decem-ber 31, 2010 from four selected hospitals in Beijing were included and followed up until December 31, 2015. Hospital-based data of stage at diagnosis, hormone receptor status, and selected clinical characteristics, including body mass index (BMI), menopausal status, histological grade, and histological type, were collected from the medical records of the study subjects. Overall survival (OS) and cancer-specific survival (CSS) were estimated. Cox proportional hazards models were employed to evaluate the associations of stage at diagnosis and molecular subtype with patient survival. Results: The 5-year OS and CSS rates for all patients were 89.4％ and 90.3％. Survival varied by stage and molecu-lar subtype. The 5-year OS rates for patients with stage Ⅰ, Ⅱ, Ⅲ, and IV diseases were 96.5％, 91.6％, 74.8％, and 40.7％, respectively, and the corresponding estimates of 5-year CSS rates were 97.1％, 92.6％, 75.6％, and 42.7％, respectively. The 5-year OS rates for patients with luminal A, luminal B, HER2, and triple-negative subtypes of breast cancer were 92.6％, 88.4％, 83.6％, and 82.9％, respectively, and the corresponding estimates of 5-year CSS rates were 93.2％, 89.1％, 85.4％, and 83.5％, respectively. Multivariate analysis showed that stage at diagnosis and molecular subtype were important prognostic factors for breast cancer. Conclusions: Survival of breast cancer patients varied significantly by stage and molecular subtype. Cancer screen-ing is encouraged for the early detection and early diagnosis of breast cancer. More advanced therapies and health care policies are needed on HER2 and triple-negative subtypes.

Objective:To investigate the change trend of etiological burden of disease of liver cancer in the Chinese population from 1990 to 2019.Methods:The descriptive epidemiologic method was conducted. Based on the Global Burden of Disease data from the Institute for Health Metrics and Evaluation at the University of Washington, the data related to liver cancer burden caused by hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, alcohol, nonalcoholic steatohepatitis (NASH) and other factors, including number of new cases, the crude incidence rate, age-specific incidence rate, number of deaths, crude mortality rate and age-specific mortality rate, in the Chinese population from 1990 to 2019 were collected. The age-standardized rate was calculated based on the world standardized population structure in 2019 from the Global Burden of Disease data. Observation indicators: (1) the incidence of liver cancer caused by different etiologies in the Chinese population from 1990 to 2019; (2) the mortality of liver cancer caused by different etiologies in the Chinese population from 1990 to 2019; (3) the change trend of age-specific incidence rate of liver cancer caused by different etiologies in the Chinese population from 1990 to 2019; (4) the age-specific mortality rate of liver cancer caused by different etiologies in the Chinese population from 1990 to 2019. Count data were expressed as absolute numbers, percentages and ratio. Based on the junction point regression model, the Joinpoint software (V.4.9.1.0) was used to calculate the annual percentage change, average annual percentage change (AAPC) and 95% confidence intervals ( CI) of age-specific incidence rate and age-specific mortality rate of liver cancer caused by different etiologies. Results:(1) The incidence of liver cancer caused by different etiologies in the Chinese population from 1990 to 2019. From 1990 to 2019, the number of new cases of liver cancer in Chinese population decreased from 236 825 to 210 462, and the crude incidence rate decreased from 20.01/100,000 to 14.80/100,000. The new cases of liver cancer caused by HBV infection, HCV infection and other factors showed a downward trend, and the absolute change rates were ?14.76%, ?3.98% and ?26.67%, respectively. The new cases of liver cancer caused by alcohol and NASH showed a increase trend, and the absolute change rates were 9.31% and 13.91%, respectively. (2) The mortality of liver cancer caused by different etiologies in the Chinese population from 1990 to 2019. From 1990 to 2019, the number of deaths of liver cancer in Chinese population decreased from 232 449 to 187 700, and the crude mortality rate decreased from 19.64/100,000 to 13.20/100,000. The number of deaths of liver cancer caused by HBV infection, HCV infection and other factors showed a down-ward trend, and the absolute change rates were ?23.34%, ?10.99% and ?33.75%, respectively. The number of deaths of liver cancer caused by alcohol showed a slow downward trend, and the absolute change rate was ?0.51%. The number of deaths of liver cancer caused by NASH showed a increase trend, and the absolute change rate was 6.03%. (3) The change trend of age-specific incidence rate of liver cancer caused by different etiologies in the Chinese population from 1990 to 2019. From 1990 to 2019, the AAPC of age-specific incidence rate of liver cancer caused by HBV infection, HCV infection, alcohol, NASH and other factors was ?3.61%(95% CI as ?4.10% to ?3.11%), ?3.57%(95% CI as ?3.99% to ?3.14%), ?2.79%(95% CI as ?3.24% to ?2.33%), ?2.65%(95% CI as ?3.09% to ?2.21%) and ?3.62%(95% CI as ?4.05% to ?3.19%), respectively. (4) The age-specific mortality rate of liver cancer caused by different etiologies in the Chinese population from 1990 to 2019. From 1990 to 2019, the AAPC of age-specific mortality rate of liver cancer caused by HBV infection, HCV infection, alcohol, NASH and other factors was ?3.92%(95% CI as ?4.42% to ?3.41%), ?3.90%(95% CI as ?4.45% to ?3.35%), ?3.15%(95% CI as ?3.71% to ?2.58%), ?2.86%(95% CI as ?3.34% to ?2.38%) and ?4.09%(95% CI as ?4.64% to ?3.55%), respectively. Conclusions:From 1990 to 2019, the liver cancer burden of the Chinese population shows an overall downward trend, in which the liver cancer burden caused by HBV and HCV infection decreases the most, but HBV and HCV infection is still the main reason for the heavy burden of liver cancer. The age-specific incidence rate and age-specific mortality rate of liver cancer caused by alcohol and NASH show a downward trend, but the number of new cases of liver cancer caused by alcohol and NASH shows significant growth. The liver cancer burden caused by other factors shows a downward trend.

BACKGROUND: The cancer burden in the United States of America (USA) has decreased gradually. However, China is experiencing a transition in its cancer profiles, with greater incidence of cancers that were previously more common in the USA. This study compared the latest cancer profiles, trends, and determinants between China and USA. METHODS: This was a comparative study using open-source data. Cancer cases and deaths in 2022 were calculated using cancer estimates from GLOBOCAN 2020 and population estimates from the United Nations. Trends in cancer incidence and mortality rates in the USA used data from the Surveillance, Epidemiology, and End Results program and National Center for Health Statistics. Chinese data were obtained from cancer registry reports. Data from the Global Burden of Disease 2019 and a decomposition method were used to express cancer deaths as the product of four determinant factors. RESULTS: In 2022, there will be approximately 4,820,000 and 2,370,000 new cancer cases, and 3,210,000 and 640,000 cancer deaths in China and the USA, respectively. The most common cancers are lung cancer in China and breast cancer in the USA, and lung cancer is the leading cause of cancer death in both. Age-standardized incidence and mortality rates for lung cancer and colorectal cancer in the USA have decreased significantly recently, but rates of liver cancer have increased slightly. Rates of stomach, liver, and esophageal cancer decreased gradually in China, but rates have increased for colorectal cancer in the whole population, prostate cancer in men, and other seven cancer types in women. Increases in adult population size and population aging were major determinants for incremental cancer deaths, and case-fatality rates contributed to reduced cancer deaths in both countries. CONCLUSIONS The decreasing cancer burden in liver, stomach, and esophagus, and increasing burden in lung, colorectum, breast, and prostate, mean that cancer profiles in China and the USA are converging. Population aging is a growing determinant of incremental cancer burden. Progress in cancer prevention and care in the USA, and measures to actively respond to population aging, may help China to reduce the cancer burden.
Adult ; Breast Neoplasms ; China/epidemiology* ; Female ; Humans ; Incidence ; Liver Neoplasms ; Male ; Neoplasms/epidemiology* ; Registries ; United States/epidemiology*

Objective: To estimate the incidence trend and change in the age distribution of female breast cancer in cancer registry areas in China from 2000 to 2014. Methods: 22 cancer registries in China with continuous monitoring data from 2000 to 2014 were selected. All datasets were checked and evaluated based on data quality control criteria and were included in the analysis. The cancer registries covered 675 954 193 person-years, including 342 010 930 person-years of male and 333 943 263 person-years of female. Female breast cancer cases (International Classification of Diseases-10^th Revision: C50) were extracted. Crude incidence rate (CR), age-standardized incidence rate by Chinese standard population(ASIRC), annual percent change (APC), crude and adjusted mean age at onset were calculated. Incidence rates stratified by regions and age groups were calculated. Results: Female breast cancer incidence rate significantly increased from 31.90/100 000 in 2000 to 63.30/100 000 in 2014. Incidence rate increased rapidly from 2000 to 2008 (CR: APC=6.5%, 95%CI: 5.3%-7.8%; ASIRC: APC=4.6%, 95%CI: 3.6%-5.7%). Its increment slowed down from 2008-2014 (CR: APC=3.2%, 95%CI: 1.4%-5.1%; ASIRC: APC=1.4%, 95%CI:-0.1%-2.9%). The crude mean age at onset increased from 54.4 in 2000 to 57.0 in 2014. Adjusted mean age at onset remained around 54.3 in 2014. Crude mean age at onset increased significantly over time in all registry areas (β=0.192, P<0.001), urban (β=0.205, P<0.001) and rural (β=0.092, P=0.014) areas, while adjusted mean age at onset remained stable in all registry areas (β=0.009, P=0.289), urban (β=0.017, P=0.139) and rural (β=-0.054, P=0.109) areas. Conclusion Female breast cancer incidence rate in China increased from 2000 to 2014. Aging of the population resulted in a significant increase in crude mean age at onset. After age adjustment, no significant changes in age distribution were found.

Objective: To analyze the trends of cancer incidence and age changes in China with using cancer registration data, and to provide evidence for the development of cancer prevention and control. Methods: Twenty-two cancer registries with continuous (2000-2014) data were selected. The incidence of different sex and regional population, the standardized incidence rate by Chinese population, the average annual change percentage (AAPC) and annual change percentage(APC) were calculated. Age-period-cohort model were used to analyze the changes of cancer incidence, age-adjusted mean ages. The age-standardized proportion of 2000 and 2014 with were compared. Results: The cancer incidence in China increased by 3.9% (95%CI: 3.7%-4.1%) from 2000 to 2014 in APC, and the age-standardized incidence rate increased by 1.2% (95%CI: 1.0%-1.4%) in AAPC. The age-specific incidence showed that each age groups increased significantly in female, ranged between 0.9% to 6.0%. The APC in male aged from 60 years old showed decline trend, the APC in 60-69, 70-79, ≥80 years old were -0.2, -0.3, -0.3, while in the population aged 0-29, 30-39 years old increased dramatically, APC were 3.5, 2.0. Female under 60 also increased, and APC in 0-29, 30-39, 40-49, 0-59 years old were 5.7, 6.0, 3.4, 2.9, respectively. The mean age of patients diagnosed with cancer were increased during the past 15 years, with about 0.11 years per year increased. However, the mean age of the patients diagnosed with cancer showed decreased trend by 0.13 years after age structure adjusted. Conclusion The trend of mean age for cancer incidence in China were getting younger than before, and the trend in women is more obviously than in man.

Objective: To establish the knowledge graph of “disease-syndrome-symptom-method-formula” in Treatise on Febrile Diseases (Shang Han Lun,《伤寒论》) for reducing the fuzziness and uncertainty of data, and for laying a foundation for later knowledge reasoning and its application. Methods: Under the guidance of experts in the classical formula of traditional Chinese medicine (TCM), the method of “top-down as the main, bottom-up as the auxiliary” was adopted to carry out knowledge extraction, knowledge fusion, and knowledge storage from the five aspects of the disease, syndrome, symptom, method, and formula for the original text of Treatise on Febrile Diseases, and so the knowledge graph of Treatise on Febrile Diseases was constructed. On this basis, the knowledge structure query and the knowledge relevance query were realized in a visual manner. Results: The knowledge graph of “disease-syndrome-symptom-method-formula” in the Treatise on Febrile Diseases was constructed, containing 6 469 entities and 10 911 relational triples, on which the query of entities and their relationships can be carried out and the query result can be visualized. Conclusion The knowledge graph of Treatise on Febrile Diseases systematically realizes its digitization of the knowledge system, and improves the completeness and accuracy of the knowledge representation, and the connection between “disease-syndrome-symptom-treatment-formula”, which is conducive to the sharing and reuse of knowledge can be obtained in a clear and efficient way.