With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China's massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high-quality data from an additional number of population-based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population-based cancer registries (2009-2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000-2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age-standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year; P = .1), whereas they increased significantly (+2.2% per year; P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (-1.4% per year; P < .05) and females (-1.1% per year; P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.

https://researchpubs.cancercouncil.com.au/cancercounciljspui/bitstream/1/1728/1/caac21338.pdf

Cancer statistics in China, 2015

Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts' personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.

/pdf/asian-pacific-clinical-practice-guidelines-on-the-management-za5qxgu5i6.pdf

Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update.

There is great geographical variation in the distribution of hepatocellular carcinoma (HCC), with the majority of all cases worldwide found in the Asia–Pacific region, where HCC is one of the leading public health problems. Since the “Toward Revision of the Asian Pacific Association for the Study of the Liver (APASL) HCC Guidelines” meeting held at the 25th annual conference of the APASL in Tokyo, the newest guidelines for the treatment of HCC published by the APASL has been discussed. This latest guidelines recommend evidence-based management of HCC and are considered suitable for universal use in the Asia–Pacific region, which has a diversity of medical environments.

/pdf/asia-pacific-clinical-practice-guidelines-on-the-management-3qdf1cp1jm.pdf

Asia–Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update

Cancer is the leading cause of death in China and depicting the cancer pattern of China would provide basic knowhows on how to tackle it more effectively. In this study we have reviewed several reports of cancer burden, including the Global cancer statistics 2018 and Cancer statistics in China, 2015, along with the GLOBCAN 2018 online database, to investigate the differences of cancer patterns between China, the United States (USA) and the United Kingdom (UK). An estimated 4.3 million new cancer cases and 2.9 million new cancer deaths occurred in China in 2018. Compared to the USA and UK, China has lower cancer incidence but a 30% and 40% higher cancer mortality than the UK and USA, among which 36.4% of the cancer-related deaths were from the digestive tract cancers (stomach, liver, and esophagus cancer) and have relatively poorer prognoses. In comparison, the digestive cancer deaths only took up ≤ 5% of the total cancer deaths in either USA or UK. Other reasons for the higher mortality in China may be the low rate of early-stage cancers at diagnosis and non-uniformed clinical cancer treatment strategies performed by different regions. China is undergoing the cancer transition stage where the cancer spectrum is changing from developing country to developed country, with a rapidly increase cancer burden of colorectal, prostate, female breast cancers in addition to a high occurrence of infection-related and digestive cancers. The incidence of westernized lifestyle-related cancers in China (i.e. colorectal cancer, prostate, bladder cancer) has risen but the incidence of the digestive cancers has decreased from 2000 to 2011. An estimated 40% of the risk factors can be attributed to environmental and lifestyle factors either in China or other developed countries. Tobacco smoking is the single most important carcinogenic risk factor in China, contributing to ~ 24.5% of cancers in males. Chronic infection is another important preventable cancer contributor which is responsible for ~ 17% of cancers. Comprehensive prevention and control strategies in China should include effective tobacco-control policy, recommendations for healthier lifestyles, along with enlarging the coverage of effective screening, educating, and vaccination programs to better sensitize greater awareness control to the general public.

/pdf/current-cancer-situation-in-china-good-or-bad-news-from-the-28evuq0fqx.pdf

Current cancer situation in China: Good or bad news from the 2018 Global Cancer Statistics?

http://bidinitiative.org/wp-content/files_mf/140270273516.Liangetal2009HepBserosurveyinChina.pdf

Epidemiological serosurvey of hepatitis B in China--declining HBV prevalence due to hepatitis B vaccination.

Background. Endemic hepatitis B virus (HBV) infection is a serious health problem in China. Hepatitis B vaccination of infants was introduced in 1992 and was progressively expanded during the subsequent 15 years. Methods. We conducted a national serosurvey, with participants selected by multiple-stage random sampling. Demographic characteristics and hepatitis B vaccination history were collected by a questionnaire and a review of vaccination records, and serum specimens were tested for hepatitis B surface antigen, antibody to hepatitis B core antigen, and hepatitis B surface antibody by enzyme-linked immunosorbent assay. Results. Hepatitis B vaccine coverage (3 doses) increased from 30.0% for children born in 1992 to 93.4% for children born in 2005. Receipt of a timely birth dose increased from 22.2% to 82.6% for children born during this interval. Multivariate analysis showed that older age, western and rural residence, birth at home, and certain ethnicities were risk factors for undervaccination with both full vaccine series and timely birth dose. The prevalence of hepatitis B surface antigen was reduced to 2.1% among all children and 1.0% among children born after 1999. The efficacy of hepatitis B vaccination with a timely birth dose was 88.3%. Conclusions. Hepatitis B vaccine has been successfully integrated into routine infant immunization in China, now reaching most infants within 24 h after birth, and the prevalence of hepatitis B surface antigen has been greatly reduced among children born after 1992.

Evaluation of the Impact of Hepatitis B Vaccination among Children Born during 1992–2005 in China

Objective To better understand and measure the impact from immunization activities over the last 10-years, we conducted a sero-epidemiological study using the remaining blood samples of a nationwide survey on Nutrition and Health in Chinese residents, in 2002. Methods HBsAg, anti-HBs and anti-HBc in blood samples were tested using enzyme-linked immunosorbent assay(ELISA) reagents and revised by solid phase radioimmunoassay and Abbott ELISA reagents. Results Among population older than 3 years, the prevalence rates of HBsAg, anti-HBs and hepatitis B virus(HBV) infection were 9.09% , 37.48% and 50.04% but for children between 3 and 12 year olds, they were 5.03%, 45.33% and 29.10% respectively. Among population older than 3 years, the rates of HBsAg and HBV infection in urban area were4.61% and 43.51% , but the rates in rural area were 9.41% and 56.77% respectively while for children from 3-years to 12-years old, they rates were 2.10%, 20.45% in urban area and 8.25%, 39.22% in rural areas, respectively. Conclusion Results revealed that since the hepatitis B vaccine was introduced into the expanded program on immunization(EPI) from 1992, the prevalence rates of HBsAg and HBV infection, especially in the children from 3 to 12 years of age, had obviously declined, suggesting that some changes had happened in the epidemic characters of hepatitis B in China.

[A study on the sero-epidemiology of hepatitis B in Chinese population aged over 3-years old].

https://doi.org/10.1016/j.ijid.2022.01.064

Gang Cui

Papers

Epidemiological serosurvey of hepatitis B in China--declining HBV prevalence due to hepatitis B vaccination.

Evaluation of the Impact of Hepatitis B Vaccination among Children Born during 1992–2005 in China

[A study on the sero-epidemiology of hepatitis B in Chinese population aged over 3-years old].

Serological reactivity of inactivated SARS-CoV-2 vaccine based on an S-RBD neutralizing antibody assay