Chest
Special FeatureGlobal MedicineLung Cancer in China: Challenges and Interventions
Section snippets
Materials and Methods
Using a Web-based search strategy, we analyzed the published data on lung cancer in China from January 1990 to September 2011, including incidence and mortality rates, economic burden, risk factors, and effectiveness of interventions. We restricted the study time because the pre-1990 literature often did not have relevant and complete data in most Chinese journals; the common practice of contacting the corresponding authors was not effective before 1990 in China; therefore, we relied on the
Incidence
At present, population-based cancer registries are not well established nationwide in China, and epidemiologic data for cancer are limited at the province level. Using data collected between 1988 and 2005 from 10 cancer registries, Chen et al6 investigated lung cancer incidence rates in Beijing; Shanghai; Wuhan, Hubei; Harbin, Helongjiang; Cixian, Hebei; Qidong, Jiangsu; Jiashan, Zhejiang; Futuo, Guangxi; ChangLe, Fujian; and Linzhou, Henan. In 2005, the crude incidence rate was 49.35 per
Smoking and Exposure to Secondhand Smoke
Smoking is a well-established global health issue and a principal risk factor for lung cancer. The mortality rate of lung cancer is about 23 times higher in current male smokers and 13 times higher in current female smokers than in lifelong nonsmokers.16 The number of smokers in the world is expected to increase to at least 1.7 billion (1.2 billion men and 500 million women) by 2025.17 In China, about 30% of the world's cigarettes are manufactured and consumed by an estimated 350 million
Smoking Cessation
Cigarette smoking is highly prevalent and associated with substantially increased morbidity and mortality as well as increased health-care expenditures in China. A large prospective cohort study (n = 169,871) showed a significant dose-response association between pack-years smoked and death from all causes in both men and women.40 The study estimated that across China, a total of 673,000 deaths (538,200 men and 134,800 women) was attributable to smoking in persons aged ≥ 40 years in 2005.40
Conclusions
Lung cancer morbidity and mortality have increased rapidly in China over the past 30 years, especially in women, with tobacco consumption and environmental pollution being the major risk factors. For the general population, continuous efforts should be concentrated on health education to increase awareness, prevention, and early detection of lung cancer. For the Chinese government, specific and timely interventions need to be implemented to reduce smoking rates and air pollution in China. For
Acknowledgments
Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or in the preparation of the manuscript.
Other contributions: We thank Hao Jiamao, PhD, for his help in the search of related references and for providing photographs.
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Funding/Support: Supported in part by the Shanghai Leading Academic Discipline Project [Project Number B115]; the third program of “973”: “Early detection of lung cancer”; and the third program of “985”: “Research on cancer metastases and the clinical translation.” Dr Yang was supported by the Mayo Foundation for Medical Education and Research.
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