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China / Cover Story

Ignorance compounds cancer threat

By Yang Wanli (China Daily) Updated: 2015-04-17 07:16

Rising death toll

Meanwhile, national surveys of the causes of death conducted in the 1970s, the 1990s and the 2000s show the number of deaths from cancer rose from 0.7 million to 1.7 million, leading to the country's mortality rate soaring by 83 percent over the 45-year period.

The figures stand in stark contrast to those in the US, where the 2015 Cancer Report, published by the American Cancer Society, shows that the overall cancer mortality rate fell by nearly 22 percent from 1991 to 2011.

The cancer patterns, which show the different causes of deaths from cancer country by country, are one of the major causes of the contrasting mortality rates in China and the US, according to Chen Wanqing, director of the National Central Cancer Registry, established in 2002 by the National Health and Family Planning Commission to improve the systematic management of cancer surveillance.

According to the ACS, at 26 percent prostate cancer accounts for the highest proportion of all new cancer cases among US males, and the survival rate five years after diagnosis is close to 100 percent.

In China, however, lung cancer accounted for about 25 percent of all new cancer cases in 2011, and although the five-year survival rate was close to the global average, about 60 percent of patients died one year after diagnosis and 70 percent died after two years, according to Chen.

Early detection plays an important role in explaining the disparity in the overall cancer mortality rates in the US and China. For example, breast cancer has the highest rate of incidence among women in both countries, but the survival rates are vastly different.

Last year, the NCCR published research that focused on 140,000 cases in 17 cancer registration centers across China. It showed that the five-year survival rate for breast cancer was just 40 percent, while in the US it was 80 to 90 percent.

Promoting awareness

"The problem in China is that many cases - about 70 percent of breast cancer cases, for example - are detected too late. That means a large number of patients miss the 'golden period' for treatment that could save their lives," said Sun Qiang, director of the Breast Cancer Clinic at Peking Union Medical College Hospital.

Sun said successful surgical techniques and advanced clinical treatments mean the survival rate for patients whose breast cancer is detected at an early stage is much higher - as high as 90 percent within five years after treatment - than for people who are diagnosed at later stages.

Because early detection is a crucial factor in the overall mortality rate for cancer, the US has promoted greater awareness through national educational campaigns, which has resulted in earlier detection and diagnosis, he said.

In China's rural areas, though, few people undergo annual health checks because the procedure isn't covered by ordinary medical insurance. Urban dwellers are luckier because their employers usually bear the cost.

Despite that, cancer cases are still being missed because many of the checkups being offered are rudimentary. "Even people who live in cities and have annual checkups are at risk, because little attention is paid to early detection of the most common cancers, such as lung and breast," Sun said, adding that the problem is compounded by the fact that specialized tests are only available in a small number of larger, better-equipped hospitals, and because many large companies only started providing annual health checks for employees relatively recently.

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