Cancer Impact to Population Health and Responses in China Fu Hua Fu Hua Fudan University Fudan University 1
Morbidity and mortality of major cancers increase over the years (1998-2008) 1/100 000 Morbidity, Male Morbidity, Female Mortality, Male Morbidity, Female Source: Cancer registry (1998-2008) Ministry of Health, People's Republic of China
New cases of cancer in 2010 and 2011 in China 3400 3350 Top one • Lung cancer 3300 in male 3250 • Breast cancer 3200 in female 3150 3100 3050 3000 2950 2010 2011 New cases (thousand) • Comp ompar ared to ed to 2010 010, mor , more e th than 28 an 280 0 thous housand ands of new can s of new cance cer r cases ases in 2 n 201 011. 1. abou about 6 t 6 p peop eople s le suff uffer ered ed from from ca canc ncer er in o in one ne mi minut nute. e. Source: China Cancer registry report (2015)
Increasing trend of cancer in last 10 years Prostate cancer in Breast male cancer in female Thyroid cancer in female Cervical cancer in female 4 Source: China Cancer registry report (2015)
Decreasing trend of cancer in last 10 years Liver cancer Esophagus Stomach cancer cancer 5 Source: China Cancer registry report (2015)
Social Determinants related to cancer 29748 RMB Population Aging Industrialization Urbanization 55% 50% 13.26% 18% 10.33% 381 RMB Per Capita GDP 1978 2010 2000 2010 1978 2010 2015 Dramatic change of lifestyle
Behavioral Risk Factors related to cancer Behavioral Risk Factors of NCDs among 18-year-old and above 80.9% 83.4% 52.8% 47.0% 17.4% 11.9% Proportion of Proportion of consuming Proportion of consuming Proportion of alcohol proportion of doing PA Male current daily consuming <400 g F salt>5 g per day oil >25 g per day overconsumption regularly smoking rate & V Doing physical activity regularly: doing recreational physical activity at least 3 times a week, Source ： 2010 PRC BRFSS and at least 10 minutes per time. Ministry of Health, People's Republic of China
What c can y you do do?
• Lung c Lung canc ancer i is the m he mos ost pr prev eventab able e for orm of of canc ancer er deat death in our n our s soc ociety. • Mor ore e than 87% of han 87% of lung c ung canc ancers ar are s e smok oking rel elat ated • Som ome e par part of of lung c ung canc ancers c can be an be at attribu buted t to o env environmen ental pollut utions ons i includ uding ng occupat pationa onal e exposur ure i e in-do door or and and out out-door oor
Smoking harms the entire body… From Erikson M’s presentation
Five countries smoke more than half of the world’s cigarettes… From Erikson M’s presentation
China leads the world in growing tobacco… • In 2011, China grew tobacco on more than 1.4 millio 1.4 million hect ectar ares es of l of land and • In 2011, more than 3.1 million tonnes of tobacco were grown in China • In 2011, China grew 41.7% of the world’s tobacco From Erikson M’s presentation
Seco econd ndhan hand smo d smoki king ng • 72.4% 72.4% ex exposur posure t e to sec o second ondhand hand smo smoking king • Publi Public p c places laces –88.5% found someone smoked in restaurant 88.5% found someone smoked in restaurant –58.4% in office buildings 58.4% in office buildings –35% in hospitals 35% in hospitals • Worki Working place ng places –63.3% 63.3% found found someone smoked someone smoked • Home Home –67.3% 67.3% found someone smoked found someone smoked 13
Evidence-based solutions are a must… Outlined in WHO FCTC, MPOWER • Clean indoor air laws (smoking free in public places in Beijing, Shanghai, and other cities) • Tax increases (In 2015, ad valorem tax increased from 5% to 11%) • Advertising bans (New Advertisement Law adds several items to ban tobacco advertising in public places/traffics/media and outdoors, and in other commercial products) • Graphic warning labels??
Immunization for hepatitis B • More More tha than 95% n 95% of of new new-bur burn bab n babies ies were were immunize immun ized by d by hep hepatiti atitis B s B vacc vaccine ine in C in Chin hina. a. • A dat A data f a from C rom Chin hina CDC a CDC sh showed owed tha that t –92 millions of people were immunized and 92 millions of people were immunized and protected from hepatitis B infection during the protected from hepatitis B infection during the period between 1992 period between 1992-2009. 2009. –24 millions of people protected from chronic 24 millions of people protected from chronic hepatitis B infection, and decreased 4.3 hepatitis B infection, and decreased 4.3 millions of deaths who suffered from cirrhosis millions of deaths who suffered from cirrhosis and cancer of liver. and cancer of liver. 15
Early Diagnosis and Treatment for Cancers Esophageal cancer, colorectal cancer, stomach cancer, cervical cancer, liver cancer, nasopharyngeal cancer and breast cancer account for more than 80 percent of cancer related deaths. Early screening and treatment program was launched in 2006 for major types of cancers among the high risk populations in high incidence localities. Detection rate (‰) Esophageal Cancer Colon/Rectum Cancer Stomach Cancer Uterine Sarcoma Liver Cancer Nasopharyngeal Cancer Breast Cancer Early diagnosis rate (% ） Esophageal Cancer Colon/Rectum Cancer Stomach Cancer Uterine Sarcoma Liver Cancer Nasopharyngeal Cancer Breast Cancer Ministry of Health, People's Republic of China
Healthy Lifestyle Action for All It was co-sponsored by the Disease Prevention and Control Bureau of MoH, the National Patriotic Sanitation Office and China CDC in 2007. Action theme: Harmonious life, Healthy Chinese Action slogan: Action, Healthy, and Happiness Action concept: Not only for conveying the knowledge, but more importantly, improving skills and taking actions Action at the first stage: healthy action ‘One Two One’ Connotation of ‘One Two One’ Walk ten thousand steps one day Balance between eating and activity Enjoy a healthy life
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