Cancer Survival Trends in Southeastern China, 2011–2021: A Population-Based Study

Figures & data

Table 1 Characteristics of the Study Population

Registry	Area	Population (2019)	Number of Patients	Exclusions(%)			Patients Included in Analyses	Morphological Verified (%)
				Death Certificate Only	Unknown Vital Status	Multiple Primary
Changle^a	Rural	766,793	16,705	0.65	1.40	3.50	15,777	60.58
Hanjiang^a	Urban	452,038	13,564	0.47	0.02	1.63	13,276	77.78
Huian^a	Rural	826,921	17,494	0.63	0.82	1.99	16,893	65.98
Jianou^a	Rural	552,805	11,878	0.44	0.69	2.62	11,432	57.17
Tongan^a	Urban	386,955	7583	0.57	0.04	1.61	7415	66.72
Xiamen^a	Urban	1,483,016	37,720	0.07	0.99	4.31	35,691	76.08
Xiangan^a	Urban	369,364	7899	0.04	2.89	1.44	7554	62.77
Yongding^a	Rural	489,703	10,631	0.32	0.43	4.17	10,108	75.82
Changtai^b	Rural	211,730	2852	0.07	0.00	0.00	2850	79.54
Fuqing^b	Rural	1,387,304	25,444	4.20	0.34	0.25	24,225	76.75
Xinluo^b	Urban	543,245	10,264	0.02	2.15	3.45	9687	66.38
Yongan^b	Rural	330,406	5734	0.23	1.22	4.62	5386	66.30
All	Urban and rural	7,800,280	167,768	0.91	0.89	2.65	160,294	71.49

Notes: ^aPatients in these 8 registries were diagnosed between 2011 and 2019; ^bPatients in these 4 registries were diagnosed between 2014 and 2019.

Table 2 Number of Patients Included in the Analyses by Sex and Type of Cancer

Site	ICD-10	All Patients (%)	Male Patients (%)	Female Patients (%)
Oral cavity and pharynx	C00-C10, C12-C14	2193(1.37)	1495(1.60)	698(1.04)
Nasopharynx	C11	2994(1.87)	2218(2.38)	776(1.16)
Oesophagus	C15	12,578(7.85)	9312(9.99)	3266(4.87)
Stomach	C16	18,230(11.37)	13,124(14.08)	5106(7.61)
Colon-rectum	C18-C21	16,337(10.19)	9686(10.39)	6651(9.92)
Liver	C22	19,309(12.05)	15,183(16.29)	4126(6.15)
Gallbladder	C23-C24	1335(0.83)	689(0.74)	646(0.96)
Pancreas	C25	2297(1.43)	1409(1.51)	888(1.32)
Larynx	C32	940(0.59)	887(0.95)	53(0.08)
Lung	C33-C34	28,940(18.05)	19,690(21.12)	9250(13.79)
Bone	C40-C41	794(0.50)	470(0.50)	324(0.48)
Breast	C50	9596(5.99)	88(0.09)	9508(14.18)
Cervix	C53	4276(2.67)	NA	4276(6.38)
Uterus	C54-C55	2286(1.43)	NA	2286(3.41)
Ovary	C56	1520(0.95)	NA	1520(2.27)
Prostate	C61	2430(1.52)	2430(2.61)	NA
Kidney	C64-C66, C68	2241(1.40)	1483(1.59)	758(1.13)
Bladder	C67	2024(1.26)	1623(1.74)	401(0.60)
Brain	C70-C72, D32-D33, D42-D43	4174(2.60)	2020(2.17)	2154(3.21)
Thyroid	C73	10,762(6.71)	2750(2.95)	8012(11.95)
Lymphoma	C81-C85, C88, C90, C96	3445(2.15)	2037(2.18)	1408(2.10)
Leukaemia	C91-C95	2848(1.78)	1697(1.82)	1151(1.72)
Others	NA	8745(5.45)	4941(5.30)	3804(5.67)
All sites		160,294(100.00)	93,232(100.00)	67,062(100.00)

Abbreviations: ICD-10, International Classification of Diseases, tenth revision; NA, not applicable.

Table 3 Overall 5-Year Relative Survival Rates for All Cancers Combined

	2011–2013		2014–2015		2016–2018		2019–2021		Crude RS Average Change (95% CI)	Adjusted RS Average Change (95% CI)
	Crude RS (95% CI)	Adjusted RS (95% CI)	Crude RS (95% CI)	Adjusted RS (95% CI)	Crude RS (95% CI)	Adjusted RS (95% CI)	Crude RS (95% CI)	Adjusted RS (95% CI)
Male	26.4 (25.7–27.0)	25.0 (24.3–25.7)	28.4 (27.7–29.0)	26.3 (25.7–27.0)	32.8 (32.2–33.3)	30.3 (29.7–30.9)	34.9 (34.4–35.5)	32.0 (31.5–32.6)	3.0 (1.6–4.4)	2.5 (1.0–4.0)
Female	43.5 (42.6–44.4)	35.9 (35.0–36.8)	48.3 (47.5–49.2)	38.5 (37.6–39.4)	56.6 (55.9–57.3)	45.2 (44.4–45.9)	60.3 (59.7–60.9)	47.8 (47.1–48.5)	5.9 (3.4–8.3)	4.2 (1.8–6.7)
Urban	34.1 (33.3–34.9)	30.8 (30.0–31.6)	37.5 (36.7–38.3)	33.2 (32.4–33.9)	45.3 (44.6–46.0)	39.2 (38.4–39.9)	48.8 (48.1–49.4)	41.7 (41.0–42.3)	5.2 (4.5–7.9)	3.9 (1.6–6.1)
Rural	31.5 (30.8–32.3)	27.2 (26.4–27.9)	36.0 (35.3–36.7)	30.2 (29.5–30.8)	41.4 (40.8–42.0)	35.0 (34.4–35.6)	44.3 (43.7–44.9)	37.1 (36.6–37.7)	4.4 (3.0–5.8)	3.5 (2.1–4.9)
All	32.9 (32.3–33.4)	29.1 (28.6–29.7)	36.7 (36.1–37.2)	31.5 (31.0–32.0)	43.1 (42.7–43.6)	36.8 (36.4–37.3)	46.3 (45.9–46.7)	39.1 (38.7–39.6)	4.7 (2.8–6.6)	3.5 (1.7–5.4)

Table 4 Trends in Age-Standardised 5-Year Relative Survival Rates by Cancer Type(95% CI)

	Cases	2011–2013	2014–2015	2016–2018	2019–2021	Average Change
Oral cavity and pharynx	2193	36.7(31.3–42.1)	37.2(32.1–42.3)	40.3(36.3–44.3)	41.7(38.1–45.4)	1.8(0.28–3.3)
Nasopharynx	2994	50.2(46.2–54.0)	47.7(44.0–51.3)	51.0(47.5–54.4)	52.9(49.7–55.9)	1.1(−2.7–4.8)
Oesophagus	12,578	16.4(15.1–17.9)	17.6(16.0–19.3)	20.3(18.8–2021.8)	21.3(19.8–22.8)	1.7(0.7–2.7)
Stomach	18,230	29.2(27.7–30.6)	29.2(27.8–30.7)	30.7(29.4–32.0)	31.9(30.7–33.1)	0.9(0.0–1.9)
Colon-rectum	16,337	42.8(40.8–44.7)	45.5(43.7–47.3)	50.5(48.9–52.0)	52.6(51.1–54.0)	3.4(1.8–5.0)
Liver	19,309	11.5(10.4–12.7)	11.2(10.2–12.3)	13.7(12.7–14.7)	13.9(13.0–14.8)	0.9(−0.6–2.5)
Gallbladder	1335	15.8(11.7–20.5)	14.3(10.4–18.8)	13.6(10.3–17.5)	15.5(12.4–19.0)	−0.2(−2.6–2.1)
Pancreas	2297	7.8(5.4–10.8)	7.4(5.2–10.2)	7.4(5.5–9.6)	6.5(5.0–8.3)	−0.4(−0.9–0.1)
Larynx	940	42.6(35.5–49.5)	45.8(37.7–53.6)	49.6(41.6–57.1)	54.1(47.3–60.5)	3.8(2.9–4.7)
Lung	28,940	13.3(12.3–14.3)	15.6(14.7–16.5)	22.6(21.7–23.5)	25.4(24.5–26.2)	4.3(1.6–7.0)
Bone	794	21.7(16.1–27.8)	24.7(18.9–30.9)	26.8(21.5–32.4)	29.8(24.2–35.5)	2.7(2.2–3.1)
Breast	9596	63.4(58.7–67.7)	63.5(58.8–67.9)	74.9(71.1–78.2)	76.0(72.6–79.0)	4.9(−1.9–11.7)
Cervix	4276	59.9(54.8–64.6)	57.8(54.0–61.4)	65.4(62.6–68.1)	66.3(63.7–68.8)	2.5(−3.0–8.0)
Uterus	2286	48.9(41.9–55.5)	48.1(42.9–53.2)	55.1(48.3–61.4)	61.0(55.0–66.5)	4.2(−0.8–9.2)
Ovary	1520	31.6(25.3–38.0)	27.7(22.6–33.1)	34.7(29.0–40.5)	31.3(26.6–36.2)	0.6(−5.8–7.0)
Prostate	2430	51.5(44.5–58.0)	55.2(48.9–61.0)	62.6(57.6–67.2)	62.3(56.2–67.8)	4.0(0.0–8.0)
Kidney	2241	48.2(42.4–53.7)	51.7(46.0–57.2)	55.9(51.4–60.2)	57.9(53.9–61.7)	3.4(2.0–4.7)
Bladder	2024	61.2(55.4–66.6)	63.0(57.9–67.7)	64.3(59.9–68.4)	66.9(63.0–70.4)	1.8(1.1–2.5)
Brain	4174	39.7(35.9–43.4)	42.9(39.7–46.1)	55.3(52.5–58.0)	55.9(53.3–58.4)	6.1(−0.2–12.4)
Thyroid	10,762	88.5(82.7–92.4)	86.9(82.8–90.1)	91.8(87.5–94.6)	94.5(90.9–96.7)	2.1(−1.8–6.1)
Lymphoma	3445	35.8(31.5–40.2)	37.0(33.1–40.9)	40.2(36.8–43.5)	43.0(39.9–46.0)	2.4(1.1–3.8)
Leukaemia	2848	27.0(21.9–32.3)	23.6(20.0–27.4)	26.1(22.8–29.4)	24.2(21.5–27.1)	−0.7(−3.9–2.6)
All others	8745	29.8(27.4–32.2)	34.5(32.1–37.0)	38.8(36.6–41.0)	39.7(37.7–41.6)	3.7(0.5–6.8)

Figure 1 Age-standardised 5-year relative survival rates by sex. (A) Male patients; (B) Female patients.

Table 5 Age-Standardised 5-Year Relative Survival Rates for All Cancers Combined and ten Major Cancers by Area

	2011–13		2014–15		2016–18		2019–21
	Urban Areas	Rural Areas	Urban Areas	Rural Areas	Urban Areas	Rural Areas	Urban Areas	Rural Areas
All cancers	30.8 (30.0–31.6)	27.2 (26.4–28.0)	33.2 (32.4–33.9)	30.2 (29.5–30.8)	39.2 (38.4–39.9)	35.0 (34.4–35.6)	41.7 (41.0–42.3)	37.1 (36.6–37.7)
Lung	13.0 (11.6–14.4)	13.5 (12.1–15.0)	15.1 (13.7–16.5)	15.9 (14.7–17.2)	24.3 (22.9–25.7)	21.4 (20.2–22.5)	26.7 (25.4–28.1)	24.2 (23.1–25.3)
Liver	13.4 (11.7–15.2)	9.6 (8.2–11.1)	10.3 (8.7–11.9)	11.8 (10.5–13.2)	14.4 (12.8–16.2)	13.3 (12.1–14.5)	14.7 (13.2–16.3)	13.3 (12.2–14.4)
Stomach	29.9 (27.9–32.0)	28.4 (26.4–30.5)	31.9 (29.6–34.1)	27.3 (25.5–29.1)	31.9 (29.9–34.0)	29.5 (27.9–31.2)	33.3 (31.5–35.2)	30.7 (29.2–32.3)
Oesophagus	19.4 (17.4–21.4)	12.9 (11.1–14.8)	18.7 (16.3–21.2)	16.7 (14.6–18.9)	22.9 (20.7–25.3)	17.7 (15.8–19.6)	24.4 (22.0–26.8)	18.0 (16.1–19.9)
Colon-rectum	43.5 (40.9–46.2)	41.7 (38.8–44.5)	47.6 (45.0–50.2)	43.4 (40.8–45.8)	53.2 (50.9–55.5)	47.9 (45.8–50.1)	55.7 (53.6–57.8)	49.6 (47.6–51.5)
Breast	67.0 (61.2–72.1)	56.2 (47.8–63.8)	68.6 (62.3–74.0)	56.6 (49.2–63.3)	77.4 (72.4–81.7)	71.3 (65.6–76.3)	78.7 (74.2–82.5)	72.5 (67.0–77.2)
Cervix	62.8 (54.9–69.6)	57.2 (50.9–63.0)	57.8 (51.8–63.3)	57.7 (52.7–62.4)	66.8 (61.9–71.3)	64.3 (60.8–67.6)	63.5 (60.0–66.8)	62.5 (59.8–65.0)
Thyroid	86.1 (76.5–92.0)	89.7 (81.3–94.4)	87.1 (80.6–91.5)	87.5 (81.9–91.4)	89.0 (81.5–93.5)	93.5 (87.6–96.7)	90.1 (85.8–93.2)	92.6 (89.4–94.9)
Brain	43.0 (37.3–48.6)	36.8 (31.8–41.9)	45.8 (40.6–50.8)	40.9 (36.8–44.9)	63.4 (59.2–67.2)	48.1 (44.4–51.7)	58.0 (54.9–60.9)	47.7 (45.1–50.2)
Lymphoma	38.2 (32.4–44.0)	32.1 (25.9–38.4)	38.8 (33.1–44.4)	35.4 (30.1–40.7)	45.2 (40.0–50.2)	36.4 (31.9–40.9)	46.9 (42.2–51.4)	40.4 (36.3–44.4)

Figure 2 5-year relative survival for all cancers combined and ten major cancers, by age.