Trends and Patterns of Cancer Mortality in North China (Hebei Province), 1973-2013.

Little was known about the cancer burden for the last 40 years in middle-income province in China. This study aimed to assess the overall, cause-specific mortality cancer trend and disability-adjusted life years (DALYs) between 1973-1975 and 2011-2013 in North China (Hebei Province). The collected data were stratified by 5-year age groups, gender and different types of cancer. We found that mortality from cancer showed an upward trend in the 1973-2013. The mortality rate of 0-79 year-old in 2011-2013 was lower than that in other periods. It was about two times higher for the 80+ age group than it was in 1973-1975. The cancer pattern in 4 periods presented differently. Esophagus cancer ranked the first in 1973-1975, whereas in 2011-2013, the most common cancer was lung cancer. DALYs also showed an increasing cancer burden in Hebei Province. This study is the first to analyze cancer burden for the last 40 years in a middle-income province. It could provide a baseline for assessment of effectiveness of cancer prevention and control. Esophagus cancer had a significant declining trend because of endoscopy screening program. Enhancing screening programs in those aged 40-69 year-old is necessary for reducing the cancer burden.