title: Lung cancer burden has increased during the last 40 years in Hebei Province, China.
abstract: BACKGROUND
  In 2011, Hebei Province, located in North China with a population of 71 794 239, accounted for approximately 6% of the national population. It is well known as a heavily air polluted area. This study reports the lung cancer burden and mortality trend in Hebei Province from 1973 to 2011.
  
  
  METHODS
  Eight cancer registries in Hebei Province submitted data to the Hebei Provincial Cancer Registry Center. Pooled data were stratified by area (urban/rural), gender, and age group. The proportions, cumulative incidence/mortality rates, and median age at death of lung cancer were calculated. Lung cancer mortality data of 1973-1975, 1990-1992, and 2004-2005 were extracted from national death surveys. Data of lung cancer from Cixian and Shexian were obtained from population-based cancer registries in each county.
  
  
  RESULTS
  The estimated numbers of newly diagnosed lung cancer cases and deaths in 2011 in Hebei Province were 32 623 and 27 612, respectively. The crude incidence rate of lung cancer was 45.44/100 000. The age-standardized incidence rate by world standard population was 39.01/100 000, ranking second among all cancers. The lung cancer mortality rate was 38.46/100 000, ranking first among all cancer deaths, with a significantly increasing trend in Hebei Province from 1973-1975 to 2010-2011, with an increased rate of 189.15%.
  
  
  CONCLUSIONS
  Hebei Province suffers a heavy disease burden of lung cancer and an obvious increasing trend has been observed over the past 40 years. Preventive and control strategies should be encouraged.
authors.affiliation: Cancer Institute the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province Shijiazhuang China.
authors.forename: Yutong
authors.initials: Y
authors.lastname: He
authors.affiliation: Cancer Institute the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province Shijiazhuang China.
authors.forename: Daojuan
authors.initials: D
authors.lastname: Li
authors.affiliation: Cixian Cancer Institute Cixian County China.
authors.forename: Guohui
authors.initials: G
authors.lastname: Song
authors.affiliation: Shexian Cancer Institute Shexian County China.
authors.forename: Yongwei
authors.initials: Y
authors.lastname: Li
authors.affiliation: Cancer Institute the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province Shijiazhuang China.
authors.forename: Di
authors.initials: D
authors.lastname: Liang
authors.affiliation: Cancer Institute the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province Shijiazhuang China.
authors.forename: Jing
authors.initials: J
authors.lastname: Jin
authors.affiliation: Cancer Institute the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province Shijiazhuang China.
authors.forename: Denggui
authors.initials: D
authors.lastname: Wen
authors.affiliation: Cancer Institute the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province Shijiazhuang China.
authors.forename: Baoen
authors.initials: B
authors.lastname: Shan
keywords: Cancer registry; heavy air pollution area; incidence rate; lung cancer; mortality rate