title: Cancer incidence and mortality in Shandong province, 2012.
abstract: OBJECTIVE
  Population-based cancer registration data in 2012 from all available cancer registries in Shandong province were collected by Shandong Center for Disease Control and Prevention (SDCDC). SDCDC estimated the numbers of new cancer cases and cancer deaths in Shandong province with compiled cancer incidence and mortality rates.
  
  
  METHODS
  In 2015, there were 21 cancer registries submitted data of cancer incidence and deaths occurred in 2012. All the data were checked and evaluated based on the National Central Cancer Registry (NCCR) criteria of data quality. Qualified data from 15 registries were used for cancer statistics analysis as provincial estimation. The pooled data were stratified by area (urban/rural), gender, age group (0, 1.4, 5.9, 10.14, …, 85+ years) and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding provincial population in 2012. The Chinese census data in 2000 and Segi's population were applied for age-standardized rates. All the rates were expressed per 100,000 person-year.
  
  
  RESULTS
  Qualified 15 cancer registries (4 urban and 11 rural registries) covered 17,189,988 populations (7,486,039 in urban and 9,703,949 in rural areas). The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 66.12% and 2.93%, respectively, and the mortality to incidence rate ratio (M/I) was 0.60. A total of 253,060 new cancer cases and 157,750 cancer deaths were estimated in Shandong province in 2012. The incidence rate was 263.86/100,000 (303.29/100,000 in males, 223.23/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 192.42/100,000 and 189.50/100,000 with the cumulative incidence rate (0.74 years old) of 22.07%. The cancer incidence, ASIRC and ASIRW in urban areas were 267.64/100,000, 195.27/100,000 and 192.02/100,000 compared to 262.32/100,000, 191.26/100,000 and 188.48/100,000 in rural areas, respectively. The cancer mortality was 164.47/100,000 (207.42/100,000 in males, 120.23/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 117.54/100,000 and 116.90/100,000, and the cumulative mortality rate (0.74 years old) was 13.53%. The cancer mortality, ASMRC and ASMRW were 141.59/100,000, 101.17/100,000 and 100.33/100,000 in urban areas, and 173.79/100,000, 124.20/100,000 and 123.64/100,000 in rural areas, respectively. Cancers of the lung, stomach, liver, esophagus, colorectum, female breast, brain, leukemia, bladder and pancreas were the most common cancers, accounting for about 82.12% of all cancer new cases. Lung cancer, stomach cancer, liver cancer, esophageal cancer, colorectal cancer, female breast cancer, pancreatic cancer, brain tumor, leukemia and lymphoma were the leading causes of cancer death, accounting for about 89.01% of all cancer deaths. The cancer spectrum showed difference between urban and rural, males and females both in incidence and mortality rates.
  
  
  CONCLUSIONS
  Cancer surveillance information in Shandong province is making great progress with the increasing number of cancer registries, population coverage and the improving data quality. Cancer registration plays a fundamental role in cancer control by providing basic information on population-based cancer incidence, mortality, survival and time trend. The disease burden of cancer is serious in Shandong province, and so cancer prevention and control in Shandong province should be enhanced including health education, health promotion, cancer screening and cancer care services.
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan 250014, China.
authors.forename: Zhentao
authors.initials: Z
authors.lastname: Fu
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan 250014, China.
authors.forename: Zilong
authors.initials: Z
authors.lastname: Lu
authors.affiliation: the Second People's Hospital of Jinan, Jinan 250001, China.
authors.forename: Yingmei
authors.initials: Y
authors.lastname: Li
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan 250014, China.
authors.forename: Jiyu
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan 250014, China.
authors.forename: Gaohui
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan 250014, China.
authors.forename: Xianxian
authors.initials: X
authors.lastname: Chen
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan 250014, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chu
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan 250014, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Ren
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan 250014, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Liu
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan 250014, China.
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Guo
keywords: Cancer registry; Shandong province; epidemiology; incidence; mortality