| Objectives: To describe and analyze the patterns and trends of cancer epidemicin Guangzhou from 1997 to the year 2006, and to examine epidemic characteristicsand determinants associated with the changes in cancer incidence and mortality.Methods: The new cases and deaths of cancer in Guangzhou from 1997 to theyear 2006 were coded according to ICD-0-1. Incidence and mortality of cancer werecalculated by groups of calendar year, gender and age, and further the secular trends ofcancer during the ten years were analyzed. Relative risks for cancer incidence andmortality were estimated for people in different generations,of different genders andages. Cancers of different sites were ranked by various incidence and mortalityindexes to show the relative seriousness from assorted respects.Results: Totally 148095 new cases (male: 79942, female: 68153) and 87969deaths (male: 50396, female: 37573) were reported in Guangzhou from 1997 to 2006.Averagely, the crude and age standardized incidence rates were 232.82/100,000 and173.97/100,000. For males, the corresponding rates were 245.54/100,000 and194.54/100,000; for females, the rates were 219.50/100,000 and 155.87/100,000. Onthe other hand, the average crude and age standardized mortality rates were 128.96/100,000 and 103.50/100,000. For males, the corresponding rates were143.14/100,000 and 123.02/100,000; for females, the rates were 113.79/100,000 and85.78/100,000. Crude rates for cancer incidence and mortality both increased duringthe ten years, with more increase in crude incidence. However, age standardized ratefor incidence and age standardized rate for mortality remained stable, and, apparently,mortality incidence ratio was also descending. In addition, mortality incidence ratiovaries considerably between different age groups. The peak age specific rate of cancerincidence was observed in the age group 75-79, while 80-84 years group for cancermortality.In the last ten years, overall cancer incidence rate decreased for people agedbetween 35 and 64, but increased for 65 years of age or more. And the rate keptalmost unchanged for people aged between 0 and 34 years.The top 5 cancer sites by incidence rate were: lung cancer, stomach cancer, livercancer, breast cancer and colorectal cancer: and the corresponding cancer sites formortality were: lung cancer, stomach cancer, liver cancer, esophagus cancer andcolorectal cancer. Statistical increasing trends for crude incidence were found in 7 ofthe top 10 cancer sites, lung cancer, breast cancer, colorectal cancer and pancreaticcancer doubled during the 10 years. Only esophagus cancer exhibited a decreasingtrend. On the other hand, Statistical increasing trends for standardized incidence werefound in 5 of the top 10 cancer sites, among them, lung cancer increased the mostdramatically, whereas esophagus cancer, stomach cancer and liver cancer all exhibiteddecreasing trends.Statistical increasing trends for crude mortality were found in 5 of the top 10cancer sites, lung cancer increased the most dramatically. Descending trends wereobserved in esophagus and stomach cancer. On the other hand, Statistical increasingtrends for standardized mortality were found in 2 of the top 10 cancer sites, lung cancer and brain cancer. Whereas esophagus cancer, stomach cancer, breast cancer,bladder cancer, liver cancer and colorectal cancer all exhibited decreasing trends.Conclusion: The ascending trends of cancer incidence and mortality inGuangzhou attribute largely to the ageing population. The aged is by all means thehigh risk group of cancer occurrence and death, therefore the health-care of the oldshould be reinforced to improve the diagnosis, prevention and treatment of cancer,and to enhance survival.Lung cancer occupied the top of all cancers with its overwhelming incidence andmortality; it threatens more and more severely the health of the public because of itsdramatic increase. The prevention of lung control in the coming cancer should be thefocus of cancer years.
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