Changing trajectory of lung cancer mortality in Chinese residents 30 years old and above, 2013 – 2018

  Objective   To analyze changing trajectory of lung cancer mortality among Chinese residents aged 30 years and above from 2013 to 2018 and to provide evidences for developing strategies on lung cancer treatment and prevention.

  Methods   From cause-of-death data in the National Disease Surveillance Point system, we extracted the data on all lung cancer deaths at ages of 30 and above (n = 588 245) registered from 2013 through 2018 at 605 surveillance sites in 31 provincial level regions across China. The population census data of 2010 was used in calculation of standardized mortality rate (SMR). Latent variable growth model was adopted to analyze gender-, age-, and region-specific changing trajectory of lung cancer mortality.

  Results   For years of 2013 – 2018, the annual crude mortality rates (1/100 000) of lung cancer were 40.2, 40.0, 44.8, 44.9, 45.4, and 46.5 for the Chinese residents aged 30 years and above, respectively and the corresponding SMRs (1/100 000) were 35.4, 37.2, 38.8, 36.5, 36.6, and 36.1, with an up-down trend (χ²_trend = 3.42, P < 0.001). Four patterns of changing trajectory of lung cancer mortality in male residents could be identified, with a pattern of linearly downward trend and other three patterns of quadratic curving. Similar changing trajectories of lung cancer mortality over years were observed in the residents aged 30 – 70 years in eastern, central and western China; but in the residents at older age with higher lung cancer mortality, different patterns of changing trajectories were identified. For female residents, three patterns of lung cancer mortality trajectories changing over years were found and the trajectories showed a trend of rising first and then decreasing; the changing trajectory for female rural residents aged 45 – 49 years in eastern China differed from that for the residents of same ages in other regions and the trajectory was similar to that for the residents at elder age with higher lung cancer mortality rates.

  Conclusion   There are different changing trajectories of lung cancer mortality between male and female residents in China. Identifying gender-, age-, and region-specific changing trajectory of lung cancer mortality is meaningful for developing targeted measures for lung cancer prevention and control.