Incidence and case survival status of cancer and influencing factors in Yantai, Shandong, 2012−2021

Objectives To understand the incidence trend, case survival status of cancer and influencing factors in Yantai of Shandong province, and provide data support for the prognosis evaluation and prevention of cancer.

Methods The follow-up and registration data of cancer cases collected from Yantai Cancer Registry from 2012 to 2021 were used to calculate the incidence rate and constituent. Annual percent of change (APC) was used to analyze the trend of incidence. The survival rate and median survival time were calculated by Kaplan-Meier method. Log-Rank test was used for comparison of survival rates between or among groups. Cox proportional hazards regression model was used for univariate and multivariate survival analysis.

Results A total of 233 097 cancer cases were reported in Yantai from 2012 to 2021, the crude incidence rate was 357.16/100 000, the age standardized mortality rates based on China population and world population were 224.63/100 000 and 222.23/100 000 respectively; which were all showed increasing trends year by year with APC=4.67%, APC=4.85% and APC=4.90% (all P<0.001); the incidence rate was higher in men than in women and in rural area than in urban area (χ²=4 022.551, χ²=330.024, all P<0.001), but the upward trend was greater in women (APC=5.66%, P<0.001)than in men (APC=3.95%, P<0.001)and in urban area (APC=6.69%, P<0.001)than in rural area (APC=3.28%, P=0.004). The incidence rate increased with age in the past decade (trend χ²=383 334.330, P<0.001), with the higher increase in age group 65-74 years (APC=7.30%, P<0.001) and <35 years (APC=6.71%, P=0.001). The incidence of epithelial malignancy was highest (204.27/100 000)and showed the largest upward trend (APC=9.850%, P<0.001). The median survival time in the cancer cases in Yantai was 2.05 years (95% confidence interval: 2.03−2.07)and the 5-year survival rate was 41.74% with the highest of breast cancer cases (81.12%)and the lowest of pancreatic cancer cases (11.01%). Cox regression analysis showed that the period of diagnosis, gender, area, age and pathological type were the influencing factors of the survival status of the cancer cases (all P<0.05).

Conclusion In the past decade, the incidence of cancer increased gradually in Yantai, especially in younger population, but the survival status was significantly improved. It is necessary to further strengthen the comprehensive prevention and control of priority cancer and in patients with poor survival.