Study reveals trends and future projections of cancer mortality in China

Cancer remains the second leading cause of death in China, accounting for nearly one-quarter of all deaths nationwide. Rapid socioeconomic change, environmental exposure, and an aging population have intensified the burden of cancer across the country. Although national programs in cancer prevention and early detection have improved survival rates, regional inequalities persist. Rural residents face limited access to medical care and lower screening coverage compared to urban populations. At the same time, lifestyle-related risk factors such as smoking, alcohol use, and obesity continue to rise. Due to these challenges, a comprehensive analysis of long-term cancer mortality trends and future projections was needed to inform national prevention strategies.

A research team from the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College has published (DOI: 10.20892/j.issn.2095-3941.2025.0158)new findings in Cancer Biology & Medicine, revealing national cancer mortality trends from 2013 to 2021 and projections through 2030. Drawing on 2.37 billion person-years of data from the China Causes of Death Surveillance System, the study reports significant overall declines in cancer mortality but warns that population aging and regional disparities will continue to drive increases in absolute cancer deaths nationwide.

The researchers analyzed mortality data from 605 surveillance sites across 31 provinces, representing 24% of China's population. Using age-period-cohort modeling, they calculated age-standardized mortality rates (ASMRs) and projected trends through 2030. Between 2013 and 2021, overall ASMRs for all cancers decreased by 2.3% annually, driven by substantial declines in esophageal (-4.8%), stomach (-4.5%), and liver cancers (-2.7%). However, mortality increased for pancreatic (+2.0%) and prostate (+3.4%) cancers. Urban areas achieved faster reductions (-3.0% per year) than rural ones (-2.0%), highlighting persistent inequalities. Decomposition analysis revealed that population aging contributed 20-50% of the increases in differentcancer deaths. By 2030, lung cancer will remain the leading cause of cancer-related death in both genders, followed by liver, colorectal, gastric, and esophageal cancers in men, and colorectal, liver, gastric, and breast cancers in women. The team estimates that 2.4 million people will die from cancer in 2030 despite continued improvements in mortality rates, underscoring the dual challenges of an aging society and unequal healthcare access.

China has made remarkable strides in reducing cancer mortality through nationwide screening and risk-control programs. However, the demographic shift toward an older population means that absolute cancer deaths will continue to rise. We need to focus on early detection and equitable access to cancer care, especially in rural regions. Integrating prevention and control measures into broader public health and aging policies will be essential to sustaining progress and narrowing the urban-rural divide."

Dr. Xiaoqiu Dai, corresponding author, National Cancer Center

The study provides a crucial evidence base for policy decisions aimed at reducing China's future cancer burden. Strengthening early screening in rural areas, promoting HPV and HBV vaccination, and encouraging healthier lifestyles could significantly reduce mortality in high-risk populations. Moreover, expanding cancer control into rural revitalization strategies can ensure that prevention and treatment reach underserved areas. The researchers suggest that coordinated national efforts to address environmental, behavioral, and demographic factors could not only lower cancer mortality but also serve as a model for other developing countries facing similar aging-related health transitions.