REVIEW article

Front. Oncol.

Sec. Cancer Epidemiology and Prevention

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1579378

The Epidemiology, Etiology, and Future Prophylactic Options for Cancers in Mainland China

Provisionally accepted
Jie  XuJie Xu1Hongsen  ChenHongsen Chen1,2,3Wenbin  LiuWenbin Liu1,2,3Xi  ChenXi Chen1,2,3Ping  LiPing Li1,2,3Guangwen  CaoGuangwen Cao1,2,3*
  • 1Second Military Medical University, Shanghai, Shanghai Municipality, China
  • 2Key Laboratory of Biological Defense, Ministry of Education, Shanghai, China
  • 3Shanghai Key Laboratory of Medical Bioprotection, Shanghai, China

The final, formatted version of the article will be published soon.

Mainland China accounts for 18.66% of the world’s population, 24.17% of global cancer new cases, and 26.44% cancer-related death worldwide in 2022. We aim to characterize the spatiotemporal distribution patterns of cancer burden, elucidate the main causes of high cancer burden, and propose evidence-based strategies for the prevention and control of major cancer types in Mainland China. We conducted a systematic search for relevant articles in PubMed and CNKI. We also analyzed the related data from two key databases: the 2022 dataset of the International Agency for Research on Cancer (IARC) and the records of China's National Mortality Surveillance System (from 2004 - 2018). Lung cancer, primary liver cancer (PLC), gastric cancer, colorectal cancer (CRC), and esophageal cancer accounted for 67.50% of all cancer-related deaths. Age-standardized incidence rates (ASIR) and mortality rates (ASMR) of PLC, gastric cancer, and esophageal cancer showed downward trends, while their crude rates kept increasing. The ASMR of lung cancer kept decreasing in urban but increasing in rural populations. The burden of CRC kept increasing. Increase in cancer incidence could be attributed to the co-existence of the poverty-related risk factors like chronic infections and affluence-related ones like metabolic disorders. Primary prevention targeting to these modifiable risk factors is cost-effective. Aerobic exercise could decrease cancer occurrence and cancer-related death via decreasing systemic low-grade inflammation. The second and tertiary prophylactic options should be epidemiologically optimized. Targeting the major risk factors co-existed during economic transformation should be a cost-effective strategy to decrease cancer burden in transforming countries.

Keywords: China's cancer burden, cancer epidemiology, Prevention strategies, chronic inflammation, modifiable risk factors, Systemic interventions

Received: 19 Feb 2025; Accepted: 05 May 2025.

Copyright: © 2025 Xu, Chen, Liu, Chen, Li and Cao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Guangwen Cao, Second Military Medical University, Shanghai, 200433, Shanghai Municipality, China

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