This dissertation was aimed to estimate and project the cancer burden at the national level in China in recent years, from both incidence and mortality profile, in order to provide background information relevant to planning on cancer prevention and control programme. A first national survey on cancer registration practices in China has been conducted to identify all, or as many as possible, of the existing cancer registries and their practices in the country. A wide variation in practices between the 48 cancer registries in China was found. Lack of qualified personnel, insufficient funding support and lack of stability of the population were identified as the major problems. Several suggestions are made about the ways to improve availability and quality of incidence and survival data from cancer registries. Comparing the two big routinely collected mortality datasets in China, data from the Center of Health Information and Statistics (CHIS) of the Ministry of Health and the “Disease Surveillance Points” (DSP), although CHIS is not completely representative of the Chinese population, the sex and region (urban/rural) specific age-standardised mortality rates from the dataset were closer to the results of the national mortality survey in 1990–1992. Based on the CHIS data, using the joinpoint regression model, time trends in the period 1987–1999 for nine major cancers were then analysed. Mortality from cancers in oesophagus, stomach, cervix uteri, leukaemia and nasopharynx declined, while lung cancer and female breast cancer showed significant increasing trends during the study period for most of population. Examining age-specific trends in mortality rates reveals trends in younger generations that differ from the overall (all age) trends, which may presage future overall trends. Starting from the national mortality data of 1991, following the annual rates of change for major cancers, by age, sex and areas from the CHIS data during 1991–1999, based on a log-linear regression model with Poisson errors, the national cancer mortality in the years 2000 and 2005 have been estimated and projected. Using ratios of the cancer incidence to mortality from those cancer registries matching the quality criteria of Cancer Incidence in Five Continents, 8th version, together with the above national mortality data for 2000 and 2005, the cancer incidence at the national level has been evaluated. A total of 2.1 million cancer new cases are estimated for the year 2000 (1.3 million in men, 0.8 million in women) and these numbers were expected to increase by 14.6% by 2005, with the most common sites lung, liver and stomach in men, and breast, lung and stomach in women. The incidence and mortality for cancers in lung (in both sexes) and female breast showed the most significant recent increases. Cancer is now becoming a huge health burden in China. Discussion about the changes of the mortality and incidence profile in China was presented. The accuracy of the estimation and projection, related to the information sources chosen, and the methodological sensitivity analyses for different models were also taken into consideration. The challenge and prospects for cancer prevention and control in China in near future were also discussed in this study.
