Abstract
Cancer is a major cause of death and morbidity in China. We aimed to analyze the trends in cancer mortality in six provinces in northwest China (Xinjiang Uyghur Autonomous Region, Qinghai Province, Shaanxi Province, Gansu Province, Ningxia Hui Autonomous Region, and Inner Mongolia Autonomous Region) from 2013 to 2021 and to explore the effect of cancer on life expectancy and the years of life lost. Based on cancer mortality data and demographic data from national surveillance units in six northwestern provinces from 2013 to 2021 in the National Cause-of-Death Surveillance, we calculated crude mortality rates, age-standardized mortality rates, life expectancy, cause-eliminated life expectancy, potential gains in life expectancy (PGLEs), years of life lost (YLL), YLL rates, and average years of life lost. Joinpoint software was used to calculate the average annual percentage change and annual percentage change (APC) for cancer mortality. Arriaga's decomposition method was used to estimate the contribution of cancer to life expectancy in each age group. The age-standardized mortality rate for cancer in the six provinces in northwest China was stable overall from 2013 to 2021 but exhibited a decreasing trend from 2017 to 2021 (APC = - 5.64%, p = 0.047), male cancer age-standardized mortality rates were consistently higher than those of women and plateaued, women exhibited a decreasing trend after 2017 (APC = - 5.56%, p = 0.032), and the standardized mortality rate was higher and stable for those aged ≥ 65 years. Compared with the study area population in 2013, that in 2021 increased by 1.01 years in life expectancy, and changes in cancer mortality contributed positively to the increase in life expectancy, contributing 0.217 years or 21.38% of the increase in life expectancy. The greatest positive effect was in the 0-1 year age group (0.066 years, 6.48%), and the greatest negative effect was in the ≥ 85 years age group (- 0.026 years, - 2.56%). At a 1.06-year increase in cancer cause-eliminated life expectancy, PGLEs increased by 0.047 years, with the highest increase in PGLEs in urban areas (0.091 years) and an upward trend in YLL rates in the study area population from 2013 to 2021 (average annual percentage change = 2.16, p = 0.001). Average years of life lost presented a stable trend. Cancer age-standardized mortality rate in the study region from 2013 to 2021 was stable overall but has exhibited a decline in recent years. However, the disease burden of YLL has continued to increase. Preventive interventions targeting male groups and the elderly population need to be strengthened.