Abstract
INTRODUCTION: Cancer is a major health problem in China. Integrated interventions have been implemented in key areas of Anhui, Henan, Jiangsu, and Shandong provinces with historically higher than average cancer mortality. Assessing the cancer mortality trend and its impact on life expectancy (LE) could help evaluate the effectiveness of interventions in these regions. METHODS: Based on the National Cause-of-Death Surveillance, we analyzed the standardized mortality rate (SMR) of cancer, cause eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs), and rate of life lost in key areas of 4 provinces from 2008 to 2018. Joinpoint program was used to compute the average annual percentage change (AAPC) of cancer mortality. Arriaga's decomposition method was used to estimate the contribution of cancer to LE in each age group. RESULTS: From 2008 to 2018, cancer SMR decreased in the study region (AAPC=-3.09%, P<0.001), which increased LE. The positive effect was the greatest in the 75-79 age group (0.120 years, 2.90%), and the negative effect was the greatest in the 50-54 age group (-0.094 years, -2.20%). Compared to 2008, cancer CELE increased by 3.95 years, PGLEs increased by 0.32 years, and rate of life lost increased by 0.21% in 2018. CONCLUSIONS: Cancer SMR decreased in key areas of 4 provinces from 2008 to 2018. This change had a positive effect on the increase of LE. However, the rate of life lost due to cancer increased. Integrated interventions should continue to further reduce the cancer burden.