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Cancer rates climb
By Tan Weiyun

While figures are most of the time convincing, they are also scary, sometimes. The latest survey for 2012 by the Shanghai Municipal Center for Disease Control and Prevention (SCDC) shows averagely 1.79 people among 100 in the city are cancer patients; the 2011 figure was 1 person out of 100 Shanghai residents.

Cancer in Shanghai is soaring to record levels, while deaths are not because of early detection and treatment, according to cancer experts. The SCDC survey reveals that every day, 82 people die of cancers in Shanghai.

"These figures have sounded the alarm," says Dr Gong Yangming from the oncology department of the SCDC.

Reasons include high-fat, high-sugar diets, obesity, lack of vegetables and fiber, lack of exercise, stress, environmental pollutants, and longer life, since cancer is also disease of age.

According to the survey, the top 10 fatal cancers for men are lung, large intestine, stomach, liver, prostate, pancreas, esophagus, urinary bladder, kidney, brain and central nervous system.

The leading cancers in women are breast, large intestine, lung, stomach, thyroid gland, liver, pancreas, brain and central nervous system, gall bladder and ovary.

These tumors account for more than 85 percent of all the cancers.

"Cancer is a chronic non-infectious disease, and we wouldn't have big changes in the short term, but in the long run, we can observe the trend," Gong says.

Compared with 10 years ago, the top lethal cancer for men (lung) and for women (breast) are the same.

Colorectal cancer is rising significantly for both men and women, while liver, stomach and esophageal cancers have dropped significantly during the past decade.

Stomach, liver and esophageal cancers have peaked and are declining, says Gao Yutang, former director of the Shanghai Cancer Institute.

"But at the same time cancers of the breast, gall bladder and large intestine are increasing, which might be caused by the changes of living habits and diet structure," Gao says.

Breast and prostate cancers are still low compared with Western countries, but they are estimated to rise in the future, he says.

The causes of cancers are extremely complicated, involving genetic inheritance, environment and living habits and the interaction among these factors, observes Professor Cao Hui from Shanghai Renji Hospital.

He notes that cancers of the large intestine (colorectal) and stomach are high for both men and women.

"This might be due to lack of fresh vegetables and fruits for urban dwellers, who live at a fast pace and work under great pressure," he says. "If the stomach keeps going like this, the gastric mucosa will be destroyed and the body will be vulnerable to developing cancer cells."

Colorectal cancer is considered a "disease of wealth" because of the high-fat, high-sugar diets, lack of fiber and physical exercise, as well as irregular bowel movement.

Another common disease in many big cities is lung cancer as a result of million tons of vehicle exhaust that has become an invisible killer. Smoking is also a big contributor to lung cancer.

As the medical system has improved and health awareness and checkups have increased in China, the reported incidence of cancer has increased significantly in recent years.

"The rising incidence of cancers and the number of patients are in sync with the aging speed of the population, which contributes greatly to the city's cancer surge," Gong says. Cancer, the abnormal growth of cells, is very much a disease of aging.

According to the latest statistics from the Bureau of Civil Affairs, Shanghai residents aged over 60 account for 23 percent of the population. By 2030, the city will have 5 to 6 million senior citizens older than 60, almost 30 percent of the total.

By 2030, Shanghai will have become the "oldest" city in China, with one elderly (above 60) person among every three people.

"If we didn't consider the aging issue, Shanghai's cancer rate would drop by about 40 percent," Gong says.

Improved diagnostic technology and more regular physical checkups also contribute the high incidence of reported cancers.

"Tumors are discovered in the early stage. Early diagnosis and treatment greatly improves the recovery and survival rate. That's why the incidence rate is increased, but the death rate is not," Gong says.

In addition to the elderly, smokers and people regularly exposed to passive smoke are at the highest risk for cancers.

"Cancer can stay away from us and it can also stalk us," Gong says.

It is a combination of chance and inevitability. "Chance is the probability of one's genetic carcinogenesis, which is quite low. Inevitability refers to the outside forces including climate, environment, personal living habit and dietary structure that might cause cancer," Gong says.

"In theory, 100-percent cutting off the external forces can 100-percent prevent cancers. In reality, it's feasible to minimize these external factors, so cancer can be prevented," Gong adds.

The biggest cause of cancer in developed areas is widely acknowledged to be living habits, which account for 80 percent, he says. Genetics and environmental pollution each account for 10 percent.

The Shanghai Center for Disease Control and Prevention released its cancer survey for 2012 in March this year.

Cancer the No. 1 cause of death

EVERY year 3.12 million new cases of cancer are reported in China, every minute six people are diagnosed with cancers, according to the National Cancer Registration Center.

The findings are contained in the center's annual report for 2012 released in January this year.

Last year a survey by the Chinese Anti-Cancer Association showed that among every five deaths, one was caused by cancer.

The top three cancers in China in terms of incidence are lung cancer, stomach cancer and colorectal cancer. Lung cancer is the top in terms of both incidence and death.

Distribution varies across the country.

The incidence of lung cancer is highest in the northeast and in Yunnan Province, both big coal and mineral mining regions, where pollutants easily enter the lungs.

Stomach or gastric cancer rates are highest in Shanghai and Jiangsu, Gansu, Qinghai and Fujian provinces, where people commonly eat salt-preserved foods.

Colorectal cancer rates are high in Shanghai as well as Zhejiang and Jiangsu provinces, all developed regions, because of high-fat and high-sugar diets, lack of dietary fiber and physical exercise.

People in Henan, Hebei and Shanxi provinces are at risk for esophageal cancer because the diet commonly features coarse and over-hot food, which scratches, damages or burns the mucous membrane.

Liver cancer is a top killer in East China, South China and coastal cities, where people eat raw fish and shellfish. This kind of food, if processed improperly, often carries parasites.

In addition, humid weather promotes mold that may contain aflatoxins, which infect the liver. Viral hepatitis is also a major cause of cancer.

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