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. 2024 Dec 10;137(24):3093–3100. doi: 10.1097/CM9.0000000000003442

Comparative analysis of cancer statistics in China and the United States in 2024

Yujie Wu 1, Siyi He 1, Mengdi Cao 1, Yi Teng 1, Qianru Li 1, Nuopei Tan 1, Jiachen Wang 1, Tingting Zuo 1, Tianyi Li 1, Yuanjie Zheng 1, Changfa Xia 1, Wanqing Chen 1,✉
Editor: Jing Ni
PMCID: PMC11706596  PMID: 39654104

Abstract

Background:

Cancer patterns in China are becoming similar to those in the United States (US). Comparing the recent cancer profiles, trends, and determinants in China and the US can provide useful reference data.

Methods:

This study used open-source data. We used GLOBOCAN 2022 cancer estimates and United Nations population estimates to calculate cancer cases and deaths in both countries during 2024. Data on cancer incidence and mortality trends were obtained from the Surveillance, Epidemiology, and End Results (SEER) program and National Centre for Health Statistics in the US and cancer registry reports of the National Cancer Center (NCC) of China. Data from the Global Burden of Disease study (GBD) and a decomposition approach were used to estimate the contributions of four determinants to the change in cancer deaths.

Results:

In 2024, there are an estimated 3,246,625 and 2,510,597 new cancer cases and 1,699,066 and 640,038 cancer deaths in China and the US, respectively. The highest estimated cancer cases are lung cancer in China and breast cancer in the US. The age-standardized incidence rates of lung and colorectal cancer in the US, and stomach, liver, and esophageal cancer in China have decreased, but the incidence rates of liver cancer in the US and colorectal cancer, prostate cancer in men, and cervical cancer in women in China have increased. Increases in the adult population size and population aging are main reasons for the increase in cancer deaths; case fatality rates are a main reason for the decrease in cancer deaths in both countries.

Conclusions:

China has made progress in cancer control but lags the US. Considering the transformation in China’s pattern of cancers epidemiology, it is imperative to develop stronger policies by adopting the cancer prevention and control strategies used in the US to address population aging and curb growing cancer trends.

Keywords: Cancer, Incidence, Mortality, Aging, China, United States, Lung cancer, Breast cancer, Esophageal cancer, Stomach cancer, Liver cancer

Introduction

Cancer has become one of the leading causes of human death owing to its chronic progression and serious mortality rates.[1] Cancer is associated with substantial societal and macroeconomic costs that vary in degree according to cancer type, geographic region, and sex.[2] In the United States (US), the field of cancer control is at a crossroads. Although the US has made progress in the fight against cancer, that progress has not benefited all populations equitably. In relevant studies, socioeconomic disparities in cancer mortality have widened, especially for the most easily preventable and early detectable cancers (e.g., cervical cancer).[3] Disadvantaged groups bear a disproportionate share of the cancer burden, a situation that is also present in China. Over the past few decades, China has experienced rapid economic and demographic changes that have been accompanied by shifts in cancer epidemiology.

According to GLOBOCAN 2022 estimates, the total number of cancer cases in China and the US was 4,824,703 and 2,380,189, accounting for 24.2% and 11.9% of global cancer cases, respectively.[4] With increasing population size and population aging, the cancer burden in China is showing a gradual upward trend, and the cancer pattern is transitioning from that of a developing country to that of a developed country. Additionally, the “Healthy China Initiative (2019–2030)” mentions that the population still carries a huge cancer burden and highlights the need for the Chinese government at all levels to increase attention given to cancer prevention and control efforts, such as popular education and organized cancer screening.[5]

Comprehensively analyzing the disease burden of cancer and national cancer prevention and control efforts in China and comparing them with those in the US, can provide a reference for further adjustment of cancer prevention strategies. The objective of this study was to describe the current cancer epidemiology for the main cancers in China and the US; to use publicly available data to estimate the number of new cancer cases and deaths owing to cancer in 2024 as well as the trends in incidence and mortality rates; and to conduct decomposition analysis of the contributions of four determinant factors to the change in cancer deaths in China and the US.

Methods

Data sources

In our study, we used publicly accessible data (incidence, mortality rate) from GLOBOCAN 2022, alongside population projections from the United Nations (UN), to construct cancer profiles for China and the US in 2024.[4,6] To analyze trends in incidence and mortality rates, we relied on data from the Surveillance, Epidemiology, and End Results (SEER) program published by the National Cancer Institute, as well as cancer registry data from the National Cancer Center (NCC) of China.[7–9] For decomposition analysis of cancer-related deaths, we used data from the Global Burden of Disease (GBD 2021) study released by the Institute for Health Metrics and Evaluation.[10]

We extracted the age- and sex-specific number of cancer cases and deaths for 35 cancer types (including all cancer sites) in 2022 from GLOBOCAN 2022.[4] Population figures for 2022 and projections for 2024 were sourced from the UN.[6] For trend analysis focusing on 11 cancer types (selected based on the 10 leading cancer types according to the number of cases and deaths in China in 2000), we used age-standardized incidence rates from 1975 to 2020 and age-standardized cancer mortality rates from 1975 to 2020 in the US, obtained from the SEER database.[7,8] The corresponding data in China from 2007 to 2017 were obtained from previous annual reports of the NCC.[9] We collected sex- and age-specific estimates of cancer cases and deaths for 29 cancer types in China and the US between 1990 and 2021 from the GBD 2021 database, as well as corresponding population estimates.[10]

Statistical analysis

We obtained sex- and age-specific cancer incidence and mortality rates in 2022 for 35 cancer types using cancer cases and deaths from GLOBOCAN 2022 and the corresponding population from the UN.[4,6] Assuming that age-specific rates remain unchanged through 2024, cancer cases and deaths in 2024 were estimated by multiplying incidence and mortality rates with the corresponding population, respectively. Cancer profiles in China during 2024 included the Chinese mainland, Hong Kong, and Macao; Taiwan was excluded owing to a lack of data in GLOBOCAN 2022. In the US, we estimated cancer profiles for 2024 across all 50 states and the District of Columbia, but not the dependencies.

Trends of incidence and mortality rates were analyzed by sex to make comparisons between China and the US. Cancer incidence (1975–2020) and mortality (1975–2020) rates for the US were adjusted by the 2000 US standard population.[7,8] Cancer incidence and mortality (2010–2020) rates in China were adjusted using Segi’s world standard population.[9] The trend analysis included 11 cancer types in China in GLOBOCAN 2022 (cancer of the esophagus, stomach, colorectum, liver, breast, lung, bladder, thyroid, cervix, uterus, and prostate).

The age-related burden of 29 cancer types was decomposed according to four key factors: the population size, age structure of the population, incidence of each cancer type, and fatality of each cancer type. To estimate the summed contribution of each indicator between 1990 and 2021, the standardized rates for the other three indicators were applied, with death metrics in 1990 being considered the reference level.[11,12] For example, the additive contribution of the adult population size (A) to the change in deaths owing to the 29 cancer types during 1990–2021 was calculated using the formula below:

Additive contribution of A = (A2021– A1990) × [(B2021C2021D2021+ B1990C1990D1990) / 4 + (B2021C2021D1990+ B2021C1990D2021+ B1990C2021D2021+ B1990C1990D2021+ B1990C2021D1990+ B2021C1990D1990) / 12],

where B represents the age structure of the adult population, C represents the cancer incidence, and D is the disease fatality. Statistical analysis was done uniformly using R 4.4.1 (The R Project for Statistical Computing, Vienna, Austria). The ggplot2 package was used to plot figures (https://ggplot2.tidyverse.org).

Results

Cancer cases and deaths in 2024

Table 1 presents the estimated number of new cancer cases during 2024 in China and the US by sex and cancer type. In total, there are an estimated 3,246,625 and 2,510,597 new cancer cases in China and the US, which is equivalent to an estimated 8895 and 6878 diagnosed cases per day, respectively. Total deaths are estimated at 1,699,066 in China and 640,038 in the US, an average of 4655 and 1754 deaths per day.

Table 1.

Estimated new cancer cases and deaths by sex in China and the US, 2024.*

ICD-10 Cancer site Estimated new case Estimated death
China US China US
Total Male Female Total Male Female Total Male Female Total Male Female
C00–97 All sites 3,246,625 1,740,015 1,506,610 2,510,597 1,360,619 1,149,978 1,699,066 1,122,634 576,432 640,038 340,348 299,690
C00–97/C44 All cancers excluding non-melanoma skin 3,213,871 1,723,238 1,490,633 1,921,870 976,307 945,563 1,689,782 1,117,128 572,554 615,273 324,790 290,483
C00–06 Lip, oral cavity 24,464 16,282 8182 28,978 19,886 90,928 13,716 9594 4122 4933 2798 2136
C07–08 Salivary glands 7418 4303 3116 5387 3140 2247 2383 1558 825 1112 697 415
C09–10 Oropharynx 5232 4277 955 14,937 12,370 2567 3502 2671 831 3492 2767 725
C11 Nasopharynx 35,383 25,576 9807 2089 1477 612 18,679 14,249 4430 909 660 249
C12–13 Hypopharynx 6114 5778 336 2445 1942 503 3694 3505 189 674 497 177
C15 Esophagus 230,751 172,103 58,648 19,822 15,629 4193 193,290 144,656 48,638 17,400 14,050 3350
C16 Stomach 232,310 163,972 68,338 26,950 16,286 10,664 171,388 123,907 47,481 11,568 7000 4568
C18–21 Colorectum 333,821 206,635 127,186 168,119 88,480 79,639 158,830 100,238 58,592 57,474 31,320 26,154
C22 Liver and intrahepatic bile ducts 241,501 180,754 60,747 45,810 32,697 13,113 207,474 155,254 52,220 32,822 22,220 10,602
C23 Gallbladder 19,600 8616 10,984 4996 1666 3330 15,551 6786 8765 2273 765 1508
C25 Pancreas 76,030 45,258 30,772 63,562 33,508 30,054 68,222 41,433 26,789 52,404 27,681 24,723
C32 Larynx 18,990 17,604 1386 12,794 10,227 2567 11,211 10,119 1092 4104 3294 810
C33–34 Trachea, bronchus and lung 681,124 437,788 243,336 239,490 119,428 120,062 478,014 348,683 129,331 135,353 71,177 64,176
C43 Melanoma of skin 5945 3109 2836 110,026 67,534 42,492 3587 2048 1539 7809 5124 2685
C45 Mesothelioma 1535 860 675 3312 2388 924 1088 695 393 2608 1965 643
C46 Kaposi sarcoma 398 280 118 1155 1,034 121 328 184 144 115 92 23
C50 Breast 369,769 – 369,769 287,284 – 287,284 77,959 – 77,959 44,973 – 44,973
C51 Vulva 2577 – 2577 6531 – 6531 1188 – 1188 1643 – 1643
C52 Vagina 1718 – 1718 1495 – 1495 633 – 633 425 – 425
C53 Cervix uteri 100,390 – 100,390 14,195 – 14,195 34,731 – 34,731 6059 – 6059
C54 Corpus uteri 48,931 – 48,931 67,687 – 67,687 8195 – 8195 12,291 – 12,291
C56 Ovary 41,436 – 41,436 21,639 – 21,639 20,065 – 20,065 13,676 – 13,676
C60 Penis 4053 4053 – 1696 1696 – 1645 1645 – 390 390 –
C61 Prostate 93,549 93,549 – 242,893 242,893 – 36,485 36,485 – 35,926 35,926 –
C62 Testis 3198 3198 – 9646 9646 – 630 630 – 517 517 –
C64 Kidney 48,894 32,122 16,772 75,268 48,879 26,389 16,179 11,416 4763 15,133 10,111 5022
C67 Bladder 62,276 50,421 11,855 85,494 65,718 19,776 29,530 24,276 5254 18,748 13,643 5105
C70–72 Brain, central nervous system 64,106 32,324 31,782 25,950 14,633 11,317 40,208 23,279 16,929 19,513 11,173 8340
C73 Thyroid 332,620 100,795 231,825 54,125 14,131 39,994 7598 3000 4598 2376 1138 1238
C81 Hodgkin lymphoma 3602 2184 1418 8831 4947 3884 1331 858 473 980 570 410
C82–86, C96 Non-Hodgkin lymphoma 55,863 32,592 23,271 82,139 45,916 36,223 26,874 16,994 9880 22,071 13,021 9050
C88, 90 Multiple myeloma 19,312 11,137 8175 34,116 19,362 14,754 12,079 7278 4801 13,887 7869 6018
C91–95 Leukaemia 69,767 40,445 29,322 66,329 39,444 26,885 38,016 22,819 15,197 24,868 14,802 10,066
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*Estimates based on data released by the International Agency for Research on Cancer for GLOBOCAN 2022, the WHO and the World Population Prospects for the United Nations. ICD: International Classification of Diseases; WHO: World Health Organization; –: Not available.

We found that the five leading cancer types newly diagnosed in 2024 in China are lung cancer (681,124), breast cancer (369,769), colorectal cancer (333,821), thyroid cancer (332,620), and liver cancer (241,501); in the US, these are breast cancer (287,284), prostate cancer (242,893), lung cancer (239,490), colorectal cancer (168,119), and melanoma of skin (110,026). The five cancer types with the highest number of deaths in 2024 in China are lung cancer (478,014), liver cancer (207,474), esophageal cancer (193,290), stomach cancer (171,388) and colorectal cancer (158,830); in the US, these are lung cancer (135,353), colorectal cancer (57,474), pancreatic cancer (52,404), breast cancer (44,973), and liver cancer (32,822). For male individuals, the most common cancer is lung cancer in China and prostate cancer in the US, and the cancer type leading to the most deaths is lung cancer in both China and the US. For female individuals, the most common cancers are breast cancer in both China and the US, with lung cancer leading to the most deaths in both China and the US. Thus, lung cancer is expected to be the largest cause of death in 2024 in both sexes and in both countries. Detailed data on other cancers can be found in Table 1.

Trends analysis in cancer incidence and mortality

Figures 1 and 2 illustrate long-term trends in 11 cancer types with respect to incidence and mortality rates. In general, incidence rates in the two countries have declined for most cancers in recent years, especially colorectal cancer and lung cancer in the US and stomach cancer, esophageal cancer, and liver cancer in China. Conversely, the incidence rates of liver cancer in the US and colorectal cancer in China are gradually increasing [Figures 1, 2].

Figure 1.

Figure 1

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Trends in cancer incidence rates by sex for China and the United States (US). Analyses based on data released by the US Surveillance, Epidemiology, and End Results program and China National Cancer Center. Rates for US cancer incidence (1975–2020) standardized by the 2000 US standard population. Rates for cancer incidence in China (2010–2020) were standardized using Segi’s world standard population.

Figure 2.

Figure 2

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Trends in cancer mortality rates by sex for China and the United States (US). Analyses based on data released by the US Surveillance, Epidemiology, and End Results program and China National Cancer Center. Rates for US cancer mortality (1975–2020) standardized using the 2000 US standard population. Rates for cancer mortality in China (2010–2020) standardized using Segi’s world standard population.

For male individuals, the incidence and mortality rates of lung and colorectal cancer in the US, and those of stomach, liver, and esophageal cancer in China, have decreased gradually in recent years. In the early 1990s, there was a sudden increase in the incidence of prostate cancer in the US [Figure 1]. The main reason is that routine use of commercial serum prostate-specific antigen (PSA) assay, which facilitates diagnosis, has resulted in an increase in the reported incidence of prostate cancer. Trends in recent years may reflect a decline in PSA testing (incidence) and improvements in treatment (mortality).[13]

For female individuals, the incidence and mortality rates of lung and colorectal cancer in the US, and those of stomach, liver, and esophageal cancer in China, have decreased gradually in recent years [Figures 1, 2]. In the US, the incidence and death rates of cervical cancer among women are steadily declining. However, the rates of cervical cancer in China are steadily increasing. It is important to note that since 2000, the incidence rate of thyroid cancer has clearly been on the rise in both China and the US. Trends in the incidence and mortality rates for other cancer types are detailed in Figures 1 and 2.

Decomposition of deaths according to cancer type

The changes in deaths for the 29 types of cancer in 1990−2000, 1990−2010, and 1990−2021 were 446, 853, 1321 thousand in China and 56, 86, 164 thousand in the US, respectively [Table 2]. The largest contributor to changes in the deaths owing to the 29 types of cancer between 1990 and 2021 in China and the US was the adult population size, with 1207 thousand and 198 thousand deaths, respectively. Changes in deaths owing to the 29 types of cancer in China and the US were associated with the increased adult population size, with absolute levels in 1990 of 84.1% and 37.3%, respectively; the corresponding variations owing to decreases in case fatality rates for these 29 cancers were −82.4% and −16.7%, respectively. Compared with 1990–2000, changes in deaths owing to these 29 cancer types were attributable to population aging in both countries, emerging as the second leading driver of the increase in cancer deaths (after population size) in both sexes during 1990–2010 and 1990–2021. Deaths for the 29 types of cancer attributable to population aging in China and the US during 2021 were 918 thousand (63.9%) and 107 thousand (20.2%), respectively. Detailed results are shown in Table 2.

Table 2.

Changes in deaths for 29 types of cancer in China and the US for 1990–2000, 1990–2010, and 1990–2021 (n × 10,000 [%]).*

Period China US
Population size Population aging Incidence Case fatality Total Population size Population aging Incidence Case fatality Total
1990–2021
Male 75.2 (83.5) 60.5 (67.1) 21.4 (23.8) –69.1 (–76.7) 88.0 (97.8) 10.8 (38.2) 7.7 (27.2) –5.2 (–18.4) –4.9 (–17.3) 8.4 (–29.7)
Female 45.5 (82.7) 31.3 (56.9) 17.9 (32.5) –50.6 (–92.0) 44.1 (80.1) 9.0 (36.1) 3.0 (12.0) 0.7 (2.8) –4.7 (–18.9) 8.0 (32.0)
Both 120.7 (84.1) 91.8 (63.9) 39.3 (27.4) –119.7 (–82.4) 132.1 (93.0) 19.8 (37.3) 10.7 (20.2) –4.5 (–8.8) –9.6 (–16.7) 16.4 (32.0)
1990–2010
Male 48.6 (53.9) 29.1 (32.3) 10.0 (11.1) –26.8 (–29.7) 60.9 (67.6) 8.5 (30.3) 5.2 (18.4) –4.8 (–17.0) –5.0 (–17.7) 3.9 (14.0)
Female 28.5 (51.8) 12.6 (22.9) 5.3 (9.6) –22.0 (–40.0) 24.4 (44.3) 6.1 (24.5) 2.3 (9.2) 1.1 (4.4) –4.8 (–19.3) 4.7 (18.8)
Both 77.1 (53.1) 41.7 (28.8) 15.3 (10.6) –48.8 (–33.7) 85.3 (58.8) 14.6 (27.5) 7.5 (14.1) –3.7 (–7.0) –9.8 (–18.5) 8.6 (16.1)
1990–2000
Male 28.4 (31.6) 6.7 (7.4) 3.8 (4.2) –7.7 (–8.6) 31.2 (34.6) 3.9 (13.8) 1.4 (5.0) 1.0 (3.5) –4.3 (–15.2) 2.0 (7.1)
Female 17.1 (31.1) 1.9 (3.5) 1.2 (2.2) –6.8 (–12.4) 13.4 (24.4) 2.7 (10.9) 0.8 (3.2) 2.8 (11.2) –2.7 (–10.8) 3.6 (14.5)
Both 45.5 (31.2) 8.6 (5.9) 5.0 (3.4) –14.5 (–10.0) 44.6 (30.5) 6.6 (12.4) 2.2 (4.1) 3.8 (7.2) –7.0 (–13.2) 5.6 (10.5)
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* Percent in parentheses indicates the relative change in deaths owing to the 29 types of cancer deaths associated with each decomposed factor compared with the absolute level in 1990. US: United States.

Over the period 1990–2021, the number of age-related cancer deaths varied more among male individuals and among those aged 60–84 years in both countries [Figure 3]. The contribution of each decomposed factor to age-related cancer deaths varied by age group and sex. Increasing population size was the primary factor contributing to changes in age-related deaths from cancer between 1990 and 2021 for men and women aged 25–74 years in China and aged 45–84 years in the US. In both sexes, the change in cancer deaths owing to population aging also increased with age, peaking earlier for women (65–69 years old) than for men (70–74 years old) in China and for men and women aged 70–74 years in the US. In China, the incidence of cancer contributed to the increase in deaths, and the proportion of deaths associated with the age-related incidence was much lower than the proportion associated with population size and population aging. Case fatality contributed to the reduction in cancer deaths in both countries, contributing more in China than in the US in recent years. Details of the changes in cancer deaths in other age groups are shown in Figure 3.

Figure 3.

Figure 3

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Decomposition of change in age-related deaths for 29 types of cancer by sex and age group in China and the United States (1990–2021). Positive values indicate an increase and negative values indicate a decrease in age-related deaths (1990–2021). US: United States.

Discussion

This study provides a secondary analysis of estimated cancer cases and deaths in 2024, incidence and mortality rates trends, and decomposition analysis of deaths. Additionally, we systematically summarized China’s current cancer profile to compare it with that of the US. In 2024, there are an estimated 3,246,625 and 2,510,597 new cancer cases and 1,699,066 and 640,038 cancer deaths in China and the US, respectively. The cancers with the highest number of cases are lung cancer in China and breast cancer in the US. Cancer continues to be a major public health problem as incidence and mortality increase, and the burden on health systems is expected to increase, consistent with population projections.[6,14] Governments need to take account of these shifts in developing cancer policies to suit local cancer profiles.

Comparing the five most common cancers in China and the US, breast cancer is the leading cancer in the US, and lung cancer remains the leading cancer in China. This difference reflects differences in the prevalence and distribution of risk factors in different regions.[15] Countries with rapid social and economic development are more likely to experience changes in the breast cancer status of their population. This may be related to Westernized lifestyles, such as reproductive patterns and obesity.[16]

China’s cancer profile is gradually moving closer to that of the US, with declining incidence and mortality rates for esophageal, liver, and stomach cancers and rising incidence rates for lung, colorectal, breast, and thyroid cancers. Lung cancer remains the leading cause of cancer deaths in both countries. Smoking is responsible for one-third of all cancer deaths and is associated with the development of approximately 13 cancer sites, with more than 70% of lung cancer cases worldwide caused by smoking.[17,18] Implementing strong tobacco control policies is an effective way to reduce the cancer incidence and mortality. In the 1960s, the US government took the lead in implementing strong tobacco control policies in the country. As a result, the number of smokers in the US has continually declined, accelerating the annual rate of decline in lung cancer mortality from 2% between 2005 and 2013 to 4% between 2013 and 2021.[19] Survey results in China show that the prevalence of smoking among people aged 18 years and older was 25.6% in 2018, among whom were 96.1% were male and 3.9% were female smokers.[20] Compared with the results of previous surveys, the smoking prevalence shows a decreasing trend, but a large gap remains to achievement of the tobacco control target of the “Healthy China Initiative (2019–2030)” planning outline, i.e., that the smoking prevalence among people aged 15 years and above will be reduced to 20% by 2030.[5] Therefore, aspects of cancer prevention and control strategies implemented in the US have important reference value for China.

China has one of the fastest-growing aging populations in the world. Population aging is likely to be a major social characteristic of China and will be a fundamental national condition for a long time.[21] In 2019, there were 254 million people aged 60 years and over in China. Owing to longer life expectancy and declining fertility, the number of people aged 60 years and over will increase to 402 million by 2040, accounting for approximately 28% of the population.[22] Currently, the leading factor in the rapid increase of cancer deaths in China is the large increase in the size of the population aged ≥25 years. However, against the backdrop of stagnant or negative population growth and continued population aging, cancer deaths in China are expected to continue a relatively rapid increasing trend, with the number of cancer deaths attributable to the aging population continuing to increase, thereby becoming the most important factor driving the increase in cancer deaths. Since 2005, four population-based mass screening programs have been initiated in China.[23] Cancer prevention and control have been strengthened under major efforts of the government. Moving the prevention and control of malignant tumors forward, screening for malignant tumors in the population aged 45–74 years is important to reduce the disease burden of cancer in older adults as well as in the whole population.

China is the world’s largest developing country, with a corresponding high cancer burden. The cancer pattern in China is different from that of developed countries such as the US. With urbanization and rapid economic and social development, the cancer pattern in China has changed significantly.[24,25] High-income or developed countries have lower fertility rates and generally higher rates of population aging; thus, their burden of malignant tumors is usually heavier, especially for lung, colorectal, and breast cancers, which are closely associated with population aging.[26] In addition to the three cancers mentioned above, five other common cancers (esophageal, stomach, liver, cervical, and nasopharyngeal) are included in the free screening program in China. Cervical cancer is a completely preventable cancer. The World Health Organization (WHO) has launched a global initiative to eliminate cervical cancer as a public health problem. In 2019, cervical and breast cancer screening was rolled out nationwide in China; the remaining cancers are only screened in selected regions. Even so, cervical cancer screening only reached 36.8% national coverage in 2018–2019;[27] In contrast, high-income countries such as the US have reached more than 70% cervical cancer screening coverage.[28] The incidence and mortality rates of cervical cancer in China are still on the rise, indicating the need for more integrated and comprehensive cervical cancer prevention and treatment policies and investment in health resources, including vaccination against human papillomavirus infection, targeted screening strategies, and early diagnosis and treatment.

The shift in the cancer pattern is also reflected in cancers of the digestive system, with a decline in the incidence and mortality rates of esophageal, liver, and stomach cancers. First, infection with hepatitis B virus (HBV) remains a major risk factor for liver cancer, involved in up to 50% of cases.[29] China bears a large portion of the global burden of HBV infection and has experienced a significant decline in HBV infection over the past 40 years; however, the prevalence of hepatitis B surface antigen in certain subpopulations still varies.[30] The estimated prevalence of people living with chronic HBV infection in the US has remained unchanged since 1999 at 0.3%.[31] Improving vaccination coverage and increasing screening and diagnosis are essential to achieving the WHO goal of eliminating HBV infection by 2030. Second, there is a high rate of Helicobacter pylori (Hp) infection in the Chinese population, with an average 40.7% of individuals infected with Hp; this rate is up to 43.5% in adults.[32] According to these findings, infection control is clearly an integral part of reducing the burden of digestive system cancers in China.

Except for upper gastrointestinal cancers, the proportion of stage I diagnoses and 5-year relative survival rates for most cancer types in the US are much higher than those in China.[33] From 2003–2005 to 2012–2015, the age-standardized 5-year relative survival rate for all cancers increased substantially in China, from 30.9% to 40.5%.[34] The 5-year relative survival rate for most cancers is higher in the US than that in China, except for esophageal and stomach cancers.[33] The above studies show that China must invest more in health services, including individualized cancer treatment and prognostic care.

In the data analysis of this study, we extracted the most recent open-source data or published studies from comprehensive databases and described the cancer profiles in China and the US. Comparisons between China and the US were based on information from the same data sources or the same period and are highly comparable. This study also has some limitations. First, estimates regarding the cancer incidence and deaths in 2024 are affected by systematic biases in the GLOBOCAN 2022 report. Second, we used the 2022 cancer incidence rate as an approximation of the 2024 incidence rate, neglecting possible variations over that period. Finally, two different standardized populations were used for calculating age-standardized incidence and mortality rates; there are no studies reporting long-term age-specific cancer cases, deaths, and populations.

In summary, the incidence and mortality rates of stomach, liver, and esophageal cancers in China have gradually declined. However, incidence rates of colorectal cancer, female breast cancer, and male prostate cancer are on the rise. China has made some progress in the cancer burden of several digestive system cancers, but the country still faces a heavy disease burden owing to cancer. Considering the impact of increased population aging on the growing burden of disease, China could learn from primary prevention strategies followed in the US and take greater action toward healthy aging. China could also actively engage in ongoing health promotion and education and expand cancer screening coverage to increase the diagnosis rate of stage I cancers, improve the 5-year survival rate, and effectively curb growth of the cancer burden in China.

Acknowledgements

We thank the GBD study and GLOBOCAN 2022 for providing open access to the data and a range of web-based information.

Conflicts of interest

None.

Footnotes

How to cite this article: Wu YJ, He SY, Cao MD, Teng Y, Li QR, Tan NP, Wang JC, Zuo TT, Li TY, Zheng YJ, Xia CF, Chen WQ. Comparative analysis of cancer statistics in China and the United States in 2024. Chin Med J 2024;137:3093–3100. doi: 10.1097/CM9.0000000000003442

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