Trend in age-specific cancer mortality and cancer-free life expectancy in China, 2008–17: a cross-sectional survey of nationwide data

Background Cancer is the main chronic disease that affects the health of Chinese residents; however, there have been few systematic studies on cancer-free life expectancy in China. We aimed to explore age-specific cancer mortality and changes in population lifespan after accounting for the removal of the burden of cancer to provide important insights and a basic reference on the development of relevant health policies, such as cancer control or elderly care. Methods We used population data from the National Bureau of Statistics and data on cancer mortality from the China Health Statistics Yearbook to produce estimates of the number of deaths from 2008 to 2017 for 18 different age groups, female and male individuals, urban areas and rural areas, and different cancer types. We analysed the change in mortality for the 18 different age groups from 2008 to 2017 and inputted the population mortality and deaths caused by cancer into a life table system to calculate life expectancy for all age groups and cancer-free life expectancy for all age groups. Findings From 2008 to 2017, total mortality associated with cancer in China decreased at a steady trend per year in urban areas and increased in rural areas. Mortality of the various age groups decreased during the 10-year period, whereas overall mortality rate increased due to population ageing. Lung cancer in rural areas increased by 2·8% (SD 1·2–4·4) per year, and liver cancer and stomach cancer significantly decreased by 2·1–2·2% per year in rural areas (p<0·0001). Life expectancy of the entire population increased from 74·6 years in 2008 to 75·6 years in 2017. Life expectancy in women (77·5–78·4 years) was higher than in men (72·0–73·1 years) from 2008 to 2017, and life expectancy in urban areas (76·0–76·2 years) was higher than rural areas (73·1–75·0 years). After removing the effects of cancer, life expectancy of the total population increased by about 3 years. Lung cancer had a greater effect on life expectancy than other types of cancer, and predominantly affects the male population younger than 54 years. If cancer were to be effectively controlled, the life expectancy of the population aged 50–84 years would be significantly improved. Interpretation Cancer is a serious disease that harms the health of the population in China. The development of medicine is the main reason for the rapid increase in life expectancy in rural areas. Increased smoking and obesity are the main factors affecting the life expectancy of the Chinese population, although the development of new drugs and some new vaccines can effectively control cancer deaths. The study of life expectancy and healthy life expectancy will be important topics of research in the future. Funding National High-tech R&D Program (863 Program) for High-end Electronic Medical Record Technology Development and System Application Demonstration (2012AA02A607).