During the critical period of global cancer epidemiological transition, the American Cancer Society (ACS) recently published "Cancer Statistics, 2026" on the projected cancer data in the United States. To objectively evaluate the differences in cancer control systems between China and the United States, we compared the actual data of 2022 from National Cancer Center of China (NCC) with the latest the United States data. The mortality-to-incidence (M/I) ratio was used as the core indicator to evaluate clinical diagnosis and screening efficiency, and the Joinpoint regression trends from the source reports were analyzed. In addition, a sensitivity analysis model was built to adjust for the differences in the proportion of death-certificate-only (DCO) cases and the potential impact of the COVID-19 pandemic on China's 2022 cancer screening data. There is a significant contrast in the epidemiological characteristics of cancer between China and the United States in terms of cancer species composition and overall prognosis, which essentially reflects the differences in the epidemiological history of the two countries. This also suggests that in the future, China's cancer prevention and control strategies should shift towards precise hierarchical management to further narrow the gap in health efficacy.
ObjectiveTo compare the disease burden of cancers and the effectiveness of prevention and control strategies among elderly populations (aged ≥65 years) between China and the United States (US). MethodsUsing data from the GLOBOCAN 2022 database, we extracted age-standardized incidence rates (ASIR), age-standardized mortality rates (ASMR), and mortality-to-incidence ratio (M/I) for major cancer types in both countries. Joinpoint regression analysis was used to examine the temporal trends in incidence rates of the US (from 2000 to 2017) and China (from 2002 to 2017). ResultsAmong Chinese elderly populations, the overall ASIR was 1109.4 per 100000, lower than that in the US of 1754.4 per 100000. However, the ASMR in China was 779.0 per 100000, higher than that in the US of 664.4 per 100000. The M/I were 0.70 for China and 0.38 for the US. Cancer incidence rates among the elderly in both China and the United States were showing an overall downward trend. By cancer type, China faced a relatively heavy burden from lung cancer, colorectal cancer, stomach cancer, and liver cancer. In contrast, the US demonstrated high incidence but low mortality for prostate and breast cancers, reflecting advantages in its screening and treatment systems. ConclusionThe differences in the disease burden of cancers among the elderly populations between China and the US reflect a combination of factors, including the two countries’ stages of economic development, the progression of cancer spectrum shifts, and differences in the prevalence of major risk factors. It is recommended that China prioritize lung cancer, colorectal cancer, stomach cancer, and liver cancer, strengthen targeted screening and primary-care management, and establish a full-cycle system encompassing "prevention, screening, diagnosis, treatment, and rehabilitation" to narrow the gap in prevention and control effectiveness between China and the US.