Objective  To analyze the burden of cancer in China from 1990 to 2021.

Methods  The 2021 Global Burden of Disease Study database was used to analyze the incidence and mortality of cancer in China from 1990 to 2021, the order of incidence and mortality, the incidence and mortality of some cancers in different age groups, the age-standardized incidence rate (ASIR) and mortality (ASMR) rates, and the average annual percentage change (AAPC).

Results  In 2021, the number of cancer cases in China was 5.3293 million, with an ASIR of 258.84 per 100,000, the number of deaths was 2.8129 million, and the ASMR was 137.23 per 100,000. Both the incidence and mortality rates were higher in men than in women. In 2021, the cancer with the highest ASIR in China was lung cancer (44.01 per 100,000 population), followed by colorectal cancer, gastric cancer, breast cancer, and esophageal cancer. Lung cancer had the highest ASIR among men (62.63 per 100,000 population), while breast cancer had the highest ASIR among women (37.00 per 100,000 population). Lung cancer had the highest ASMR in China (38.89 per 100,000 population), followed by gastric cancer, esophageal cancer, colorectal cancer, and liver cancer. Lung cancer had the highest ASMR in both men and women. In 2021, breast cancer had the highest incidence rate before age 50, while lung cancer had the highest incidence rate after age 50. The mortality rate for lung cancer was higher than that of other cancers across all age groups. From 1990 to 2021, the ASIR of cancer in China showed an overall upward trend [AAPC=0.70%, 95%CI (0.52%, 1.02%)], and the ASMR of cancer showed an overall downward trend [AAPC= -0.90%, 95%CI (-1.12%, -0.83%)].

Conclusion  From 1990 to 2021, the ASMR of cancer in China showed a downward trend, but the ASIR continued to increase. Both the incidence and mortality rates of cancer increased with age. Lung cancer, colorectal cancer, gastric cancer, and breast cancer are malignant tumors with a heavy disease burden in China.

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