Objective To analyze the changing trend of cancer burden in China from 2005 to 2020, so as to provide reference for the formulation of cancer prevention and control strategies. Method Based on the report “National and subnational trends in cancer burden in China, 2005–20”, the overall changes in cancer deaths in China by gender, age, urban and rural areas, and different regions of the country were analyzed. Results ① Among the whole population, the number of cancer-related deaths and years of life lost (YLLs) in China increased by 21.6% and 5.0% respectively, and the top third leading cause of cancer-related deaths ranked by mortality rate were tracheal, bronchus, and lung cancer, liver cancer, and stomach cancer. ② In different gender groups, for the males, the top five leading cause of cancer-related deaths by mortality rate remained unchanged from 2005 to 2020, they were tracheal, bronchus, and lung cancer, liver cancer, stomach cancer, oesophageal cancer, and colon and rectum cancer. The average annual percent change (AAPC) of the age-standardized mortality rate (ASMR) increased in 4 of the leading 10 cancers, followed by prostate cancer (1.70 per 100 000), pancreatic cancer (0.95 per 100 000), lymphoma (0.33 per 100 000), and colon and rectum cancer (0.31 per 100 000). For the females, the tracheal, bronchus, and lung cancer remained the first leading cancer from 2005 to 2020, the second to the fifth leading cancers by mortality rate showed evident changes, with the liver cancer moving from the third to the second position, the stomach cancer moving from the second to the third position, the colon and rectum cancers moving from the fifth to the fourth position, and the breast cancer moving from the sixth to the fifth position, the pancreatic cancer moving from the ninth to the eighth position. Among the top 10 cancers, only the pancreatic cancer had an increase in AAPC of ASMR (0.67 per 100 000). ③ Among different age groups, the cancer-related mortality in young people (18–44 years old) and middle-aged people (45–59 years old) was much lower than that of the elderly (over 60 years old). ④ The mortality and YLL rates due to cancer in rural areas were higher than those in urban areas for both sexes. The cancer mortality rates of 11 provinces or regions such as Anhui were higher than those the national average value. The mortality, ASMR, YLL rates, and age-standardized YLL rates of all cancer types in Guangxi Zhuang Autonomous Region, Hebei, Xinjiang Uygur Autonomous Region, Henan, and Qinghai decreased in the males and which in Jiangsu, Henan, Guangxi Zhuang Autonomous Region, Xinjiang Uygur Autonomous Region, and Shanghai in the females also decreased. The ASMR of the colon and rectum cancer and pancreatic cancer increased significantly in some provinces or regions.Conclusions From 2005 to 2020, there are rising trends in the number of cancer-related deaths and YLLs in China, and there are differences in the gender, age, urban and rural, and regional distribution of cancer burden. The prevention and control situation is grim, there is an urgent need for a comprehensive cancer prevention and control strategy to deal with the changing cancer burden in China.

Citation： FENG Wei, ZHANG Wei. National and subnational trends in cancer burden in China, 2005–2020: an interpretation of national mortality surveillance data. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(7): 803-809. doi: 10.7507/1007-9424.202406068 Copy