Occupational and environmental cancer incidence and mortality in China

Background Most cancers are due to environmental, occupational or other non-genetic factors and are potentially preventable. Aims To provide an evidence-based assessment of the burden of occupational and environmental-related cancers in China in 2005. Methods The population attributable fraction (PAF) was calculated based on the assumption of no occupational agent exposure. Relative risk estimates for specific cancers of interest and prevalence of exposure were mainly derived from large-scale studies. Data on cancer incidence and mortality was obtained from the Third National Death Cause Survey and cancer registries in China. Results We estimated that a total of 48 511 deaths of cancer were attributable to occupational agents in China in 2005, with 34 975 among men (3.1% of all cancer deaths) and 13 536 among women (2.1%). A total of 59 410 incident cases of cancer were attributable to occupational agents in China in 2005, with 42 724 among men (2.8% of all cancer incident cases) and 16 686 among women (1.6%). The highest PAF was observed for mesothelioma with asbestos, followed by leukaemia, bladder and lung cancers. Indoor radon was responsible for 0.2% of lung cancer-related deaths among men and women. Conclusions Occupational agents represent an important cause of cancer, but indoor radon plays a relatively limited role in cancer causes in China. Our report provides strong evidence of the need for policy makers to develop strategies to reduce the risk of occupational cancers.