Life expectancy of cancer patients in China.

Abstract

Background: A cancer diagnosis is usually associated with a substantial loss of life years. However, few studies have quantified life expectancy (LE) and years of life lost (YLL) among cancer patients, particularly in China. This study aims to estimate LE and YLL by cancer type, sex, age at diagnosis, and attained age (i.e., the age a cancer survivor has reached at a given time) for cancer patients in China.

Methods: This is a comparative assessment based on population-based cancer registration and death surveillance in China. Data on all-cause deaths, cancer cases, and relative survival in 2021 were obtained from publicly available reports released by the National Cancer Center and the Chinese Center for Disease Control and Prevention. Life tables for the general population were constructed using age-specific all-cause mortality rates, whereas relative survival rates and parameterized long-term excess hazard functions were used to construct life tables for cancer patients. We used the standard period life table method to estimate LE of both the general population and cancer patients, assuming that mortality probabilities remained constant over time. The YLL was the LE difference between cancer patients and the sex- and age-matched general population.

Results: For cancer patients diagnosed at the median age of 64 years, the LE is 8.8 years [95% confidence interval (CI) 8.7-9.0], corresponding to a YLL of 9.2 years (95% CI 9.0-9.3). Male patients have an LE and YLL of 6.7 years (95% CI 6.6-6.8) and 9.8 years (95% CI 9.7-9.9), respectively, while females have 11.2 years (95% CI 11.1-11.4) and 8.4 years (95% CI 8.3-8.6). Thyroid cancer had the highest LE [31.9 years (95% CI 31.5-32.0)], while pancreatic cancer had the lowest [2.6 years (95% CI 2.4-2.8)]. Female patients had better LEs than males across 20 cancer types that affect both sexes. Younger patients experienced greater YLL, except in cases of thyroid cancer, oropharyngeal cancer, ovarian cancer, and male bladder cancer. LE gradually increased in patients who survived the first three years; thereafter, the decline depended on attained age, approaching that of the general population.

Conclusions: LE of cancer patients in China varied by sex, cancer type, age at diagnosis, and attained age. Cancer patients, healthcare providers, and policymakers may incorporate these estimates into their decision-making.