Interpretation of "Cancer Statistics, 2026": Comparative study on cancer epidemiological characteristics and prevention and control effectiveness between China and the United States_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

DONG Changqing ¹ , HE Huayu ¹ , TAO Ye ² ,  QIANG Guangliang ¹

1. Department of Thoracic Surgery, Peking University Third Hospital, Beijing, 100191, P. R. China;
2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Thoracic Surgery Ⅱ, Peking University Cancer Hospital & Institute, Beijing, 100142, P. R. China;

Corresponding?author：

QIANG Guangliang, Email: pkudd@bjmu.edu.cn

Keywords：

Neoplasms; disease burden; mass screening; mortality-to-incidence ratio; epidemiological characteristics; lung cancer; gastrointestinal cancers; breast cancer

DOI：

10.7507/1007-4848.202602040

Video：

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Abstract Full text Figures/Tables Video References Cited by

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.

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2.	Siegel RL, Kratzer TB, Wagle NS. Cancer statistics, 2026. CA Cancer J Clin, 2026: e70043.
3.	Plummer M, de Martel C, Vignat J. Global burden of cancers attributable to infections in 2012: a synthetic analysis. Lancet Glob Health, 2016, 4(9): e609-e616.
4.	Han B, Zheng R, Zeng H. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent, 2024, 4(1): 47-53.
5.	Chen W, Zheng R, Baade PD. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
6.	Fidler MM, Bray F, Soerjomataram I. The global cancer burden and human development: a review. Scand J Public Health, 2018, 46(1): 27-36.
7.	Li X. The burden of cancer in China, 2016-2030. J Glob Health, 2021, 11: 04074.
8.	Committee HCAP. Editor-in Chief. Healthy China Action (2019-2030). Beijing: People's Medical Publishing House, 2019: 70-71 .
9.	He J, Chen W. Cancer prevention and control in China: progress and challenges. Lancet, 2023, 401: S10.
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11.	Bray F, Laversanne M, Sung H. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
12.	Vostakolaei FA. The validity of the mortality to incidence ratio as a proxy for site-specific cancer survival. Eur J Public Health, 2011, 21(5): 573-577.
13.	Goddard KAB, Feuer EJ, Mandelblatt JS. Estimation of cancer deaths averted from prevention, screening, and treatment efforts, 1975-2020. JAMA Oncol, 2024, 10(7): 933-942.
14.	Tervonen HE, Roder D, Morrell S. Does exclusion of cancers registered only from death-certificate information diminish socio-demographic disparities in recorded survival? Cancer Epidemiol, 2017, 48: 70-77.
15.	Centers for Disease Control and Prevention (CDC). Use of cancer screening tests: United States, 2023. Prev Chronic Dis, 2025, 22: E139.
16.	Hugosson J, Roobol MJ, M?nsson M. A 16-yr follow-up of the European Randomized study of Screening for Prostate Cancer. Eur Urol, 2019, 76(1): 43-51.
17.	Giaquinto AN, Sung H, Newman LA. Breast cancer statistics 2024. CA Cancer J Clin, 2024, 74(1): 20-41.
18.	Star J, Bandi P, Nargis N. Updated review of major cancer risk factors and screening test use in the United States, with a focus on changes during the COVID-19 pandemic. Cancer Epidemiol Biomarkers Prev, 2023, 32(7): 879-888.
19.	Vaccarella S, Franceschi S, Bray F. Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. N Engl J Med, 2016, 375(7): 614-617.
20.	Cao B, Bray F, Ilbawi A. Effect on longevity of 15 years of the WHO Framework Convention on Tobacco Control: a simulation study. Lancet Public Health, 2024, 9(2): e120-e130.
21.	Parascandola M, Xiao L. Tobacco and the lung cancer epidemic in China. Transl Lung Cancer Res, 2019, 8(Suppl 1): S21-S30.
22.	Wang J, Yang L, Nie J. Air pollution and health in China: progress and challenges. Lancet Planet Health, 2019, 3(2): e57-e58.
23.	Sun D, Cao M, Li H. Cancer burden in China: trends, risk factors and prevention. Cancer Biol Med, 2020, 17(4): 879-895.
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25.	Moolgavkar SH, Holford TR, Levy DT. Impact of reduced tobacco smoking on lung cancer mortality in the United States during 1975-2000. J Natl Cancer Inst, 2012, 104(7): 541-548.
26.	Jeon J, Holford TR, Levy DT. Smoking and lung cancer mortality in the United States from 2015 to 2065: a comparative modeling approach. Ann Intern Med, 2018, 169(10): 684-693.
27.	Jemal A, Fedewa SA, Ma J. Higher lung cancer incidence in young women than young men in the United States. N Engl J Med, 2018, 378(21): 1999-2009.
28.	Vermeulen R, Downward GS, Zhang J. Constituents of household air pollution and lung cancer risk among never-smoking women in Xuanwei, China. Environ Health Perspect, 2019, 127(9): 97001.
29.	Seow WJ, Hu W, Vermeulen R. Household air pollution and lung cancer in China: a review of studies in Xuanwei. Chin J Cancer, 2014, 33(10): 471-475.
30.	Midha A, Dearden S, McCormack R. EGFR mutation incidence in non-small-cell lung cancer of adenocarcinoma histology: a systematic review and global map by ethnicity (mutMapⅡ). Am J Cancer Res, 2015, 5(9): 2892-2911.
31.	Shi Y, Au JS, Thongprasert S. A prospective, molecular epidemiology study of EGFR mutations in Asian patients with advanced non-small-cell lung cancer of adenocarcinoma histology (PIONEER). J Thorac Oncol, 2014, 9(2): 154-162.
32.	Song J, Hwang EJ, Yoon SH. CT screening challenges amid rising threat of lung cancer in individuals Who have never smoked. Radiology, 2026, 318(1): e251305.
33.	Xie D, Zhang L, He N. Overdiagnosis of lung cancer due to the introduction of low-dose computed tomography in average-risk populations in the People's Republic of China. J Thorac Oncol, 2025, 20(7): 884-896.
34.	Zhu Q, Liu J, Hu J. The epidemiological landscape of thyroid cancer and estimates of overdiagnosis in China: a population-based study. Thyroid, 2025, 35(2): 307-320.
35.	Li M, Zheng R, Dal Maso L. Mapping overdiagnosis of thyroid cancer in China. Lancet Diabetes Endocrinol, 2021, 9(6): 330-332.
36.	Wang F, Wang C, Xia H. Burden of prostate cancer in China, 1990-2019: findings from the 2019 global burden of disease study. Front Endocrinol (Lausanne), 2022, 13: 853623.
37.	Sun K, Zheng R, Lei L. Trends in incidence rates, mortality rates, and age-period-cohort effects of cervical cancer China, 2003-2017. China CDC Wkly, 2022, 4(48): 1070-1076.
38.	Zhao F, Qiao Y. Cervical cancer prevention in China: a key to cancer control. Lancet, 2019, 393(10175): 969-970.
39.	Yeh JM, Hur C, Ward ZJ, et al. Contribution of H. pylori and smoking trends to US incidence of intestinal-type noncardia gastric adenocarcinoma: a microsimulation model. PLoS Med, 2013, 10(5): e1001451.
40.	Chen Z, Xu Y, Xin L, et al. Summary of the 2024 report on gastroenterology and digestive endoscopy in China. Chin Med J (Engl), 2025, 138(21): 2693-2701.
41.	Chen R, Liu Y, Song G. Effectiveness of one-time endoscopic screening programme in prevention of upper gastrointestinal cancer in China: a multicentre population-based cohort study. Gut, 2021, 70(2): 251-260.
42.	Zauber AG, Winawer SJ, O'Brien MJ. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med, 2012, 366(8): 687-696.
43.	Jiao. Development and status quo of digestive endoscopy in China: an analysis based on the national census in 2024. J Trans Int Med, 2024, 12(2): 177-187.
44.	Chen H, Li N, Ren J. Participation and yield of a population-based colorectal cancer screening programme in China. Gut, 2019, 68(8): 1450-1457.
45.	Fan X, Qin X, Zhang Y. Screening for gastric cancer in China: advances, challenges and visions. Chin J Cancer Res, 2021, 33(2): 168-180.
46.	Collaborators GRTC. Global, regional, and national burden of respiratory tract cancers and associated risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Respir Med, 2021, 9(9): 1030-1049.
47.	de Koning HJ, van der Aalst CM, de Jong PA. Reduced lung-cancer mortality with volume CT screening in a randomized trial. N Engl J Med, 2020, 382(6): 503-513.
48.	Fedewa SA, Bandi P, Smith RA. Lung cancer screening rates during the COVID-19 pandemic. Chest, 2022, 161(2): 586-589.
49.	Smith RA, Andrews KS, Brooks D. Cancer screening in the United States, 2019: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin, 2019, 69(3): 184-210.
50.	Zeng H, Chen W, Zheng R. Changing cancer survival in China during 2003–15: a pooled analysis of 17 population-based cancer registries. Lancet Glob Health, 2018, 6(5): e555-e567.
51.	Fan L, Strasser-Weippl K, Li JJ. Breast cancer in China. Lancet Oncol, 2014, 15(7): e279-e289.
52.	Monticciolo DL, Malak SF, Friedewald SM. Breast cancer screening recommendations inclusive of all women at average risk: update from the ACR and Society of Breast Imaging. J Am Coll Radiol, 2021, 18(9): 1280-1288.
53.	Berry DA, Cronin KA, Plevritis SK. Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med, 2005, 353(17): 1784-1792.
54.	Wang S, Ji Y, Ren M. Estimating the proportion of overdiagnosis among prostate, breast, and thyroid cancers in China: findings from the global burden of disease 2019. Curr Oncol, 2024, 31(9): 5643-5651.
55.	Ma Z, Zhu Y, Ye D. Prostate cancer in China: changes in epidemiology and standard of care. Asian J Urol, 2020, 7(1): 1-2.
56.	Liu C, Piao H, Zhang T. Delayed diagnosis and treatment of cancer patients during the COVID-19 pandemic in Henan, China: an interrupted time series analysis. Front Public Health, 2022, 10: 881718.
57.	Wei WQ, Chen ZF, He YT. Long-term follow-up of a community assignment, one-time endoscopic screening study of esophageal cancer in China. J Clin Oncol, 2015, 33(17): 1951-1957.
58.	Wang G, Wei W, Editor-in-Chief. Screening and Early Diagnosis and Treatment Techniques for Upper Gastrointestinal Cancer: 2020 Pilot Edition. Beijing: People's Medical Publishing House, 2020: 1.
59.	Ajani JA, D'Amico TA, Bentrem DJ. Gastric cancer, version 2. 2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2022, 20(2): 167-192.
60.	Giaquinto AN, Miller KD, Tossas K. Cancer statistics for African American/Black People 2024. CA Cancer J Clin, 2024, 74(3): 213-239.
61.	Liu Y, Lai F, Long J. Screening and the epidemic of thyroid cancer in China: an analysis of national representative inpatient and commercial insurance databases. Int J Cancer, 2021, 148(5): 1106-1114.

1. Bray F, Laversanne M, Weiderpass E. The ever-increasing global burden of cancer due to population growth and ageing. Int J Cancer, 2024, 154(8): 123-135.
2. Siegel RL, Kratzer TB, Wagle NS. Cancer statistics, 2026. CA Cancer J Clin, 2026: e70043.
3. Plummer M, de Martel C, Vignat J. Global burden of cancers attributable to infections in 2012: a synthetic analysis. Lancet Glob Health, 2016, 4(9): e609-e616.
4. Han B, Zheng R, Zeng H. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent, 2024, 4(1): 47-53.
5. Chen W, Zheng R, Baade PD. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
6. Fidler MM, Bray F, Soerjomataram I. The global cancer burden and human development: a review. Scand J Public Health, 2018, 46(1): 27-36.
7. Li X. The burden of cancer in China, 2016-2030. J Glob Health, 2021, 11: 04074.
8. Committee HCAP. Editor-in Chief. Healthy China Action (2019-2030). Beijing: People's Medical Publishing House, 2019: 70-71 .
9. He J, Chen W. Cancer prevention and control in China: progress and challenges. Lancet, 2023, 401: S10.
10. 徐瑞, 王華, 車焱, 等. "Cancer Statistics 2025"解讀: 中美癌癥流行病學特征與長期趨勢比較研究. 中國胸心血管外科臨床雜志, 2025, 32(4): 442-452.Xu R, Wang H, Che Y, et al. Interpretation of "Cancer Statistics 2025": A comparative study on the epidemiological characteristics and long-term trends of cancer in China and the United States. Chin J Clin Thorac Cardiovasc Surg, 2025, 32(4): 442-452.
11. Bray F, Laversanne M, Sung H. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
12. Vostakolaei FA. The validity of the mortality to incidence ratio as a proxy for site-specific cancer survival. Eur J Public Health, 2011, 21(5): 573-577.
13. Goddard KAB, Feuer EJ, Mandelblatt JS. Estimation of cancer deaths averted from prevention, screening, and treatment efforts, 1975-2020. JAMA Oncol, 2024, 10(7): 933-942.
14. Tervonen HE, Roder D, Morrell S. Does exclusion of cancers registered only from death-certificate information diminish socio-demographic disparities in recorded survival? Cancer Epidemiol, 2017, 48: 70-77.
15. Centers for Disease Control and Prevention (CDC). Use of cancer screening tests: United States, 2023. Prev Chronic Dis, 2025, 22: E139.
16. Hugosson J, Roobol MJ, M?nsson M. A 16-yr follow-up of the European Randomized study of Screening for Prostate Cancer. Eur Urol, 2019, 76(1): 43-51.
17. Giaquinto AN, Sung H, Newman LA. Breast cancer statistics 2024. CA Cancer J Clin, 2024, 74(1): 20-41.
18. Star J, Bandi P, Nargis N. Updated review of major cancer risk factors and screening test use in the United States, with a focus on changes during the COVID-19 pandemic. Cancer Epidemiol Biomarkers Prev, 2023, 32(7): 879-888.
19. Vaccarella S, Franceschi S, Bray F. Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. N Engl J Med, 2016, 375(7): 614-617.
20. Cao B, Bray F, Ilbawi A. Effect on longevity of 15 years of the WHO Framework Convention on Tobacco Control: a simulation study. Lancet Public Health, 2024, 9(2): e120-e130.
21. Parascandola M, Xiao L. Tobacco and the lung cancer epidemic in China. Transl Lung Cancer Res, 2019, 8(Suppl 1): S21-S30.
22. Wang J, Yang L, Nie J. Air pollution and health in China: progress and challenges. Lancet Planet Health, 2019, 3(2): e57-e58.
23. Sun D, Cao M, Li H. Cancer burden in China: trends, risk factors and prevention. Cancer Biol Med, 2020, 17(4): 879-895.
24. Wu Y, He S, Cao M. Comparative analysis of cancer statistics in China and the United States in 2024. Chin Med J (Engl), 2024, 137(24): 3093-3100.
25. Moolgavkar SH, Holford TR, Levy DT. Impact of reduced tobacco smoking on lung cancer mortality in the United States during 1975-2000. J Natl Cancer Inst, 2012, 104(7): 541-548.
26. Jeon J, Holford TR, Levy DT. Smoking and lung cancer mortality in the United States from 2015 to 2065: a comparative modeling approach. Ann Intern Med, 2018, 169(10): 684-693.
27. Jemal A, Fedewa SA, Ma J. Higher lung cancer incidence in young women than young men in the United States. N Engl J Med, 2018, 378(21): 1999-2009.
28. Vermeulen R, Downward GS, Zhang J. Constituents of household air pollution and lung cancer risk among never-smoking women in Xuanwei, China. Environ Health Perspect, 2019, 127(9): 97001.
29. Seow WJ, Hu W, Vermeulen R. Household air pollution and lung cancer in China: a review of studies in Xuanwei. Chin J Cancer, 2014, 33(10): 471-475.
30. Midha A, Dearden S, McCormack R. EGFR mutation incidence in non-small-cell lung cancer of adenocarcinoma histology: a systematic review and global map by ethnicity (mutMapⅡ). Am J Cancer Res, 2015, 5(9): 2892-2911.
31. Shi Y, Au JS, Thongprasert S. A prospective, molecular epidemiology study of EGFR mutations in Asian patients with advanced non-small-cell lung cancer of adenocarcinoma histology (PIONEER). J Thorac Oncol, 2014, 9(2): 154-162.
32. Song J, Hwang EJ, Yoon SH. CT screening challenges amid rising threat of lung cancer in individuals Who have never smoked. Radiology, 2026, 318(1): e251305.
33. Xie D, Zhang L, He N. Overdiagnosis of lung cancer due to the introduction of low-dose computed tomography in average-risk populations in the People's Republic of China. J Thorac Oncol, 2025, 20(7): 884-896.
34. Zhu Q, Liu J, Hu J. The epidemiological landscape of thyroid cancer and estimates of overdiagnosis in China: a population-based study. Thyroid, 2025, 35(2): 307-320.
35. Li M, Zheng R, Dal Maso L. Mapping overdiagnosis of thyroid cancer in China. Lancet Diabetes Endocrinol, 2021, 9(6): 330-332.
36. Wang F, Wang C, Xia H. Burden of prostate cancer in China, 1990-2019: findings from the 2019 global burden of disease study. Front Endocrinol (Lausanne), 2022, 13: 853623.
37. Sun K, Zheng R, Lei L. Trends in incidence rates, mortality rates, and age-period-cohort effects of cervical cancer China, 2003-2017. China CDC Wkly, 2022, 4(48): 1070-1076.
38. Zhao F, Qiao Y. Cervical cancer prevention in China: a key to cancer control. Lancet, 2019, 393(10175): 969-970.
39. Yeh JM, Hur C, Ward ZJ, et al. Contribution of H. pylori and smoking trends to US incidence of intestinal-type noncardia gastric adenocarcinoma: a microsimulation model. PLoS Med, 2013, 10(5): e1001451.
40. Chen Z, Xu Y, Xin L, et al. Summary of the 2024 report on gastroenterology and digestive endoscopy in China. Chin Med J (Engl), 2025, 138(21): 2693-2701.
41. Chen R, Liu Y, Song G. Effectiveness of one-time endoscopic screening programme in prevention of upper gastrointestinal cancer in China: a multicentre population-based cohort study. Gut, 2021, 70(2): 251-260.
42. Zauber AG, Winawer SJ, O'Brien MJ. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med, 2012, 366(8): 687-696.
43. Jiao. Development and status quo of digestive endoscopy in China: an analysis based on the national census in 2024. J Trans Int Med, 2024, 12(2): 177-187.
44. Chen H, Li N, Ren J. Participation and yield of a population-based colorectal cancer screening programme in China. Gut, 2019, 68(8): 1450-1457.
45. Fan X, Qin X, Zhang Y. Screening for gastric cancer in China: advances, challenges and visions. Chin J Cancer Res, 2021, 33(2): 168-180.
46. Collaborators GRTC. Global, regional, and national burden of respiratory tract cancers and associated risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Respir Med, 2021, 9(9): 1030-1049.
47. de Koning HJ, van der Aalst CM, de Jong PA. Reduced lung-cancer mortality with volume CT screening in a randomized trial. N Engl J Med, 2020, 382(6): 503-513.
48. Fedewa SA, Bandi P, Smith RA. Lung cancer screening rates during the COVID-19 pandemic. Chest, 2022, 161(2): 586-589.
49. Smith RA, Andrews KS, Brooks D. Cancer screening in the United States, 2019: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin, 2019, 69(3): 184-210.
50. Zeng H, Chen W, Zheng R. Changing cancer survival in China during 2003–15: a pooled analysis of 17 population-based cancer registries. Lancet Glob Health, 2018, 6(5): e555-e567.
51. Fan L, Strasser-Weippl K, Li JJ. Breast cancer in China. Lancet Oncol, 2014, 15(7): e279-e289.
52. Monticciolo DL, Malak SF, Friedewald SM. Breast cancer screening recommendations inclusive of all women at average risk: update from the ACR and Society of Breast Imaging. J Am Coll Radiol, 2021, 18(9): 1280-1288.
53. Berry DA, Cronin KA, Plevritis SK. Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med, 2005, 353(17): 1784-1792.
54. Wang S, Ji Y, Ren M. Estimating the proportion of overdiagnosis among prostate, breast, and thyroid cancers in China: findings from the global burden of disease 2019. Curr Oncol, 2024, 31(9): 5643-5651.
55. Ma Z, Zhu Y, Ye D. Prostate cancer in China: changes in epidemiology and standard of care. Asian J Urol, 2020, 7(1): 1-2.
56. Liu C, Piao H, Zhang T. Delayed diagnosis and treatment of cancer patients during the COVID-19 pandemic in Henan, China: an interrupted time series analysis. Front Public Health, 2022, 10: 881718.
57. Wei WQ, Chen ZF, He YT. Long-term follow-up of a community assignment, one-time endoscopic screening study of esophageal cancer in China. J Clin Oncol, 2015, 33(17): 1951-1957.
58. Wang G, Wei W, Editor-in-Chief. Screening and Early Diagnosis and Treatment Techniques for Upper Gastrointestinal Cancer: 2020 Pilot Edition. Beijing: People's Medical Publishing House, 2020: 1.
59. Ajani JA, D'Amico TA, Bentrem DJ. Gastric cancer, version 2. 2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2022, 20(2): 167-192.
60. Giaquinto AN, Miller KD, Tossas K. Cancer statistics for African American/Black People 2024. CA Cancer J Clin, 2024, 74(3): 213-239.
61. Liu Y, Lai F, Long J. Screening and the epidemic of thyroid cancer in China: an analysis of national representative inpatient and commercial insurance databases. Int J Cancer, 2021, 148(5): 1106-1114.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Latest ArticlesInterpretation of "Cancer Statistics, 2026": Comparative study on cancer epidemiological characteristics and prevention and control effectiveness between China and the United States

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