Chronic Disease in China - Progress in Chronic Disease Prevention and Control

Progress in Chronic Disease Prevention and Control

The establishment of Chinese cancer registries began in 1963 in Shanghai, and data from registries led to some of the first programs that addressed chronic diseases in China. For example, mortality from cervical cancer in the Jing'an county of Jiangxi province decreased to 9.6 per 100 000 in 1985 from 42.0 per 100 000 in 1974, at least in part a result of the introduction of the "early detection, early diagnosis and early treatment" of cervical cancer (Kong L, unpublished). Cancer has led the way in chronic disease control initiatives. In 2003, the Ministry of Health of the People's Republic of China, which is responsible for health policy, completed a national cancer control plan on the basis of expert opinions in diverse fields. Some elements of the Program of Cancer Prevention and Control in China (2004–2010) are now being implemented, for example with rapid diagnosis and screening trials for cervical cancer.

Between 1991 and 2000, a community-based intervention trial on management of diabetes and hypertension was done in an urban population of 300,000 in three cities (Beijing, Shanghai, and Changsha). The most notable outcomes were that the incidence of stroke decreased by 52% in men and 53% in women, and the mortality rate of stroke fell by 54% overall.

In 1995, the World Bank Loan Health VII: China Disease Prevention Project—health promotion component (1996–2002) began in seven cities: Beijing, Tianjin, Shanghai, Chengdu, Luoyang, Liuzhou and Weihai, and some regions of Yunnan province. The program covered about 90 million people. To date, among the chronic diseases outcomes reported are an overall reduction of 15% in the prevalence of male adult cigarette smokers, and in Beijing substantial increases in hypertension detection and treatment with a fall in cardiovascular disease death rates of more than 15% in the last year of the project (Wu Z, Director, Beijing Institute of Heart, Lung and Blood Vessel Diseases, personal communication).

Based on the experience of this project, the Ministry of Health began establishing demonstration sites for chronic disease prevention and control nationwide in 1997. There are currently 32 community-based sites and the major activities include community diagnosis, community mobilization, development of integrated community interventions (smoking control, healthy diet, physical activity, hypertension prevention, mental health, prevention and control of cardiovascular disease, diabetes, cancer, chronic respiratory disease), training, and evaluations of interventions.