Editor’s Note: The just-released 2012 China Tumor Registry Annual Report shows that the incidence of tumors in China is about 3.12 million cases, and the incidence rate is higher in urban than in rural areas, regardless of gender. In this regard, Cheng Lin, deputy director of the Breast Center of Peking University People’s Hospital, believes that although it is possible that many rural cancer cases are not counted, according to the experience of developed countries, the industrialization process is bound to be accompanied by an increase in cancer incidence. China is currently undergoing rapid urbanization and should pay more attention to the prevention and treatment of cancer. The following is the transcript of Cheng Lin’s interview with Xinhua. Reporter: Hello, Dr. Cheng Lin! Thank you for your interview with us. You especially pointed out the relationship between urbanization and cancer, and the statistical survey on cancer in China also showed that the cancer rate in urban areas is significantly higher than that in rural areas, what are the reasons behind? Cheng Lin: First of all, we need to clarify that the registration system in China is not very perfect, and the statistics may do better in urban areas. In rural areas, because China is so big, many remote rural areas may not be counted. However, we can confirm that there is a relationship between industrialization and urbanization and the increase of cancer incidence. This is related to the urban lifestyle. For example, industrial pollution, the accelerated pace of life in the city, the greater pressure of people’s lives, and so on. In the past, there were people who said “five cancers in cities”, which refer to lung cancer, breast cancer, colorectal cancer, upper gastrointestinal cancer and liver cancer. There is some truth to this. The current clinical situation, I am afraid to add one more prostate cancer. The chances of getting prostate cancer are increasing because people are living longer. The industrialization process in China over the years has, to some extent, repeated the same path as in the western developed countries. We can see statistically that cancer rates are increasing in many cities. The incidence of cancer is basically increasing in parallel with the pollution index brought about by economic development. There is also the improvement in the quality of life. For example, breast cancer and colorectal cancer are definitely related to the increase of fat intake. Reporter: According to statistics, the incidence rate of cancer is rapidly increasing in the age group above 40 years old, which means that people above 40 years old have become a “high-risk group” for cancer. Cheng Lin: In fact, we used to think that cancer is an “old age disease”, usually people after 50 years old get it. 20 years ago, if a hospital received a cancer patient in his 30s or 40s, it was very rare. Cancer is a chronic disease, which may be latent for a long time, and then stimulated by external factors after middle age, causing mutation of cell genes. Therefore, middle-aged people are reminded to pay special attention to the prevention of cancer. Reporter: In fact, cancer is getting younger in recent years, and in October 2012, Qilu Evening News reported that cancer cells were detected in a 2-year-old baby, and the report also pointed out that cancer patients in the post-80s and post-90s are gradually increasing. Does this seem to be the case from the cases you have treated? What are the characteristics of these younger people who have cancer? Cheng Lin: I haven’t read this report and I don’t know what kind of cancer it refers to. Because cancer is a general term, it includes cancers that are prone to occur in various age groups. For example, leukemia, retinoblastoma, these cancers happen more often in children. So it is not surprising. It would be strange if lung cancer or liver cancer was detected in children. But the low age of cancer is really a factor worth noting. We now receive a cancer patient in their 30s almost every month, which used to be uncommon. Sometimes there are even college students in their 20s. According to our observation, these young people who have cancer had greater psychological trauma before they got cancer. For example, adolescent depression. I also met one some time ago who had a disharmonious family relationship and was a single parent. Others had a family history of genetic predisposition, with three or four relatives in the family having cancer. All these factors have something to do with the low age of cancer. Reporter: Recently there have been a lot of media reports about cancer. Some media quoted data that 6 people are diagnosed with cancer every minute in China, 5 people die from cancer, and the probability of people getting cancer in their lifetime is 22%. Is cancer really so close to us? Cheng Lin: If we say that 6 people get cancer every minute, this number is reliable. After all, China has a large population base of more than one billion people, so it is not an exaggeration to convert it into this number. However, if it is said that the chance of cancer in a person’s life is 22%, one in five people will get cancer, it is definitely an exaggeration, which may have something to do with the conversion method. Because as I said earlier, cancer is a general term which includes all kinds of tumors, from leukemia, liver cancer, prostate cancer and so on. There are very many kinds. However, it is an indisputable fact that the incidence of cancer has increased, and we cannot ignore it. Especially cancer needs to be detected and treated early, the earlier it is treated, the better the treatment, the less money spent and the better the results. Reporter: We know that emotion has a great influence on cancer, and there is a saying of “cancer personality” in the society, which means people with depressive personality are prone to cancer. Is there any scientific basis? Cheng Lin: This is from psychology, psychology divided people into four types of ABCD personality, type A pursuit of perfection, career-oriented, to their own urgency, such people have a greater chance of cardiovascular, hypertensive disease. You just learn to say “cancer personality” usually refers to type C, this kind of person introverted, no outlet, life is always pleasing to others, is usually what we call “good old boy”, this kind of person will be buried in the heart of the unhappy. That will also have an impact on the immune system, causing your immunity to decline. At the same time, such people often have a greater psychological burden, which may lead to cancer. However, I do not advocate labeling such people. It is easy to distinguish the “good old boy” personality type in life. Not really. In my clinical practice, I have also met cancer patients with cheerful personalities. Therefore, it is not comprehensive to attribute to personality. In particular, we also say that “it is easy to change one’s nature, but it is hard to change one’s character”. Therefore, I disagree with the expression “cancer personality”, which will increase the psychological pressure of people with type C personality. Reporter: According to a statistical report by Cancer Research UK on January 29, men in the UK are more than 35% more likely to die from cancer than women. If we exclude cancers with high gender correlation such as prostate, testicular and ovarian cancers, men in the UK are 67% more likely to die from cancer than women. We have not found the most recent authoritative survey on this in China, what is the situation in China based on your experience in the medical field? What does this tell us about the problem? Cheng Lin: Clinically speaking, men are more likely to develop cancer than women. The mortality rate of male cancer patients is also higher than that of female cancer patients. This is true from a worldwide perspective. Including the average age of people in the world, men are also lower than women. This is also true in China. This should be seen from two aspects: one is the working environment, for example, more men than women work outdoors and in polluted environment, and they have a higher chance of receiving bad environment than women; the second is the living environment, men are more likely to get involved in bad habits such as smoking and drinking. Therefore, the chance of cancer is also higher. In addition, men are under higher pressure in life, which is also an important factor. This also requires men to pay more attention to their personal health. Reporter: We know that Chinese medicine and Western medicine are two completely different knowledge and technology systems, but China-Japan Friendship Hospital combines Chinese and Western medicine to treat cancer, how is this achieved? What is the effect? Cheng Lin: Chinese medicine focuses on the whole, it is more like a culture or philosophy. Western medicine focuses on the individual, the local and the microcosm. We believe that TCM can be used as an adjuvant therapy to treat cancer, which can help reduce some of the toxic side effects of the treatment according to the diagnosis. Cancer we now see it more as a chronic disease. We believe that TCM may be better at chronic diseases, for example, chronic cough, where Western medicine is less effective, and TCM is more effective. There are also sequelae of cerebrovascular diseases, and Chinese medicine acupuncture treatment also has a better recovery effect. Chinese and Western medicine should find the right position in order to maximize their curative effects. Reporter: What specific suggestions do you have for the general public regarding cancer prevention and treatment? Cheng Lin: The earlier cancer is detected, the better it is treated. Especially for people over 40 years old, they should care more about their health. In terms of cancer prevention, we have not found a clear root cause of the disease, but the influencing factors are clear, smoking and drinking are important influencing factors. In terms of diet, do not eat too much fat, and consume green vegetables and coarse fiber foods regularly. Also we should pay attention to the management of bad emotions and keep a healthy, upward and happy state of mind. For some clear cancer-causing factors we should avoid or quit, such as smoking, for example, Helicobacter pylori infection, hepatitis B virus infection have active means to get rid of or prevent. Lin Cheng, Deputy Chief Physician, Breast Center, Peking University People’s Hospital She received her PhD degree in Surgery from Peking University Medical School in 2003 and was selected for an EPU scholarship to conduct postdoctoral research at the Medical University of Vienna in 2007, where she received systematic clinical and scientific training under the supervision of Prof. Gnant, President of the Austrian Breast and Colorectal Cancer Society (ABCSG). She is currently the Deputy Chief Physician of the Breast Center of Peking University People’s Hospital. She has published several papers in core journals. She is mainly engaged in the diagnosis and treatment of breast diseases, especially breast cancer. She specializes in breast cancer surgery and comprehensive treatment, image guided breast aspiration, sentinel lymph node biopsy and other comprehensive breast cancer treatment.