Cancer survival in Hebei Province, China (2009–2018): a population-based study

Population-based survival is the key indicator for evaluating cancer-control effectiveness. This study aims to conduct a comprehensive population-based cancer survival analysis in Hebei Province, China, utilizing data from population-based cancer registries. We included 139,293 first primary invasive cancers diagnosed during 2009–2018 and followed up to 31 December 2025 from 13 population-based registries in Hebei province. Five-year age-standardized relative survival (ASRS) for 2009–2018 were computed with the cohort approach. Trends were quantified with Joinpoint regression. Overall 5-year ASRS was 47.7% (95% confidence interval [CI]: 47.4%-48.0%). Thyroid (89.3%), uterus (78.8%), breast (77.6%), testis (76.2%), cervix (70.1%) and bladder (69.4%) showed the highest ASRS; pancreas (13.0%), liver (18.6%), lung (30.4%), gallbladder (36.4%), and oesophagus (37.0%) showed the lowest ASRS. Survival was higher in women (ASRS = 55.7%) than men (ASRS = 40.8%). The age-specific relative survival declined from 67.8% (≤ 44 years) to 33.0% (≥ 75 years). Between 2009 and 2018, ASRS increased by 19.7% points, from 40.2% to 59.9% (annual average percent change [AAPC] = 3.14%, 95% CI: 0.28%-8.75%), driven by liver (AAPC = 6.53%, 95% CI: 0.14%-10.75%), laryngeal (AAPC = 4.50%, 95% CI: 2.03%-8.26%), gallbladder (AAPC = 4.20%, 95% CI: 1.36%-12.21%), leukemia (AAPC = 4.06%, 95% CI: 0.25%-13.98%), and esophagus (AAPC = 3.96%, 95% CI: 1.13%-6.23%). Hebei Province has made substantial progress in improving cancer survival, while disparities persist across gender, age groups, and cancer types. Sustained, targeted interventions remain critically important to consolidate existing achievements and advance equity in cancer prevention and control across the province.