To explore the mortality and probability of premature mortality caused by four major NCDs (cardiovascular and cerebrovascular diseases, cancer, diabetes and chronic respiratory disease) in Pudong New Area of Shanghai from 2002 to 2020, providing a reference for the development of measures to the target of reducing the probability of premature mortality due to these four major NCDs in the Health China 2030 plan.

This analysis was conducted in May 2021 based on data collected from Pudong New Area's Residents Death Surveillance Database, involving registered residents of Pudong New Area who died of cardiovascular and cerebrovascular diseases, cancer, diabetes and chronic respiratory disease between 2002-01-01 and 2020-12-31. Crude mortality, age-standardized mortality and probability of premature mortality were used for analyzing deaths due to the four above-mentioned NCDs. The annual percent change (APC) was adopted to analyze the temporal trend of mortality and probability of premature mortality.

The crude mortality of four major NCDs ascended from 526.82/100 000 in 2002 to 678.84/100 000 in 2020 (APC=1.56%, Z=13.715, P<0.001) . The age-standardized mortality of four major NCDs decreased from 404.05/100 000 in 2002 to 260.87/100 000 in 2020 (APC=-2.09%, Z=-12.428, P<0.001) . The probability of premature mortality caused by four major NCDs decreased from 13.09% in 2002 to 8.45% in 2020 (APC=-2.31%, Z=-15.847, P<0.001) . The probability of premature mortality caused by cardiovascular and cerebrovascular diseases was declined from 3.57% in 2002 to 2.38% in 2020 (APC=-2.21%, Z=-9.739, P<0.001) , and that caused by cancer decreased from 8.36% to 5.49% (APC=-2.24%, Z=-19.476, P<0.001) , and that by chronic respiratory disease reduced from 1.08% to 0.24% (APC=-7.23%, Z=-13.326, P<0.001) . No significant temporal trend for the probability of premature mortality caused by diabetes was found (Z=-0.395, P=0.698) . The probability of premature mortality caused by four major NCDs in males was higher than that in females. According to the annual increase rates during 2015 to 2020, it is estimated that the probability of premature mortality caused by these four major NCDs would be 6.67%.

The crude mortality of the four major NCDs in Pudong New Area ascended during 2002—2020, and both the age-standardized mortality and the probability of premature mortality showed a downward tendency in the same period. Pudong New Area had achieved the goal in the Health China 2020 plan of reducing the probability of premature mortality of four NCDs in 2020. However, according to the present annual increase rates, the task of achieving the Health China 2030 target of the decent of the probability of premature mortality caused by four major NCDs would be daunting. Thus, more measures should be taken to strengthen the containment of such NCDs. Moreover, males should be treated as the key group, and more attention should be paid to the premature death caused by diabetes in males.