Background:The level of premature deaths(deaths among those aged 30-69 years)caused by cancer is an important indicator of evaluating the level of cancer prevention and control.However,the current burden and temporal ...Background:The level of premature deaths(deaths among those aged 30-69 years)caused by cancer is an important indicator of evaluating the level of cancer prevention and control.However,the current burden and temporal trends in cancer-related premature deaths,and their impact on life expectancy at the global,regional,and national levels are not clear.Methods:Cancer mortality data for 185 countries were obtained from the GLOBOCAN 2022 database.High-quality cancer mortality data and national population statistics for 47 countries were extracted from the United Nations and national cancer registry databases,covering the period 2003-2022.Countries were classified based on the human development index(HDI).The death probability,the year of life lost(YLL),and the potential gain in life expectancy(PGLE)attributable to premature deaths from site-specific and all-cancers combined were calculated.Results:Globally,the probability of premature cancer deaths was 6.49%(95%UI 6.49-6.50).The YLLs caused by cancer-related premature death were 163.86 million(95%UI 163.70-164.03),constituting 65.58%of the total cancer-related YLLs.The PGLEs were 1.16 years(95%UI 1.16-1.16).The premature death probability increased with higher HDI levels in men,but decreased in women.Cancer-related premature deaths as a proportion of total cancer deaths varied from 18.31%(95%UI 18.20-18.43)in Japan to 84.44%(95%UI 76.10-91.16)in São Toméand Príncipe.Lung cancer was the leading cause of cancer-related premature deaths in men,and breast cancer ranked first in women.By eradicating premature deaths attributable to lung,liver,colorectal,and stomach cancer in men,and to breast,cervical,and lung cancer in women,0.55 years(95%UI 0.55-0.55)and 0.49 years(95%UI 0.49-0.49)of PGLEs could be achieved,accounting for 48.67%and 42.24%of the total PGLEs,respectively.Cancer-related premature deaths decreased significantly in 38 countries during 2003-2022(P<0.05).The probability of premature cancer-related deaths decreased by more than 15.50%from 2015 to 2022 in 16 countries.Conclusions:Cancer-related premature deaths declined in many countries,with 16 of them having achieved the expected reduction by 2022.The current burden of cancer-related premature deaths is profound but varies around the world.Eliminating premature deaths from major cancer types could substantially increase life expectancy,underscoring the importance of prevention and treatment efforts for these cancers.展开更多
[目的]分析1972—2021年江苏省启东市育龄妇女(15~49岁)恶性肿瘤死亡率的长期变化趋势,并预测其后10年死亡率水平。[方法]基于启东市1972—2021年连续肿瘤登记数据,提取15~49岁户籍女性恶性肿瘤死亡病例,计算粗死亡率(crude mortality r...[目的]分析1972—2021年江苏省启东市育龄妇女(15~49岁)恶性肿瘤死亡率的长期变化趋势,并预测其后10年死亡率水平。[方法]基于启东市1972—2021年连续肿瘤登记数据,提取15~49岁户籍女性恶性肿瘤死亡病例,计算粗死亡率(crude mortality rate,CMR)、中国人口标化死亡率(age-standardized mortality rate by Chinese standard population,ASMRC)、世界人口标化死亡率(age-standardized mortality rate by world standard population,ASMRW),采用Joinpoint 4.9.1.0软件计算平均年度变化百分比(average annual percentage change,AAPC),分析死亡率时间趋势变化;通过SAS 9.2软件构建ARIMA模型,预测2022—2031年育龄妇女恶性肿瘤粗死亡率。[结果]1972—2021年启东市育龄妇女恶性肿瘤累计死亡6371例,50年间CMR从1972—1976年的38.89/10万降至2017—2021年的26.75/10万,趋势变化无统计学意义(AAPC=-0.04%,P=0.844);ASMRC从45.81/10万降至19.89/10万(AAPC=-1.56%,P<0.001),ASMRW从43.94/10万降至19.51/10万(AAPC=-1.48%,P<0.001),呈现显著下降趋势。年龄别死亡率随年龄增长呈显著上升趋势,15~19岁组最低(5.84/10万),45~49岁组最高(112.51/10万);除15~19岁年龄组死亡率无明显趋势变化外(AAPC=-0.99%,P=0.299),其余年龄组均存在显著下降趋势(P均<0.05)。1972—2021年启东市育龄妇女恶性肿瘤死亡顺位前10位依次为肝癌、胃癌、乳腺癌、肺癌、白血病、结直肠癌、脑及中枢神经系统肿瘤、淋巴瘤、宫颈癌和胰腺癌,占总恶性肿瘤死亡的89.81%;其中肝癌、胃癌和结直肠癌的ASMRW呈现明显下降趋势(AAPC分别为-3.14%、-1.64%和-1.88%,P均<0.05);而宫颈癌的ASMRW呈现明显上升趋势(AAPC=3.41%,P=0.001)。预测结果显示,2026年启东市育龄妇女恶性肿瘤CMR将降至21.07/10万,2031年进一步降至19.69/10万。[结论]50年来启东市育龄妇女恶性肿瘤标化死亡率显著下降,反映区域癌症防控成效,但粗死亡率无明显变化,且宫颈癌死亡率上升趋势突出,需重点关注;未来10年死亡率将持续降低,仍需针对重点恶性肿瘤(如宫颈癌)和高危年龄组强化早筛早治与健康干预。展开更多
Cancers remain a major health burden with a high mortality rate in China.Basic medical insurance,is the most important element in the financial support system of healthcare resources in both urban and rural areas,and ...Cancers remain a major health burden with a high mortality rate in China.Basic medical insurance,is the most important element in the financial support system of healthcare resources in both urban and rural areas,and requires further understanding to improve health policy.For instance,a single hospital-based prospective cohort study found that esophageal cancer survival outcomes were associated with different healthcare payment patterns and situations.Comparing the extracted literature-data between urban employee basic medical insurance and urban and rural resident basic medical insurance,the proportions of tumor-node-metastasis(TNM)stage I-II were 27.1%and 34.6%,while those of TNM stage IV were 35.0%and 26.1%,respectively.Additionally,high out-of-pocket rate(>60%)of hospitalization was associated with a higher proportion of TNM stage I-II(40.3%vs 26.9%)and a lower proportion of TNM stage IV(22.7%vs 32.8%).In addition,healthcare payment simultaneously influenced or was influenced by the proportions of early and advanced esophageal cancers.The critical difficulty in improving survival of esophageal cancer in populations should be a low proportion of early disease.A more comprehensive and robust public healthcare insurance system is desired to support cancer prevention and control in particular,in order to increase the proportion of early cancers and consequently improve patient survival.Additionally,commercial medical insurance and social charities hope to be fully introduced and encouraged to achieve these goals as active supplement.展开更多
Objective:This study aimed to analyze the temporal trends in cancer mortality in China from 2013-2021 and project the future trends through 2030.Methods:This study was based on the China Causes of Death Surveillance D...Objective:This study aimed to analyze the temporal trends in cancer mortality in China from 2013-2021 and project the future trends through 2030.Methods:This study was based on the China Causes of Death Surveillance Dataset,which covers 2.37 billion person-years.Age-standardized mortality rates(ASMRs)were calculated using Segi’s world standard population and the trends were evaluated via Joinpoint regression.Bayesian age-period-cohort models were used for mortality projections.Contributions of demographic changes(population size and age structure)and risk factors to the mortality burden were quantified using the decomposition analysis.Results:The combined ASMRs for all cancers decreased annually by 2.3%,driven by significant declines in esophageal(4.8%),stomach(4.5%),and liver cancers(2.7%).In contrast,the pancreatic and prostate cancer ASMRs increased by 2.0% and 3.4% annually,respectively.Urban areas demonstrated a more rapid decline in the combined ASMRs for all cancers[average annual percent change(AAPC)=-3.0% in urban areas vs.-2.0% in rural areas],highlighting persistent disparities.Population aging contributed 20%-50% to death increases between 2013 and 2021.The combined ASMRs for all cancers,like the findings of temporal trend analyses,will continue to decrease and the regional(urban and rural)difference is projected to simulate that of the temporal trend through 2030.In fact,cancer deaths are projected to reach 2.4 million by 2030.Conclusions:The cancer burden in China is facing the dual challenges of population aging and urban-rural disparities.It is necessary to prioritize rural screening,control risk factors,such as smoking and diet,and integrate more efficacious cancer prevention and control programmes into the policy to reduce mortality in the future.展开更多
基金supported by the Capital’s Funds for Health Improvement and Research(CFH2024-2G-40214)the CAMS Innovation Fund for Medical Sciences(2021-I2M-1-011,2021-I2M-1-061).
文摘Background:The level of premature deaths(deaths among those aged 30-69 years)caused by cancer is an important indicator of evaluating the level of cancer prevention and control.However,the current burden and temporal trends in cancer-related premature deaths,and their impact on life expectancy at the global,regional,and national levels are not clear.Methods:Cancer mortality data for 185 countries were obtained from the GLOBOCAN 2022 database.High-quality cancer mortality data and national population statistics for 47 countries were extracted from the United Nations and national cancer registry databases,covering the period 2003-2022.Countries were classified based on the human development index(HDI).The death probability,the year of life lost(YLL),and the potential gain in life expectancy(PGLE)attributable to premature deaths from site-specific and all-cancers combined were calculated.Results:Globally,the probability of premature cancer deaths was 6.49%(95%UI 6.49-6.50).The YLLs caused by cancer-related premature death were 163.86 million(95%UI 163.70-164.03),constituting 65.58%of the total cancer-related YLLs.The PGLEs were 1.16 years(95%UI 1.16-1.16).The premature death probability increased with higher HDI levels in men,but decreased in women.Cancer-related premature deaths as a proportion of total cancer deaths varied from 18.31%(95%UI 18.20-18.43)in Japan to 84.44%(95%UI 76.10-91.16)in São Toméand Príncipe.Lung cancer was the leading cause of cancer-related premature deaths in men,and breast cancer ranked first in women.By eradicating premature deaths attributable to lung,liver,colorectal,and stomach cancer in men,and to breast,cervical,and lung cancer in women,0.55 years(95%UI 0.55-0.55)and 0.49 years(95%UI 0.49-0.49)of PGLEs could be achieved,accounting for 48.67%and 42.24%of the total PGLEs,respectively.Cancer-related premature deaths decreased significantly in 38 countries during 2003-2022(P<0.05).The probability of premature cancer-related deaths decreased by more than 15.50%from 2015 to 2022 in 16 countries.Conclusions:Cancer-related premature deaths declined in many countries,with 16 of them having achieved the expected reduction by 2022.The current burden of cancer-related premature deaths is profound but varies around the world.Eliminating premature deaths from major cancer types could substantially increase life expectancy,underscoring the importance of prevention and treatment efforts for these cancers.
文摘[目的]分析1972—2021年江苏省启东市育龄妇女(15~49岁)恶性肿瘤死亡率的长期变化趋势,并预测其后10年死亡率水平。[方法]基于启东市1972—2021年连续肿瘤登记数据,提取15~49岁户籍女性恶性肿瘤死亡病例,计算粗死亡率(crude mortality rate,CMR)、中国人口标化死亡率(age-standardized mortality rate by Chinese standard population,ASMRC)、世界人口标化死亡率(age-standardized mortality rate by world standard population,ASMRW),采用Joinpoint 4.9.1.0软件计算平均年度变化百分比(average annual percentage change,AAPC),分析死亡率时间趋势变化;通过SAS 9.2软件构建ARIMA模型,预测2022—2031年育龄妇女恶性肿瘤粗死亡率。[结果]1972—2021年启东市育龄妇女恶性肿瘤累计死亡6371例,50年间CMR从1972—1976年的38.89/10万降至2017—2021年的26.75/10万,趋势变化无统计学意义(AAPC=-0.04%,P=0.844);ASMRC从45.81/10万降至19.89/10万(AAPC=-1.56%,P<0.001),ASMRW从43.94/10万降至19.51/10万(AAPC=-1.48%,P<0.001),呈现显著下降趋势。年龄别死亡率随年龄增长呈显著上升趋势,15~19岁组最低(5.84/10万),45~49岁组最高(112.51/10万);除15~19岁年龄组死亡率无明显趋势变化外(AAPC=-0.99%,P=0.299),其余年龄组均存在显著下降趋势(P均<0.05)。1972—2021年启东市育龄妇女恶性肿瘤死亡顺位前10位依次为肝癌、胃癌、乳腺癌、肺癌、白血病、结直肠癌、脑及中枢神经系统肿瘤、淋巴瘤、宫颈癌和胰腺癌,占总恶性肿瘤死亡的89.81%;其中肝癌、胃癌和结直肠癌的ASMRW呈现明显下降趋势(AAPC分别为-3.14%、-1.64%和-1.88%,P均<0.05);而宫颈癌的ASMRW呈现明显上升趋势(AAPC=3.41%,P=0.001)。预测结果显示,2026年启东市育龄妇女恶性肿瘤CMR将降至21.07/10万,2031年进一步降至19.69/10万。[结论]50年来启东市育龄妇女恶性肿瘤标化死亡率显著下降,反映区域癌症防控成效,但粗死亡率无明显变化,且宫颈癌死亡率上升趋势突出,需重点关注;未来10年死亡率将持续降低,仍需针对重点恶性肿瘤(如宫颈癌)和高危年龄组强化早筛早治与健康干预。
基金Supported by the Foundation of Science and Technology Department of Sichuan Province,China,No.23ZDYF0839Ya'an Science and Technology Plan of Economic and Social Development(Health Field),Ya’an,China,No.2024-1the Ya’an Philosophic and Social Science Research Plan,Ya’an,China,No.YAA20240035.
文摘Cancers remain a major health burden with a high mortality rate in China.Basic medical insurance,is the most important element in the financial support system of healthcare resources in both urban and rural areas,and requires further understanding to improve health policy.For instance,a single hospital-based prospective cohort study found that esophageal cancer survival outcomes were associated with different healthcare payment patterns and situations.Comparing the extracted literature-data between urban employee basic medical insurance and urban and rural resident basic medical insurance,the proportions of tumor-node-metastasis(TNM)stage I-II were 27.1%and 34.6%,while those of TNM stage IV were 35.0%and 26.1%,respectively.Additionally,high out-of-pocket rate(>60%)of hospitalization was associated with a higher proportion of TNM stage I-II(40.3%vs 26.9%)and a lower proportion of TNM stage IV(22.7%vs 32.8%).In addition,healthcare payment simultaneously influenced or was influenced by the proportions of early and advanced esophageal cancers.The critical difficulty in improving survival of esophageal cancer in populations should be a low proportion of early disease.A more comprehensive and robust public healthcare insurance system is desired to support cancer prevention and control in particular,in order to increase the proportion of early cancers and consequently improve patient survival.Additionally,commercial medical insurance and social charities hope to be fully introduced and encouraged to achieve these goals as active supplement.
基金supported by the CAMS Innovation Fund for Medical Sciences(Grant No.2021-I2M-1-011)the Capital’s Funds for Health Improvement and Research(Grant No.CFH2024-2G-40214).
文摘Objective:This study aimed to analyze the temporal trends in cancer mortality in China from 2013-2021 and project the future trends through 2030.Methods:This study was based on the China Causes of Death Surveillance Dataset,which covers 2.37 billion person-years.Age-standardized mortality rates(ASMRs)were calculated using Segi’s world standard population and the trends were evaluated via Joinpoint regression.Bayesian age-period-cohort models were used for mortality projections.Contributions of demographic changes(population size and age structure)and risk factors to the mortality burden were quantified using the decomposition analysis.Results:The combined ASMRs for all cancers decreased annually by 2.3%,driven by significant declines in esophageal(4.8%),stomach(4.5%),and liver cancers(2.7%).In contrast,the pancreatic and prostate cancer ASMRs increased by 2.0% and 3.4% annually,respectively.Urban areas demonstrated a more rapid decline in the combined ASMRs for all cancers[average annual percent change(AAPC)=-3.0% in urban areas vs.-2.0% in rural areas],highlighting persistent disparities.Population aging contributed 20%-50% to death increases between 2013 and 2021.The combined ASMRs for all cancers,like the findings of temporal trend analyses,will continue to decrease and the regional(urban and rural)difference is projected to simulate that of the temporal trend through 2030.In fact,cancer deaths are projected to reach 2.4 million by 2030.Conclusions:The cancer burden in China is facing the dual challenges of population aging and urban-rural disparities.It is necessary to prioritize rural screening,control risk factors,such as smoking and diet,and integrate more efficacious cancer prevention and control programmes into the policy to reduce mortality in the future.
