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
Background:The oxidative balance score(OBS)is a comprehensive scoring mechanism for evaluating oxidative stress.Previous studies have not yet clarified the correlations between OBS and mortality risk due to the divers...Background:The oxidative balance score(OBS)is a comprehensive scoring mechanism for evaluating oxidative stress.Previous studies have not yet clarified the correlations between OBS and mortality risk due to the diversity of antioxidant and pro-oxidant constituents.This research investigates the relationship between OBS,which is composed of 20 prespecified oxidative stressrelated factors,and the overall and specific-cause mortality.Methods:This study analyzed 24,299 adults aged older than or equal to 18 years from the National Health and Nutrition Examination Survey(NHANES)1999–2018,followed for survival until December 31,2019.Cox proportional hazards regression was used to evaluate the links between the OBS and mortality from all causes,cardiovascular disease(CVD),and cancer,adjusted for several relevant demographic and comorbidity factors.Results:During a median follow-up of 9.6 years,there were 3,003 deaths,including 740 from CVD,746 from cancer.The Kaplan-Meier curves showed a reduced risk of mortality for the subjects with a higher OBS relative to their counterparts in the lowest quartile.The highest OBS quartile was inversely associated with a decreased risk of mortality(all-cause HR:0.68,95%CI:0.60–0.77;CVD HR:0.58,95%CI:0.45–0.74;cancer HR:0.61,95%CI:0.48–0.78)after covariate correction.In addition,a significant link between dietary patterns,lifestyle components,and a significant association with mortality was observed,demonstrating consistency across subgroup analyses.Conclusions:An inverse correlation exists between OBS and mortality from all-cause,CVD,and cancer.These results suggest that diet and lifestyle modifications can substantially impact health outcomes by modulating oxidative balance.展开更多
Objectives:There is a debate on the association between the circulating manganese(Mn)levels and mortality.The aim of this study was to explore the nonlinear association between the serum Mn levels and all-cause or cau...Objectives:There is a debate on the association between the circulating manganese(Mn)levels and mortality.The aim of this study was to explore the nonlinear association between the serum Mn levels and all-cause or cause-specific mortality.Methods:We included 8,145 adults from the United States(US)and their serum Mn concentrations obtained from the National Health and Nutrition Examination Survey(NHANES 2011–2014).We retrieved their survival information from baseline until 2019 using the national death index.Multivariable Cox proportional hazards models were used to show the risk of all-cause or cause-specific mortality according to the baseline serum Mn concentrations.Smooth curve fitting and threshold effect analyses were used to clarify the potential nonlinearity.Results:During a median follow-up of 6.2 years,there were 716 deaths from all causes,224 of which were due to cardiovascular dis-ease(CVD)and 165 due to cancer.The serum Mn levels exhibited a U-shaped relationship with all-cause or CVD-associated mortality.Serum Mn levels lower than the threshold value(7.32μg/L)were negatively associated with all-cause(fully adjusted HR:0.86,95%CI:0.80–0.94)and CVD(fully adjusted HR:0.82,95%CI:0.71–0.94)mortality.In contrast,serum Mn levels higher than the threshold value(7.32μg/L)were positively associated with all-cause(fully adjusted HR:1.04,95%CI:1.02–1.06)and CVD(fully adjusted HR:1.05,95%CI:1.02–1.08)mortality.Conclusions:The serum Mn concentrations showed a U-shaped relationship with all-cause and CVD-associated mortality among NHANES participants.展开更多
Among cancers, lung cancer is the most common cause of death in China. For the prevention and control of lung cancer, it is necessary to investigate the spatial and temporal distribution of lung cancer mortality, as w...Among cancers, lung cancer is the most common cause of death in China. For the prevention and control of lung cancer, it is necessary to investigate the spatial and temporal distribution of lung cancer mortality, as well as the changes in the trend and the affecting mechanism. Based on statistics and auto-correlation analysis, this paper studied the spatial and temporal distribution of lung cancer mortality in Yuhui District, Bengbu, Huaihe River Basin, from 2017 to 2020. In addition, Spearman’s Rank Correlation Assessment Model and Geographic Detector Model were used to examine the relationship between environmental factors and lung cancer mortality to identify impact factors and their mechanisms. The findings indicated that: 1) from the characteristics of temporal distribution, the number of lung cancer deaths exhibited a linear growth tendency, with the highest mortality in winter;2) from the characteristics of spatial distribution, lung cancer mortality showed a strong spatial agglomeration form, concentrating on two clustering areas, located in the old city and the central city of Bengbu, near the Huaihe River;3) from the point of view of the whole research area, there were 15 impact factors with significant correlation in the built and natural environment factors. The significant impacting factors in the built environment included land use, road traffic, spatial form and blue-green space, which could indirectly affect lung cancer mortality, while air pollution and temperature constituted the significant impacting factors in the natural environment;4) the influence of screened environmental factors on lung cancer mortality was different. Spatial stratified heterogeneity assessment, the interaction among environmental factors demonstrated statistical significance, it was found that the interaction between environmental factors in pairs had a significant enhancement effect on lung cancer mortality. To some extent, urban planning and policies could reduce lung cancer mortality.展开更多
Both case-control and cohort studies were undertaken from July 1,1969 to June 30,1983 to ascertain whether exposure to chloroprene increases the risk of cancer.Fifty-five cases of cancer deaths were verified,16 of whi...Both case-control and cohort studies were undertaken from July 1,1969 to June 30,1983 to ascertain whether exposure to chloroprene increases the risk of cancer.Fifty-five cases of cancer deaths were verified,16 of which had histories of exposure to chloroprene ranging from 3 to 23 years(median 11 years)with a latent period of 8-27 years,except for one case of 3 years(median 12.5 years).Fifty-four pairs were obtained by matching the cancer deaths to noncaneer deaths in accordance with strict requirements.The odds ratio for the paired data was 13,x^2=8.64,P <0.005.The average age at death from cancer of workers exposed to chloroprene was 12.7 years younger than that of unexposed workers,t'=2.98,P<0.001.The total cohort consisted of 1213 persons,among whom 149(11.6%)had histories of exposure for over 25 years,381(31.5%) for over 20 years,and 852(70.2%) for over 15 years.The SMR for the total cohort was 2.38(P <0.01),and all SMRs for the high-exposure occupations were of significance(P<0.05or P<0.01),in contrast to those of the low-exposure groups whose SMRs were low or zero.Thus, a dose-response relationship existed.Among the high-exposure occupations,maintenance me- chanics seem to have the highest risk of cancers,and SMRs for liver,lung,and lymphatic cancers were significant in this group.These results suggested that chloroprene exposure increases the risk of developing cancer.1989 Academic Press,Inc.展开更多
Shandong Province, with a population of 84 million and located in the east coastline of China, is rich in natural resources and ranks middle in economic develpment of the whole nation. Around 90000 people are dead of ...Shandong Province, with a population of 84 million and located in the east coastline of China, is rich in natural resources and ranks middle in economic develpment of the whole nation. Around 90000 people are dead of cancer each year. In the recent twenty years, trends in malignant neoplasm展开更多
The daily intake of total dietary fiber (TDF) was evaluated from data of the National Nutrition Survey (NNS) in Japan for 41 years since 1947. An interrelationship between the nutrient intake, including TDF, and the m...The daily intake of total dietary fiber (TDF) was evaluated from data of the National Nutrition Survey (NNS) in Japan for 41 years since 1947. An interrelationship between the nutrient intake, including TDF, and the mortality from colon cancer in Japanese people was calculated by a simple correlation coefficient and time-series correlation coeffcient.TDF intake per capita decreased rapidly from 27.4 g in 1947 to 15.8 g in 1963, and subsequently decreased by a lesser rate to 15.3 g in 1987. Fat intake increased rapidly from 18.0 g in 1950 to 56.6 g in 1987.The age-adjusted mortality from colon cancer shows a significant positive correlation with both the intakes of animal protein and of total fat, and the fat energy ratio. A time-series analysis indicates that the mortality from colon cancer was negatively correlated with TDF with a 15-27 year delay, the maximum correlation existing with a 23-year lag (r = -0.947). The TDF intake was less than 17.9 g in 1965. At the same time, the mortality from colon cancer increased rapidly. A fat/TDF ratio above 3.0 resulted in a rapid increase in colon cancer mortality.The non-adjusted mortality from colon cancer has much the same interrelationship with TDF and fat intake as the adjusted figures. It is suggested that the cause of the increased mortality from colon cancer in Japan is positively related to the increased intake of fat and protein. In addition, the decrease in TDF intake has accelerated the mortality of colon cancer after a delay of 23-24 years. The importance of fat/TDF as a nutritional criterion for the incidence of colon cancer needs to be better recognized展开更多
This study deals with the analysis of relationship between 67 environmental indicators in geological environment and breast cancer mortality in Slovakia. Primary data comprises a database of 67 environmental indicator...This study deals with the analysis of relationship between 67 environmental indicators in geological environment and breast cancer mortality in Slovakia. Primary data comprises a database of 67 environmental indicators for groundwater and soils as a mean value for every Slovak municipality and the data on relative mortality from breast cancer for Slovak municipalities (about 2900) collected for the period of 22 years. The training neural network was used as a mathematical model for data analysis. The top 200 networks have identified 12 environmental indicators (8 for soils: pHKCl, carbonates, Ca, Mg, Na, Co, Sr and 4 for groundwater: Ba, SiO2, Zn, Fe) with high rate of influence. As the most influential environmental indicator was identified pHKCl in soil that should be within the range of acids, definitely under the neutral point. Most of environmental indicators were unambiguously identified as negative (Mg, Ca, Sr, carbonates, Ba, SiO2, Zn and Fe). These indicators should be at the lowest level of their concentration in related geological component. Three environmental indicators, Ce, Na and Co had parabolic function where certain essential concentration levels of these elements are presumed with protective effect on human health. For all influential indicators limit values with respect to the lowest mortality were proposed. The verification of achieved results was performed through regressive model of breast cancer mortality for 12 calculated influential environmental indicators for all municipalities in the Slovak Republic. The revealed difference between real mortality levels and the model values was found for 6 environmental indicators (pHKCl, Mg, Ca, Sr, Ba, Zn). Each executed limit has decreased breast cancer mortality for about 0.79 cases per 100,000 inhabitants.展开更多
Proton pump inhibitors(PPIs)are widely utilized in oncology to treat gastroeso-phageal reflux disease,peptic ulcer disease,and chemotherapy-induced mucosal injury.Emerging evidence has suggested that prolonged use of ...Proton pump inhibitors(PPIs)are widely utilized in oncology to treat gastroeso-phageal reflux disease,peptic ulcer disease,and chemotherapy-induced mucosal injury.Emerging evidence has suggested that prolonged use of PPIs is associated with increased mortality in patients with cancer.The findings of Krishnan et al are proof of this but need to be considered cautiously due to potential confounding factors.This letter raised important methodological concerns,including con-founding by indication,reverse causality,and polypharmacy that can influence the observed association.While PPIs are important in oncology,their advantages and disadvantages should be weighed judiciously by clinicians.Future prospective studies with robust analytical approaches will be required to ascertain more definite causality.展开更多
This commentary delves into the evolving landscape of cancer incidence and mortality in Costa Rica, presenting a comprehensive analysis of the data. Key findings reveal a concerning upward trajectory in cancer inciden...This commentary delves into the evolving landscape of cancer incidence and mortality in Costa Rica, presenting a comprehensive analysis of the data. Key findings reveal a concerning upward trajectory in cancer incidence rates, placing Costa Rica at the forefront within Central America. While prostate cancer and breast cancer dominate, disparities emerge when scrutinizing gender-specific trends. Notably, stomach and cervical cancers show declines, potentially attributed to targeted interventions. However, colorectal and liver cancers witness mortality increases, necessitating strategic responses. Geographical disparities persist across provinces, highlighting the need for equitable healthcare access. In conclusion, this commentary underscores the urgency of addressing the burgeoning cancer burden in Costa Rica, calling for evidence-based interventions and collaborative efforts on a global scale.展开更多
Background:High adiposity and low physical activity are associated with cancer risk.Whether different amounts and intensities of physical activity can mitigate this association is unclear.We aimed to examine the indep...Background:High adiposity and low physical activity are associated with cancer risk.Whether different amounts and intensities of physical activity can mitigate this association is unclear.We aimed to examine the independent and combined associations of adiposity and devicemeasured physical activity levels of different intensities with cancer incidence and mortality.Methods:This prospective cohort study included data from 70,747 UK Biobank participants(mean age=61.6±7.9 years,mean±SD;56.4%women)with wrist-worn accelerometer measurements of physical activity and without chronic diseases or mobility limitations.Physical activity exposures included min per week of light intensity physical activity(LPA),moderate-to-vigorous intensity physical activity(MVPA),and vigorous intensity physical activity(VPA),along with total weekly volume.Body mass index(BMI)was calculated from anthropometric measurements.Participants were categorized into 9 groups based on joint tertiles of physical activity and BMI categories(normal weight,overweight,and obesity).Secondary analyses included adiposity using bio-impedance and waist circumference measurements.The outcome was incidence and death from cancer retrieved from national registries.Associations between adiposity,physical activity,and cancer hazard were calculated as subdistribution hazard ratios.A secondary analysis focused on cancer types strongly associated with physical activity.Results:We observed 2625 events(2572 non-fatal and 53 fatal)during a median follow-up of 6.1 years.Compared with the referent(normal weight and high physical activity),overweight and obesity were associated with a 6%to 36%higher cancer hazard across physical activity intensities.However,high MVPA and VPA(approximately 500 min and 32 min per week in the top tertiles,respectively)attenuated the hazard associated with overweight and obesity.Being normal weight was not associated with a higher cancer hazard regardless of physical activity level.The results were similar,although more pronounced,when modeling cancer types strongly associated with physical activity as the outcome.Conclusion:High MVPA and VPA levels may attenuate the association of overweight and obesity with cancer hazard,but maintaining a normal weight seems comparatively more important than physical activity to reduce the hazard.Maintaining a healthy body weight and engaging in physical activity is needed to minimize risk of some cancer types.展开更多
Objective Although dietary preferences influence chronic diseases,few studies have linked dietary preferences to mortality risk,particularly in large cohorts.To investigate the relationship between dietary preferences...Objective Although dietary preferences influence chronic diseases,few studies have linked dietary preferences to mortality risk,particularly in large cohorts.To investigate the relationship between dietary preferences and mortality risk(all-cause,cancer,and cardiovascular disease[CVD])in a large adult cohort.Methods A cohort of 1,160,312 adults(mean age 62.48±9.55)from the Shenzhen Healthcare Big Data Cohort(SHBDC)was analyzed.Hazard ratios(HRs)for mortality were estimated using the Cox proportional hazards model.Results The study identified 12,308 all-cause deaths,of which 3,865(31.4%)were cancer-related and 3,576(29.1%)were attributed to CVD.Compared with a mixed diet of meat and vegetables,a mainly meat-based diet(hazard ratio[HR]=1.13;95%confidence interval[CI]:1.02,1.27)associated with a higher risk of all-cause mortality,while mainly vegetarian(HR=0.87;95%CI:0.78,0.97)was linked to a reduced risk.Furthermore,there was a stronger correlation between mortality risk and dietary preference in the>65 age range.Conclusion A meat-based diet was associated with an increased risk of all-cause mortality,whereas a mainly vegetarian diet was linked to a reduced risk.展开更多
Background:Little was known about the association among time in range(TIR),time above range(TAR),time below range(TBR),and cancer mortality among patients with type 2 diabetes.We aimed to investigate the association a...Background:Little was known about the association among time in range(TIR),time above range(TAR),time below range(TBR),and cancer mortality among patients with type 2 diabetes.We aimed to investigate the association among TIR,TAR,TBR,and the risk of cancer mortality among patients with type 2 diabetes.Methods:A total of 6225 patients with type 2 diabetes were prospectively recruited in Shanghai,China.TIR was measured with continuous glucose monitoring at baseline and was defined as the average percentage of time in the target glucose range during a 24 h period.Cox proportion hazard regression analysis was used to determine the association between TIR and the risk of cancer mortality.Results:During a mean follow-up of 7.10 years,we confirmed 237 death events related to cancer.The multivariable-adjusted hazard ratio(HR)for cancer mortality was 1.32(95%confidence interval[CI]:1.01-1.75)in patients with TIR≤70%compared with those with TIR>70%.When TIR was considered as a continuous variable,the multivariable-adjusted HR for cancer mortality associated with each 10%decrease in TIR was 1.07(95%CI:1.02-1.14).In the site-specific analysis,a significant association between TIR as a continuous variable and the risk of hepatocellular cancer was found(HR:1.24;95%CI:1.09-1.41).However,no relationship between hemoglobin A1c and cancer mortality was observed(HR:1.04;95%CI:0.97-1.10).Conclusions:The present study found an inverse association of TIR with the risk of cancer mortality among patients with type 2 diabetes.New evidence of TIR was added into the clinical practice that TIR may be an optimal target of glycemic control among patients with type 2 diabetes.展开更多
Background： National Central Cancer Registry of China（NCCRC） updated nationwide cancer statistics using population-based cancer registry data in 2014 collected from all available cancer registries.Methods： In 2017...Background： National Central Cancer Registry of China（NCCRC） updated nationwide cancer statistics using population-based cancer registry data in 2014 collected from all available cancer registries.Methods： In 2017, 449 cancer registries submitted cancer registry data in 2014, among which 339 registries＇ data met the criteria of quality control and were included in analysis. These cancer registries covered 288,243,347 population, accounting for about 21.07% of the national population in 2014. Numbers of nationwide new cancer cases and deaths were estimated using calculated incidence and mortality rates and corresponding national population stratified by area, sex, age group and cancer type. The world Segi＇s population was applied for agestandardized rates.Results： A total of 3,804,000 new cancer cases were diagnosed, the crude incidence rate was 278.07/100,000（301.67/100,000 in males, 253.29/100,000 in females） and the age-standardized incidence rate by world standard population（ASIRW） was 186.53/100,000. Calculated age-standardized incidence rate was higher in urban areas than in rural areas（191.6/100,000 vs. 179.2/100,000）. South China had the highest cancer incidence rate while Southwest China had the lowest incidence rate. Cancer incidence rate was higher in female for population between20 to 54 years but was higher in male for population younger than 20 years or over 54 years. A total of 2,296,000 cancer deaths were reported, the crude mortality rate was 167.89/100,000（207.24/100,000 in males,126.54/100,000 in females） and the age-standardized mortality rate by world standard population（ASMRW） was106.09/100,000. Calculated age-standardized mortality rate was higher in rural areas than in urban areas（110.3/100,000 vs. 102.5/100,000）. East China had the highest cancer mortality rate while North China had the lowest mortality rate. The mortality rate in male was higher than that in female. Common cancer types and major causes of cancer death differed between age group and sex.Conclusions： Heavy cancer burden and its disparities between area, sex and age group pose a major challenge to public health in China. Nationwide cancer registry plays a crucial role in cancer prevention and control.展开更多
Objective: To provide an overview of the incidence and mortality of female breast cancer for countries in the Asia-Pacific region.Methods: Statistical information about breast cancer was obtained from publicly availab...Objective: To provide an overview of the incidence and mortality of female breast cancer for countries in the Asia-Pacific region.Methods: Statistical information about breast cancer was obtained from publicly available cancer registry and mortality databases(such as GLOBOCAN), and supplemented with data requested from individual cancer registries. Rates were directly age-standardised to the Segi World Standard population and trends were analysed using joinpoint models.Results: Breast cancer was the most common type of cancer among females in the region, accounting for 18% of all cases in 2012, and was the fourth most common cause of cancer-related deaths(9%). Although incidence rates remain much higher in New Zealand and Australia, rapid rises in recent years were observed in several Asian countries. Large increases in breast cancer mortality rates also occurred in many areas, particularly Malaysia and Thailand, in contrast to stabilising trends in Hong Kong and Singapore, while decreases have been recorded in Australia and New Zealand. Mortality trends tended to be more favourable for women aged under 50 compared to those who were 50 years or older. Conclusion: It is anticipated that incidence rates of breast cancer in developing countries throughout the Asia-Pacific region will continue to increase. Early detection and access to optimal treatment are the keys to reducing breast cancerrelated mortality, but cultural and economic obstacles persist. Consequently, the challenge is to customise breast cancer control initiatives to the particular needs of each country to ensure the best possible outcomes.展开更多
Objective：In this research,the patterns of cancer incidence and mortality in areas with different gross domestic product per capita（GDPPC）levels in China were explored,using data from population-based cancer regist...Objective：In this research,the patterns of cancer incidence and mortality in areas with different gross domestic product per capita（GDPPC）levels in China were explored,using data from population-based cancer registries in 2013,collected by the National Central Cancer Registry（NCCR）.Methods：Data from 255 cancer registries were qualified and included in this analysis.Based on the GDPPC data of 2014,cities/counties were divided into 3 levels：high-,middle-and low-GDPPC areas,with 40,000 and 80,000 RMB per year as cut points.We calculated cancer incidences and mortalities in these three levels,stratified by gender and age group.The national population of the Fifth Census in 2000 and Segi’s population were applied for age-standardized rates.Results：The crude incidence and mortality rates as well as age-standardized incidence rate（ASIR）showed positive associations with GDPPC level.The age-standardized mortality rate（ASMR）nevertheless showed a negative association with GDPPC level.The ASMR in high-,middle-and low-GDPPC areas was 103.12/100,000,112.49/100,000 and 117.43/100,000,respectively.Lung cancer was by far the most common cancer in all three GDPPC levels.It was also the leading cause of cancer death,regardless of gender and GDPPC level.Negative associations with GDPPC level were found for the ASIRs of lung,stomach,esophageal and liver cancer,whereas colorectal and breast cancer showed positive associations.Except for breast cancer,the ASMRs of the other five cancers were always higher in middle-and low-GDPPC areas than in high-GDPPC areas.Conclusions：The economic development is one of the main factors of the heavy cancer burden on Chinese population.It would be reasonable to implement cancer control strategies referring to the local GDPPC level.展开更多
Gastric cancer(GC)is the fourth most common cancer in the world with more than 70%of cases occur in the developing world.More than 50%of cases occur in Eastern Asia.GC is the second leading cause of cancer death in bo...Gastric cancer(GC)is the fourth most common cancer in the world with more than 70%of cases occur in the developing world.More than 50%of cases occur in Eastern Asia.GC is the second leading cause of cancer death in both sexes worldwide.In Asia,GC is the third most common cancer after breast and lung and is the second most common cause of cancer death after lung cancer.Although the incidence and mortality rates are slowly declining in many countries of Asia,GC still remains a significant public health problem.The incidence and mortality varies according to the geographic area in Asia.These variations are closely related to the prevalence of GC risk factors;especially Helicobacter pylori(H.pylori)and its molecular virulent characteristics.The gradual and consistent improvements in socioeconomic conditions in Asia have lowered the H.pylori seroprevalence rates leading to a reduction in the GC incidence.However,GC remains a significant public health and an economic burden in Asia.There has been no recent systemic review of GC incidence,mortality,and H.pylori molecular epidemiology in Asia.The aim of this report is to review the GC incidence,mortality,and linkage to H.pylori in Asia.展开更多
Breast cancer is the first cancer of women in the world and in France.In very elderly patients,the treatment options are often very limited.Neoadjuvant hormone therapy has shown similar or even better results than che...Breast cancer is the first cancer of women in the world and in France.In very elderly patients,the treatment options are often very limited.Neoadjuvant hormone therapy has shown similar or even better results than chemotherapy.This is why we decided to evaluate the clinical response following exclusive hormonal therapy and the 5,then 10 years survival in these very elderly women.This was a retrospective,longitudinal cohort-type study with descriptive and analytical purposes.The study population consisted of 59 patients,with an average age of 85 years.Fifteen(15,25%)of our patients had a complete clinical response after two years of treatment,16(27%)a partial clinical response,23(39%)lesion stabilization and 5(9%)cancer progression.The presence of metastasis at diagnosis increased the risk of cancer progression by 2.84.Overall 5-year survival was 72.5%,and breast cancer mortality 5.88%.The 10-year survival was 27.5%and breast cancer mortality 15%.In the age group 85 and over increased the risk of death by 3.25 in the first 10 years of treatment.The clinical response after 2 years was marked by a low rate of cancer progression.Mortality over 5 and 10 years was mostly related to patient comorbidities.展开更多
Background:Cancer has become a global health problem,and assessments of cancer mortality are important for effective public health policy-making and adequate resource allocation.In this study,we aimed to predict the m...Background:Cancer has become a global health problem,and assessments of cancer mortality are important for effective public health policy-making and adequate resource allocation.In this study,we aimed to predict the mortality rates and numbers of deaths related to four common cancers(lung,liver,stomach,and esophagus)in China from 2020 to 2030 and to estimate the corresponding cancer burden caused by population aging and tobacco smoking.Methods:Cancer mortality data(2004-2017)were extracted from China’s death surveillance datasets,and China’s population figures(2020-2030)were obtained from the United Nations population projections.Smoking prevalence data were retrieved from a World Health Organization global report,and relative risks of smoking and cancers were derived from large-scale Asian studies.We predicted the deaths related to the four major cancers and age-standardized mortality rates using joinpoint regression and linear regression models.The tobacco smoking related burden of these four major cancers was estimated using the population attributable fraction.Results:Unlike lung cancer mortality which was predicted to continue to increase,the age-standardized mortality rates for digestive cancers(liver,stomach,and esophageal cancers)are predicted to decline over the next decade.The number of deaths caused by the four major cancers is predicted to increase from 1,490,304 in 2020 to 1,823,960 in 2030.The age-specific mortality rates of the four major cancers are predicted to increase with age after 40-45 years,peaking in the age groups of 80-84 and ≥85 years.In 2030,the combined number of deaths from the four examined cancers among adults aged ≥65 years is predicted to be 1,167,153,accounting for 64% of all deaths from these cancers.Tobacco smoking is predicted to contribute to nearly 29% of deaths fromthese cancers,corresponding to 527,577 deaths.Conclusions:The overall trend in the combined total mortality from four major cancers is predicted to decline over the next decade;however,the corresponding death toll is expected to surge,in the context of China’s population aging and high smoking prevalence.These estimates provide data-driven evidence for China to implement effective cancer control measures in the future.展开更多
Background:Female breast and five gynecological cancers remain substantial burden in China and worldwide.GLOBOCAN 2022 has recently updated the estimates of cancer burden.This study aims to depict the profiles of dise...Background:Female breast and five gynecological cancers remain substantial burden in China and worldwide.GLOBOCAN 2022 has recently updated the estimates of cancer burden.This study aims to depict the profiles of disease burden and to compare the age-specific rates of female breast and five gynecological cancers in China with those in other countries.Methods:The latest estimates of incidence and mortality of female breast and five gynecological cancers from various regions and countries were extracted from the GLOBOCAN 2022 database.We compared the proportion of total cases or deaths for cancers affecting female breast and five gynecological cancers and other tumor types in China and globally.Correlation analysis was conducted to evaluate the relationship between age-standardized incidence rate(ASIR)or age-standardized mortality rate(ASMR)and the Human Development Index(HDI).Additionally,age-specific rate curves were plotted for ten exemplary countries with different income levels.Results:Female breast and five gynecological cancers in China accounted for 30.2%of all newly diagnosed cancer cases.Breast cancer and cervical cancer are the most commonly diagnosed,with nearly 507,000 new cases,representing 23.48%of the new cases.The incidence rates of breast,uterine corpus,ovarian,and vulvar cancers were positively associated with HDI tiers.Chinese women aged 50-54 years are experiencing high incidence rates of breast,cervix uteri,corpus uteri,and ovarian cancers.Conclusions:Female breast and five gynecological cancers continue to be a significant health concern for women in China and worldwide.It is crucial to implement comprehensive prevention strategies tailored to address the increasing trend among younger individuals and reduce regional disparities.展开更多
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.
基金supported by the Young Talent Development Plan of ChangZhou Health Commission(No.CZQM2021023)Youth Foundation of ChangZhou Health Commission(No.QN202379)+1 种基金Foundation of Jiangsu University(No.JDYY2023156)Changzhou Municipal 14th Five-Year Plan for High-level Health Care Talent Training Program(No.CJ20242001).
文摘Background:The oxidative balance score(OBS)is a comprehensive scoring mechanism for evaluating oxidative stress.Previous studies have not yet clarified the correlations between OBS and mortality risk due to the diversity of antioxidant and pro-oxidant constituents.This research investigates the relationship between OBS,which is composed of 20 prespecified oxidative stressrelated factors,and the overall and specific-cause mortality.Methods:This study analyzed 24,299 adults aged older than or equal to 18 years from the National Health and Nutrition Examination Survey(NHANES)1999–2018,followed for survival until December 31,2019.Cox proportional hazards regression was used to evaluate the links between the OBS and mortality from all causes,cardiovascular disease(CVD),and cancer,adjusted for several relevant demographic and comorbidity factors.Results:During a median follow-up of 9.6 years,there were 3,003 deaths,including 740 from CVD,746 from cancer.The Kaplan-Meier curves showed a reduced risk of mortality for the subjects with a higher OBS relative to their counterparts in the lowest quartile.The highest OBS quartile was inversely associated with a decreased risk of mortality(all-cause HR:0.68,95%CI:0.60–0.77;CVD HR:0.58,95%CI:0.45–0.74;cancer HR:0.61,95%CI:0.48–0.78)after covariate correction.In addition,a significant link between dietary patterns,lifestyle components,and a significant association with mortality was observed,demonstrating consistency across subgroup analyses.Conclusions:An inverse correlation exists between OBS and mortality from all-cause,CVD,and cancer.These results suggest that diet and lifestyle modifications can substantially impact health outcomes by modulating oxidative balance.
基金supported by the Young Talent Development Plan of Changzhou Health Commission(No.CZQM2021023)Medical Education Collaborative Innovation Fund of Jiangsu University(No.JDYY2023156)the Changzhou Municipal 14th Five-Year Plan for High-level Health Care Talent Training Program.
文摘Objectives:There is a debate on the association between the circulating manganese(Mn)levels and mortality.The aim of this study was to explore the nonlinear association between the serum Mn levels and all-cause or cause-specific mortality.Methods:We included 8,145 adults from the United States(US)and their serum Mn concentrations obtained from the National Health and Nutrition Examination Survey(NHANES 2011–2014).We retrieved their survival information from baseline until 2019 using the national death index.Multivariable Cox proportional hazards models were used to show the risk of all-cause or cause-specific mortality according to the baseline serum Mn concentrations.Smooth curve fitting and threshold effect analyses were used to clarify the potential nonlinearity.Results:During a median follow-up of 6.2 years,there were 716 deaths from all causes,224 of which were due to cardiovascular dis-ease(CVD)and 165 due to cancer.The serum Mn levels exhibited a U-shaped relationship with all-cause or CVD-associated mortality.Serum Mn levels lower than the threshold value(7.32μg/L)were negatively associated with all-cause(fully adjusted HR:0.86,95%CI:0.80–0.94)and CVD(fully adjusted HR:0.82,95%CI:0.71–0.94)mortality.In contrast,serum Mn levels higher than the threshold value(7.32μg/L)were positively associated with all-cause(fully adjusted HR:1.04,95%CI:1.02–1.06)and CVD(fully adjusted HR:1.05,95%CI:1.02–1.08)mortality.Conclusions:The serum Mn concentrations showed a U-shaped relationship with all-cause and CVD-associated mortality among NHANES participants.
基金Under the auspices of Natural Science Foundation of Anhui Province (No. 2008085ME160)Provincial Natural Science Research Projects in Anhui Province-Postgraduate Projects (No. YJS20210500)。
文摘Among cancers, lung cancer is the most common cause of death in China. For the prevention and control of lung cancer, it is necessary to investigate the spatial and temporal distribution of lung cancer mortality, as well as the changes in the trend and the affecting mechanism. Based on statistics and auto-correlation analysis, this paper studied the spatial and temporal distribution of lung cancer mortality in Yuhui District, Bengbu, Huaihe River Basin, from 2017 to 2020. In addition, Spearman’s Rank Correlation Assessment Model and Geographic Detector Model were used to examine the relationship between environmental factors and lung cancer mortality to identify impact factors and their mechanisms. The findings indicated that: 1) from the characteristics of temporal distribution, the number of lung cancer deaths exhibited a linear growth tendency, with the highest mortality in winter;2) from the characteristics of spatial distribution, lung cancer mortality showed a strong spatial agglomeration form, concentrating on two clustering areas, located in the old city and the central city of Bengbu, near the Huaihe River;3) from the point of view of the whole research area, there were 15 impact factors with significant correlation in the built and natural environment factors. The significant impacting factors in the built environment included land use, road traffic, spatial form and blue-green space, which could indirectly affect lung cancer mortality, while air pollution and temperature constituted the significant impacting factors in the natural environment;4) the influence of screened environmental factors on lung cancer mortality was different. Spatial stratified heterogeneity assessment, the interaction among environmental factors demonstrated statistical significance, it was found that the interaction between environmental factors in pairs had a significant enhancement effect on lung cancer mortality. To some extent, urban planning and policies could reduce lung cancer mortality.
文摘Both case-control and cohort studies were undertaken from July 1,1969 to June 30,1983 to ascertain whether exposure to chloroprene increases the risk of cancer.Fifty-five cases of cancer deaths were verified,16 of which had histories of exposure to chloroprene ranging from 3 to 23 years(median 11 years)with a latent period of 8-27 years,except for one case of 3 years(median 12.5 years).Fifty-four pairs were obtained by matching the cancer deaths to noncaneer deaths in accordance with strict requirements.The odds ratio for the paired data was 13,x^2=8.64,P <0.005.The average age at death from cancer of workers exposed to chloroprene was 12.7 years younger than that of unexposed workers,t'=2.98,P<0.001.The total cohort consisted of 1213 persons,among whom 149(11.6%)had histories of exposure for over 25 years,381(31.5%) for over 20 years,and 852(70.2%) for over 15 years.The SMR for the total cohort was 2.38(P <0.01),and all SMRs for the high-exposure occupations were of significance(P<0.05or P<0.01),in contrast to those of the low-exposure groups whose SMRs were low or zero.Thus, a dose-response relationship existed.Among the high-exposure occupations,maintenance me- chanics seem to have the highest risk of cancers,and SMRs for liver,lung,and lymphatic cancers were significant in this group.These results suggested that chloroprene exposure increases the risk of developing cancer.1989 Academic Press,Inc.
文摘Shandong Province, with a population of 84 million and located in the east coastline of China, is rich in natural resources and ranks middle in economic develpment of the whole nation. Around 90000 people are dead of cancer each year. In the recent twenty years, trends in malignant neoplasm
文摘The daily intake of total dietary fiber (TDF) was evaluated from data of the National Nutrition Survey (NNS) in Japan for 41 years since 1947. An interrelationship between the nutrient intake, including TDF, and the mortality from colon cancer in Japanese people was calculated by a simple correlation coefficient and time-series correlation coeffcient.TDF intake per capita decreased rapidly from 27.4 g in 1947 to 15.8 g in 1963, and subsequently decreased by a lesser rate to 15.3 g in 1987. Fat intake increased rapidly from 18.0 g in 1950 to 56.6 g in 1987.The age-adjusted mortality from colon cancer shows a significant positive correlation with both the intakes of animal protein and of total fat, and the fat energy ratio. A time-series analysis indicates that the mortality from colon cancer was negatively correlated with TDF with a 15-27 year delay, the maximum correlation existing with a 23-year lag (r = -0.947). The TDF intake was less than 17.9 g in 1965. At the same time, the mortality from colon cancer increased rapidly. A fat/TDF ratio above 3.0 resulted in a rapid increase in colon cancer mortality.The non-adjusted mortality from colon cancer has much the same interrelationship with TDF and fat intake as the adjusted figures. It is suggested that the cause of the increased mortality from colon cancer in Japan is positively related to the increased intake of fat and protein. In addition, the decrease in TDF intake has accelerated the mortality of colon cancer after a delay of 23-24 years. The importance of fat/TDF as a nutritional criterion for the incidence of colon cancer needs to be better recognized
基金performed within the project LIFE10 ENV/SK/000086.
文摘This study deals with the analysis of relationship between 67 environmental indicators in geological environment and breast cancer mortality in Slovakia. Primary data comprises a database of 67 environmental indicators for groundwater and soils as a mean value for every Slovak municipality and the data on relative mortality from breast cancer for Slovak municipalities (about 2900) collected for the period of 22 years. The training neural network was used as a mathematical model for data analysis. The top 200 networks have identified 12 environmental indicators (8 for soils: pHKCl, carbonates, Ca, Mg, Na, Co, Sr and 4 for groundwater: Ba, SiO2, Zn, Fe) with high rate of influence. As the most influential environmental indicator was identified pHKCl in soil that should be within the range of acids, definitely under the neutral point. Most of environmental indicators were unambiguously identified as negative (Mg, Ca, Sr, carbonates, Ba, SiO2, Zn and Fe). These indicators should be at the lowest level of their concentration in related geological component. Three environmental indicators, Ce, Na and Co had parabolic function where certain essential concentration levels of these elements are presumed with protective effect on human health. For all influential indicators limit values with respect to the lowest mortality were proposed. The verification of achieved results was performed through regressive model of breast cancer mortality for 12 calculated influential environmental indicators for all municipalities in the Slovak Republic. The revealed difference between real mortality levels and the model values was found for 6 environmental indicators (pHKCl, Mg, Ca, Sr, Ba, Zn). Each executed limit has decreased breast cancer mortality for about 0.79 cases per 100,000 inhabitants.
文摘Proton pump inhibitors(PPIs)are widely utilized in oncology to treat gastroeso-phageal reflux disease,peptic ulcer disease,and chemotherapy-induced mucosal injury.Emerging evidence has suggested that prolonged use of PPIs is associated with increased mortality in patients with cancer.The findings of Krishnan et al are proof of this but need to be considered cautiously due to potential confounding factors.This letter raised important methodological concerns,including con-founding by indication,reverse causality,and polypharmacy that can influence the observed association.While PPIs are important in oncology,their advantages and disadvantages should be weighed judiciously by clinicians.Future prospective studies with robust analytical approaches will be required to ascertain more definite causality.
文摘This commentary delves into the evolving landscape of cancer incidence and mortality in Costa Rica, presenting a comprehensive analysis of the data. Key findings reveal a concerning upward trajectory in cancer incidence rates, placing Costa Rica at the forefront within Central America. While prostate cancer and breast cancer dominate, disparities emerge when scrutinizing gender-specific trends. Notably, stomach and cervical cancers show declines, potentially attributed to targeted interventions. However, colorectal and liver cancers witness mortality increases, necessitating strategic responses. Geographical disparities persist across provinces, highlighting the need for equitable healthcare access. In conclusion, this commentary underscores the urgency of addressing the burgeoning cancer burden in Costa Rica, calling for evidence-based interventions and collaborative efforts on a global scale.
基金funded by the Spanish Ministry of Universities under application 33.50.460A.752by the European Union Next Generation EU/PRTR through a Margarita Salas contract of the University of Vigosupported by the Government of Andalusia, Research Talent Recruitment Programme (EMERGIA 2020/00158)。
文摘Background:High adiposity and low physical activity are associated with cancer risk.Whether different amounts and intensities of physical activity can mitigate this association is unclear.We aimed to examine the independent and combined associations of adiposity and devicemeasured physical activity levels of different intensities with cancer incidence and mortality.Methods:This prospective cohort study included data from 70,747 UK Biobank participants(mean age=61.6±7.9 years,mean±SD;56.4%women)with wrist-worn accelerometer measurements of physical activity and without chronic diseases or mobility limitations.Physical activity exposures included min per week of light intensity physical activity(LPA),moderate-to-vigorous intensity physical activity(MVPA),and vigorous intensity physical activity(VPA),along with total weekly volume.Body mass index(BMI)was calculated from anthropometric measurements.Participants were categorized into 9 groups based on joint tertiles of physical activity and BMI categories(normal weight,overweight,and obesity).Secondary analyses included adiposity using bio-impedance and waist circumference measurements.The outcome was incidence and death from cancer retrieved from national registries.Associations between adiposity,physical activity,and cancer hazard were calculated as subdistribution hazard ratios.A secondary analysis focused on cancer types strongly associated with physical activity.Results:We observed 2625 events(2572 non-fatal and 53 fatal)during a median follow-up of 6.1 years.Compared with the referent(normal weight and high physical activity),overweight and obesity were associated with a 6%to 36%higher cancer hazard across physical activity intensities.However,high MVPA and VPA(approximately 500 min and 32 min per week in the top tertiles,respectively)attenuated the hazard associated with overweight and obesity.Being normal weight was not associated with a higher cancer hazard regardless of physical activity level.The results were similar,although more pronounced,when modeling cancer types strongly associated with physical activity as the outcome.Conclusion:High MVPA and VPA levels may attenuate the association of overweight and obesity with cancer hazard,but maintaining a normal weight seems comparatively more important than physical activity to reduce the hazard.Maintaining a healthy body weight and engaging in physical activity is needed to minimize risk of some cancer types.
基金supported by the National Natural Science Foundation of China(No.82425052).
文摘Objective Although dietary preferences influence chronic diseases,few studies have linked dietary preferences to mortality risk,particularly in large cohorts.To investigate the relationship between dietary preferences and mortality risk(all-cause,cancer,and cardiovascular disease[CVD])in a large adult cohort.Methods A cohort of 1,160,312 adults(mean age 62.48±9.55)from the Shenzhen Healthcare Big Data Cohort(SHBDC)was analyzed.Hazard ratios(HRs)for mortality were estimated using the Cox proportional hazards model.Results The study identified 12,308 all-cause deaths,of which 3,865(31.4%)were cancer-related and 3,576(29.1%)were attributed to CVD.Compared with a mixed diet of meat and vegetables,a mainly meat-based diet(hazard ratio[HR]=1.13;95%confidence interval[CI]:1.02,1.27)associated with a higher risk of all-cause mortality,while mainly vegetarian(HR=0.87;95%CI:0.78,0.97)was linked to a reduced risk.Furthermore,there was a stronger correlation between mortality risk and dietary preference in the>65 age range.Conclusion A meat-based diet was associated with an increased risk of all-cause mortality,whereas a mainly vegetarian diet was linked to a reduced risk.
基金This work was supported by grants from the National Key R&D Program of China(No.2018YFC2001004)the National Natural Science Foundation of China(No.31971485)+1 种基金the Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(No.20161430)the Shanghai Municipal Project for Academic Leaders Public Health(No.GWV-10.2-XD20)。
文摘Background:Little was known about the association among time in range(TIR),time above range(TAR),time below range(TBR),and cancer mortality among patients with type 2 diabetes.We aimed to investigate the association among TIR,TAR,TBR,and the risk of cancer mortality among patients with type 2 diabetes.Methods:A total of 6225 patients with type 2 diabetes were prospectively recruited in Shanghai,China.TIR was measured with continuous glucose monitoring at baseline and was defined as the average percentage of time in the target glucose range during a 24 h period.Cox proportion hazard regression analysis was used to determine the association between TIR and the risk of cancer mortality.Results:During a mean follow-up of 7.10 years,we confirmed 237 death events related to cancer.The multivariable-adjusted hazard ratio(HR)for cancer mortality was 1.32(95%confidence interval[CI]:1.01-1.75)in patients with TIR≤70%compared with those with TIR>70%.When TIR was considered as a continuous variable,the multivariable-adjusted HR for cancer mortality associated with each 10%decrease in TIR was 1.07(95%CI:1.02-1.14).In the site-specific analysis,a significant association between TIR as a continuous variable and the risk of hepatocellular cancer was found(HR:1.24;95%CI:1.09-1.41).However,no relationship between hemoglobin A1c and cancer mortality was observed(HR:1.04;95%CI:0.97-1.10).Conclusions:The present study found an inverse association of TIR with the risk of cancer mortality among patients with type 2 diabetes.New evidence of TIR was added into the clinical practice that TIR may be an optimal target of glycemic control among patients with type 2 diabetes.
基金supported by Ministry of Science and Technology (2014FY121100)CAMS Innovation Fund for Medical Sciences (CIFMS) (201612M-2-004)
文摘Background： National Central Cancer Registry of China（NCCRC） updated nationwide cancer statistics using population-based cancer registry data in 2014 collected from all available cancer registries.Methods： In 2017, 449 cancer registries submitted cancer registry data in 2014, among which 339 registries＇ data met the criteria of quality control and were included in analysis. These cancer registries covered 288,243,347 population, accounting for about 21.07% of the national population in 2014. Numbers of nationwide new cancer cases and deaths were estimated using calculated incidence and mortality rates and corresponding national population stratified by area, sex, age group and cancer type. The world Segi＇s population was applied for agestandardized rates.Results： A total of 3,804,000 new cancer cases were diagnosed, the crude incidence rate was 278.07/100,000（301.67/100,000 in males, 253.29/100,000 in females） and the age-standardized incidence rate by world standard population（ASIRW） was 186.53/100,000. Calculated age-standardized incidence rate was higher in urban areas than in rural areas（191.6/100,000 vs. 179.2/100,000）. South China had the highest cancer incidence rate while Southwest China had the lowest incidence rate. Cancer incidence rate was higher in female for population between20 to 54 years but was higher in male for population younger than 20 years or over 54 years. A total of 2,296,000 cancer deaths were reported, the crude mortality rate was 167.89/100,000（207.24/100,000 in males,126.54/100,000 in females） and the age-standardized mortality rate by world standard population（ASMRW） was106.09/100,000. Calculated age-standardized mortality rate was higher in rural areas than in urban areas（110.3/100,000 vs. 102.5/100,000）. East China had the highest cancer mortality rate while North China had the lowest mortality rate. The mortality rate in male was higher than that in female. Common cancer types and major causes of cancer death differed between age group and sex.Conclusions： Heavy cancer burden and its disparities between area, sex and age group pose a major challenge to public health in China. Nationwide cancer registry plays a crucial role in cancer prevention and control.
基金supported by an Australian National Health and Medical Research Council Career Development Fellowship (Grant No.1005334)
文摘Objective: To provide an overview of the incidence and mortality of female breast cancer for countries in the Asia-Pacific region.Methods: Statistical information about breast cancer was obtained from publicly available cancer registry and mortality databases(such as GLOBOCAN), and supplemented with data requested from individual cancer registries. Rates were directly age-standardised to the Segi World Standard population and trends were analysed using joinpoint models.Results: Breast cancer was the most common type of cancer among females in the region, accounting for 18% of all cases in 2012, and was the fourth most common cause of cancer-related deaths(9%). Although incidence rates remain much higher in New Zealand and Australia, rapid rises in recent years were observed in several Asian countries. Large increases in breast cancer mortality rates also occurred in many areas, particularly Malaysia and Thailand, in contrast to stabilising trends in Hong Kong and Singapore, while decreases have been recorded in Australia and New Zealand. Mortality trends tended to be more favourable for women aged under 50 compared to those who were 50 years or older. Conclusion: It is anticipated that incidence rates of breast cancer in developing countries throughout the Asia-Pacific region will continue to increase. Early detection and access to optimal treatment are the keys to reducing breast cancerrelated mortality, but cultural and economic obstacles persist. Consequently, the challenge is to customise breast cancer control initiatives to the particular needs of each country to ensure the best possible outcomes.
基金supported by Ministry of Science and Technology of China (Grant No. 2014FY121100)CAMS Innovation Fund for Medical Sciences (CIFMS) (Grant No. 2016-12M-2-004)+1 种基金National Key Research and Development Program (Grant No. 2016YFC1302502)the Basic Research Fund of Central Public Welfare Scientific Institute (Grant No. 2016ZX310182-2)
文摘Objective：In this research,the patterns of cancer incidence and mortality in areas with different gross domestic product per capita（GDPPC）levels in China were explored,using data from population-based cancer registries in 2013,collected by the National Central Cancer Registry（NCCR）.Methods：Data from 255 cancer registries were qualified and included in this analysis.Based on the GDPPC data of 2014,cities/counties were divided into 3 levels：high-,middle-and low-GDPPC areas,with 40,000 and 80,000 RMB per year as cut points.We calculated cancer incidences and mortalities in these three levels,stratified by gender and age group.The national population of the Fifth Census in 2000 and Segi’s population were applied for age-standardized rates.Results：The crude incidence and mortality rates as well as age-standardized incidence rate（ASIR）showed positive associations with GDPPC level.The age-standardized mortality rate（ASMR）nevertheless showed a negative association with GDPPC level.The ASMR in high-,middle-and low-GDPPC areas was 103.12/100,000,112.49/100,000 and 117.43/100,000,respectively.Lung cancer was by far the most common cancer in all three GDPPC levels.It was also the leading cause of cancer death,regardless of gender and GDPPC level.Negative associations with GDPPC level were found for the ASIRs of lung,stomach,esophageal and liver cancer,whereas colorectal and breast cancer showed positive associations.Except for breast cancer,the ASMRs of the other five cancers were always higher in middle-and low-GDPPC areas than in high-GDPPC areas.Conclusions：The economic development is one of the main factors of the heavy cancer burden on Chinese population.It would be reasonable to implement cancer control strategies referring to the local GDPPC level.
文摘Gastric cancer(GC)is the fourth most common cancer in the world with more than 70%of cases occur in the developing world.More than 50%of cases occur in Eastern Asia.GC is the second leading cause of cancer death in both sexes worldwide.In Asia,GC is the third most common cancer after breast and lung and is the second most common cause of cancer death after lung cancer.Although the incidence and mortality rates are slowly declining in many countries of Asia,GC still remains a significant public health problem.The incidence and mortality varies according to the geographic area in Asia.These variations are closely related to the prevalence of GC risk factors;especially Helicobacter pylori(H.pylori)and its molecular virulent characteristics.The gradual and consistent improvements in socioeconomic conditions in Asia have lowered the H.pylori seroprevalence rates leading to a reduction in the GC incidence.However,GC remains a significant public health and an economic burden in Asia.There has been no recent systemic review of GC incidence,mortality,and H.pylori molecular epidemiology in Asia.The aim of this report is to review the GC incidence,mortality,and linkage to H.pylori in Asia.
文摘Breast cancer is the first cancer of women in the world and in France.In very elderly patients,the treatment options are often very limited.Neoadjuvant hormone therapy has shown similar or even better results than chemotherapy.This is why we decided to evaluate the clinical response following exclusive hormonal therapy and the 5,then 10 years survival in these very elderly women.This was a retrospective,longitudinal cohort-type study with descriptive and analytical purposes.The study population consisted of 59 patients,with an average age of 85 years.Fifteen(15,25%)of our patients had a complete clinical response after two years of treatment,16(27%)a partial clinical response,23(39%)lesion stabilization and 5(9%)cancer progression.The presence of metastasis at diagnosis increased the risk of cancer progression by 2.84.Overall 5-year survival was 72.5%,and breast cancer mortality 5.88%.The 10-year survival was 27.5%and breast cancer mortality 15%.In the age group 85 and over increased the risk of death by 3.25 in the first 10 years of treatment.The clinical response after 2 years was marked by a low rate of cancer progression.Mortality over 5 and 10 years was mostly related to patient comorbidities.
基金Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences,Grant/Award Number:2017-I2M-1-009Peking Union Medical College Innovation Fund for Graduate Students,Grant/Award Number:2018-1002-01-21.
文摘Background:Cancer has become a global health problem,and assessments of cancer mortality are important for effective public health policy-making and adequate resource allocation.In this study,we aimed to predict the mortality rates and numbers of deaths related to four common cancers(lung,liver,stomach,and esophagus)in China from 2020 to 2030 and to estimate the corresponding cancer burden caused by population aging and tobacco smoking.Methods:Cancer mortality data(2004-2017)were extracted from China’s death surveillance datasets,and China’s population figures(2020-2030)were obtained from the United Nations population projections.Smoking prevalence data were retrieved from a World Health Organization global report,and relative risks of smoking and cancers were derived from large-scale Asian studies.We predicted the deaths related to the four major cancers and age-standardized mortality rates using joinpoint regression and linear regression models.The tobacco smoking related burden of these four major cancers was estimated using the population attributable fraction.Results:Unlike lung cancer mortality which was predicted to continue to increase,the age-standardized mortality rates for digestive cancers(liver,stomach,and esophageal cancers)are predicted to decline over the next decade.The number of deaths caused by the four major cancers is predicted to increase from 1,490,304 in 2020 to 1,823,960 in 2030.The age-specific mortality rates of the four major cancers are predicted to increase with age after 40-45 years,peaking in the age groups of 80-84 and ≥85 years.In 2030,the combined number of deaths from the four examined cancers among adults aged ≥65 years is predicted to be 1,167,153,accounting for 64% of all deaths from these cancers.Tobacco smoking is predicted to contribute to nearly 29% of deaths fromthese cancers,corresponding to 527,577 deaths.Conclusions:The overall trend in the combined total mortality from four major cancers is predicted to decline over the next decade;however,the corresponding death toll is expected to surge,in the context of China’s population aging and high smoking prevalence.These estimates provide data-driven evidence for China to implement effective cancer control measures in the future.
基金supported by the special research fund for central universities,Peking Union Medical College(No.3332023025)
文摘Background:Female breast and five gynecological cancers remain substantial burden in China and worldwide.GLOBOCAN 2022 has recently updated the estimates of cancer burden.This study aims to depict the profiles of disease burden and to compare the age-specific rates of female breast and five gynecological cancers in China with those in other countries.Methods:The latest estimates of incidence and mortality of female breast and five gynecological cancers from various regions and countries were extracted from the GLOBOCAN 2022 database.We compared the proportion of total cases or deaths for cancers affecting female breast and five gynecological cancers and other tumor types in China and globally.Correlation analysis was conducted to evaluate the relationship between age-standardized incidence rate(ASIR)or age-standardized mortality rate(ASMR)and the Human Development Index(HDI).Additionally,age-specific rate curves were plotted for ten exemplary countries with different income levels.Results:Female breast and five gynecological cancers in China accounted for 30.2%of all newly diagnosed cancer cases.Breast cancer and cervical cancer are the most commonly diagnosed,with nearly 507,000 new cases,representing 23.48%of the new cases.The incidence rates of breast,uterine corpus,ovarian,and vulvar cancers were positively associated with HDI tiers.Chinese women aged 50-54 years are experiencing high incidence rates of breast,cervix uteri,corpus uteri,and ovarian cancers.Conclusions:Female breast and five gynecological cancers continue to be a significant health concern for women in China and worldwide.It is crucial to implement comprehensive prevention strategies tailored to address the increasing trend among younger individuals and reduce regional disparities.
