Background:With industrial and economic development in recent decades in South China,cancer incidence may have changed due to the changing lifestyle and environment.However,the trends of lung cancer and the roles of s...Background:With industrial and economic development in recent decades in South China,cancer incidence may have changed due to the changing lifestyle and environment.However,the trends of lung cancer and the roles of smoking and other environmental risk factors in the development of lung cancer in rural areas of South China remain unclear.The purpose of this study was to explore the lung cancer incidence trends and the possible causes of these trends.Methods:Joinpoint regression analysis and the age-period-cohort(APC) model were used to analyze the lung cancer incidence trends in Sihui,Guangdong province,China between 1987 and 2011,and explore the possible causes of these trends.Results:A total of 2,397 lung cancer patients were involved in this study.A 3-fold increase in the incidence of lung cancer in both sexes was observed over the 25-year period.Joinpoint regression analysis showed that while the incidence continued to increase steadily in females during the entire period,a sharp acceleration was observed in males starting in 2005.The full APC model was selected to describe age,period,and birth cohort effects on lung cancer incidence trends in Sihui.The age cohorts in both sexes showed a continuously significant increase in the relative risk(RR)of lung cancer,with a peak in the eldest age group(80-84 years).The RR of lung cancer showed a fluctuating curve in both sexes.The birth cohorts identified an increased trend in both males and females;however,males had a plateau in the youngest cohorts who were born during 1955-1969.Conclusions:Increasing trends of the incidence of lung cancer in Sihui were dominated by the effects of age and birth cohorts.Social aging,smoking,and environmental changes may play important roles in such trends.展开更多
Introduction:In the past several decades,declining incidences of nasopharyngeal carcinoma(NPC) have been observed in Chinese populations in Hong Kong,Taiwan,Los Angeles,and Singapore.A previous study indicated that th...Introduction:In the past several decades,declining incidences of nasopharyngeal carcinoma(NPC) have been observed in Chinese populations in Hong Kong,Taiwan,Los Angeles,and Singapore.A previous study indicated that the incidence of NPC in Sihui County,South China remained stable until 2002,but whether age,diagnosis period,and birth cohort affect the incidence of NPC remains unknown.Methods:Age-standardized rates(ASRs) of NPC incidence based on the world standard population were examined in both males and females in Sihui County from 1987 to 2011.Joinpoint regression analysis was conducted to quantify the changes in incidence trends.A Poisson regression age-period-cohort model was used to assess the effects of age,diagnosis period,and birth cohort on the risk of NPC.Results:The ASRs of NPC incidence during the study period were 30.29/100,000 for males and 13.09/100,000 for females.The incidence of NPC remained stable at a non-significant average annual percent change of 0.2%for males and-1.6%for females throughout the entire period.A significantly increased estimated annual percent change of 6.8%(95%confidence interval,0.1%-14.0%) was observed from 2003 to 2009 for males.The relative risk of NPC increased with advancing age up to 50-59 and decreased at ages >60 years.The period effect curves on NPC were nearly flat for males and females.The birth cohort effect curve for males showed an increase from the1922 cohort to the 1957 cohort and a decrease thereafter.In females,there was an undulating increase in the relative risk from the 1922 cohort to the 1972 cohort.Conclusions:The incidence trends for NPC remained generally stable in Sihui from 1987 to 2011,with an increase from 2003 to 2009.The relative risks of NPC increased in younger females.展开更多
Background: Serum immunoglobulin A antibodies against Epstein–Barr virus(EBV), viral capsid antigen(VCA?Ig A) and early antigen(EA?Ig A), are used to screen for nasopharyngeal carcinoma(NPC) in endemic areas. However...Background: Serum immunoglobulin A antibodies against Epstein–Barr virus(EBV), viral capsid antigen(VCA?Ig A) and early antigen(EA?Ig A), are used to screen for nasopharyngeal carcinoma(NPC) in endemic areas. However, their routine use has been questioned because of a lack of specificity. This study aimed to determine the distributions of different subtypes of antibody and to illustrate how the natural variation patterns affect the specificity of screening in non?NPC participants.Methods: The distribution of baseline VCA?IgA was analyzed between sexes and across 10?year age groups in 18,286 non?NPC participants using Chi square tests. Fluctuations in the VCA?IgA level were assessed in 1056 non?NPC participants with at least two retests in the first 5?year period(1987–1992) after the initial screening using the Kaplan–Meier method.Results: The titers of VCA?Ig A increased with age(P < 0.001). Using a previous serological definition of high NPC risk, nasopharyngeal endoscopy and/or nasopharyngeal biopsy would be recommended in 55.5% of the non?NPC partici?pants with an initial VCA?Ig A?positive status and in 20.6% with an initial negative status during the 5?year follow?up. However, seroconversions were common; 85.2% of the participants with a VCA?Ig A?positive status at baseline con?verted to negative, and all VCA?Ig A?negative participants changed to positive at least once during the 5?year follow?up. The EA?Ig A status had a high seroconversion probability(100%) from positive to negative; however, it had a low probability(19.6%) from negative to positive.Conclusions: Age? and sex?specific cutoff titer values for serum anti?EBV antibodies as well as their specific titer fluc?tuation patterns should be considered when defining high NPC risk criteria for follow?up diagnostics and monitoring.展开更多
Background:The association of circulating inflammation markers with nasopharyngeal carcinoma(NPC)is still largely unclear.This study aimed to comprehensively explore the relationship between circulating cytokine level...Background:The association of circulating inflammation markers with nasopharyngeal carcinoma(NPC)is still largely unclear.This study aimed to comprehensively explore the relationship between circulating cytokine levels and the subsequent risk of NPC with a two-stage epidemiologic study in southern China.Methods:The serum levels of 33 inflammatory cytokines were first measured in a hospital-based case-control study(150 NPC patients and 150 controls)using multiplex assay platforms.Marker levels were categorized into two or more groups based on the proportion of sample measurements that was above the lower limit of detection.Odds ratios(ORs)and 95%confidence intervals(CIs)relating the serum marker concentration to the risk of NPC were computed by multivariable logistic regression models.The associations were validated in 60 patients with NPC and 120 con-trols in a subsequent nested case-control study within a NPC screening trial.Potential interactions between serum cytokines and Epstein-Barr virus(EBV)relating to the risk of NPC were assessed using a likelihood ratio test.Results:The levels of serum macrophage inflammatory protein(MIP)-1αand MIP-1βin the highest categories were associated with a decreased risk of NPC in both the case-control study(MIP-1α:OR=0.49,95%CI=0.26-0.95;MIP-1β:OR=0.47,95%CI=0.22-1.00)and the nested case-control study(MIP-1α:OR=0.13,95%CI=0.03-0.62;MIP-1β:OR=0.20,95%CI=0.04-0.94),compared with those in the lowest categories.Furthermore,individuals with lower levels of these two cytokine markers who were EBV seropositive presented with a largely higher risk of NPC compared with patients with higher levels who were EBV seronegative in both the case-control study(MIP-1α:OR=16.28,95%CI=7.11-37.23;MIP-1β:OR=12.86,95%CI=5.9-28.05)and the nested case-control study(MIP-1α:OR=86.12,95%CI=10.58-701.03;MIP-1β:OR=115.44,95%CI=13.92-957.73).Conclusions:Decreased preclinical MIP-1αand MIP-1βlevels might be associated with a subsequently increased risk of NPC.More mechanistic studies are required to fully understand this finding.展开更多
基金supported by the National High Technology Research and Development Program of China(No.2012AA02A501)the Special Fund for Public Health Trade(No.201202014)
文摘Background:With industrial and economic development in recent decades in South China,cancer incidence may have changed due to the changing lifestyle and environment.However,the trends of lung cancer and the roles of smoking and other environmental risk factors in the development of lung cancer in rural areas of South China remain unclear.The purpose of this study was to explore the lung cancer incidence trends and the possible causes of these trends.Methods:Joinpoint regression analysis and the age-period-cohort(APC) model were used to analyze the lung cancer incidence trends in Sihui,Guangdong province,China between 1987 and 2011,and explore the possible causes of these trends.Results:A total of 2,397 lung cancer patients were involved in this study.A 3-fold increase in the incidence of lung cancer in both sexes was observed over the 25-year period.Joinpoint regression analysis showed that while the incidence continued to increase steadily in females during the entire period,a sharp acceleration was observed in males starting in 2005.The full APC model was selected to describe age,period,and birth cohort effects on lung cancer incidence trends in Sihui.The age cohorts in both sexes showed a continuously significant increase in the relative risk(RR)of lung cancer,with a peak in the eldest age group(80-84 years).The RR of lung cancer showed a fluctuating curve in both sexes.The birth cohorts identified an increased trend in both males and females;however,males had a plateau in the youngest cohorts who were born during 1955-1969.Conclusions:Increasing trends of the incidence of lung cancer in Sihui were dominated by the effects of age and birth cohorts.Social aging,smoking,and environmental changes may play important roles in such trends.
文摘Introduction:In the past several decades,declining incidences of nasopharyngeal carcinoma(NPC) have been observed in Chinese populations in Hong Kong,Taiwan,Los Angeles,and Singapore.A previous study indicated that the incidence of NPC in Sihui County,South China remained stable until 2002,but whether age,diagnosis period,and birth cohort affect the incidence of NPC remains unknown.Methods:Age-standardized rates(ASRs) of NPC incidence based on the world standard population were examined in both males and females in Sihui County from 1987 to 2011.Joinpoint regression analysis was conducted to quantify the changes in incidence trends.A Poisson regression age-period-cohort model was used to assess the effects of age,diagnosis period,and birth cohort on the risk of NPC.Results:The ASRs of NPC incidence during the study period were 30.29/100,000 for males and 13.09/100,000 for females.The incidence of NPC remained stable at a non-significant average annual percent change of 0.2%for males and-1.6%for females throughout the entire period.A significantly increased estimated annual percent change of 6.8%(95%confidence interval,0.1%-14.0%) was observed from 2003 to 2009 for males.The relative risk of NPC increased with advancing age up to 50-59 and decreased at ages >60 years.The period effect curves on NPC were nearly flat for males and females.The birth cohort effect curve for males showed an increase from the1922 cohort to the 1957 cohort and a decrease thereafter.In females,there was an undulating increase in the relative risk from the 1922 cohort to the 1972 cohort.Conclusions:The incidence trends for NPC remained generally stable in Sihui from 1987 to 2011,with an increase from 2003 to 2009.The relative risks of NPC increased in younger females.
基金supported by Grants from the National High Technology Research and Development Program of China(No.2012AA02A501)the Special Fund for Public Health Trade(No.201202014)+1 种基金National Natural Science Foundation of China(No.81373068)the 5010 Clinical Trail Study of Sun Yat-sen University(No.2013012)
文摘Background: Serum immunoglobulin A antibodies against Epstein–Barr virus(EBV), viral capsid antigen(VCA?Ig A) and early antigen(EA?Ig A), are used to screen for nasopharyngeal carcinoma(NPC) in endemic areas. However, their routine use has been questioned because of a lack of specificity. This study aimed to determine the distributions of different subtypes of antibody and to illustrate how the natural variation patterns affect the specificity of screening in non?NPC participants.Methods: The distribution of baseline VCA?IgA was analyzed between sexes and across 10?year age groups in 18,286 non?NPC participants using Chi square tests. Fluctuations in the VCA?IgA level were assessed in 1056 non?NPC participants with at least two retests in the first 5?year period(1987–1992) after the initial screening using the Kaplan–Meier method.Results: The titers of VCA?Ig A increased with age(P < 0.001). Using a previous serological definition of high NPC risk, nasopharyngeal endoscopy and/or nasopharyngeal biopsy would be recommended in 55.5% of the non?NPC partici?pants with an initial VCA?Ig A?positive status and in 20.6% with an initial negative status during the 5?year follow?up. However, seroconversions were common; 85.2% of the participants with a VCA?Ig A?positive status at baseline con?verted to negative, and all VCA?Ig A?negative participants changed to positive at least once during the 5?year follow?up. The EA?Ig A status had a high seroconversion probability(100%) from positive to negative; however, it had a low probability(19.6%) from negative to positive.Conclusions: Age? and sex?specific cutoff titer values for serum anti?EBV antibodies as well as their specific titer fluc?tuation patterns should be considered when defining high NPC risk criteria for follow?up diagnostics and monitoring.
基金supported by the National Key R&D Program of China(No.2016YF0902000 and No.2017YF0907100 to S.C.)the National Natural Science Foundation of China(No.81373068 to S.C.,and No.81672872,No.81272340 and No.81472386 to C.Q.)+2 种基金National Key Research and Development Program of China(No.2014BAI09B and No.2016YFC0902001 to S.C.)the Science and Technology Planning Project of Guangdong Province,China(No.2014B020212017,No.2014B050504004 and No.2015B050501005 to C.Q.)the Provincial Natural Science Foundation of Guangdong,China(No.2016A030311011 to C.Q.).
文摘Background:The association of circulating inflammation markers with nasopharyngeal carcinoma(NPC)is still largely unclear.This study aimed to comprehensively explore the relationship between circulating cytokine levels and the subsequent risk of NPC with a two-stage epidemiologic study in southern China.Methods:The serum levels of 33 inflammatory cytokines were first measured in a hospital-based case-control study(150 NPC patients and 150 controls)using multiplex assay platforms.Marker levels were categorized into two or more groups based on the proportion of sample measurements that was above the lower limit of detection.Odds ratios(ORs)and 95%confidence intervals(CIs)relating the serum marker concentration to the risk of NPC were computed by multivariable logistic regression models.The associations were validated in 60 patients with NPC and 120 con-trols in a subsequent nested case-control study within a NPC screening trial.Potential interactions between serum cytokines and Epstein-Barr virus(EBV)relating to the risk of NPC were assessed using a likelihood ratio test.Results:The levels of serum macrophage inflammatory protein(MIP)-1αand MIP-1βin the highest categories were associated with a decreased risk of NPC in both the case-control study(MIP-1α:OR=0.49,95%CI=0.26-0.95;MIP-1β:OR=0.47,95%CI=0.22-1.00)and the nested case-control study(MIP-1α:OR=0.13,95%CI=0.03-0.62;MIP-1β:OR=0.20,95%CI=0.04-0.94),compared with those in the lowest categories.Furthermore,individuals with lower levels of these two cytokine markers who were EBV seropositive presented with a largely higher risk of NPC compared with patients with higher levels who were EBV seronegative in both the case-control study(MIP-1α:OR=16.28,95%CI=7.11-37.23;MIP-1β:OR=12.86,95%CI=5.9-28.05)and the nested case-control study(MIP-1α:OR=86.12,95%CI=10.58-701.03;MIP-1β:OR=115.44,95%CI=13.92-957.73).Conclusions:Decreased preclinical MIP-1αand MIP-1βlevels might be associated with a subsequently increased risk of NPC.More mechanistic studies are required to fully understand this finding.
