Epidemiological characteristics of centenarian deaths in China during 2013-2020:A trend and subnational analysis

Background:Studies that comprehensively address the characteristics of centenarian deaths are rare.The present study aimed to depict the characteristics of centenarian deaths in China and their changing trends.Methods:Data on centenarian deaths between 2013 and 2020 were obtained from the national mortality surveillance system of China,including date,place of death(PoD),and underlying cause of death(CoD).Descriptive analyses were performed to understand the epidemiological characteristics,and a joinpoint regression model was adopted to examine the changing trends in the proportions of different PoDs,CoDs among centenarians,and centenarian deaths accounting for all deaths and deaths among people aged 65 years and older.Results:There were 46,938 registered centenarian deaths between 2013 and 2020 that included 34,311 females(73.10%)and 12,627 males(26.90%).January(12.05%),February(9.99%),and December(9.74%)were the top three months with the highest number of deaths.The proportions of deaths that occurred in homes,hospitals,and nursing homes were 81.71%,13.63%,and 2.68%,respectively.The proportion of deaths in nursing homes increased by 9.60%(95%confidence intervals[CIs],6.4-12.9%)from 2014 to 2020.Heart disease(35.72%)was the leading cause of death,followed by respiratory diseases(17.63%),cerebrovascular disease(15.60%),and old age(11.22%).The proportion of respiratory diseases decreased by 4.8%(95%CI,-8.8 to-0.7%),and the proportion of deaths from old age decreased by 2.3%(95%CI,-4.4 to-0.1%)per year.Shanghai had the highest proportions of deaths in hospitals(39.38%)and nursing homes(14.68%).Sichuan had the highest proportion of deaths attributed to respiratory diseases(32.30%),while Jiangsu(26.58%)and Zhejiang(23.61%)had the highest proportions of deaths from old age.Conclusion:Unlike other countries,centenarian deaths in China are characterized by a higher proportion of home and heart disease deaths,and this death pattern differs across provinces.

1990～2015年中国省级行政区医疗可及性和质量分析

医疗可及性和质量(healthcare access and quality index,HAQ)是反映医疗系统及时、有效地发现、管理、治疗从而避免疾病死亡能力的重要指标.本研究利用2015年全球疾病负担研究结果,比较2015年中国与全球主要国家的HAQ指数差异,同时分析1990~2015年期间中国疾病间、省级行政区间HAQ指数及其变化幅度的差异.2015年中国HAQ指数为74.2分,高出全球平均水平20.5分;中国HAQ指数与其期望值仅相差1.2分,此差距远低于全球平均水平(20.1分).1990~2015年中国在呼吸系统疾病(上呼吸道感染、慢性呼吸系统疾病)、计划免疫性疾病(白喉、百日咳、破伤风和麻疹)、通过常规手术治愈的疾病(阑尾炎和腹股沟、股骨和腹部疝)、孕产妇疾病、缺血性心脏病和医疗副作用表现出较高的HAQ.2015年北京、澳门、上海等9个省级行政区的HAQ指数达到80分以上;西藏、青海、贵州、新疆和云南的HAQ指数最低;且处于高和中高社会人口发展水平的大部分省级行政区,其HAQ指数均高于其相应的期望值.1990~2015年中国HAQ指数增长49.30%,其中长幅最大的省级行政区为新疆、江西、云南和陕西,均超过55%;长幅最小的省级行政区为西藏、香港和澳门.研究表明,1990~2015年间,中国医疗可及性和质量有较大程度的提高,但在不同疾病领域、不同省级行政区表现出的医疗可及性和质量及其改善程度差异较大.

Cardiovascular Disease Mortality—China,2019

Introduction:Cardiovascular disease(CVD)is the leading cause of death and has caused a heavy burden in China.China has about 106 million CVD patients,including 33 million with stroke.This study presents the latest cardiovascular mortality in China in 2019 to provide evidence for disease control and prevention.Methods:Mortality data from the China Death Surveillance Point System(DSP System)was used for CVD mortality estimation.A descriptive analysis was conducted to demonstrate the results.Results:A total of 5.09 million CVD deaths were estimated in China in 2019,with a mortality rate and age-standardized mortality rate of 364.5 per 100,000 population and 276.0 per 100,000,respectively.Stroke is the leading cause of death,and the mortality rate and age-standardized mortality rate(ASMR)were 171.6 per 100,000 and 130.0 per 100,000,respectively.The second major cause was ischemic heart diseases,and the mortality rate and ASMR were 147.3 per 100,000 and 142.1 per 100,000,respectively.Stroke and ischemic heart diseases were the two major causes of CVD deaths,which accounted for over 87%of all CVD deaths.Conclusions:Although age-standardized mortality of CVD continues to decline in China,the number of deaths is still increasing.Therefore,prevention and control efforts for CVD should be maintained.In order to achieve the“Healthy China 2030”goal of reducing the mortality rate of CVD in China,it is necessary to further strengthen the prevention,control,and treatment capacity of stroke.Meanwhile,increases in ischemic heart disease deaths in highly developed areas should be monitored.

National Cancer Data Linkage Platform of China:Design,Methods,and Application

Background:The National Cancer Center(NCC)and China CDC cooperatively designed a National Cancer Data Linkage(NCDL)Platform to fulfill the task of sharing cancer outcome data through an automatic web-based system.Methods:NCC and China CDC established a web-based NCDL Platform to link death information from China CDC with the cancer database from NCC.Overall,76,708 cancer patients’data were analyzed to assess the feasibility and match rate of the NCDL Platform for 7 major cancers.Results:The function of the platform includes a data application and approval system,data linkage module,and results visualization system.Through the platform,38.9%cases were identified as deaths cases from the NCDL Platform in the first 3 years after cancer diagnosis.The linkage rate was highest in liver cancer and lowest in breast cancer.Conclusions:The NCDL Platform provides a powerful and efficient way to link national vital statistics with national cancer programs’data.Expanding cancer outcome data linkage may not only improve data collection efficiency,but also improve data use.

Incidence,Prevalence,and Mortality of Four Major Chronic Non-communicable Diseases—China,1990-2017

Introduction Chronic and non-communicable diseases(NCDs)have become an important public health concern in China.We aimed to estimate the incidence,prevalence,and mortality of four major NCDs including cardiovascular disease(CVD),cancer,chronic respiratory diseases(CRD),and diabetes in China during 1990-2017.Methods The general analytic framework of Global Burden of Diseases Study 2017(GBD 2017)was applied.Data from Disease Surveillance Point System,censuses,and Chinese Center for Disease Control and Prevention Cause-of-Death Reporting System were used for mortality estimates.National surveys,cancer registries,and published studies were used for incidence and prevalence estimates.Results In 2017,new cases for CVD,cancer,and diabetes were 13.5,4.6,and 3.3 million,an increase of 120.4%,159.7%,and 57.3%respectively compared with 1990.There were 9.6 million incident cases for CRD in 2017,a 4.9%decrease compared with 1990.A total of 8.1 million people died from cancer,CVD,CRD,and diabetes in China in 2017.There was a substantial decline in age-standardized mortality rate for CRD and a steady but slow decline for CVD and cancer.During 1990-2017,the age-standardized prevalence rate increased by 7.4%,135.2%,and 17.0%for CVD,cancer,and diabetes respectively.Conclusions and Implications for Public Health Practice The accumulated prevalence of the four major NCDs are increasing but the age-standardized mortality rate for CVD,cancer,and CRD has been on a decline during 1990-2017.More effective intervention strategies should be developed to deal with the continuously increasing burden caused by NCDs in China.

Cancer Mortality--China, 2018

Introduction Cancer is an important public health concern with heavy disease burden in China.In 2017,cancer is the leading cause of death,with around 2.60 million deaths,which accounts for 26.07%of all deaths.This study aims to present cancer mortality in China in 2018 to provide evidence for cancer control and prevention.Methods Mortality data from China Cause of Death Reporting System(CDRS)and population data from National Bureau of Statistics are used for cancer mortality estimation.A descriptive analysis was conducted to demonstrate the results.

Number of Deaths due to Carbon Monoxide Poisoning by Month and by Place of Death--China,2018

In 2018,there were 11,523 deaths caused by carbon monoxide poisoning reported in China,with the highest number of deaths in January(2,845),February(2,321),and December(2,010).The proportions of carbon monoxide poisoning deaths occurring at home were far higher than that of other places in the winter with the highest proportions occurring in December(72.59%),January(67.42%),and February(66.48%).

Mortality and Causes of Death in Primary and Secondary School Students--China,2018

What is already known about this topic?There were approximately 1.23 million deaths reported among individuals aged 5-19 years worldwide in 2017.Limited attention has been paid to current mortality among primary and secondary school students aged 6-18 years in China.What is added by this report?In 2018,an estimated 28,519 deaths occurred among primary and secondary school students aged 6-18 years in China with an age-standardized mortality rate(ASMR)of 17.66 per 100,000.Substantial disparities existed among sexes,age groups,areas,and regions for different causes of death.Drowning,road traffic injuries,and leukemia were three leading causes of death.What are the implications for public health practice?Government support,legislation enforcement,multisectoral cooperation,and stakeholder engagement should be initiated to reduce premature deaths among primary and secondary school students in China,especially those due to injuries.