Prevalence of common upper gastrointestinal diseases in Chinese adults aged 18-64 years

To investigate the prevalence of gastroesophageal reflux disease(GERD),reflux esophagitis(RE),digestive ulcer gastric ulcer(GU),duodenal ulcer(DU),and Helicobacter pylori infection in Chinese adults aged 18-64 years and their associated factors,a community-based cross-sectional study using a stratified multi-stage sampling method was conducted.A standardized questionnaire survey,the^(13)C-urea breath test,and gastroscopy were performed.Weighted methods were used to estimate the prevalence of diseases or infection mentioned above and their risk factors.Finally,27,637 participants aged 18-64 years were enrolled from 2017 to 2018.The prevalence(95%confidence interval)of GERD,RE,GU,DU,and H.pylori infection was estimated to be 10.5%(7.8%-14.2%),5.4%(3.9%-7.3%),2.5%(1.7%-3.7%),4.5%(3.6%-5.4%),and 41.5%(36.7%-46.4%),respectively.The fraction of H.pylori infection reached 58.6%and 61.1%among the GU and DU patients,respectively.Weighted multivariable logistic regression models showed that GERD,RE,and GU shared the common risk factors of age and obesity.Dose-response relationships were observed between smoking and all four diseases,as well as alcohol consumption and GERD and H.pylori infection.Northwest China had the highest prevalence of GERD(23.9%),RE(8.7%),GU(7.8%),DU(7.3%),and H.pylori infection(63.6%);however,the southwest region had the highest prevalence of GU but the lowest of DU,RE,and H.pylori infection.Non-steroidal anti-inflammatory drugs were positively associ-ated with GERD risk.On the contrary,a reduced risk of GU was observed among H.pylori-infected patients taking this drug.In summary,the prevalence of GERD,RE,and H.pylori infection still appears high in China.H.pylori infection eradication remains the priority to reduce the burden of peptic ulcer dis-ease.The aging population,high prevalence of overweight or obesity,smoking,and drinking in China could explain the high burden of these diseases,thus suggesting the targeted preventive measures for upper gastrointestinal diseases in the future.

Cervical Cancer Screening Coverage — China, 2018–2019

What is already known about this topic?The World Health Organization set a 2030 target of 70%cervical cancer screening coverage for women aged 35–45 years.Coverage stood at 37%in China in 2015.What is added by this report?In 2018–2019,China’s cervical cancer screening coverage reached 43.4%in women aged 35–44 years and 36.8%in women aged 35–64 years.Screening coverage was still lower in rural areas as well as central and western regions;large variations existed across provincial-level administrative divisions.What are the implications for public health practice?National and local policy and financial support should be maintained for cervical cancer screening,along with more targeted health education and outreach efforts and strengthened accessibility of health services in the rural areas and central and western regions.

Cervical Cancer Screening Rates Among Chinese Women—China,2015

What is already known about this topic?Cervical cancer is the fourth most common cancer of women around the world.Age-adjusted incidence and mortality rates of cervical cancer were 11.78 and 3.29 per 100,000,respectively,in China in 2015.What is added by this report?Cervical cancer screening rates were 25.7%for women aged 20–64 years old and 31.4%for women aged 35–64 years old in China in 2015.Screening rates were lower in rural areas than in urban areas and varied across provinces.What are the implications for public health practice?Efforts should be made to continue to strengthen national and local policy initiatives,financial support,health education,and accessibility to women in rural areas for cervical cancer screening coverage.

Leisure-Time Physical Activity Among Chinese Adults--China, 2015

What is already known on this topic?Leisure-time physical activity(LTPA)such as sports,fitness,and recreation,is well documented to prevent chronic disease and improve health.The age-adjusted prevalence of regular LTPA was only 11.9%among Chinese adults in China in 2010.It has been reported that the age-adjusted LTPA prevalence increased from 7.13%in 2000 to 11.79%in 2011.What is added by this report?According to the latest available data,in 2015,the prevalence of LTPA and regular LTPA was 19.7%and 12.5%in adults aged 18 years old and above,respectively.Both LTPA and regular LTPA were lower in rural areas than in urban areas,higher in people with higher socioeconomic position,and varied across provinces.What are the implications for public health practice?To promote more people,especially those with lower socioeconomic position to participate in LTPA,great efforts are required to strengthen national and local policy initiatives,financial support,sports facility construction,and health education,especially in rural areas and in western China.

Breast Cancer Screening Rates Among Women Aged 20 Years and Above—China,2015

What is already known about this topic?Breast cancer is the most common cancer in women in China and around the world.By 2019,121 countries have instituted a national screening program as a secondary prevention measure for breast cancer.What is added by this report?Breast cancer screening rates in China were 18.9%in women aged 20 years and above,and 25.7%in women aged 35-64 years in 2015.The screening rate for women aged 20 years and above was significantly higher in urban areas than in rural areas(24.6%vs.15.0%),and in the eastern region than in the central and western regions(24.0%vs.15.1%and 15.3%).

The Status of Blood Lipids Among Children and Adolescents—China,2016-2017

Summary What is already known about this topic?Dyslipidemia is attributed to cardiovascular disease(CVD).A recent report suggests dyslipidemia prevalence has increased among children and adolescents.What is added by this report?Dyslipidemia prevalence was 19.43% among Chinese children and adolescents aged 6-17 years in 2016–2017.The abnormal blood lipid prevalence and the average blood lipid levels showed a diversified distribution across demographics.What are the implications for public health practice?Continued monitoring of abnormal blood lipids among Chinese children and adolescents,especially triglyceride(TG)and high-density lipoprotein cholesterol(HDL-C),may inform public health interventions to promote long-term cardiovascular health and prevent CVD in adulthood.

Breast Cancer Screening Coverage—China,2018-2019

Summary What is already known about this topic?In 2015,only 18.9%of adult women underwent breast cancer screening in China.What is added by this report?Breast cancer screening coverage for women aged 20 years and above in China reached 22.3%during 2018-2019.Women with lower socioeconomic status had lower screening coverage.There were significant variations across the provincial-level administrative divisions.

Associations Between Hypertension Status and Increased Heart Rate-China, 2015

Summary What is already known on this topic?Hypertension is a major public health concern in China,and hypertensive patients have elevated heart rates(HR),which can synergize with higher blood pressure to promote adverse health outcomes.What is added by this report?The risk of increased HR was statistically significant but relatively lower in subjects with treated and controlled hypertension.This lower impact might be modified by sex,marital status,smoking,and physical activity.

Sleep Status Among Children and Adolescents Aged 6-17 Years—China,2016-2017

Summary What is already known about this topic?There has been little to no description of sleep status among children and adolescents nationwide in recent years.What is added by this report?This report assesses the sleep duration and sleep patterns of children and adolescents in China.Approximately half of the adolescents did not get the recommended amount of sleep on school days,and more than half overslept on weekends.

Geographic Distribution of Alcohol Use Among Chinese Adults--China, 2015

What is already known on this topic?Alcohol use is attributed to more than 200 diseases and injury conditions.Recent conventional and genetic evidence is beginning to counter the benefit of moderate drinking.The prevalence of current alcohol use was 35.7%in 2007 among the Chinese population aged 18–69 years,but comparable estimations on a provincial-level has not been reported in China.What is added by this report?The prevalence of current alcohol use in the preceding year was 41.3%among the Chinese population aged 18 years and above in 2015.The prevalence of current alcohol use and the average level of daily pure alcohol intake among drinkers showed clustered and diversified geographic distribution across provinces.What are the implications for public health practice?Given diversified demographics and geographic characteristics of the current alcohol drinking population,the alcohol control policies and intervention strategies should be adopted at a provincial level to reduce alcohol-related mortality and disability.

Hypertension Prevalence,Awareness,Treatment,Control,and Associated Factors in the Labor Force Population--China,2015

What is already known about this topic?Hypertension has become a major public health problem worldwide because of its high prevalence and various complications,and it ranks the most important risk factor for cardiovascular diseases(CVDs).What is added by this report?The prevalence,awareness,treatment,and control of hypertension in the labor force population in 2015 in China were 21.4%,26.1%,19.6%,and 6.3%,respectively.Hypertension prevalence in the labor force population remains high and the control of hypertension is still very low.What are the implications for public health practice?Effective public health strategies targeting the labor force population,especially older adults,males,and overweight and obese participants are needed for hypertension prevention and control.

Association Between Urinary Sodium and Potassium Excretion and Blood Pressure Among Non-Hypertensive Adults--China,2018−2019

Summary What is already known about this topic?High sodium and low potassium in 24 h urinary excretion were associated with elevated blood pressure.What is added by this report?With increasing body mass index levels,decreasing unit urinary sodium excretion was more effective in reducing systolic and diastolic blood pressure,and increasing unit urinary potassium excretion was more effective in reducing diastolic blood pressure.What are the implications for public health practice?Reducing sodium and increasing potassium intake was more effective in reducing blood pressure in overweight and obese non-hypertensive adults compared to underweight and normal weight adults.

Salt-Related Knowledge,Behaviors,and Associated Factors Among Chinese Adults--China,2015

What is already known about this topic?Excessive salt intake is an important risk factor for hypertension and cardiovascular diseases(CVDs).The amount of salt intake of Chinese is one of the highest all over the world.At a national level,the awareness of maximum daily salt intake recommended by the“Dietary Guidelines of Chinese residents”had not been reported.What is added by this report?This is the first nationally representative study about awareness of maximum daily salt intake in China.In 2015,the awareness rate of maximum daily salt intake and behavior rate of salt reduction among Chinese adults aged 18 years old and above was 6.1%and 37.3%,respectively.The awareness rate of maximum daily salt intake and behavior rate of salt reduction was low among adult residents in China.What are the implications for public health practice?To increase the behavior rate of salt reduction in China,awareness of the maximum daily salt intake needs to be strengthened to Chinese residents,especially in rural areas or for people with low education levels and low incomes.

Association between physical activity energy expenditure and cardiometabolic risk factor clustering among Chinese adults in 2015

To understand the association between cardiometabolic risk factor(CMRF)clustering and physical activity(PA)levels,we included 86520 Chinese adults aged 18–64 years having at least one CMRF(hypertension,diabetes,dyslipidemia,or obesity)from the China Chronic Disease and Nutrition Surveillance survey in 2015,a nationally and provincially representative investigation with a multistage clustering sampling design.Self-reported PA information was collected with the Global Physical Activity Questionnaire through face-to-face interviews.In view of the obesity epidemic in CMRF patients,PA energy expenditure(PAEE)per kilogram body weight was used,and was defined into four categories:(i)inactivity:0 kJ/kg/day;(ii)low activity:0–5 kJ/kg/day;(iii)moderate activity:6–11 kJ/kg/day;and(iv)vigorous activity:≥12 kJ/kg/day.The estimated weighted prevalence(95%confidence interval[CI])of having 1,2,3,and 4 CMRFs was 60.57%(59.48%–61.67%),28.10%(27.40%–28.79%),9.82%(9.22%–15.42%)and 1.50%(1.37%–1.63%),respectively.The rate(95%CI)of inactivity,low activity,moderate activity,and vigorous activity was 34.52%(32.69%–36.35%),22.22%(21.37%–23.37%),15.98%(15.38%–16.58%)and 27.28%(26.02%–28.53%),respectively.For those having 2,3 and 4 CMRFs(compared to those having 1 CMRF),the adjusted odds ratio(95%CI)for moderate activity and vigorous activity were 0.91(0.85–0.98)and 0.92(0.85–0.99),0.87(0.80–0.95)and 0.84(0.77–0.92),and 0.77(0.67–0.89)and 0.85(0.72–1.00),respectively.In conclusion,CMRF clustering was a pandemic among Chinese adults in 2015 and was inversely associated with PA level.PAEE(in kJ/kg/day)may be introduced into PA management practice,especially for populations with high body weight.