Trends in cancer mortality in China from 2004 to 2018:A nationwide longitudinal study

Background:The long-term trend in cancer death in a rapidly developing country provides information for cancer prophylaxis.Here,we aimed to identify the trends in cancer mortality in China during the 2004-2018 period.Methods:Using raw data from the national mortality surveillance system of China,we assessed the mortalities of all cancer and site-specific cancers during the 2004-2018 period.The participants were divided into three age groups:≥65 years,40-64 years,and≤39 years.Changing trends in cancer death by gender,residency,and tumor location were estimated using fitting joinpoint models to log-transformed crude mortality rates(CMRs)and age-standardizedmortality rates(ASMRs).Results:Cancer death accounted for 24% of all-cause of death in China during 2014-2018.The CMR of all cancer was 150.0 per 100,000 persons.Cancer was the leading cause of death in the population<65 years.The six major cancer types(lung/bronchus cancer,liver cancer,stomach cancer,esophagus cancer,colorectal cancer,and pancreas cancer)accounted for 75.85% of all cancer deaths.The CMR of all cancer increased while the ASMR decreased during 2014-2018(P<0.001).Lung/bronchus cancer and liver cancer were the leading causes of cancer death in the population<65 years,accounting for 45.31%(CMR)and 44.35%(ASMR)of all cancer death,respectively.The ASMR of liver cancer was higher in the 40-64 years population than in the≥65 years population,in contrast to the other five major cancers.The ASMRs of liver cancer,stomach cancer,and esophagus cancer decreased although they were higher in rural residents than in urban residents;the ASMRs of lung/bronchus cancer,colorectal cancer,and pancreas cancer increased in rural residents although they were higher in urban residents than in rural residents during 2014-2018.Conclusion:Although the ASMR of all cancer decreased in China during 2004-2018,lung/bronchus cancer and liver cancer remained the leading causes of cancer-related premature death.Lung/bronchus cancer,colorectal cancer,and pancreas cancer increased in rural residents.

Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran： 2011-2014 data

Purpose： The administrative data from trauma centers could serve as potential sources of invaluable information while studying epidemiologic features of car accidents. In this cross-sectional analysis of Shahid Rajaee hospital administrative data, we aimed to evaluate patients injured in car accidents in terms of age, gender, injury severity, injured body regions and hospitalization outcome in the recent four years （2011-2014）. Methods： The hospital registry was accessed at Shiraz Trauma Research Center （Shiraz, lran） and the admission＇s unit data were merged with the information gathered upon discharge. A total number of 27,222 car accident patients aged over 15 years with International Classification of Diseases 10th revision （ICD-10） external causes of injury codes （V40.9-V49.9） were analyzed. Injury severity score and injured body regions were determined based on converting ICD-10 injury codes to Abbreviated Injury Scale （AIS- 98） severity codes using a domestically developed electronic algorithm. A binary logistic regression model was applied to the data to examine the contribution of all independent variables to in-hospital mortality. Results： Men accounted for 68.9% of the injuries and the male to female ratio was 2.2：1. The age of the studied population was （34 ±15） years, with more than 77.2% of the population located in the 15-45 years old age group. Head and neck was the most commonly injured body region （39.0%） followed by extremities （27.2%）. Injury severity score （ISS） was calculated for 13,152 （48.3%） patients, of whom, 80.9% had severity scores less than 9. There were 332 patients （1.2%） admitted to the intensive care units and 422 in-hospital fatalities （1.5%） were recorded during the study period. Age above 65 years [OR = 7.4, 95%, CI （5.0-10.9）], ISS above 16 [OR - 9.1, 95% CI （5.5-14.9）], sustaining a thoracic inJury [OR - 7.4, 95%, CI （4.6 -11.9）] and head injury [OR - 4.9, 95%, CI （3.1-7.6）] were the most important independent predictors of death following car accidents. Conclusion： Hospital administrative databases of this hospital could be used as reliable sources of in- formation in providing epidemiologic reports of car accidents in terms of severity and outcomes. Improving the quality of recordings at hospital databases is an important initial step towards more comorehensive iniurv surveillance in Fats, Iran.