Spatio-temporal Distribution Characteristics and Environmental Impact Factors of Lung Cancer Mortality: A Case Study of Yuhui District in Bengbu City, China

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.

Epidemiologic Study of Cancer Mortality among Chloroprene Workers

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.

THE PREDICTION OF CANCER MORTALITY IN SHANDONG PROVINCE (1991-2000) AND CANCER CONTROL STRATEGY

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

Time-Lag Effect of Dietary Fiber and Fat Intake Ratio on Japanese Colon Cancer Mortality

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

Linking of Environmental and Health Indicators by Neural Networks:Case of Breast Cancer Mortality,Slovak Republic

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.

Comprehensive Analysis of Cancer Incidence and Mortality Trends in Costa Rica: Implications for Public Health

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.

Association between time in range and cancer mortality among patients with type 2 diabetes:a prospective cohort study

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.

Cancer incidence and mortality in China, 2014

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.

Comparison of cancer incidence and mortality in three GDP per capita levels in China, 2013

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.

Exclusive Hormonal Therapy in Breast Cancer in Elderly Women:Clinical Response and Survival over 10 Years

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.

Predictions of mortality related to four major cancers in China,2020 to 2030

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.

Cancer situation in China:what does the China cancer map indicate fromthe first national death survey to the latest cancer registration?

Background:Over the past four decades,the Chinese government has conducted three surveys on the distribution of causes of death and built cancer registration.In order to shine a new light on better cancer prevention strategies in China,we evaluated the profile of cancer mortality over the forty years and analyzed the policies that have been implemented.Methods:We described spatial and temporal changes in both cancer mortality and the ranking of major cancer types in China based on the data collected from three national surveys during 1973-1975,1990-1992,2004-2005,and the latest cancer registration data published by National Central Cancer Registry of China.The mortality data were compared after conversion to age-standardized mortality rates based on the world standard population(Segi’s population).The geographical distribution characteristics were explored by marking hot spots of different cancers on the map of China.Results:From 1973 to 2016,China witnessed an evident decrease in mortality rate of stomach,esophageal,and cervical cancer,while a gradual increase was recorded in lung,colorectal,and female breast cancer.A slight decrease of mortality rate has been observed in liver cancer since 2004.Lung and liver cancer,however,have become the top two leading causes of cancer death for the last twenty years.From the three national surveys,similar profiles of leading causes of cancer death were observed among both urban and rural areas.Lowermortality rates from esophageal and stomach cancer,however,have been demonstrated in urban than in rural areas.Rural areas had similar mortality rates of the five leading causes of cancer death with the small urban areas in 1973-1975.Additionally,rural areas in 2016 also had approximate mortality rates of the five leading causes with urban areas in 2004-2005.Moreover,stomach,esophageal,and liver cancer showed specific geographical distributions.Althoughmortality rates have decreased atmost of the hotspots of these cancers,they were still higher than the national average levels during the same time periods.Conclusions:Building up a strong primary public health system especially among rural areas may be one critical step to reduce cancer burden in China.

HPV Vaccination in Young Girls from Developing Countries: What Are the Barriers for Its Implementation? A Systematic Review

Cervical cancer is the second most common cancer in women living in developing countries that account high HPV incidence and mortality rates. Vaccinating girls between 9 and 14 years old is supposed to be the most cost-effective public health approach against cervical cancer. This systematic review aims to assess the application and coverage of the HPV vaccine in developing countries and identify the main challenges for the introduction of the vaccine in these settings. Eligible studies were selected according to the defined inclusion and exclusion criteria. To determine the quality of the studies was employed the STROBE checklist. This review included seven studies, encompassing the analysis of 19 countries and 112,116 girls aged from 9 to 18 years old. The coverage of HPV vaccination ranged from 13.8% to 107.4%, with most of the programs having more than 60% of coverage, which reflects a high percentage of vaccinated girls. The main challenges were lack of knowledge and worries about the vaccine, insufficient financial resources and staff workers, lack of community involvement and dissemination of important information about HPV. In developing countries that implemented the HPV vaccine, high coverage rates were achieved, despite sociocultural, economic and political challenges. In the future, studies that analyze the coverage rates after the elimination of the barriers and the repercussions on the mortality rates should be conducted, so that more developing countries have the opportunity to efficiently implement the vaccine.

Trend analysis of cancer incidence and mortality in China

The National Central Cancer Registry of China(NCCRC)updated their nationwide statistics of cancer incidence and mortality in China according to 2013 population-based cancer registration data(due to the time required for data collection,quality control and analysis,the latest cancer statistics available in China have a 3-year lag behind the current year).In this report,the NCCRC provides a comprehensive review of cancer incidence and mortality rates,as well as the statistics overall and by geographical area,cancer sites or age groups(Chen et al.,2017a).It shows that the burden of cancer

Oncological outcomes of patients with ductal adenocarcinoma of the prostate receiving radical prostatectomy or radiotherapy

Objective:To evaluate the oncological outcomes of ductal adenocarcinoma of the prostate(DAC)managed with radical prostatectomy(RP)or radiotherapy(RT)and optimize the proper treatment modality to DAC comprehensively.Methods:The cohorts included a total of 528 patients from the Surveillance,Epidemiology and End Results(SEER)database,354 receiving RP and 174 receiving RT.Cox proportional hazards regressions were performed to assess cancer specific mortality(CSM)and overall mortality(OM)between treatment groups.A competing risk analysis was further conducted.Subgroup analyses by age and level of prostate-specific antigen(PSA)were performed.Propensity score matching was implemented.Results:Patients managed with RP had lower risks of CSM and OM compared with RT(before matching:Hazard ratio[HR]=0.24,95%confidence interval[CI]0.13-0.47 and HR=0.26,95%CI 0.17-0.40,respectively;after matching:HR=0.18,95%CI 0.04-0.82 and HR=0.28,95%CI 0.11-0.70,accordingly).Subgroup analyses demonstrated that patients in the middle tertile of the age or with lower tertile PSA level managed with RP took lower risks of OM significantly(HR=0.18,95%CI 0.06-0.57,p<0.01 and HR=0.17,95%CI 0.06-0.54,p<0.01).Conclusion:Among patients with DAC,treatment with RP was associated with better survival outcomes in comparison with RT.Patients with DAC in the middle tertile of the age and with lower tertile PSA level benefited the most from RP.

Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020

Background:Cancer is one of the leading causes of death globally,but its burden is not uniform.GLOBOCAN 2020 has newly updated the estimates of cancer burden.This study summarizes the most recent changing profiles of cancer burden worldwide and in China and compares the cancer data of China with those of other regions.Methods:We conducted a descriptive secondary analysis of the GLOBOCAN 2020 data.To depict the changing global profile of the leading cancer types in 2020 compared with 2018,we extracted the numbers of cases and deaths in 2018 from GLOBOCAN 2018.We also obtained cancer incidence and mortality from the 2015 National Cancer Registry Report in China when sorting the leading cancer types by new cases and deaths.For the leading cancer types according to sex in China,we summarized the estimated numbers of incidence and mortality,and calculated China’s percentage of the global new cases and deaths.Results:Breast cancer displaced lung cancer to become the most leading diagnosed cancer worldwide in 2020.Lung,liver,stomach,breast,and colon cancers were the top five leading causes of cancer-related death,among which liver cancer changed from the third-highest cancer mortality in 2018 to the second-highest in 2020.China accounted for 24%of newly diagnosed cases and 30%of the cancer-related deaths worldwide in 2020.Among the 185 countries included in the database,China’s age-standardized incidence rate(204.8 per 100,000)ranked 65th and the age-standardized mortality rate(129.4 per 100,000)ranked 13th.The two rates were above the global average.Lung cancer remained the most common cancer type and the leading cause of cancer death in China.However,breast cancer became the most frequent cancer type among women if the incidence was stratified by sex.Incidences of colorectal cancer and breast cancer increased rapidly.The leading causes of cancer death varied minimally in ranking from 2015 to 2020 in China.Gastrointestinal cancers,including stomach,colorectal,liver,and esophageal cancers,contributed to a massive burden of cancer for both sexes.Conclusions:The burden of breast cancer is increasing globally.China is undergoing cancer transition with an increasing burden of lung cancer,gastrointestinal cancer,and breast cancers.The mortality rate of cancer in China is high.Comprehensive strategies are urgently needed to target China’s changing profiles of the cancer burden.

Complex multimorbidity and health outcomes in older adult cancer survivors

Objective:To characterize complex multimorbidity among cancer survivors and evaluate the association between cancer survivorship,time since cancer diagnosis,and self-reported fair/poor health,self-rated worse health in 2 years,and 2-year mortality.Methods:We used the 2010-2012 Health and Retirement Study.Cancer survivors were indi-viduals who reported a(nonskin)cancer diagnosis 2 years or more before the interview.We defined complex multimorbidity as the co-occurrence of chronic conditions,functional limitations,and/or geriatric syndromes.In addition to descriptive analyses,we used logistic regression to evaluate the independent association between cancer survivor status and health outcomes.We also examined whether cancer survivorship differed by the number of years since diagnosis.Results:Among 15,808 older adults(age≥50 years),11.8%were cancer survivors.Compared with cancer-free individuals,a greater percentage of cancer survivors had complex multimorbidity:co-occurring chronic conditions,functional limitations,and geriatric syndromes.Cancer survivor-ship was significantly associated with self-reported fair/poor health,self-rated worse health in 2 years,and 2-year mortality.These effects declined with the number of years since diagnosis for fair/poor health and mortality but not for self-rated worse health.Conclusion:Cancer survivor status is independently associated with more complex multi-morbidity,and with worse health outcomes.These effects attenuate with time,except for patient perception of being in worse health.