Estimated cancer incidence and mortality in Hebei province,2012

Objective： This study estimates the numbers of new cancer cases and cancer deaths in Hebei province using incidence and mortality data from 9 population-based cancer registries in 2012. Methods： The data of new diagnosed cancer cases and cancer deaths in 2012 were collected from 9 population-based cancer registries of Hebei province in 2015. All the data met the National Central Cancer Registry of China （NCCR） criteria of data quality. The pooled data analysis was stratified by areas （urban/ rural）, gender, age group （0, 1-4, 5-9, 10-14 85＋） and cancer type. New cancer cases and deaths in Hebei province were estimated using age-specific rates and corresponding provincial population in 2012. The 10 most common cancers in different groups and the cumulative rates were calculated. Chinese population census in 2000 and Segi＇s population were used for age-standardized incidence/mortality rates. Results： All cancer registries covered 4,986,847 populations, 6.84% of Hebei provincial population （2,098,547 in urban and 2,888,300 in rural areas）. The percentage of cases morphologically verified （MV%） and death certificate-only cases （DCO%） were 76.40% and 4.72%, respectively. The mortality to incidence rate ratio （M/I） was 0.64. In 2012, it is estimated that there were about 187,900 new diagnosed cancer cases and 119,800 cancer deaths in Hebei province. The incidence rate of cancer was 258.12/100,000 （275.75/100,000 in males, 239.78/100,000 in females）, and the age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 210.65/100,000 and 208.50/100,000, with the cumulative incidence rates （0-74 years old） of 24.46%. The cancer incidence and ASIRC were 256.99/100,000 and 211.32/100,000 in urban areas and 258.94/100,000 and 209.99/100,000 in rural areas, respectively. The cancer mortality rate was 164.63/100,000 （201.85/100,000 in males, 125.92/100,000 in females）. Age- standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were 137.30/100,000 and 137.39/100,000 with the cumulative mortality rate （0-74 years old） of 14.58%, respectively. The cancer mortality rate in rural areas （167.16/100,000） was higher than that in urban areas （161.16/100,000）. The most common cancers were lung cancer, stomach cancer, breast cancer, esophageal cancer, liver cancer and colorectal cancer, which accounted for 72.31% of all cancer cases. Lung cancer, stomach cancer, liver cancer, esophageal cancer and colorectal cancer were the major causes of cancer death in Hebei province, which accounted for 75.24% of all cancer deaths. The cancer spectrum differs between urban and rural, males and females in both incidence and mortality rates. Conclusions： The most common cancers were lung cancer, stomach cancer, esophageal cancer, breast cancer, liver cancer and eolorectal cancer in Hebei province.

Impact of regional differences in stroke symptom awareness and low-income status on seeking emergency medical service in China

Background:Unawareness of stroke symptoms and low income are two barriers that affect the seeking of emergency medical service(EMS).This study aimed to assess the effect of unawareness and low income on seeking EMS and to investigate the regional distribution of the unawareness and low-income status and their associations with failing to call EMS in China.Methods:A total of 187,723 samples from the China National Stroke Screening Survey was interviewed cross-sectionally.Four status of awareness and annual income were identified:unaware and low-income,unaware-only,low-income-only,and aware and regular income.The outcomes were whether they intended to call EMS or not.The regional distribution of each status and their associations with not calling EMS were presented.Results:The status of unaware and low-income,unaware-only,and low-income-only accounted for 6.3%(11,806/187,673),11.9%(22,241/187,673),and 21.5%(40,289/187,673)of the total sample,respectively.Not calling EMS was significantly associated with the status of unaware and low-income(odds ratio[OR]:3.21,95%confidence interval[Cl]:3.07-3.35),unaware-only(OR:2.38,95%Cl:2.31-2.46),and low-income-only(OR:1.67,95%Cl:1.63-1.71),compared with the aware and regular income status.The Midwest regions had higher percentages of people in the unaware and low-income status;the East,South,and Central had higher percentages of unaware-only status;the North and Northeast regions had a higher percentage of low-income-only status,compared with other regions.Conclusion:The existence of the regional difference in unawareness and low income justifies the specific stroke education strategies for the targeted regions and population.