East meets West:ethnic differences in epidemiology and clinical behaviors of lung cancer between East Asians and Caucasians

Lung cancer is the leading cause of cancer death worldwide,with large variation of the incidence and mortality across regions.Although the mortality of lung cancer has been decreasing,or steady in the US,it has been increasing in Asia for the past two decades.Smoking is the leading cause of lung cancer,and other risk factors such as indoor coal burning,cooking fumes,and infections may play important roles in the development of lung cancer among Asian never smoking women.The median age of diagnosis in Asian patients with lung cancer is generally younger than Caucasian patients,particularly among never-smokers.Asians and Caucasians may have different genetic susceptibilities to lung cancer,as evidenced from candidate polymorphisms and genome-wide association studies.Recent epidemiologic studies and clinical trials have shown consistently that Asian ethnicity is a favorable prognostic factor for overall survival in non-small cell lung cancer(NSCLC),independent of smoking status.Compared with Caucasian patients with NSCLC,East Asian patients have a much higher prevalence of epidermal growth factor receptor(EGFR) mutation(approximately 30% vs.7%,predominantly among patients with adenocarcinoma and never-smokers),a lower prevalence of K-Ras mutation(less than 10% vs.18%,predominantly among patients with adenocarcinoma and smokers),and higher proportion of patients who are responsive to EGFR tyrosine kinase inhibitors.The ethnic differences in epidemiology and clinical behaviors should be taken into account when conducting global clinical trials that include different ethnic populations.

Mortality in relation to changes in physical activity in middle-aged to older Chinese:An 8-year follow-up of the Guangzhou Biobank Cohort Study

Background:Physical activity(PA)is generally encouraged.Studies from developed countries in the West have shown that maintenance of adequate PA or increasing PA are associated with lower mortality risk.It is unclear whether these associations apply to an older Chinese population.Hence,we examined the changes in PA prospectively among a middle-aged and older Chinese population over an average of 4 years and explored their subsequent mortality risks.Methods:Metabolic equivalent scores of PA among participants in the Guangzhou Biobank Cohort Study were calculated.Participants were divided into 3 groups related to PA level,and changes in PA were classified into 9 categories.Information on vital status and causes of death from March 2008 to December 2012(the first repeated examination)until December 31,2017,was obtained via record linkage with the Death Registry.Results:Of 18,104 participants aged 61.21±6.85 years(mean±SD),1461 deaths occurred within 141,417 person-years.Compared to participants who maintained moderate PA,those who decreased PA from moderate or high levels to a low level had increased risks for all-cause mortality(hazard ratio(HR)=1.47,95%confidence interval(95%CI):1.11-1.96).Participants who maintained a high level of PA(HR=0.83,95%CI:0.70-0.98)or increased PA from low to high levels(HR=0.71,95%CI:0.52-0.97)showed lower all-cause mortality risks.Those who maintained low PA levels showed a higher all-cause mortality risk,whereas those who increased their PA levels showed a non-significantly lower risk.Similar results were found for cardiovascular disease risk.Conclusion:Even at an older age,maintaining a high PA level or increasing PA from low to high levels results in lower mortality risks,suggesting that substantial health benefits might be achieved by maintaining or increasing engagement in adequate levels of PA.The increased risk of maintaining a low PA level or decreasing PA to a low level warrants the attention of public health officials and clinicians.

Risk of group aggregative behavior during COVID-19 outbreak: A case report

BACKGROUND At the end of 2019,a new epidemic of viral pneumonia emerged in China and was determined to be caused by a novel coronavirus,which was named coronavirus disease 2019(COVID-19)by the World Health Organization.The epidemic quickly spread,causing a worldwide pandemic.Scientists and clinicians across the globe have shifted their research efforts towards understanding the virus itself and its epidemiology.CASE SUMMARY In mid-January 2020,a Chinese family made a visit to a local city,and within the next 2 wk one after another fell ill with COVID-19.At the beginning of their first illness onset,the family had eaten in a restaurant,which led to the subsequent illness onset in another two families.All cases were diagnosed as COVID-19 by real-time fluorescent reverse transcription-polymerase chain reaction.Epidemiological investigation showed that the transmission chain was complete.CONCLUSION This chain of social exposure highlights the danger of group aggregative behavior for spread of COVID-19.