Cancer Incidence In China Research Articles

Influence of the atmospheric environment on spatial variation of lung cancer incidence in China.

Conducting this research contributes to a deeper understanding of the correlation between atmospheric environmental quality and lung cancer incidence, and provides the scientific basis for formulating effective environmental protection and lung cancer prevention and control strategies. Lung cancer incidence in China has strong spatial variation. However, few studies have systematically revealed the characteristics of the spatial variation in lung cancer incidence, and have explained the causes of this spatial variation in lung cancer incidence from the perspectives of multiple components of the atmospheric environment to explain this spatial variation in lung cancer incidence. To address research limitations, we first analyze the spatial variation and spatial correlation characteristics of lung cancer incidence in China. Then, we build a spatial regression model using GeoDa software with lung cancer incidence as the dependent variable, five atmospheric environment factors-particulate matter 2.5 (PM2.5) concentration, temperature, atmospheric pressure, and elevation as explanatory variables, and four socio-economic characteristics as control variables to systematically analyze the influence and intensity of these factors on lung cancer incidence. The results show that lung cancer incidence in China has apparent changes in geographical and spatial unevenness, and spatial autocorrelation characteristics. In China, the lung cancer incidence is relatively high in Northeast China, while some areas of high lung cancer incidence still exist in Central China, Southwest China and South China, although the overall lung cancer incidence is relatively low. The atmospheric environment significantly affects lung cancer incidence. Different elements of the atmospheric environment vary in the direction and extent of their influence on the development of lung cancer. A 1% increase in PM2.5 concentration is associated with a level of 0.002975 increase in lung cancer incidence. Atmospheric pressure positively affects lung cancer incidence, and an increase in atmospheric pressure by 1% increases lung cancer incidence by a level of 0.026061. Conversely, a 1% increase in temperature is linked to a level of 0.006443 decreases in lung cancer incidence, and a negative correlation exists between elevation and lung cancer incidence, where an increase in elevation by 1% correlates with a decrease in lung cancer incidence by a level of 0.000934. The core influencing factors of lung cancer incidence in the seven geographical divisions of China exhibit variations. This study facilitates our understanding of the spatial variation characteristics of lung cancer incidence in China on a finer scale, while also offering a more diverse perspective on the impact of the atmospheric environment on lung cancer incidence.

Prevalence of High-Risk Human Papillomavirus Infection, Associated Risk Factors, and Relationship With Cervical Precancerous Lesions in Perimenopausal and Older Women in an Area With High Cervical Cancer Incidence in China.

Purpose This study delves into the epidemiology of high-risk human papillomavirus (HR-HPV) infection and its link to precancerous lesions among perimenopausal (40-59 years) and elderly (60-65 years) women in a Chinese county with a notably high incidence of cervical cancer. By uniquely focusing on these age groups in underdeveloped regions, the research aims to offer novel strategies for the management and prevention of cervical cancer. It seeks to inform targeted interventions and public health policies that could significantly benefit women at heightened risk for HPV, addressing a critical gap in current prevention efforts in economically disadvantaged communities. Methods This observational study was conducted at the Maternal and Child Health and Family Planning Service Centre in Lueyang County, from September 2021 to January 2022. It assessed 2008 women aged 40-65 for HPV screening, with 342 undergoing further cytological examination. The study evaluated the prevalence of HPV infection across different age groups and risk categories. It utilized a questionnaire to collect participants' basic information, health behaviors, and other relevant data to analyze factors influencing HR-HPV infection. Statistical analyses comprised chi-square tests, trend analysis, logistic regression, and multiple imputation techniques to address missing data. Results The prevalence of HR-HPV infection among women aged 40-65 years in Lueyang County was 18.43%. Older women exhibited a higher incidence of HPV infection, abnormal ThinPrep Cytology Test (TCT) results (Shaanxi Fu'an Biotechnology Co.Ltd., Baoji City, China), and low/high-grade squamous intraepithelial lesions (LSIL/HSIL) (P<0.05). The most prevalent HR-HPV genotypes in the overall, perimenopausal, and elderly groups were HPV-52, -53, and -58; HPV-52, -53, and -16; and HPV-58, -52, and -53, respectively. The prevalent HR-HPV genotypes in the abnormal The Bethesda System (TBS) results were HPV-16, -52, -33, -58; -16, -52, -58; and-16, -33, and -52. HPV-16, -18, -33 prevalence increased with increasing lesion severity (P<0.05). In this study, factors affecting HR-HPV in the three age groups were found to be mainly related to sexual behavior and education level, including history of lower genital tract diseases, multiple pregnancies, contraceptive methods without tubal ligation, age at first marriage greater than 18 years, never washing the vulva after sex, abstinence from sex, education level of junior high school or above, and spouse's education level of high school or above. Conclusions These findings suggest that the elevated rate of abnormal TBS in the older age group may be attributed to the higher prevalence of persistent infection-prone HR-HPV genotypes (HPV-58, -52, and-53), multiple infections, and potent oncogenic HR-HPV genotypes (HPV-16 and -33). Additionally, the higher HR-HPV prevalence in older patients may be related to lower education attainment, reduced screening rate, and limited condom usage. Therefore, strategies targeting perimenopausal and older women should prioritize enhancing health awareness, increasing screening rates, and encouraging condom utilization.

Cancer statistics for young adults aged 20 to 49 years in China from 2000 to 2017: a population-based registry study.

An increasing cancer incidence among adults younger than 50 years has been reported for several types of cancer in multiple countries. We aimed to report cancer profiles and trends among young adults in China. Data from the China Cancer Registry Annual Report were used to estimate incidence and mortality among young adults (ages 20-49 years) in China in 2017, and an age-period-cohort model was employed to estimate the average annual percent change (AAPC) in incidence and mortality from 2000 to 2017. All 25 cancer types were grouped into obesity- or overweight-associated cancers (12 cancer types) and additional cancers (13 cancer types). In 2017, there were 681,178 new cases and 214,591 cancer deaths among young adults in China. Among young adults, the most common cancers were thyroid, breast, cervical, liver, lung, and colorectal cancer, and the leading causes of cancer deaths were liver, lung, cervical, stomach, breast, and colorectal cancer. From 2000 to 2017, the cancer incidence increased for all cancers combined among young adults, with the highest AAPC (1.46%) for adults aged 20-24 years, while cancer mortality decreased, with the highest AAPC (-1.63%) for those aged 35-39 years. In conclusion, the cancer incidence in China has increased among young adults, while cancer mortality has decreased for nearly all ages. Cancer control measures, such as obesity control and appropriate screening, may contribute to reducing the increasing cancer burden among young adults.

Geographic, sex and socioeconomic disparities in esophageal cancer incidence in China: A population-based study.

Geographic and sex differences in esophageal cancer have been reported in China, but data are lacking at the local level. We aimed to investigate geographic and sex disparities in esophageal cancer incidence among Chinese counties and whether county-level socioeconomic status was associated with these variations. We obtained esophageal cancer data from 2015 to 2017 for 782 counties from population-based cancer registries in China. We calculated age-standardized incidence rates and male-to-female incidence rate ratios (IRRs) by county. We performed hotspot analysis to identify geographical clusters. We used negative binomial regression models to analyze the association between incidence rates and county-level socioeconomic factors. There were significant geographic disparities in esophageal cancer incidence, with 8.1 times higher rate in the 90th-percentile county than in the 10th-percentile county (23.7 vs 2.9 per 100 000 person-years). Clusters of elevated rates were prominent across north-central China. Nationally, men had 2.9 times higher incidence of esophageal cancer than women. By county, the male-to-female IRRs ranged from 1.1 to 21.1. Clusters of high male-to-female IRRs were observed in northeast China. Rurality (IRR 1.16, 95% CI 1.10-1.22), per capita gross domestic product (IRR 0.95, 0.92-0.98) and percentage of people with a high school diploma (IRR 0.86, 0.84-0.87) in a county were significantly associated with esophageal cancer incidence. The male-to-female IRRs were higher in counties with higher socioeconomic status. Substantial differences in incidence rates and sex ratios of esophageal cancer exist between Chinese counties, and county-level socioeconomic status was associated with these variations. These findings may inform interventions to reduce these disparities.

Assessment of the spatial association between multiple pollutants of surface water and digestive cancer incidence in China: A novel application of spatial machine learning

Surface water pollution and digestive cancers are concerning environmental health issues. Multiple pollutants of surface water coexist within unique geospatial heterogeneous contexts of surface water flow, which can lead to complex patterns of impact on cancer incidence. This complexity has posed challenges to comprehensive assessment. In this study, we integrated nationwide surface water data of 21 pollutants collected from 3632 sections of nine large river basins and cancer incidence data for six digestive cancers covering 381.6 million people in China. Local Moran's I method was used to assess the patterns of spatial aggregation of each surface water pollutant separately to observe the local spatial nonstationarity and heterogeneity of the pollutant concentrations in different spatial areas. A geographically weighted random forest (GWRF) model, a spatial machine learning approach, was applied to address the spatial heterogeneity of the pollutants and assess their association with cancer incidence. Goodness-of-fit and overall performance of the GWRF model were assessed by the local statistics in the out-of-bag set, such as the mean local pseudo-R2, increase in mean squared error, and local residuals in each local model. Compared with the aspatial random forest model, the GWRF model had better performance (mean local pseudo-R2 ranged from 0.16 (gallbladder cancer) to 0.60 (pancreatic cancer)). Surface water pollution was associated with digestive cancer incidence mainly in the Songhua and Liaohe, Haihe, and Huaihe River Basins. By focusing on these areas, we identified key pollutants specific to different cancer types. Incidence of oesophageal, stomach, colorectal, gallbladder, and pancreatic cancer was associated with common pollutants such as fluoride and arsenic. Our assessment provides targets for the government and environmental health specialists to take tailored actions to control pollution and effectively prevent cancer incidence.

Impact of changing the prevalence of smoking, alcohol consumption and overweight/obesity on cancer incidence in China from 2021 to 2050: a simulation modelling study

Smoking, alcohol consumption and overweight/obesity are key cancer risk factors contributing to the cancer burden in China. We aimed to quantify the cancer burden in China associated with smoking, alcohol consumption and overweight/obesity, and estimate the potential effect for cancer prevention interventions under different scenarios. We used a macro-simulation approach called Prevent Model to estimate for a 30-year study period (2021-2050) numbers and proportions of future avoidable cancer cases under different scenarios of reducing the prevalence of smoking, alcohol consumption and overweight/obesity in Chinese adults. Cancer incidence was predicted under three scenarios: elimination, ambitious target (between elimination and manageable target) and manageable target (from national policy or global action plan). Risk factor prevalence was obtained from China Chronic Disease and Risk Factor Surveillance, and cancer incidence data were derived from the China Cancer Registry Annual Report. Relative risks were obtained from several recent large-scale studies or high-quality meta-analysis. Population data were extracted from the China Population & Employment Statistical Yearbook, China Health Statistical Yearbook and World Population Prospects. Estimates of the avoidable cancer burden varied with different scenarios. In the theoretical maximum intervention scenario, where the prevalence of smoking, alcohol consumption and overweight/obesity would be eliminated, 9.17% (males: 13.50%; females: 1.47%) of smoking-related cancer cases, 7.06% (males: 11.49%; females: 1.00%) of cancer cases related to alcohol consumption and 8.22% (males: 7.91%; females: 8.52%) of overweight/obesity-related cancer cases were estimated to be avoidable during 2021-2050. Other scenarios, with more moderate goals in the exposure prevalence of smoking, alcohol use and overweight/obesity were also found to be associated with substantial reductions in the future cancer burden. Our results suggested that a substantial number of future cancer cases could be avoided in Chinese adults by reducing the prevalence of smoking, alcohol consumption and overweight/obesity. National Science & Technology Fundamental Resources Investigation Program of China; Sanming Project of Medicine in Shenzhen.

Unintrusive multi-cancer detection by circulating cell-free DNA methylation sequencing (THUNDER): development and independent validation studies

Early detection of cancer offers the opportunity to identify candidates when curative treatments are achievable. The THUNDER study (THe UNintrusive Detection of EaRly-stage cancers, NCT04820868) aimed to evaluate the performance of ELSA-seq, a previously described cfDNA methylation-based technology, in the early detection and localization of six types of cancers in the colorectum, esophagus, liver, lung, ovary and pancreas. A customized panel of 161,984 CpG sites was constructed and validated by public and in-house (cancer: n=249; non-cancer: n=288) methylome data, respectively. The cfDNA samples from 1,693 participants (cancer: n=735; non-cancer: n=958) were retrospectively collected to train and validate two multi-cancer detection blood test models (MCDBT-1/2) for different clinical scenarios. The models were validated on a prospective and independent cohort of age-matched 1,010 participants (cancer: n=505; non-cancer: n=505). Simulation using the cancer incidence in China was applied to infer stage-shift and survival benefits to demonstrate the potential utility of the models in the real world. MCDBT-1 yielded a sensitivity of 69.1% (64.8%‒73.3%), a specificity of 98.9% (97.6%‒99.7%) and tissue origin accuracy of 83.2% (78.7%‒87.1%) in the independent validation set. For early stage (I‒III) patients, the sensitivity of MCDBT-1 was 59.8% (54.4%‒65.0%). In the real-world simulation, MCDBT-1 achieved the sensitivity of 70.6% in detecting the six cancers, thus decreasing late-stage incidence by 38.7%‒46.4%, and increasing 5-year survival rate by 33.1%‒40.4%, respectively. In parallel, MCDBT-2 was generated at a slightly low specificity of 95.1% (92.8%-96.9%) but a higher sensitivity of 75.1% (71.9%-79.8%) than MCDBT-1 for populations at relatively high risk of cancers, and also had ideal performance. In this large-scale clinical validation study, MCDBT-1/2 models showed a high sensitivity, specificity, and accuracy of predicted origin in detecting six types of cancers.

Pediatric cancer incidence in China.

Pediatric cancer incidence in China.

Time Trend of Upper Gastrointestinal Cancer Incidence in China from 1990 to 2019 and Analysis Using an Age-Period-Cohort Model.

The aim of this study was to investigate the upper gastrointestinal cancer incidence trend in China from 1990 to 2019 with Joinpoint software and to evaluate the age effect, cohort effect, and period effect using the age–period–cohort model, with the data obtained from the Global Burden of Disease, Injuries, and Risk Factors Study. The crude incidence rate (CR) of upper gastrointestinal cancer in China increased from 41.48/100,000 in 1990 to 62.64/100,000 in 2019, and the average annual percent change (AAPC) was 1.42 (p < 0.05). The age-standardized incidence rate (ASIR) decreased from 50.77/100,000 to 37.42/100,000, and the AAPC was −1.12 (p < 0.05). The net drift was −0.83 (p < 0.05), and the local drifts in the 35–79 age groups of males and all age groups of females were less than 0 (p < 0.05). The age effect showed that the upper gastrointestinal cancer onset risk gradually increased with age, the period effect was fundamentally manifested as a downward trend in onset risk after 2000, and the cohort effect indicated the decreased onset risk of the overall birth cohort after 1926. The ASIR of upper gastrointestinal cancer in China from 1990 to 2019 showed a downward trend, and the onset risk indicated the age, period, and cohort effects.

Preoperative neoadjuvant chemotherapy in patients with breast cancer evaluated using strain ultrasonic elastography.

BACKGROUNDThe incidence of breast cancer in China is increasing while its mortality rate is decreasing. The annual breast cancer incidence in China is 39.2 million, accounting for two-thirds of the urban population. In China, breast cancer is the fifth most common malignant tumor overall and the most common in women, accounting for 17% of female malignant tumors. AIMTo investigate the accuracy of strain ultrasound elastography (SUE) on the evaluation of preoperative neoadjuvant chemotherapy (NAC) in breast cancer.METHODSOverall, 90 patients with breast cancer treated at our hospital between January 2018 and February 2019 were selected for this study. The patients received six cycles of NAC with docetaxel, epirubicin, and cyclophosphamide. Surgical treatment was also performed, and pathological reactivity was assessed. The patients were evaluated using conventional ultrasonography and SUE before biopsy. The differences between groups were analyzed to calculate the mean and standard deviation with significance measured using a t-test, while multivariate analysis was performed using logistic regression analysis.RESULTSOf the patients analyzed, 20 had a pathological complete remission (pCR) while 70 did not achieve pCR after NAC. The ratio of the elastic strain ratio (SR) and elastic score of 4–5 in patients with pCR were 5.5 ± 1.16 and 15.00%, respectively; these were significantly lower than those in patients without pCR (85%) and significantly higher than in patients without pCR (14%). SR and elastic score 4–5 were independent factors influencing NAC efficacy (OR=0.644, 1.426 and 1.366, respectively, P < 0.05). SR was positively correlated with elasticity score (rs = 0.411, P < 0.05). The area under the receiver operator characteristic curve of SR and SR combined with elastic score in predicting patients without pCR was 0.822 and 0.891, respectively (P < 0.05).CONCLUSIONStrain ultrasonic elastography may be used to evaluate the effects of preoperative NAC in patients with breast cancer.

Application of multidisciplinary treatment comprehensive management model for early-stage lung cancer

Objective: To explore the application of multidisciplinary treatment (MDT) and comprehensive management model in the diagnosis and treatment of early-stage lung cancer, and analyze its clinical value and the feasibility and significance of promotion. Methods: A retrospective study of 470 patients in Xijing Hospital who underwent surgery after MDT from January 8, 2018 to December 31, 2019. There were 172 males and 298 females, aged from 23 to 79 (54.46±11.08) years. Basic diagnosis and treatment information as well as postoperative pathology were analyzed, of which 441 cases were recommended for surgery by MDT and 29 cases were subjectively requested for surgery. The patients' general condition, preoperative diagnosis and pathological results were compared, and the specific content of the MDT and comprehensive management model were summarized. We also explored the value of MDT integrated management model in early stage lung cancer treatment in the context of the current lung cancer incidence in China. Results: Among 470 surgical patients, the majority of males had solid nodules (69/172,40.1%), and the majority of females had ground glass nodules (135/298,45.3%). The distribution of nodules showed a trend of more upper lobe(277/470)than lower lobe(161/470) and more right lung(276/470) than left lung(194/470). Among the 441 patients recommended for surgery, 98.11% of males (156/159) and 97.87% of females (276/282) showed malignant pathology after surgery. Adenocarcinoma was the main pathological type (93.59% of males, 146/156; 97.46% of females, 269/276). Among the malignant pathological results, carcinoma in situ (42.31% of males, 66/156; 47.10% of females, 130/276) and stage I lung cancer (50.64% of males, 79/156; 47.46% of females, 131/276) were the most common. In all patients, 1.89% of the males (3/159) and 2.13% of the females (6/282) recommended for surgery showed benign postoperative pathology, of which tuberculosis and fungal infection were the main pathological types (66.67% for each gender, males 2/3, females, 4/6). The postoperative pathology of 29 patients who subjectively requested surgery was also tuberculosis and fungal infection as the main pathological types (69.23% of males, 9/13; 68.75% of females, 11/16). The MDT comprehensive management model made full use of a variety of auxiliary diagnostic technologies and combined the experience advantages of multidisciplinary participation to make up for the limitations of single-diagnosis. The overall diagnosis coincidence rate reached 98.09%, with strong consistency (Kappa>0.81). The positive predictive value (PPV) was 97.96%, the negative predictive value (NPV) was 100%, and the average patient diagnosis and treatment cycle was 24.28-26.51 days. Conclusions: The MDT comprehensive management model meets the consensus requirements. It has great advantages in diagnostic efficiency and diagnosis and treatment cycle, and has a high promotion and application value for the diagnosis and treatment of early-stage lung cancer. At the same time, tuberculosis and fungal infection should be regarded as an important differential diagnosis item.

Cost-utility analysis of palliative care in patients with advanced cancer: a retrospective study

BackgroundAging population and other factors have led to a rapid rise in cancer incidence in China. However, under the influence of traditional perception of diseases, deaths and economic factors, many patients who are unresponsive to radical treatment are still adherent to excessive and unnecessary treatment, which may lead to poor quality of life (QoL) and increase unnecessary medical burden.AimCompare the difference of the quality of life and cost-utility value between patients who received palliative care (PC) and patients who were adherent to conventional anticancer treatment (CAT) and provides empirical evidence of clinical and economic value for hospital-based PC.MethodsChinese Quality of Life Questionnaire (CQLQ) Scale was used to collect advanced cancer patients’ QoL on admission and discharge days. Paired and independent samples’ statistical analysis were used to compare inter- and intra- QoL between PC and CAT group. Delphi and Analytic Hierarchy Process were used to weight QoL scores and converted the QoL to quality-adjusted life years (QALYs). Propensity Score Matching (PSM) for 1:1 was used to compare average hospitalization expenses between two groups. The expense per QALYs was used for Cost-Utility analysis between the two treatments.ResultsA total of 248 hospitalized patients diagnosed with metastatic disease at stage IV were recruited from West China Fourth Hospital between January 2018 and August 2018, including 128 patients receiving PC and 120 patients receiving CAT. Although both treatments had positive effects on improving QoL for patients, the QoL in the PC group were significantly higher than that in the CAT group (55.90 ± 18.80 vs 24.00 ± 8.60, t = 7.51, p < 0.05). The QALY (days) of pre- and post- treatment increased by 55.9 and 24.0 days in PC and CAT group respectively. Compared average hospitalization expense in 613 pairs of advanced cancer inpatients after PSM 1:1, the per capita expense of PC group was higher (13,743.5 ± 11,574.1 vs 11,689.0 ± 8876.8, t = 3.44, p < 0.05), while each unit of QALYs paid by PC group was only 50% of that paid by those receiving CAT.ConclusionsPC played a positive role in improving the QoL for patients diagnosed with advanced cancer and alleviating economic burdens of both patient families and the society from the viewpoint of cost-utility. Our findings imply that PC should be recognized as a proactive care model in China that helps patients with some terminal diseases.

Potential Impact of Time Trend of Lifestyle Risk Factors on Burden of Major Gastrointestinal Cancers in China

China has the largest number of incident liver, esophageal, gastric, and colorectal cancer cases in 2020. Examining the time trend of relevant lifestyle risk factors would help project the trend of these gastrointestinal (GI) cancer incidence in China. We estimated the time trend of the lifestyle factors based on the China Health and Nutrition Survey 1991 to 2011. We applied the comparative risk assessment method to estimate the population attributable fraction of GI cancers attributable to each risk factor. We also projected the prevalence of lifestyle factors and the associated burden of GI cancer from 2011 to2031. In 2011, 56.5% of colorectal, 59.8% of gastric, 48.5% of esophageal, and 35.2% of liver cancer in China were attributable to the lifestyle risk factors under study. Smoking, sodium intake, low vegetable intake, and low fruit intake have improved over time but remained far from optimal and are expected to be responsible for 170,000, 35,000, 22,000, and 50,000 GI cancer cases in 2031, respectively. High body mass index, red and processed meat consumption, and low physical activity are expected to contribute increasingly more GI cancer, accounting for 142,000, 185,000, 60,000, and 53,000 cases in 2031, respectively. The estimated population attributable fraction for all risk factors in 2031 is 52.1%. Lifestyle risk factors have had an impact on the risk of GI cancer in China, and the impact is projected to increase. If everyone could adhere to the optimal lifestyle, half of all GI cancer events would be prevented by year2031.

Abstract 793: Potential impact of time trend of lifestyle factors on burden of gastrointestinal cancer in China

Abstract BACKGROUND: Colorectal, esophageal, stomach, and liver cancers are four major gastrointestinal (GI) cancers that have 2-3 times the age-standardized incidence rates in China compared to the global average. Examining the time trend of risk factors associated with GI cancer would help us project the future trend of GI cancer incidence in China and guide public health policymaking. METHODS: We estimated the time trend of relevant dietary and lifestyle factors in China based on data from the China Health and Nutrition Survey 1991-2011. We applied the comparative risk assessment method to estimate the population attributable fraction (PAF%) and the absolute number of GI cancer events attributable to all non-optimal levels of each risk factor. We have also projected the lifestyle factors and the estimated burden of GI cancer in the next 30 years. RESULTS: In 2011, the overall estimated PAF% by all risk factors under study is 73% for esophageal cancer, 59% for colorectal cancer, 47% for gastric cancer, and 35% for liver cancer. Smoking, low fruit intake, high red meat consumption, high body mass index (BMI), and high alcohol consumption were the top 5 contributors to GI cancer incidence in China; each accounted for 173, 134, 132, 125, and 91 thousand GI cancer cases, respectively. For specific cancer sites, high red meat consumption accounted for the most cases of colorectal cancer in 2011 (N = 51,405; PAF% = 19%) and is projected to have higher PAF% from 15% in 1997 to 23% in 2041. High BMI is responsible for the most liver cancer cases in 2011 (N = 55,244; PAF% = 17%) and has an increasing trend in expected PAF% from 7% in 1991 to 20% in 2041; low fruit intake is the top contributor for esophageal cancer in 2011 (N = 85,345; PAR% = 29%) with a downward trend in the next few decades (PAF% from 33% in 1997 to 23% in 2041); high sodium intake represented the highest PAF% for gastric cancer in 2011 (68,858 cases, PAF% = 17%), but is expected to be overpassed by smoking, high BMI, and red meat consumption in 2015-2025. CONCLUSIONS: China has witnessed significant transitions in lifestyle, including diet, physical activity, and obesity. The impact of the lifestyle risk factors on the risk of GI cancer has been increasing from 1991 to 2011 and is projected to continue growing. High red meat consumption and high BMI call for extra attention as they are among the top contributors to GI cancer and are expected to have stronger impacts in the next 30 years in China. Citation Format: You Wu, Yanping Li, Edward Giovannucci, Frank B. Hu. Potential impact of time trend of lifestyle factors on burden of gastrointestinal cancer in China [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 793.

Climatic modification effects on the association between PM1 and lung cancer incidence in China

BackgroundNationwide studies that examine climatic modification effects on the association between air pollution and health outcome are limited in developing countries. Moreover, few studies focus on PM1 pollution despite its greater health effect.ObjectivesThis study aims to determine the modification effects of climatic factors on the associations between PM1 and the incidence rates of lung cancer for males and females in China.MethodsWe conducted a nationwide analysis in 345 Chinese counties (districts) from 2014 to 2015. Mean air temperature and relative humidity over the study period were used as the proxies of climatic conditions. In terms of the multivariable linear regression model, we examined climatic modification effects in the stratified and combined datasets according to the three-category and binary divisions of climatic factors. Moreover, we performed three sensitivity analyses to test the robustness of climatic modification effects.ResultsWe found a stronger association between PM1 and the incidence rate of male lung cancer in counties with high levels of air temperature or relative humidity. If there is a 10 μg/m3 shift in PM1, then the change in male incidence rate relative to its mean was higher by 4.39% (95% CI: 2.19, 6.58%) and 8.37% (95% CI: 5.18, 11.56%) in the middle and high temperature groups than in the low temperature group, respectively. The findings of climatic modification effects were robust in the three sensitivity analyses. No significant modification effect was discovered for female incidence rate.ConclusionsMale residents in high temperature or humidity counties suffer from a larger effect of PM1 on the incidence rate of lung cancer in China. Future research on air pollution-related health impact assessment should consider the differential air pollution effects across different climatic conditions.

Urban–rural disparity in cancer incidence in China, 2008–2012: a cross-sectional analysis of data from 36 cancer registers

ObjectiveThe substantial differences in socioeconomic and lifestyle exposures between urban and rural areas in China may lead to urban–rural disparity in cancer risk. This study aimed to assess the urban–rural...

36P Cost-effectiveness of lung cancer screening with low-dose computed tomography in China: A modeling study

Background: Smoking is considered not the only major risk factor that contributing to the lung cancer incidence in China, due to the fact that about half of patients with lung cancers are never-smokers. Considering the potential of the implementation of lung cancer screening in the general Chinese population, this study aimed to assess the potential cost-effectiveness of lung cancer screening with low-dose CT in a general population in China.

Bladder cancer incidence, mortality and temporal trends in China

Objective: To describe the epidemiological characteristics of bladder cancer in 2015 and temporal trends in China. Methods: From 501 cancer registries in China, we collected data of cancer new cases, deaths and populations in 2015. After qualified, sex-specific, area-specific, age-specific and overall incidence/mortality rates (including age-standardized rates by Chinese standard population and by world standard population) and estimated cases of bladder cancer were calculated. Annual Percent Change (APC)/Average Annual Percent Change (AAPC) fitted from Log-line model was applied to evaluate the temporal trends of bladder cancer incidence/mortality rates from 1998 to 2015. Results: Bladder cancer is the 13(th) most common cancer in China. The crude, age-standardized by China standard population and by world standard population rates were 5.80/10(5), 3.60/10(5) and 3.57/10(5) for incidence, and 2.37/10(5), 1.31/10(5) and 1.32/10(5) for mortality, respectively. The incidence of bladder cancer ranked 7(th) in male. The incidence and mortality of male were 3.8 and 4.0 times as high as those of female. Bladder cancer incidence in urban area was 1.4 times as high as that in rural area. Incidence in western areas and middle areas of China were similar, which were lower than that in eastern areas. Geographical distribution characteristics of mortality was along with incidence.Both incidence and mortality remained low before 45 and 55 years old, then they increased rapidly and peaked at 80-84 and over 85 years old age group. Temporal trend analysis suggested that bladder cancer incidence in China increased in 1998-2007 (APC=2.58, P<0.001), while decreased from 2007 to 2015 (APC=-3.82, P<0.001). Bladder cancer mortality declined gradually, with APCs for 1998-2003 and 2003-2015 of 3.65% (P=0.002) and 1.42% (P<0.001). Conclusions: Bladder cancer is one of the main cancers in China. Its epidemiological distributions varies among different sex, area and age group. Both incidence and mortality of bladder cancer decline. More efforts on tobacco control should be made, and awareness of early diagnosis and early treatment could be enhanced for the middle-aged and elderly.

Insufficient iodine nutrition may affect the thyroid cancer incidence in China.

Epidemiological studies have focused on the effects of iodine intake on the risk of thyroid cancer. However, their relationship is still obscure. The objective of the present study was to examine the association in the Chinese population. A new ecological study which combined the Data of Annual Report of Cancer, the Survey of Iodine Deficiency Disorders (IDD) surveillance and the Water Iodine Survey was conducted to analyse the relationship between iodine intake and the thyroid cancer incidence in China. In total, 281 counties were included. Thyroid cancer incidence was negatively correlated with the consumption rate of qualified iodised salt (CRQIS) and positively correlated with goiter prevalence (GP) of children aged 8-10 years, residents' annual income and coastal status. Areas with a low CRQIS and areas with a high GP had a relatively high incidence of thyroid cancer. Regression models showed that a low CRQIS and a high GP in children aged 8-10 years (both reflecting iodine deficiency status) play a substantial role in thyroid cancer incidence in both males and females. Additionally, living in coastal areas and having a high annual income may also increase the risk of thyroid cancer. These findings suggest that mild iodine deficiency may contribute to the exceptionally high incidence of thyroid cancer in some areas in China. Maintaining appropriate iodine nutrition not only helps to eliminate IDD but also may help to reduce the occurrence of thyroid cancer.

Do socioeconomic factors modify the effects of PM1 and SO2 on lung cancer incidence in China?

BackgroundIt remains uncertain whether socioeconomic factors modify the effect of air pollution on human health. Moreover, studies investigating socioeconomic modifying roles on the effect of PM1 are quite limited, especially in developing countries. ObjectivesThe present study aims to investigate socioeconomic modification effects on the associations of the incidence rate of male lung cancer with ambient PM1 and SO2 in China. MethodsWe conducted a nationwide analysis in 345 Chinese counties (districts) between 2014 and 2015. In terms of multivariable linear regression models, we examined the modification effects of urban-rural division, education level and proportion of construction workers in the stratified and combined datasets according to the tertile and binary divisions of the three factors. Moreover, we performed three sensitivity analyses to test the robustness of socioeconomic modification effects. ResultsWe found a larger effect of PM1 on the incidence rate of male lung cancer in urban areas than in rural areas. The association between PM1 (or SO2) and the incidence rate of male lung cancer was stronger in counties with low education levels than in those with high education levels. The findings of the significant modification effects of urban-rural division and education level were robust in the three sensitivity analyses. No significant modification effect was observed for the proportion of construction workers. ConclusionsMale residents in urban areas have a high risk of lung cancer incidence associated with ambient PM1. Male residents with low education levels suffer from larger effects of PM1 and SO2 on the incidence rate of lung cancer. Area- and population-specific strategies should be developed to reduce the urban-rural and educational disparities in air pollution effects, which thereby alleviates air pollution-associated health disparities in China.