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Liu G, Li CM, Xie F, Li QL, Liao LY, Jiang WJ, Li XP, Lu GM. Colorectal cancer's burden attributable to a diet high in processed meat in the Belt and Road Initiative countries. World J Gastrointest Oncol 2024; 16:182-196. [PMID: 38292848 PMCID: PMC10824120 DOI: 10.4251/wjgo.v16.i1.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/20/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Colorectal cancer (CRC) plays a significant role in morbidity, mortality, and economic cost in the Belt and Road Initiative ("B and R") countries. In addition, these countries have a substantial consumption of processed meat. However, the burden and trend of CRC in relation to the consumption of a diet high in processed meat (DHPM-CRC) in these "B and R" countries remain unknown. AIM To analyze the burden and trend of DHPM-CRC in the "B and R" countries from 1990 to 2019. METHODS We used the 2019 Global Burden of Disease Study to collate information regarding the burden of DHPM-CRC. Numbers and age-standardized rates (ASRs) of deaths along with the disability-adjusted life years (DALYs) were determined among the "B and R" countries in 1990 and 2019. Using joinpoint regression analysis, the average annual percent change (AAPC) was used to analyze the temporal trends of age-standardized DALYs rate (ASDALR) from 1990 to 2019 and in the final decade (2010-2019). RESULTS We found geographical differences in the burden of DHPM-CRC among "B and R" countries, with the three highest-ranking countries being the Russian Federation, China, and Ukraine in 1990, and China, the Russian Federation, and Poland in 2019. The burden of DHPM-CRC generally increased in most member countries from 1990 to 2019 (all P < 0.05). The absolute number of deaths and DALYs in DHPM-CRC were 3151.15 [95% uncertainty interval (UI) 665.74-5696.64] and 83249.31 (95%UI 15628.64-151956.31) in China in 2019. However, the number of deaths (2627.57-2528.51) and DALYs (65867.39-55378.65) for DHPM-CRC in the Russian Federation has declined. The fastest increase in ASDALR for DHPM-CRC was observed in Vietnam, Southeast Asia, with an AAPC value of 3.90% [95% confidence interval (CI): 3.63%-4.16%], whereas the fastest decline was observed in Kyrgyzstan, Central Asia, with an AAPC value of -2.05% (95% CI: -2.37% to -1.73%). A substantial upward trend in ASR of mortality, years lived with disability, years of life lost, and DALYs from DHPM-CRC changes in 1990-2019 and the final decade (2010-2019) for most Maritime Silk Route members in East Asia, South Asia, Southeast Asia, North Africa, and the Middle East, as well as Central Europe, while those of the most Land Silk Route members in Central Asia and Eastern Europe have decreased markedly (all P < 0.05). The ASDALR for DHPM-CRC increased more in males than in females (all P < 0.05). For those aged 50-74 years, the ASDALR for DHPM-CRC in 40 members exhibited an increasing trend, except for 20 members, including 7 members in Central Asia, Maldives, and 12 high or high-middle social development index (SDI) members in other regions (all P < 0.05). CONCLUSION The burden of DHPM-CRC varies substantially across "B and R" countries and threatens public health. Relevant evidence-based policies and interventions tailored to the different trends of countries in SDIs or Silk Routes should be adopted to reduce the future burden of CRC in "B and R" countries via extensive collaboration.
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Affiliation(s)
- Gu Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Jinan University, Guangzhou 510630, Guangdong Province, China
- Department of Gastrointestinal Surgery, Chenzhou Third People’s Hospital, Chenzhou 423000, Hunan Province, China
| | - Chang-Min Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Jinan University, Guangzhou 510630, Guangdong Province, China
- Department of Gastrointestinal Surgery, Chenzhou First People’s Hospital and the First Affiliated Hospital of Xiangnan University, Chenzhou, 423000 Hunan Province, China
| | - Fei Xie
- Department of Gastrointestinal Surgery, Chenzhou Third People’s Hospital, Chenzhou 423000, Hunan Province, China
| | - Qi-Lai Li
- Department of Gastrointestinal Surgery, Chenzhou Third People’s Hospital, Chenzhou 423000, Hunan Province, China
| | - Liang-Yan Liao
- Department of Breast and Thyroid Surgery, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Wen-Jun Jiang
- Department of Breast and Thyroid Surgery, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Xiao-Pan Li
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai 200032, China
| | - Guan-Ming Lu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Jinan University, Guangzhou 510630, Guangdong Province, China
- Department of Breast and Thyroid Surgery, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
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Friebel-Klingner TM, Alvarez GG, Lappen H, Pace LE, Huang KY, Fernández ME, Shelley D, Rositch AF. State of the Science of Scale-Up of Cancer Prevention and Early Detection Interventions in Low- and Middle-Income Countries: A Scoping Review. JCO Glob Oncol 2024; 10:e2300238. [PMID: 38237096 PMCID: PMC10805431 DOI: 10.1200/go.23.00238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/22/2023] [Accepted: 10/18/2023] [Indexed: 01/23/2024] Open
Abstract
PURPOSE Cancer deaths in low- and middle-income countries (LMICs) will nearly double by 2040. Available evidence-based interventions (EBIs) for cancer prevention and early detection can reduce cancer-related mortality, yet there is a lack of evidence on effectively scaling these EBIs in LMIC settings. METHODS We conducted a scoping review to identify published literature from six databases between 2012 and 2022 that described efforts for scaling cancer prevention and early detection EBIs in LMICs. Included studies met one of two definitions of scale-up: (1) deliberate efforts to increase the impact of effective intervention to benefit more people or (2) an intervention shown to be efficacious on a small scale expanded under real-world conditions to reach a greater proportion of eligible population. Study characteristics, including EBIs, implementation strategies, and outcomes used, were summarized using frameworks from the field of implementation science. RESULTS This search yielded 3,076 abstracts, with 24 studies eligible for inclusion. Included studies focused on a number of cancer sites including cervical (67%), breast (13%), breast and cervical (13%), liver (4%), and colon (4%). Commonly reported scale-up strategies included developing stakeholder inter-relationships, training and education, and changing infrastructure. Barriers to scale-up were reported at individual, health facility, and community levels. Few studies reported applying conceptual frameworks to guide strategy selection and evaluation. CONCLUSION Although there were relatively few published reports, this scoping review offers insight into the approaches used by LMICs to scale up cancer EBIs, including common strategies and barriers. More importantly, it illustrates the urgent need to fill gaps in research to guide best practices for bringing the implementation of cancer EBIs to scale in LMICs.
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Affiliation(s)
| | - Gloria Guevara Alvarez
- Department Public Health Policy and Management, School of Global Public Health, New York University, New York, NY
| | - Hope Lappen
- Division of Libraries, New York University, New York, NY
| | - Lydia E. Pace
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Keng-Yen Huang
- Department of Population Health, Center for Early Childhood Health & Development (CEHD), New York, NY
| | - Maria E. Fernández
- Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, School of Public Health Houston, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX
| | - Donna Shelley
- Department Public Health Policy and Management, School of Global Public Health, New York University, New York, NY
| | - Anne F. Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Zheng HC, Zhou J, Chen YC, Yu Y, Dai W, Han Y, Li XP, Jiang SF. The burden and trend of liver metastases in Shanghai, China: a population-based study. Eur J Cancer Prev 2023; 32:517-524. [PMID: 37401477 DOI: 10.1097/cej.0000000000000823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
BACKGROUND Studies on the epidemiology of liver metastases (LM)-related mortality are rare. we aimed to describe the burden and trend of liver metastases in Pudong of Shanghai, which could be beneficial to cancer prevention. METHODS We performed a retrospective population-based analysis of cancer mortality data with liver metastases in Shanghai Pudong from 2005 to 2021. Long-term trends in crude mortality rates (CMRs), age-standardized mortality rates worldwide, and rate of years of life lost (YLL) were analyzed by the Join-point regression model. In addition, we evaluate the impact of the demographic and nondemographic factors on the mortality of disease by the decomposition method. RESULTS Cancer with liver metastases accounted for 26.68% of all metastases. The CMR and age-standardized mortality rates by Segi's world population (ASMRW) of cancer with liver metastases were 15.12/105 person-years and 6.33/105 person-years, respectively. The YLL from cancer with liver metastases was 84 959.87 years, with the age group of 60-69 years having the highest YLL of 26 956.40 years. The top three cancer types in liver metastases are colorectal, gastric, and pancreatic cancer. The long-term trend of ASMRW significantly decreased by 2.31% per year ( P <0.05). The ASMRW and YLL rates of those over 45 decreased year by year. Particularly striking was the 70-79 age group. Although the overall mortality of cancer with liver metastases decreased, there was still a significant upward trend toward an increased mortality rate caused by cancer with liver metastases in aging patients. CONCLUSION Liver metastases were a common site of metastases in patients with cancers originating from the digestive system. The disease burden caused by cancer with liver metastases provides valuable evidence for cancer management.
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Affiliation(s)
- Hui-Chao Zheng
- Department of Health Management Centre, Zhongshan Hospital, Fudan University
- Department of General Practice, Zhongshan Hospital, Fudan University
| | - Jing Zhou
- Department of Health Management Centre, Zhongshan Hospital, Fudan University
| | - Yi-Chen Chen
- Department of Epidemiology, School of Public Health, Fudan University
- Department of Scientific Research and Information Management, Pudong Institute of Preventive Medicine and
- Department of Scientific Research and Information Management, Centers for Disease Control and Prevention, Pudong New Area
| | - Ying Yu
- Department of General Practice, Zhongshan Hospital, Fudan University
| | - Wei Dai
- Department of Health Management Centre, Zhongshan Hospital, Fudan University
| | - Yan Han
- Department of Health Management Centre, Zhongshan Hospital, Fudan University
| | - Xiao-Pan Li
- Department of Health Management Centre, Zhongshan Hospital, Fudan University
- Department of Scientific Research and Information Management, Pudong Institute of Preventive Medicine and
| | - Sun-Fang Jiang
- Department of Health Management Centre, Zhongshan Hospital, Fudan University
- Department of General Practice, Zhongshan Hospital, Fudan University
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Li X, Liu R, Chen Y, Han Y, Wang Q, Xu Y, Zhou J, Jiang S. Patterns and Trends in Mortality Associated With and Due to Diabetes Mellitus in a Transitioning Region With 3.17 Million People: Observational Study. JMIR Public Health Surveill 2023; 9:e43687. [PMID: 37665630 PMCID: PMC10507522 DOI: 10.2196/43687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 06/20/2023] [Accepted: 07/25/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) imposes a significant disease burden in economically transitioning regions. Most transitioning regions share similar experience in urbanization processes. Shanghai's Pudong district serves as a representative area of such regions. OBJECTIVE We aimed to assess the burden of and trends in DM mortality in Shanghai's Pudong district and analyze the impact of aging and multimorbidity. METHODS A longitudinal, population-based study was conducted to analyze DM mortality in Pudong from 2005 to 2020. We used joinpoint regression to analyze epidemiological features and long-term trends in crude mortality rate (CMR), age-standardized mortality rate worldwide (ASMRW), and years of life lost (YLL). Furthermore, the decomposition method was used to evaluate the contribution of demographic and nondemographic factors associated with mortality. RESULTS There were 49,414 deaths among individuals with DM, including 15,512 deaths due to DM. The CMR and ASMRW were 109.55/105 and 38.01/105 person-years, respectively. Among the mortality associated with and due to DM, the total annual ASMRW increased by 3.65% (95% CI 3.25%-4.06%) and 1.38% (95% CI 0.74%-2.02%), respectively. Additionally, the total annual YLL rate increased by 4.98% (95% CI 3.92%-6.05%) and 2.68% (95% CI 1.34%-4.04%). The rates of YLL increase in persons aged 30 to 44 years (3.98%, 95% CI 0.32%-7.78%) and 45 to 59 years (4.31%, 95% CI 2.95%-5.69%) were followed by the increase in persons aged 80 years and older (10.53%, 95% CI 9.45%-11.62%) for deaths associated with DM. The annual CMR attributable to demographic factors increased by 41.9% (95% CI 17.73%-71.04%) and 36.72% (95% CI 16.69%-60.2%) for deaths associated with and due to DM, respectively. Hypertension, cerebrovascular disease, and ischemic heart disease were the top 3 comorbidities. CONCLUSIONS Aging and multimorbidity played essential roles in changing the burden of DM in an urbanizing and transitioning region. There is an increasing disease burden among young and middle-aged people, emphasizing the need for greater attention to these groups. Health management is an emerging method that holds important implications for alleviating the future burden of DM.
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Affiliation(s)
- Xiaopan Li
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ru Liu
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yichen Chen
- Office of Scientific Research and Information Management, Center for Disease Control and Prevention, Pudong New Area, Shanghai, China
- School of Public Health, Fudan University, Shanghai, China
| | - Yan Han
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qizhe Wang
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yaxin Xu
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Zhou
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Sunfang Jiang
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
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Hu LF, Yue QQ, Tang T, Sun YX, Zou JY, Huang YT, Zeng X, Zeng Y. Knowledge and belief of fecal occult blood screening: A systematic review. Public Health Nurs 2023; 40:782-789. [PMID: 37177843 DOI: 10.1111/phn.13206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Colorectal cancer (CRC) is associated with a high incidence and mortality rate. Fecal occult blood test (FOBT) is effective in the prevention of CRC. OBJECTIVE This study aimed to assess knowledge and beliefs regarding FOBT-based screening. METHODS This study used PubMed, Cochrane Library, MEDLINE Complete, and Web of Science to search for articles. Original full-text studies in English language focusing on knowledge and beliefs of FOBT screening were included. RESULTS A total of 32 articles were included. This study indicated that the population in most studies had inadequate knowledge and lacked beliefs toward FOBT-based screening. Most of the extracted studies showed that less than half of the participants had heard of FOBT-based screening. Six studies showed that less than 50% of participants had knowledge of FOBT age. Three studies found that less than 40% of participants were aware of the screening interval. Some participants perceived the benefits of FOBT-based screening, while others perceived many barriers to the test. CONCLUSION Participants' knowledge and belief in FOBT-based screening were insufficient. This review highlights the importance of educational programs to increase knowledge and beliefs regarding FOBT-based screening. It is important to include FOBT-based screening in the health care system to promote the secondary prevention of CRC.
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Affiliation(s)
- Li-Feng Hu
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Qian-Qian Yue
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Tian Tang
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Ying-Xue Sun
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Jin-Yu Zou
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Yu-Ting Huang
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Xi Zeng
- Key Laboratory of Tumor Cellular & Molecular Pathology, Cancer Research Institute; Hengyang Medical School, University of South China, Hengyang, China
| | - Ying Zeng
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
- Key Laboratory of Tumor Cellular & Molecular Pathology, Cancer Research Institute; Hengyang Medical School, University of South China, Hengyang, China
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Zhao Y, Zou J, Chen Y, Zhou J, Dai W, Peng M, Li X, Jiang S. Changes of the acute myocardial infarction-related resident deaths in a transitioning region: a real-world study involving 3.17 million people. Front Public Health 2023; 11:1096348. [PMID: 37670829 PMCID: PMC10476525 DOI: 10.3389/fpubh.2023.1096348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/10/2023] [Indexed: 09/07/2023] Open
Abstract
Background The impact of acute myocardial infarction (AMI) on the life span of residents in a transitioning region has not been studied in depth. Therefore, we aimed to evaluate the changes in AMI-related resident deaths in a transitioning region in China. Methods A longitudinal, population-based study was performed to analyze the deaths with/of AMI in Pudong New Area (PNA), Shanghai from 2005 to 2021. The average annual percentage change (AAPC) of AMI in crude mortality rates (CMR), age-standardized mortality rates worldwide (ASMRW), and rates of years of life lost (YLLr) were calculated by the joinpoint regression. The impact of demographic and non-demographic factors on the mortality of residents who died with/of AMI was quantitatively analyzed by the decomposition method. Results In 7,353 residents who died with AMI, 91.74% (6,746) of them were died of AMI from 2005 to 2021. In this period, the CMR and ASMRW of residents died with/of AMI were 15.23/105 and 5.17/105 person-years, the AAPC of CMR was 0.01% (95% CI: -0.71,0.72, p = 0.989) and 0.06% (95% CI: -0.71,0.84, p = 0.868), and the ASMRW decreased by 2.83% (95% CI: -3.66,-2.00, p < 0.001) and 2.76% (95% CI: -3.56,-1.95, p < 0.001), respectively. The CMR of people died of AMI showed a downward trend (all p < 0.05) in people ≥60 years but an upward trend [AAPC = 2.47% (95% CI: 0.07,4.94, p = 0.045)] in people of 45-59 years. The change in CMR of people died with/of AMI caused by demographic factors was 28.70% (95% CI: 12.99,46.60, p = 0.001) and 28.07% (95% CI: 12.71,45.52, p = 0.001) per year, respectively. Conclusion Preventative strategies for AMI should be applied to enhance the health management of residents aged 45-59 years or with comorbidities in the transitioning region.
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Affiliation(s)
- Yajun Zhao
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jian Zou
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yichen Chen
- Office of Scientific Research and Information Management, Centres for Disease Control and Prevention, Shanghai, China
- Office of Scientific Research and Information Management, Pudong Institute of Preventive Medicine, Shanghai, China
- School of Public Health, Fudan University, Shanghai, China
| | - Jing Zhou
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Dai
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Minghui Peng
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaopan Li
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China
- Office of Scientific Research and Information Management, Pudong Institute of Preventive Medicine, Shanghai, China
| | - Sunfang Jiang
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China
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Huang J, Chen Y, Liu G, Tu W, Bergquist R, P Ward M, Zhang J, Xiao S, Hong J, Zhao Z, Li X, Zhang Z. Optimizing allocation of colorectal cancer screening hospitals in Shanghai: a geospatial analysis. GEOSPATIAL HEALTH 2023; 18. [PMID: 37401409 DOI: 10.4081/gh.2023.1152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/21/2023] [Indexed: 07/05/2023]
Abstract
Screening programmes are important for early diagnosis and treatment of colorectal cancer (CRC) but they are not equally efficient in all locations. Depending on which hospital people belong to, they often are not willing to follow up even after a positive result, resulting in a lower-than-expected overall detection rate. Improved allocation of health resources would increase the program's efficiency and assist hospital accessibility. A target population exceeding 70,000 people and 18 local hospitals were included in the investigation of an optimization plan based on a locationallocation model. We calculated the hospital service areas and the accessibility for people in communities to CRC-screening hospitals using the Huff Model and the Two-Step Floating Catchment Area (2SFCA) approach. We found that only 28.2% of the residents with initially a positive screening result had chosen followup with colonoscopy and significant geographical differences in spatial accessibility to healthcare services indeed exist. The lowest accessibility was found in the Southeast, including the Zhangjiang, Jichang and Laogang communities with the best accessibility mainly distributed near the city centre of Lujiazui; the latter also had relatively a high level of what is called "ineffective screening" as it represents wasteful resource allocation. It is recommended that Hudong Hospital should be chosen instead of Punan Hospital as the optimization, which can improve the service population of each hospital and the populations served per colonoscope. Based on our results, changes in hospital configuration in colorectal cancer screening programme are needed to achieve adequate population coverage and equitable facility accessibility. Planning of medical services should be based on the spatial distribution trends of the population served.
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Affiliation(s)
- Jiaqi Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
| | - Yichen Chen
- Center for Disease Control and Prevention, Pudong New Area, Shanghai.
| | - Gu Liu
- Department of General Surgery, the first people's Hospital of Chenzhou, Hunan.
| | - Wei Tu
- Department of Geology and Geography, Georgia Southern University, Statesboro, GA.
| | | | - Michael P Ward
- Faculty of Veterinary Science, University of Sydney, NSW.
| | - Jun Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
| | - Shuang Xiao
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
| | - Jie Hong
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
| | - Zheng Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
| | - Xiaopan Li
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China; Office of Scientific Research and Information Management, Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai.
| | - Zhijie Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
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Zhong W, Chen L, Li X, Chen Y, Zhang Y, Guo C, Shen Y, Chen H. Disability-adjusted life years and the trends of the burden of colorectal cancer: a population-based study in Shanghai, China during 2002 to 2016. Chin Med J (Engl) 2022; 135:2950-2955. [PMID: 36191587 PMCID: PMC10106251 DOI: 10.1097/cm9.0000000000002064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) still ranks the top in morbidity and mortality of cancers worldwide, posing a huge threat and burden to the society. We aimed to determine the age-standardized incidence, mortality, and disability-adjusted life years (DALYs) of CRC and explore potential changes in the temporal trends of the CRC burden in Shanghai during 2002 to 2016. METHODS The cancer statistics and demographics were obtained from the Cancer Registry and the Statistics Bureau of Pudong New Area, respectively. Data from 2002 to 2016 were included and analyzed retrospectively. DALYs were calculated using DisMod and the age-standardized rates (ASRs) were obtained according to Segi world standard population. Joinpoint regression was used to measure the trends in CRC incidence and to estimate the annual percent change. RESULTS The increasing trend of CRC ASR incidence halted after 2014, coinciding with the introduction of the Shanghai CRC screening program. The ASRs of mortality and DALYs increased, at 0.42% ( P < 0.05) and 4.07% ( P < 0.001) per year, respectively, which were mainly driven by men and individuals aged above the CRC screening program target. CONCLUSIONS The disease burden of CRC in Shanghai remains serious, especially among men, and individuals aged >74 years. The benefits of the screening program have been partially proven by the ASRs of CRC incidence, providing important insights into better and wider application of screening programs.
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Affiliation(s)
- Wei Zhong
- Department of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China
| | - Liping Chen
- Department of Internal Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China
| | - Xiaopan Li
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai 200136, China
| | - Yichen Chen
- Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai 200136, China
| | - Yao Zhang
- Department of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China
| | - Canjie Guo
- Department of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China
| | - Yufeng Shen
- Department of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China
| | - Huimin Chen
- Department of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China
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Rasooly A, Pan Y, Tang Z, Jiangjiang H, Ellen ME, Manor O, Hu S, Davidovitch N. Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China. Int J Health Policy Manag 2022; 11:3019-3031. [PMID: 35942954 PMCID: PMC10105207 DOI: 10.34172/ijhpm.2022.6372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/17/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Quality measurements in primary healthcare (PHC) have become an essential component for improving diabetes outcomes in many high-income countries. However, little is known about their implementation within the Chinese health-system context and how they are perceived by patients, physicians, and policy-makers. We examined stakeholders' perceptions of quality and performance measurements for primary diabetes care in Shanghai, China, and analyzed facilitators and barriers to implementation. METHODS In-depth interviews with 26 key stakeholders were conducted from 2018 to 2019. Participants were sampled from two hospitals, four community healthcare centers (CHCs), and four institutes involved in regulating CHCs. The Consolidated Framework for Implementation Research (CFIR) guided data analysis. RESULTS Existing quality measurements were uniformly implemented via a top-down process, with daily monitoring of family doctors' work and pay-for-performance incentives. Barriers included excluding frontline clinicians from indicator planning, a lack of transparent reporting, and a rigid organizational culture with limited bottom-up feedback. Findings under the CFIR construct "organizational incentives" suggested that current pay-for-performance incentives function as a "double-edged sword," increasing family doctors' motivation to excel while creating pressures to "game the system" among some physicians. When considering the CFIR construct "reflecting and evaluating," policy-makers perceived the online evaluation application - which provides daily reports on family doctors' work - to be an essential tool for improving quality; however, this information was not visible to patients. Findings included under the "network and communication" construct showed that specialists support the work of family doctors by providing training and patient consultations in CHCs. CONCLUSION The quality of healthcare could be considerably enhanced by involving patients and physicians in decisions on quality measurement. Strengthening hospital-community partnerships can improve the quality of primary care in hospital-centric systems. The case of Shanghai provides compelling policy lessons for other health systems faced with the challenge of improving PHC.
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Affiliation(s)
- Alon Rasooly
- School of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yancen Pan
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Zhenqing Tang
- Shanghai Health Development Research Center, Shanghai, China
| | - He Jiangjiang
- Shanghai Health Development Research Center, Shanghai, China
| | - Moriah E. Ellen
- School of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Orly Manor
- Braun School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel. 5 School of Public Health, Fudan University, Shanghai, China
| | - Shanlian Hu
- School of Public Health, Fudan University, Shanghai, China
| | - Nadav Davidovitch
- School of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel
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10
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Li X, Zhang M, Chen Y, Lv H, Du Y. Longitudinal analysis of ovarian cancer death patterns during a rapid transition period (2005-2020) in Shanghai, China: A population-based study. Front Oncol 2022; 12:1003297. [PMID: 36263229 PMCID: PMC9574098 DOI: 10.3389/fonc.2022.1003297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/20/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives It is important to assess the burden of ovarian cancer related premature death so as to develop appropriate evidence-based care and improve women’s health. This study aimed to characterize the long-term trends in mortality, survival and disease burden of ovarian cancer in Shanghai, China. Materials and Methods Co-morbidities, crude mortality rate (CMR), age-standardised mortality rate by Segi’s world standard population (ASMRW), years of life lost (YLL), and survival rates were analysed. Temporal trends for the mortality rates and disease burden were analyzed using the Joinpoint Regression Program. Mortality rate increases by demographic and non-demographic factors were estimated by the decomposition method. Results A total of 1088 ovarian cancer as underlying cause of deaths were recorded. CMR and ASMRW were 4.82/105 and 2.32/105 person-years, respectively. The YLL was 16372.96 years, and the YLL rate was 72.46/105 person-years. The YLL rate increased only in the age group of 70-79 years (P = 0.017). The survival rates of ovarian cancer patients did not improve during the ten year period (2005-2015). The top co-morbidities were diseases of the respiratory system, digestive system, and circulatory system. The rates of ovarian cancer deaths caused by non-demographic and demographic factors increased by 21.29% (95%CI: 4.01% to 41.44%, P = 0.018) and 25.23% (95%CI: 14.64% to 36.81%, P < 0.001), respectively. Conclusions Population ageing and all cause of death may affect ovarian cancer related deaths in Pudong, Shanghai. The high mortality and the stagnant survival rates suggest the need for more efforts in targeted prevention and treatment of this disease.
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Affiliation(s)
- Xiaopan Li
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, China
| | - Mo Zhang
- Clinical Research Unit, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yichen Chen
- Office of Scientific Research and Information Management, Center for Disease Control and Prevention & Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, China
| | - Huihui Lv
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Yan Du, ; Huihui Lv,
| | - Yan Du
- Clinical Research Unit, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- *Correspondence: Yan Du, ; Huihui Lv,
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11
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Wu Y, Saito H, Ozaki A, Tanimoto T, Jiang Y, Yang P, Li J, Zhou Z, Zhu X, Lu F, Kanemoto Y, Kurokawa T, Tsubokura M, Zhao G. Colorectal Cancer Screening Program in Songjiang district, Shanghai between 2015 and 2017: Evaluation of participation rate and the associated factor. Medicine (Baltimore) 2022; 101:e29259. [PMID: 35960121 PMCID: PMC9371502 DOI: 10.1097/md.0000000000029259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Little is known about the participation rate of newly implemented colorectal cancer (CRC) screening programs in China. Our goals were to identify factors associated with nonparticipation for CRC screening in Songjiang District, Shanghai. We analyzed individuals included in an observational cohort study from 4 towns (Xin Qiao, She Shan, Mao Gang, and Zhong Shan) in Songjiang District. The participation rate was calculated for the CRC screening program based on a fecal immunochemical test and a risk assessment questionnaire between 2015 and 2017 inclusive. Of the 27,130 individuals eligible for inclusion in this study, 20,863 (76.9%) participated in CRC screening at least once during 2015 and 2017. The factors linked with nonparticipation were; being male (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.82-0.93, P < .01), unmarried (OR 0.71, 95% CI 0.64-0.80, P < .01), having a high education level (middle school, OR 0.82, 95% CI 0.74-0.90, P < .01, high school or above, OR 0.64, 95% CI 0.57-0.73, P < .01), absence of chronic disease (OR 0.90, 95% CI 0.85-0.96, P < .01), and living in 2 out of the 4 towns covered (Xin Qiao, OR 0.72, 95% CI 0.66-0.78, P < .01, Zhong Shan, OR 0.29, 95% CI 0.26-0.31, P < .01). The current study revealed several associated factors with nonparticipation for the CRC screening in Songjiang district. These findings will help identify target populations that require an individualized approach to increase the participation rate.
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Affiliation(s)
- Yiling Wu
- Songjiang Center for Disease Control and Prevention, Shanghai, China
| | - Hiroaki Saito
- Department f Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | | | - Yonggen Jiang
- Songjiang Center for Disease Control and Prevention, Shanghai, China
- * Correspondence: Yonggen Jiang, MPH, Songjiang Center for Disease Control and Prevention, Shanghai, China (e-mail: )
| | - Peng Yang
- Songjiang Center for Disease Control and Prevention, Shanghai, China
| | - Jing Li
- Department of Public Health, Zhongshan Street Community Health Service Center, Shanghai, China
| | - Zhiming Zhou
- Department of Public Health, Sheshan Community Health Service Center, Shanghai, China
| | - Xiuguo Zhu
- Department of Public Health, Maogang Community Health Service Center, Shanghai, China
| | - Fei Lu
- Department of Public Health, Xinqiao Community Health Service Center, Shanghai, China
| | - Yoshiaki Kanemoto
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | - Tomohiro Kurokawa
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Genming Zhao
- School of Public Hsealth, Fudan University, Shanghai, China
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12
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Cenin D, Li P, Wang J, de Jonge L, Yan B, Tao S, Lansdorp-Vogelaar I. Optimising colorectal cancer screening in Shanghai, China: a modelling study. BMJ Open 2022; 12:e048156. [PMID: 35577474 PMCID: PMC9115025 DOI: 10.1136/bmjopen-2020-048156] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/31/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION To reduce the burden of colorectal cancer (CRC) in Shanghai, China, a CRC screening programme was commenced in 2013 inviting those aged 50-74 years to triennial screening with a faecal immunochemical test (FIT) and risk assessment. However, it is unknown whether this is the optimal screening strategy for this population. We aimed to determine the optimal CRC screening programme for Shanghai in terms of benefits, burden, harms and cost-effectiveness. METHODS Using Microsimulation Screening Analysis-Colon (MISCAN-Colon), we estimated the costs and effects of the current screening programme compared with a situation without screening. Subsequently, we estimated the benefits (life years gained (LYG)), burden (number of screening events, colonoscopies and false-positive tests), harms (number of colonoscopy complications) and costs (Renminb (¥)) of screening for 324 alternative screening strategies. We compared several different age ranges, screening modalities, intervals and FIT cut-off levels. An incremental cost-effectiveness analysis determined the optimal strategy assuming a willingness-to-pay of ¥193 931 per LYG. RESULTS Compared with no screening, the current screening programme reduced CRC incidence by 40% (19 cases per 1000 screened individuals) and CRC mortality by 67% (7 deaths). This strategy gained 32 additional life years, increased colonoscopy demand to 1434 per 1000 individuals and cost an additional ¥199 652. The optimal screening strategy was annual testing using a validated one-sample FIT, with a cut-off of 10 µg haemoglobin per gram from ages 45 to 80 years (incremental cost-effectiveness ratio, ¥62 107). This strategy increased LY by 0.18% and costs by 27%. Several alternative cost-effective strategies using a validated FIT offered comparable benefits to the current programme but lower burden and costs. CONCLUSIONS Although the current screening programme in Shanghai is effective at reducing CRC incidence and mortality, the programme could be optimised using a validated FIT. When implementing CRC screening, jurisdictions with limited health resources should use a validated test.
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Affiliation(s)
- Dayna Cenin
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Pei Li
- The Center for Disease Prevention and Control Huangpu Shanghai, Shanghai, China
| | - Jie Wang
- Department of Public Health, Fudan University, Shanghai, China
| | - Lucie de Jonge
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Bei Yan
- Xi'an International Medical Center Hospital, Xi'an, China
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Sha Tao
- Department of Public Health, Fudan University, Shanghai, China
| | - Iris Lansdorp-Vogelaar
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
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13
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Luo Z, Zou Y, Xie J, Cao H, Chen Y, Ding Y, Li X, Deng Y, Wu L. Influence of Demographic Factors on Long-Term Trends of Premature Mortality and Burden Due to Liver Cancer: Findings From a Population-Based Study in Shanghai, China, 1973–2019. Front Public Health 2022; 10:808917. [PMID: 35242731 PMCID: PMC8885583 DOI: 10.3389/fpubh.2022.808917] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/21/2022] [Indexed: 11/27/2022] Open
Abstract
Objective Liver cancer is one of the most common causes of cancer-related death. Understanding how demographic factors influence mortality due to liver cancer is crucial for optimizing disease-control strategies. We aimed to characterize the long-term trends in the mortality and years of life lost (YLL) of liver cancer in Shanghai, China, 1973–2019, and quantitatively analyze the contributions of demographic and non-demographic factors on the mortality of liver cancer. Methods Using mortality data from the Mortality Registration System of Pudong New Area, the largest district of Shanghai with a population of permanent resident of 5.68 million, during 1973–2019, we analyzed the temporal trends for the mortality rates and YLL by Joinpoint Regression Program. The difference decomposition method was employed to estimate the increasing mortality rates related to demographic and non-demographic factors. Results A total of 21,530 deaths from liver cancer occurred from 1973 to 2019. The crude mortality rates (CMR) and age-standardized mortality rate by Segi's world standard population (ASMRW) of liver cancer were 26.73/105 person-years and 15.72/105 person-years, respectively. The CMR, ASMRW, and YLL rates of liver cancer showed significantly decreasing trends in males, females and the total population from 1973 to 2019, whereas the upward trends in the YLL were seen in males, females and the total population (all P < 0.05). A significant upward trend was observed in the increased CMR caused by demographic factors, but the changing rate caused by non-demographic factors decreased. Conclusions The CMR and ASMRW of liver cancer continually decreased although YLL increased during 1973–2019 in Pudong New Area, Shanghai. The demographic factors, especially aging, might be responsible for the increase in the mortality of liver cancer. More effective prevention strategies tailored to liver cancer are needed to further reduce its disease burden in the elderly population.
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Affiliation(s)
- Zheng Luo
- Department of Neurology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Yongbin Zou
- Department of Oncology, Chenzhou First People's Hospital, Chenzhou, China
| | - Jiaxin Xie
- Department of High Altitude Operational Medicine, Army Medical University, Chongqing, China
| | - Hui Cao
- Department of Oncology, Chenzhou First People's Hospital, Chenzhou, China
| | - Yichen Chen
- Center for Disease Control and Prevention of Pudong New Area, Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Yibo Ding
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Xiaopan Li
- Center for Disease Control and Prevention of Pudong New Area, Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
- *Correspondence: Xiaopan Li
| | - Yang Deng
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China
- Yang Deng
| | - Lile Wu
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Lile Wu
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Jin P, You P, Fang J, Kang Q, Gu F, Cai Y, Zhai H, Wang B, Li Y, Xu J, Wang J, He Y, Wang Y, Dai M, Sheng J. Comparison of performance of two Stool DNA Tests and a Faecal Immunochemical Test in Detecting Colorectal Neoplasm: a Multicentre Diagnostic Study. Cancer Epidemiol Biomarkers Prev 2021; 31:654-661. [PMID: 34933958 DOI: 10.1158/1055-9965.epi-21-0991] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/25/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The most widely used non-invasive screening tests for colorectal cancer (CRC) are faecal occult blood tests. Stool DNA test was developed in recent years. However, direct comparative analyses of these tests within the same population are still sparse. METHODS 2842 participants who visited outpatient clinics or cancer screening centres were enrolled. Stool DNA test-I (KRAS, BMP3, NDRG4, and haemoglobin immunochemical tests), stool DNA test-II (SDC2 and SFRP2 tests) and FIT alone were performed and colonoscopy was used as the gold standard among 2240 participants. 42 and 302 participants had CRC and advanced adenomas (AA), respectively. RESULTS The sensitivity for CRC of stool DNA test-I, -II and FIT was 90.5%, 92.9% and 81.0%, respectively. The sensitivity for advanced neoplasm (CRC plus AA) of stool DNA test-I, -II and FIT was 34.9%, 42.2% and 25.9%, respectively. The specificity of stool DNA test-I, -II and FIT was 91.4%, 93.3% and 96.8%, respectively, among those with negative results on colonoscopy. When the specificity of FIT was adjusted to match that of stool DNA tests by changing the threshold, no significant difference was seen in the sensitivities among the 3 tests for detecting CRC. For advanced neoplasm, the sensitivity of FIT was higher than DNA test-I and similar to DNA test-II under the same specificities. CONCLUSIONS There was no significant advantage of the two stool DNA tests compared to FIT in detecting CRC or advanced neoplasm in this study. IMPACT Our findings do not support extensive use of stool DNA tests instead of FIT.
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Affiliation(s)
- Peng Jin
- Gastroenterology, Seventh Medical Center of Chinese PLA General Hospital
| | - Peng You
- Gastroenterology, Peking University People's Hospital
| | - Jingyuan Fang
- Division of Gastroenterology and Hepatology, Shanghai Jiao Tong University of Medicine Affiliated Renji Hospital
| | - Qian Kang
- Outpatient department of Tai Hu, Eastern Medical District of Chinese PLA General Hospital
| | - Fang Gu
- Peking University Third Hospital
| | | | - Huihong Zhai
- National Clinical Research Center for Digestive Diseases, Capital Medical University Affiliated Beijing Friendship Hospital
| | - Bangmao Wang
- Department of Gastroenterology, Tianjin Medical University General Hospital
| | - Yanqing Li
- Gastroenterology, Qilu Hospital of Shandong University
| | - Junfeng Xu
- Gastroenterology, First Medical Center of Chinese PLA General Hospital
| | - Jiheng Wang
- Department of Gastroenterology, Seventh Medical Center of Chinese PLA General Hospital
| | - Yuqi He
- Department of Gastroenterology, Seventh Medical Center of Chinese PLA General Hospital
| | - Yang Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences
| | - Min Dai
- Office for Cancer Screening, National Cancer Center / Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College
| | - Jianqiu Sheng
- Gastroenterology, Seventh Medical Center of Chinese PLA General Hospital
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Schliemann D, Ramanathan K, Matovu N, O'Neill C, Kee F, Su TT, Donnelly M. The implementation of colorectal cancer screening interventions in low-and middle-income countries: a scoping review. BMC Cancer 2021; 21:1125. [PMID: 34666704 PMCID: PMC8524916 DOI: 10.1186/s12885-021-08809-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/23/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Low- and middle-income countries (LMICs) experienced increasing rates of colorectal cancer (CRC) incidence in the last decade and lower 5-year survival rates compared to high-income countries (HICs) where the implementation of screening and treatment services have advanced. This review scoped and mapped the literature regarding the content, implementation and uptake of CRC screening interventions as well as opportunities and challenges for the implementation of CRC screening interventions in LMICs. METHODS We systematically followed a five-step scoping review framework to identify and review relevant literature about CRC screening in LMICs, written in the English language before February 2020. We searched Medline, Embase, Web of Science and Google Scholar for studies targeting the general, asymptomatic, at-risk adult population. The TIDieR tool and an implementation checklist were used to extract data from empirical studies; and we extracted data-informed insights from policy reviews and commentaries. RESULTS CRC screening interventions (n = 24 studies) were implemented in nine middle-income countries. Population-based screening programmes (n = 11) as well as small-scale screening interventions (n = 13) utilised various recruitment strategies. Interventions that recruited participants face-to-face (alone or in combination with other recruitment strategies) (10/15), opportunistic clinic-based screening interventions (5/6) and educational interventions combined with screening (3/4), seemed to be the strategies that consistently achieved an uptake of > 65% in LMICs. FOBT/FIT and colonoscopy uptake ranged between 14 and 100%. The most commonly reported implementation indicator was 'uptake/reach'. There was an absence of detail regarding implementation indicators and there is a need to improve reporting practice in order to disseminate learning about how to implement programmes. CONCLUSION Opportunities and challenges for the implementation of CRC screening programmes were related to the reporting of CRC cases and screening, cost-effective screening methods, knowledge about CRC and screening, staff resources and training, infrastructure of the health care system, financial resources, public health campaigns, policy commitment from governments, patient navigation, planning of screening programmes and quality assurance.
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Affiliation(s)
- Désirée Schliemann
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK.
| | - Kogila Ramanathan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Nicholas Matovu
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Ciaran O'Neill
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Frank Kee
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Tin Tin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
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Ye W, Lu W, Li X, Chen Y, Wang L, Zeng G, Xu C, Ji C, Cai Y, Yang L, Luo Z. Long-term changes in premature death of lung cancer in a developed region of China: a population-based study from 1973 to 2019 (Preprint). JMIR Public Health Surveill 2021; 8:e33633. [PMID: 35442209 PMCID: PMC9069300 DOI: 10.2196/33633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/20/2021] [Accepted: 02/24/2022] [Indexed: 12/24/2022] Open
Abstract
Background Lung cancer is a leading cause of death worldwide, and its incidence shows an upward trend. A study of the long-term changes in the premature death rate in lung cancer in a developed region of China has great exploratory significance to further clarify the effectiveness of intervention measures. Objective This study examined long-term changes in premature lung cancer death rates in order to understand the changes in mortality and to design future prevention plans in Pudong New Area (PNA), Shanghai, China. Methods Cancer death data were collected from the Mortality Registration System of PNA. We analyzed the crude mortality rate (CMR), age-standardized mortality rate by Segi’s world standard population (ASMRW), and years of life lost (YLL) of patients with lung cancer from 1973 to 2019. Temporal trends in the CMR, ASMRW, and YLL rate were calculated by joinpoint regression expressed as an average annual percentage change (AAPC) with the corresponding 95% CI. Results All registered permanent residents in PNA (80,543,137 person-years) from 1973 to 2019 were enrolled in this study. There were 42,229 deaths from lung cancer. The CMR and ASMRW were 52.43/105 and 27.79/105 person-years, respectively. The YLL due to premature death from lung cancer was 481779.14 years, and the YLL rate was 598.16/105 person-years. The CMR and YLL rate showed significantly increasing trends in men, women, and the total population (P<.001). The CMR of the total population increased by 2.86% (95% CI 2.66-3.07, P<.001) per year during the study period. The YLL rate increased with an AAPC of 2.21% (95% CI 1.92-2.51, P<.001) per year. The contribution rates of increased CMR values caused by demographic factors were more evident than those caused by nondemographic factors. Conclusions Lung cancer deaths showed an increasing trend in PNA from 1973 to 2019. Demographic factors, such as the aging population, contributed more to an increased CMR. Our research can help us understand the changes in lung cancer mortality and can be used for similar cities in designing future prevention plans.
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Affiliation(s)
- Wenjing Ye
- Department of Respiratory Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiwei Lu
- Department of General Practice, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaopan Li
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, China
- Office of Scientific Research and Information Management, Pudong Institute of Preventive Medicine, Shanghai, China
| | - Yichen Chen
- Office of Scientific Research and Information Management, Pudong Institute of Preventive Medicine, Shanghai, China
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, China
| | - Lin Wang
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Guangwang Zeng
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Cheng Xu
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Chen Ji
- Warwick Clinical Trials Unit, Warwick Medical School, Coventry, United Kingdom
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ling Yang
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Zheng Luo
- Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Pudong New Area, Shanghai, China
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Li XP, Chen HM, Lei XH, Dou GS, Chen YC, Chen LP, Zhang Y, Zhao GM, Zhong W. Cost-effectiveness analysis of a community-based colorectal cancer screening program in Shanghai, China. J Dig Dis 2021; 22:452-462. [PMID: 34086400 DOI: 10.1111/1751-2980.13027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/17/2021] [Accepted: 06/03/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study investigated the cost-effectiveness of a community-based colorectal cancer-screening program (C-CRCSP) in Shanghai, China, among the residents in the urban, suburban and rural areas. METHODS A Markov model was constructed to evaluate the cost-effectiveness of a 25-year annual C-CRCSP including 100 000 populations. Cost-effectiveness was determined by the incremental cost-effectiveness ratio (ICER); referring to either life-years gained, or quality-adjusted life-years (QALYs) gained. The threshold was gross domestic product per capita. Univariate and multivariate sensitivity analyses were performed to investigate the influence of compliance, prevalence, technological performance, medical cost and annual cost discount rate (3.5%) on ICER. A probabilistic sensitivity analysis evaluated the probability of the cost-effectiveness of C-CRCSP at different maximum acceptable ceiling ratios. RESULTS Compared with no screening, the C-CRCSP resulted in total gains of 7840 QALYs and 2210 life-years (LY), at a total cost of CNY 58.54 million; that is, the ICER were CNY 7460/QALYs and CNY 26650/LY. Stratifying by residency, the cumulative gains in QALYs and LY were estimated to be the lowest in the urban populations compared with the rural and suburban populations. The cost for the urban population was 3-fold and 6-fold that of the suburban and rural populations. The ICER for QALYs ranged from 2180 (rural) to 16 840 (urban). CONCLUSION The cost-effectiveness of a C-CRCSP in Shanghai was most favorable for the rural population, while the urban population benefits less in terms of QALYs. ICER could be enhanced by measures that increase compliance.
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Affiliation(s)
- Xiao Pan Li
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Office of Scientific Research and Information Management, Pudong Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Hui Min Chen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiao Hong Lei
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Guan Shen Dou
- Department of Health Economics, Key Laboratory For Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| | - Yi Chen Chen
- Office of Scientific Research and Information Management, Pudong Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Li Ping Chen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yao Zhang
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Gen Ming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Wei Zhong
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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18
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Huang RL, Liu Q, Wang YX, Zou JY, Hu LF, Wang W, Huang YH, Wang YZ, Zeng B, Zeng X, Zeng Y. Awareness, attitude and barriers of colorectal cancer screening among high-risk populations in China: a cross-sectional study. BMJ Open 2021; 11:e045168. [PMID: 34253663 PMCID: PMC8276297 DOI: 10.1136/bmjopen-2020-045168] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To assess the awareness, attitude and barriers of colorectal cancer screening among high-risk populations in China. DESIGN A cross-sectional study was employed. SETTING This study was conducted in nine hospitals in Hunan province, China. PARTICIPANTS Individuals with a high-risk for colorectal cancer were interviewed using a pretested structured questionnaire. PRIMARY AND SECONDARY OUTCOME MEASURES Knowledge, attitude towards colorectal cancer screening, sociodemographic factors associated with screening knowledge and behaviour and barriers of colorectal cancer screening. RESULTS This study included 684 participants. The mean knowledge score was 11.86/24 (SD 4.84). But over 70% of them held a positive attitude towards screening. Only 13.3% had undergone colorectal cancer screening. Independent factors related to knowledge were education level of college or above, working as a white collar, higher income, having health insurance, having seen a doctor in the past year and with a high perceived risk (p<0.05). Factors independently associated with screening behaviour included personal history of colorectal disease, having seen a doctor in the past year, previous discussion of colorectal cancer screening, high perceived risk and better knowledge (p<0.05). Main reasons for not undergoing screening were no symptoms or discomfort (71.1%), never having thought of the disease or screening (67.4%) and no doctor advised me (29.8%). CONCLUSION In China, the majority of high-risk people had deficient knowledge and had never undergone colorectal cancer screening. But most of them held a positive attitude towards the benefits of colorectal cancer screening. This has promising implications to design targeted educational campaigns and establish screening programmes to improve colorectal cancer awareness and screening participation. Healthcare professionals should advise high-risk individuals to participate in screening and inform them about cancer risk.
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Affiliation(s)
- Ruo-Lin Huang
- Department of International and Humanistic Nursing, School of Nursing, University of South China, Hengyang, Hunan, China
| | - Qi Liu
- Department of International and Humanistic Nursing, School of Nursing, University of South China, Hengyang, Hunan, China
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Ying-Xin Wang
- Department of International and Humanistic Nursing, School of Nursing, University of South China, Hengyang, Hunan, China
| | - Jin-Yu Zou
- Department of International and Humanistic Nursing, School of Nursing, University of South China, Hengyang, Hunan, China
| | - Li-Feng Hu
- Department of International and Humanistic Nursing, School of Nursing, University of South China, Hengyang, Hunan, China
| | - Wen Wang
- Department of International and Humanistic Nursing, School of Nursing, University of South China, Hengyang, Hunan, China
| | - Ying-Hui Huang
- Department of International and Humanistic Nursing, School of Nursing, University of South China, Hengyang, Hunan, China
| | - Yi-Zhuo Wang
- Department of International and Humanistic Nursing, School of Nursing, University of South China, Hengyang, Hunan, China
| | - Bo Zeng
- Hengyang No.8 High School, Hengyang, China
| | - Xi Zeng
- Cancer Research Institute, Hunan Province Key Laboratory of Tumor Cellular & Molecular Pathology, University of South China, Hengyang, Hunan, China
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, Hunan, China
| | - Ying Zeng
- Department of International and Humanistic Nursing, School of Nursing, University of South China, Hengyang, Hunan, China
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19
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Shen J, Wu Y, Feng X, Liang F, Mo M, Cai B, Zhou C, Wang Z, Zhu M, Cai G, Zheng Y. Assessing Individual Risk for High-Risk Early Colorectal Neoplasm for Pre-Selection of Screening in Shanghai, China: A Population-Based Nested Case-Control Study. Cancer Manag Res 2021; 13:3867-3878. [PMID: 34012295 PMCID: PMC8126801 DOI: 10.2147/cmar.s301185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/02/2021] [Indexed: 01/08/2023] Open
Abstract
Objective To identify people with high-risk early colorectal neoplasm is highly desirable for pre-selection in colorectal cancer (CRC) screening in low-resource countries. We aim to build and validate a risk-based model so as to improve compliance and increase the benefits of screening. Patients and Methods Using data from the Shanghai CRC screening cohort, we conducted a population-based nested case–control study to build a risk-based model. Cases of early colorectal neoplasm were extracted as colorectal adenomas and stage 0-I CRC. Each case was matched with five individuals without neoplasm (controls) by the screening site and year of enrollment. Cases and controls were then randomly divided into two groups, with two thirds for building the risk prediction model and the other one third for model validation. Known risk factors were included for risk prediction models using logistic regressions. The area under the receiver operating characteristic curve (AUC) and Hosmer–Lemeshow chi-square statistics were used to evaluate model discrimination and calibration. The predicted individual risk probability was calculated under the risk regression equation. Results The model incorporating age, sex, family history and lifestyle factors including body mass index (BMI), smoking status, alcohol, regular moderate-to-intensity physical activity showed good calibration and discrimination. When the risk cutoff threshold was defined as 17%, the sensitivity and specificity of the model were 63.99% and 53.82%, respectively. The validation data analysis also showed well discrimination. Conclusion A risk prediction model combining personal and lifestyle factors was developed and validated for high-risk early colorectal neoplasm among the Chinese population. This risk-based model could improve the pre-selection for screening and contribute a lot to efficient population-based screening in low-resource countries.
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Affiliation(s)
- Jie Shen
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yiling Wu
- Department of Noninfectious Chronic Disease Control and Prevention, Songjiang District Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Xiaoshuang Feng
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Fei Liang
- Department of Biostatistics, Zhongshan Hospital Fudan University, Shanghai, People's Republic of China
| | - Miao Mo
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Binxin Cai
- Department of Noninfectious Chronic Disease Control and Prevention, Songjiang District Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Changming Zhou
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Zezhou Wang
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Meiying Zhu
- Department of Noninfectious Chronic Disease Control and Prevention, Songjiang District Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Guoxiang Cai
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.,Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
| | - Ying Zheng
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
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20
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Luo Z, Lv H, Chen Y, Xu X, Liu K, Li X, Deng Y, Zhou Y. Years of Life Lost Due to Premature Death and Their Trends in People With Selected Neurological Disorders in Shanghai, China, 1995-2018: A Population-Based Study. Front Neurol 2021; 12:625042. [PMID: 33746880 PMCID: PMC7973274 DOI: 10.3389/fneur.2021.625042] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/01/2021] [Indexed: 12/06/2022] Open
Abstract
Background: Neurological disorders are the leading cause of long-term disability and the second leading cause of death in the world. We aimed to characterize the long-term trends in mortality and disease burden of selected neurological disorders and quantitatively analyze the contributions of demographic and non-demographic factors on the mortality of selected neurological disorders in Shanghai, China, 1995–2018. Methods: Mortality data were derived from the Vital Statistics System of Pudong New Area, Shanghai, China, during 1995–2018. Temporal trends for the mortality rates and burden of selected neurological disorders were analyzed by Joinpoint Regression Program. Years of life lost (YLL) was used to analyze the burden of disease. The increasing mortality rates related to demographic and non-demographic factors were estimated by the decomposition method. Results: A total of 4432 deaths from selected neurological disorders occurred during 1995–2018, accounting for 0.98% of total deaths. The crude mortality rates (CMR) and age-standardized mortality rates (ASMRW) of neurological disorders were 7.14/105 person–years and 4.08/105 person–years, respectively. Extrapyramidal and movement disorders, other degenerative diseases of the nervous system, and episodic and paroxysmal disorders were the three leading causes of mortality and YLL of selected neurological disorders. The CMR, ASMRW, and rate of YLL for deaths from selected neurological disorders showed significantly increasing trends in males, females, and the total population during 1995–2018 (all P < 0.001). The contribution rates of increased values of CMR related to demographic factors were more evident than non-demographic factors. Conclusion: The mortality rate and rate of YLL for death from selected neurological disorders increased significantly during 1995–2018 in Pudong New Area, Shanghai. The demographic factors, particularly aging, might be related to an increase in the mortality of neurological disorders. More effective prevention strategies are needed to prevent the aging-related death and burden from neurological disorders in the future.
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Affiliation(s)
- Zheng Luo
- Department of Neurology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Huihui Lv
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yichen Chen
- Center for Disease Control and Prevention of Pudong New Area, Shanghai, China.,Office of Scientific Research and Information Management, Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Xiaoyun Xu
- Department of Neurology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Kangyong Liu
- Department of Neurology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Xiaopan Li
- Office of Scientific Research and Information Management, Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Yang Deng
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China
| | - Yi Zhou
- Center for Disease Control and Prevention of Pudong New Area, Shanghai, China.,Office of Scientific Research and Information Management, Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
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21
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Luo Z, He Y, Ma G, Deng Y, Chen Y, Zhou Y, Xu X, Li X, Du Y. Years of life lost due to premature death and their trends in people with malignant neoplasm of female genital organs in Shanghai, China during 1995-2018: a population based study. BMC Public Health 2020; 20:1489. [PMID: 33004024 PMCID: PMC7528500 DOI: 10.1186/s12889-020-09593-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background The increasing aging population has been posing a significant challenge to disease burden in developing countries. In particular, the contribution of population aging to and long term changes of disease burden of malignant neoplasm of female genital organs (MNFGO) have not been quantitatively demonstrated. Methods Data were collected from the Shanghai Vital Statistics System of Pudong New Area (PNA). Crude mortality rate (CMR), age-standardized mortality rate by Segi’s world standard population (ASMRW), and years of life lost (YLL) of MNFGO as the underlying cause of death in age and pathology types from 1995 to 2018 were calculated. The joinpoint regression was used to estimate the trends of those rates by identifying the annual percent changes (APCs), and the decomposition method was used to calculate the increased rates and the contribution resulting from demographic and non-demographic factors. Results From 1995 to 2018, a total of 2869 MNFGO-specific deaths were reported in PNA, accounting for 0.64% of the total deaths. The CMR and ASMRW of MNFGO were 9.23/105 person-years and 4.80/105 person-years, respectively. Ovary cancer was the most common cause of MNFGO death, accounting for 43.9% (1260/2869) of all MNFGO death. Other common causes of MNFGO death included cervix uteri cancer, uterus unspecified cancer, and corpus uteri cancer. With the increase of age, the mortality rate of MNFGO in residents had shown an upward trend ([APC (95%CI) = 3.46 (2.74, 4.18), P < 0.001)] for each five-year age group from 0 to 4 to 85+ years. From 1995 to 2018, YLL of MNFGO in Shanghai PNA was 42,152.82 years, and the rate of YLL was 135.56 /105. The top three MNFGO types in YLLs were ovary cancer, cervix uteri cancer and uterus unspecified cancer. Demographic factors contributed significantly to the upward trends of CMR, ASMRW, and YLL rates of MNFGO. Conclusion With aggravated population aging in Shanghai, MNFGO is and will continue to be a serious threat to women’s health. More precise and effective prevention strategies are needed to target high risk population, to achieve efficient health resource allocation and to improve women’s health in particular.
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Affiliation(s)
- Zheng Luo
- Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, No. 1500 Zhouyuan Rd., Pudong New Area, Shanghai, 201318, China
| | - Yuan He
- Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai, 200011, China
| | - Guifen Ma
- Department of Radiotherapy, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yang Deng
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Yichen Chen
- Center for Disease Control and Prevention, No. 3039 Zhangyang Rd., Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Yi Zhou
- Center for Disease Control and Prevention, No. 3039 Zhangyang Rd., Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Xiaoyun Xu
- Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, No. 1500 Zhouyuan Rd., Pudong New Area, Shanghai, 201318, China.
| | - Xiaopan Li
- Center for Disease Control and Prevention, No. 3039 Zhangyang Rd., Pudong New Area, Shanghai, 200136, China. .,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China.
| | - Yan Du
- Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai, 200011, China.
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22
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Li X, Zhou Y, Luo Z, Gu Y, Chen Y, Yang C, Wang J, Xiao S, Sun Q, Qian M, Zhao G. The impact of screening on the survival of colorectal cancer in Shanghai, China: a population based study. BMC Public Health 2019; 19:1016. [PMID: 31357981 PMCID: PMC6664771 DOI: 10.1186/s12889-019-7318-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 07/15/2019] [Indexed: 12/23/2022] Open
Abstract
Background Shanghai is one of the earliest cities in developing countries to introduce an organized colorectal screening program for its residents to fight against the rising disease burden of colorectal cancer (CRC). This study aims to investigate the impact of the Shanghai screening program implemented in 2013 on the survival rates of CRC patients. Methods We calculated up to 5-year survival rates for 18,592 CRC patients from a representative district of Shanghai during 2002–2016, using data from the Shanghai Cancer Registry. We performed joinpoint regressions to examine temporal changes in the trends of the CRC survival rates. We then conducted Kaplan-Meier and Cox proportional hazards modelling to study the association of the survival rates with screening behaviors of the patients. In all the model specifications, we took into account the gender, age and TNM stage at diagnosis, and level of treatment hospital of the patients. Results We find that the annual percentage changes of the survival rates increased faster after somewhere around 2013, however, the differential trends were not significant. Results from the Cox multivariate regression analysis suggest that patients who did not participate in the screening program showed significantly lower cancer-specific survival (hazard ratio (HR) = 1.46; 95% confidence interval (CI): 1.12–1.91) and all-causes survival (HR = 1.37; 95% CI: 1.05–1.77), compared to those who did. Among program participants, delayed colonoscopy was associated with poor cancer-specific survival (hazard ratio (HR) = 2.93; 95% confidence interval (CI): 1.64–5.23) and all-causes survival (HR = 3.29; 95% CI: 1.85–5.84). Conclusion Screening participation and high level of colonoscopy compliance can improve the survival of CRC participants. Electronic supplementary material The online version of this article (10.1186/s12889-019-7318-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaopan Li
- School of Public Health, Fudan University, 130 Dong'an Rd, Shanghai, 200032, China.,Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Yi Zhou
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Zheng Luo
- Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Pudong New Area, Shanghai, 201318, China
| | - Yi'an Gu
- Department of epidemiology, Columbia University, New York, NY, USA
| | - Yichen Chen
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Chen Yang
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Jing Wang
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Shaotan Xiao
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Qiao Sun
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Mengcen Qian
- School of Public Health, Fudan University, 130 Dong'an Rd, Shanghai, 200032, China.
| | - Genming Zhao
- School of Public Health, Fudan University, 130 Dong'an Rd, Shanghai, 200032, China. .,The Key Laboratory of Public Health and Safety of Education Ministry, Fudan University, 138 Yixueyuan Rd, Shanghai, 200032, China.
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