Analysis of the efficacy of gastric cancer screening in rural population in Henan Province / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the efficacy of endoscopic screening for gastric cancer in rural population in high risk areas of upper gastrointestinal cancer in Henan province.</p><p><b>METHODS</b>Subjects aged 40-69 years in the high risk areas were selected to participate in the endoscopic screening based on the cluster sampling, and screening-positive subjects were sampled for pathological examination. The data of screening were summarized and the detection rates of severe chronic atrophic gastritis, severe intestinal metaplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia, early and middle-late cancer were calculated, and the constituent ratio of early cancer cases was calculated. The detection rates and early diagnosis rates for the first round screening and follow-up screening were compared.</p><p><b>RESULTS</b>In the 5 years, a total of 88 263 subjects were endoscopically examined in the first round screening and 4 004 subjects were diagnosed with low grade intraepithelial neoplasia or above (the detection rate was 4.54%), in which 3 256 cases were with low grade intraepithelial neoplasia (the detection rate of 3.69%), 366 cases with high grade intraepithelial neoplasia (the rate of 0.41%), 199 cases with early cancer (the rate of 0.22%) and 183 cases with middle-late cancer (the rate of 0.21%). The number of cases of high grade intraepithelial neoplasia and early cancer was 565 and the early diagnosis rate was 75.53%. 1 894 subjects with severe chronic atrophic gastritis, severe intestinal metaplasia and low grade intraepithelial were followed up with a compliance of 66.32%. A total of 45 cases of early cancer were diagnosed, with a detection rate of 2.38% and early diagnosis rate of 100%. The detection rate and early diagnosis rate in the follow-up screening were both statistically significantly higher than that in the first round screening (P<0.01 for both).</p><p><b>CONCLUSION</b>The efficacy of endoscopic screening for gastric cancer is significant in high risk areas of upper gastrointestinal cancer, and improving the quality of follow-up screening will achieve a better performance of the screening.</p>

Analysis of effect of screening of esophageal cancer in 12 cities and counties of Henan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate effect of screening of esophageal cancer at rural areas in Henan province.</p><p><b>METHODS</b>At rural areas with high incidence of upper gastrointestinal carcinoma in Henan province total of 88,263 persons with 40 to 69 years old were set to the target population of the screening by the 12 cities and countries and endoscope and pathology diagnosis were performed during 2009-2013. For patients with precancerous lesions, follow-up visits were conducted and defined as follows: once in three years for patients with mild dysplasia, once per year for moderate hyperplasia patients, the patients with severe intraepithelial neoplasia/carcinoma in situ should be treat, at least once per year for those one who didn't under treatment. The result data of screening were summarized and detection rates of esophagus hyperplasia, carcinoma in situ, early and middle-late cancer were calculated, as well as the early diagnosis rate. The result between first round and follow-up screening was compared.</p><p><b>RESULTS</b>Target population were examined in first round screening. There were 8,434 persons with above mild dysplasia and the detection rate was 9.56%, among them there were 7,224 (8.18%) cases with light-middle hyperplasia, 789 (0.89%) cases with serious dysplasia or cancer in situ, 239 (0.27%) cases with early cancer and 182 (0.21%) cases with middle-late cancer. The sum of serious dysplasia or cancer in situ and early cancer was 1 028 and the early detection rate was 84.96% (1,028/1,210). From 2012 to 2013, the follow-up screening for persons with light-middle hyperplasia which should be followed 4,230 cases, there were 2 853 people to take in screening and compliance was 67.45%. Total of 94 cases were diagnosed with cancer in situ or early cancer. The detection rate and the early detection rate were 3.29% and 100%, respectively. The rates of detection and early detection in phase of follow-up screening were statistically significantly higher than that in first round screening respectively (P<0.001).</p><p><b>CONCLUSION</b>At rural areas of high incidence upper gastrointestinal carcinoma in Henan province, the screening with endoscope had good effect and strengthening the follow-up screening could increase the effect.</p>

A meta-analysis of body mass index and the risk of lung cancer in the Chinese population / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the association between obesity and the risk of lung cancer and evaluate a dose-response relationship between body mass index (BMI) and incidence risk of lung cancer in the Chinese population.</p><p><b>METHODS</b>A systematic literature search for BMI and incidence risk of lung cancer in the Chinese population, as well as through the reference lists of retrieved articles. The literature databases including Chinese National Knowledge Infrastructure, Wanfang, PubMed, Embase and Google Scholar. Time range was from the founding of each database to September 2014 and a total of 93 research papers were collected. Meta-analysis was conducted to calculate pooled odds ratio and corresponding 95% CI. Generalized least-squares regression methods were used to make a dose-response meta-analysis between BMI and incidence risk of lung cancer.</p><p><b>RESULTS</b>Seven studies were included in the meta-analysis, with a number of 2 351 lung cancer cases. Results showed that obesity was inversely associated with lung cancer incidence (OR = 0.68, 95% CI: 0.59-0.79) (heterogeneity test: I² = 0, P = 0.594). The association did not change with stratification by study design, sex, smoking status, BMI measurement method and study population. A linear dose-response association between BMI and risk of lung cancer was visually significant, and lung cancer risk would be reduced 21% for per 5 kg/m² BMI increase (OR = 0.79, 95% CI: 0.71-0.89) (heterogeneity test: q = 22.43, P = 0.002).</p><p><b>CONCLUSION</b>The results of this meta-analysis indicated that higher BMI was a protective factor against lung cancer, but smoking may play a stronger role as a confounding factor for the most important role with lung cancer incidence.</p>

Analysis of results of endoscopic screening of esophageal, gastric cardia and gastric cancers in high risk population / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To summarize the results of endoscopic screening of esophageal, gastric cardiac and gastric cancers in the high-risk population, and analyze the influencing factors such as age, gender and biopsy rate on their detection and early diagnosis rates.</p><p><b>METHODS</b>Nine high incidence cities and counties of esophageal cancer in Henan province were included in this study. People aged 40-69 years were set to the target population. Excluding contraindications for gastroscopy, in accordance with the national technical scheme of early cancer diagnosis and treatment, gastroscopic screening and biopsy pathology for human esophageal, cardiac and gastric cancers were carried out.</p><p><b>RESULTS</b>During the 3-year period, a total of 40 156 subjects were screened. Among them, 18 459 cases of various precancerous lesions (46.0%) were detected. The cancer detection rate was 2.3% (916 cases), including 763 cases of early cancers. The diagnosis rate of early cancers was 83.3%. Precancerous lesions were detected in 9297 cases (23.2%) for esophagus and 9162 cases (22.8%) for gastric cardia as well as stomach, respectively.</p><p><b>CONCLUSIONS</b>The results of this study demonstrate that endoscopic screening is feasible for early detection, diagnosis and treatment of esophageal, gastric cardia and gastric cancers among high risk population in high incidence area. Exploration analysis of relevant affecting factors may help to further improve the screening project for early diagnosis and treatment of those cancers.</p>

Ten-year trends of mortality from cerebrovascular diseases in two resident areas in Henan / 中华全科医师杂志

The cluster sampling method was used and a retrospective survey on mortality trends of cerebrovascular diseases from 1989 to 2008 was conducted among residents from Erqi District in Zhengzhou city and Xigong District in Luoyang city. The average mortality rate of cerebrovascular diseases in these two districts was 69. 5/100 000 in 1989 to 2008. The standardized mortality rate for men was 118. 67/100 000 in 1989 to 1993, and dropped to 44. 23/100 000 in 2004 to 2008. The standardized mortality rate for women was 68.21/100 000 in 1989 to 1993, and dropped to 30. 2/100 000 in 2004 to 2008. The declining trends of cerebrovascular disease mortality rates might be related to early diagnosis and early treatment of the disease, and the extensive health education and prevention programs.

Period survival analysis of stomach cancer in the population of Linzhou City, Henan Province / 肿瘤

Objective: To analyze the survival rate of stomach cancer patients and its variation during different periods in Linzhou city, Henan Province, from 1988 to 2004, and evaluate the level of secondary prevention and diagnosis of stomach cancer in this area. Methods: All of the incidence and death records of stomach cancer from 1988 to 2004 were collected and matched from Linzhou Cancer Registry. The records that were identified as duplicate cases or had only death certificate (DCO) were excluded. The tumor cause eliminated life tables in this area were calculated and linked to the data of incidence and death of stomach cancer. FivE-year observed survival rates and fivE-year relative survival rates in three periods (1990-1994, 1995-1999, and 2000-2004) were calculated using period survival analysis mehod. The relative survival curves in the three periods were plotted. Results:The 5-year relative survival rate of stomach cancer was 26.66% during 1990-1994, 32.01% during 1995-1999, and 40.43% during 2000-2004 in Linzhou city. It showed a gradually increasing trend. The 5-year survival rates were higher in males than those in females. During 1990-1994 and 1995-1999, the 5-year survival rates of gastric cardia cancer were higher than those of non-cardia cancer. During 2000-2004 period, the 5-year survival rate of gastric cardia cancer was lower than that of non-cardia cancer. Conclusion: The survival rates of stomach cancer in Linzhou city are increasing gradually since 1990s in 20 century. It indicates that the levels of secondary prevention and clinical diagnosis and treatment on stomach cancer kept increasing in this area.

Risk factors for oesophageal cancer in Linzhou, China: a case-control study.

Linzhou City has one of the highest incidences of oesophageal cancer in China, and in the world. A case-control study was here conducted to investigate potential risk factors in this area. Linzhou Cancer Registry was used to identify cases of oesophageal cancer, aged between 30 and 75, diagnosed between January 1998 and April 1999. Three neighbourhood controls were selected for each case, matched according to age, sex and village of residence. A total of 211 cases and 633 controls were interviewed. A strong association was found between socio-economic status and the risk of oesophageal cancer. Increased income, residential space and education were all significantly associated with a decreased risk (OR 0.54, 0.36 and 0.30 respectively). Using a drinking water source other than tap water was significantly associated with an increased risk (OR 5.49). The consumption of beans, vegetables and vinegar all showed a protective effect with odds ratios of 0.37, 0.44 and 0.37 respectively. Preferences for a low salt diet or a high salt diet were both associated with an increased risk. It can be concluded that in Linzhou, oesophageal cancer is a disease related to poverty. Having a drinking water source other than tap water increases the risk of oesophageal cancer. As in other populations, a high consumption of vegetables and beans are associated with a decreased risk and a preference for a high salt diet is associated with an increased risk.

Trends in the epidemiology of lung cancer in Henan, China / 中国肺癌杂志

<p><b>BACKGROUND</b>To evaluate the epidemiological trends of lung cancer in Henan, China.</p><p><b>METHODS</b>Cancer mortality data were collected from 1974 to 1999. The mortality trends of lung cancer were studied. Secular trend on lung cancer form 1974 to 2010 with regression used for spatial analysis.</p><p><b>RESULTS</b>The data showed that lung cancer was the dominating cause of all cancer-related deaths in Henan. During the period of 1974 to 1999, marked changes took place in Henan in the mortality rate of lung cancer. Lung cancer mortality rates increased from 4.15 per 100 000 in the early seventies to 12.13 per 100 000 in the late nineties, lung cancer accounted for 5.09% of all cancer related deaths in the early seventies and 14.09% in the late nineties. In general, men had higher mortality rate than women, and urban area had higher mortality rates than rural area. The mortality rate for male and female would be about 25 per 100 000 and 15 per 100 000 respectively in 2010 if no intervention strategy was taken</p><p><b>CONCLUSIONS</b>The overall age-adjusted mortality rate of lung cancer in Henan has increased during the past two decades, strengthening education for health is very important in cancer control.</p>

Analysis of mortality trends of digestive system cancer in Henan Province from 1987 to 2006 / 中国癌症杂志

Background and purpose:Henan is a big agricultural province and the high mortality rate of digestive system cancer threatened the life and the health of the people.In order to make some good strategies,we investigated the mortality rate and characteristic distribution of digestive system cancer in Henan province. Methods :The mortality and age-standardized mortality rate from 1987 to 2006 in Henan province were analyzed by using the data from registration system of all causes of death from 1/10 population in Henan province. Results :The crude mortality rate of digestive system cancer from 1987 to 2006 in Henan province was 81.95/10 5,and the age-standardized mortality in Chinese standard population was 71.31/10 5,which accounted for 71.29% of all cancers.The mortality rates,age-standardized mortality in male was 101.17/10 5 and 94.81/10 5 respectively,compared to 61.58/10 5 and 49.28/10 5 respectively in female.The foremost four in rank of the digestive system cancer were gastric cancer,esophageal cancer,liver cancer and intestinal cancer.The mortality of digestive system cancer has descended in the recent twenty years.Comparing in 1987 and in 2006,the age-standardized mortality rates of gastric cancer and esophageal cancer had decreased significantly from 30.38/10 5 to 21.27/10 5 and from 34.12/10 5 to 15.70/10 5 respectively.The death rate of intestinal cancer remained constant.But age-standardized mortality rate of liver cancer had increased significantly from 12.45/10 5 in 1987 to 18.26/10 5 in 2006. Conclusions :The distribution of death rate of digestive system cancer had changed greatly,so the prevention measures have to be changed accordingly.