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Objective@#To investigate the status of self-measurement of body weight in overweight and obese adults in China and identify the related factors.@*Methods@#A total of 87 670 adults were enrolled in this study, who were selected through multi stage cluster random sampling from 177 099 residents aged ≥18 years in 302 surveillance areas in China where the fourth chronic non-communicable disease and related factor surveillance project was conducted in 2013. The information about their demographic characteristics and body weight measurement were collected by using questionnaire. Their body height, body weight, waist circumstance and blood pressure were measured respectively through physical examination. Fasting venous blood samples were obtained and assayed for FPG, TC, TG, LDL-C and HDL-C levels. Venous blood samples after 75 g glucose intake were obtained and assayed for OGTT-2h level. The proportion of self-body weight measurement were analyzed after complex sample weighting.@*Results@#The proportion of overweight and obese adults who had self-body weight measurement within 1 week, 1 month and 1 year were 18.9%, 23.0% and 30.2%, respectively. The proportion of those having self-body weight measurement within 1 week was higher in men than in women, and lowest in ≥60 years old group (P<0.05). The proportion of overweight and obese adults who had never measured their body weight was 20.5%, the proportion was higher in women than in men, and highest in ≥60 years old group (P<0.05). Older age (OR=0.73, 95%CI: 0.64-0.82) was risk factor for self-body weight measurement; female (OR=1.11, 95%CI: 1.03-1.19), higher education level (junior college and above OR=3.79, 95%CI: 2.89-4.97), high- income (OR=1.61, 95%CI: 1.31-1.98), dyslipidemia (OR=1.13, 95%CI: 1.04-1.23), diabetes (OR=1.15, 95%CI: 1.03-1.30) were the protective factors for self-body weight measurement.@*Conclusion@#It is necessary to promote self-body weight measurement in overweight and obese adults in China. Targeted health education should be carried out for different groups to encourage regular self-body weight measurement to maintain healthy body weight.
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Objective@#To understand the control attempts of body weight and its related factors among overweight and obese adults in China.@*Methods@#Data was from the 2013 Chinese Chronic Diseases and Risk Factors Surveillance Program, which covered 302 surveillance sites. 179 570 adults, selected through multistage stratified cluster sampling method, were interviewed. Demographic characteristics and weight-control attempts were collected via face-to-face interview. BMI, waist circumstance and blood pressure were individually measured under physical examination. Venous blood samples were obtained and tested for FPG, OGTT-2h, TC, TG, LDL-C and HDL-C. A total of 87 545 overweight and obese patients were included in this study, with the exclusion of 152 patients having the missed critical information. Rates on weight control and attempts were analyzed, using the complex weighting on samples to represent the overall overweight and obese adults in China.@*Results@#The rate of weight-control attempts was 16.3% (95%CI: 14.9%-17.7%). Among all the 12 133 patients who had undergone weight-control measures, the proportions of different attempts were as follows: diet (40.9%, 95%CI: 38.4%-43.3%), combination of diet and physical activity (31.5%, 95%CI: 28.9%-34.0%), physical activity (22.8%, 95%CI: 21.0%-24.6%) and drug control (1.3%, 95%CI: 1.0%-1.7%). Factors as: being female (OR=1.26, 95%CI: 1.15-1.38), at younger age (18-44 years old, OR=1.51, 95%CI: 1.31-1.74), with high education levels (college degree or above, OR=4.52, 95%CI: 3.76-5.43), having high annual income (≥24 000 Yuan, OR=1.94, 95%CI: 1.63-2.30) etc., appeared as favorable factors for taking the measures vs. rural residency (OR=0.63, 95%CI: 0.55- 0.72) as the unfavorable one.@*Conclusion@#The rate of weight-control attempts appeared low among the overweight and obese adults who were affected by factors as age, education and income level. Personalized intervention measures should be carried out for people with different characteristics.
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Objective@#To understand medical treatment seeking behaviors and its influencing factors in employed floating population in China and provide evidence for the development of health service policies for floating population.@*Methods@#Data were from the national chronic disease and risk factor surveillance (floating population part) in 2012. Floating population were selected through multistage clustering sampling stratified by industries in 170 counties and districts from 31 provinces (autonomous regions, municipality directly under the central government) and Xinjiang Production and Construction Corps in the mainland of China. Information on demographic basic information, health status and health seeking behaviors six months before the investigation were collected through face-to-face questionnaire interview. The people aged 18-59 who had physical discomfort in the past six months was analyzed. After complex weighted analysis, multinomial logistic regression model was used to analyze the health seeking behavior and its influencing factors in the employed floating population.@*Results@#A total of 11 134 suitable people aged 18-59 years were included in the study. The number and proportion of the people seeking medical treatment, having self-treatment and having no treatment were 4 950 (44.5%), 3 880 (34.8%) and 2 304 (20.7%), respectively. Multinomial logistic regression analysis showed that women were 1.275 times (95%CI: 1.100-1.477) more likely to seek medical treatment compared with men. The medical treatment seeking rates of floating population in the eastern, central and western areas were 2.153 times (95%CI: 1.669-2.777), 2.310 times (95%CI:1.777-3.002), 2.177 times (95%CI: 1.695-2.796) higher than that of floating population in northeastern area. In terms of seeking treatment, the proportion of the floating population with annual income of more than 25 000 yuan was 1.255 times (95%CI: 1.088-1.448) higher than that of the floating population with annual income of 25 000 yuan or less than 25 000 yuan. The proportion of the floating population with severe physical discomfort within the past six months was 8.076 times (95%CI: 6.091-10.707) higher than that of the floating population without severe physical discomfort and the proportion of the floating population who participated in medical insurance in both original living places and current living places was 1.566 times (95%CI: 1.250-1.961) higher than that of the floating population who did not participate in medical insurance in two places. The incidence ratio of medical care seeking and self-treatment in new generation of floating population was 1.369 (95%CI: 1.157-1.619) and 1.240 (95%CI: 1.042-1.475) compared with old generation of floating population. Compared with the widowed/divorced/separated, the incidence ratio of medical treatment seeking and self-treatment for the married/cohabited was 1.590 (95%CI: 1.057-2.391) and 1.815 (95%CI: 1.209-2.725). The more severe physical discomfort, the higher level medical institutions they chose (P<0.05).@*Conclusions@#The treatment rate in medical institutions of employed floating population was low in China. Gender, generation of floating population, marital status, area, annual income, severity of physical discomfort in past six months and the way to participate in medical insurance were the main factors affecting the medical treatment seeking behaviors of employed floating population.
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Objective@#To estimate the prevalence of MS in elderly people aged ≥60 years and its related factors in China and provide scientific evidence for prevention and control of MS in the elderly.@*Methods@#Data used in this study were obtained from the 2013 Chinese Chronic Diseases and Risk Factor Surveillance Program. A total of 50 497 people aged ≥60 years were selected and interviewed through multistage stratified cluster sampling at 298 surveillance sites in 31 provinces. According to the Chinese MS diagnostic criteria proposed by the Chinese Medical Association Diabetes Branch in 2017, the prevalence rates of different MS forms were compared, and the main related factors were analyzed.@*Results@#The prevalence rate of MS was 36.9% (95%CI: 35.4-38.5). The prevalence rate was higher in urban area than in the rural area, higher in females than in males, higher in eastern area than in western area. The prevalence rate of MS in elderly people aged ≥70 years was lower than that in those aged 60-69 years. The rate in the elderly with higher education and income levels was higher than that in the elderly with lower socioeconomic level. The comparison of the prevalence of the five forms of MS in the elderly showed that hypertension had the highest prevalence rate (72.8%), followed by hyperglycemia (41.7%) and central obesity (37.6%). The prevalence rates of hypertriglyceridemia and low HDL-C were 25.8% and 17.5%. The risk for MS in women was 1.20 times higher than that in men. Age, gender, education level, living area and urban or rural residence were the main factors influencing the prevalence of MS. Smoking, drinking and physical activity levels were correlated with MS.@*Conclusions@#The risk for MS was higher in women than in men in China’s elderly population, and the risk was related to socioeconomic level and life behaviors. It is recommended to carry out lifestyle interventions, such as increasing exercise and having reasonable diet for the elderly patients with MS. Hypertension and diabetes patients also need to be treated with drugs to reduce the risk of cardiovascular disease morbidity and mortality.
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Objective@#To understand the prevalence and disease burden of major chronic diseases in the elderly in China and provide scientific basis for the prevention and control of chronic diseases and for the rational allocation of health resources.@*Methods@#We analyzed the prevalence of chronic diseases in residents aged ≥60 years in China by using national and provincial surveillance data of chronic diseases and related risk factors in China. We conducted the analysis on the burden of chronic diseases in the elderly in China by using the data of global burden of disease.@*Results@#The prevalence rates of hypertension, diabetes and hypercholesterolemia were 58.3%, 19.4% and 10.5% respectively in residents aged ≥60 years in China. Up to 75.8% of the residents aged ≥60 years had at least one chronic disease. The prevalence rate was higher in women than in men, higher in urban area than in rural area. With the increase of age, the prevalence rate of chronic diseases also increased. The top three chronic diseases with heavy disease burden in residents aged ≥70 years were stroke, myocardial infarction, cancer and chronic obstructive pulmonary disease.@*Conclusion@#The prevalence of major chronic diseases in the elderly is high with three quarters of the elderly suffering from at least one chronic disease, and the burden of chronic diseases is increasing.
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Objective To study the relationship between blood pressure level and major risk factors for cardiovascular diseases in adults in China.Methods A total of 179 347 adults aged ≥18 years were recruited from 298 surveillance points in 31 provinces in China in 2013 through complex multistage stratified sampling.The survey included face to face interview and physical examination to collect information about risk factors,such as smoking,drinking,diet pattern,physical activity,overweight or obesity,and the prevalence of hypertension.The blood pressure was classified into 6 levels (ideal blood pressure,normal blood pressure,normal high blood pressure and hypertension phase Ⅰ,Ⅱ and Ⅲ).The relationship between the prevalence or co-prevalence of risk factors for cardiovascular disease and blood pressure was analyzed.Results The adults with ideal blood pressure,normal blood pressure,normal high pressure,hypertension phase Ⅰ,Ⅱ and Ⅲ accounted for 36.14％,22.77％,16.22％,16.43％,5.97％ and 2.48％,respectively.Among them,the blood pressure was higher in men,people in Han ethnic group and those married,and the blood pressure was higher in those with older age,lower income level and lower education level,the differences were all significant (P＜0.05).Whether taking antihypertensive drug or not,co-prevalence of risk factors influenced the blood pressure levels of both sexes (P＜0.05),and the blood pressure levels of those taking no antihypertensive drug was influenced more by the co-prevalence of risk factors.Finally,multiple logistic analysis showed that the risks for high blood pressure in adults with 1,2 and ≥3 risk factors were 1.36,1.79 and 2.38 times higher,respectively,than that of the adults without risk factor.Conclusion The more the risk factors for cardiovascular disease in adults,the higher their blood pressure were.It is necessary to conduct comprehensive behavior intervention targeting ≥ 2 risk factors for the better control of blood pressure in general population.
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Objective To explore the relations between the prevalence of multiple chronic diseases and cigarette smoking behavior in the Chinese adults.Methods Based on the results from the 2013 Chronic Disease Risk Factor Surveillance (NCD Surveillance),176 534 Chinese residents aged 18 years and above,covering 298 counties (districts) in 31 provinces,was randomly recruited,using the multi-stage stratified clustering sampling method.Information on demographics,cigarette smoking (status,quantity and period) was obtained through face-to-face interviews and questionnaires.Anthropometric data and blood samples were collected and properly stored for analysis.Results In total,175 386 adults were included for statistical analyses,with 42.7％ as males and 57.3％ as females.The prevalence rates of hypertension,high total cholesterol and high triglycerides were 30.4％,7.2％ and 18.0％ in male smokers,35.6％,14.0％,10.3％ and 15.9％ in female smokers respectively,which were all higher than those in the respective non-smokers.Male smokers were found under lower risk on hypertension,but 19％ higher on total glycerides when compared with non-smokers of the same sex (OR=1.19,95％CI:1.10-1.30),when multiple risk factors were under control.Male current smokers with more than 20 cigarettes per day have 41％ (OR=1.41,95％CI:1.28-1.55) higher risk of high TG than non-smokers.Female smokers presented 40％ (OR=1.40,95％CI:1.15-1.70) higher risk in high glycerides than the non-smokers.Specifically,women smoking longer than 20 years have 60％(OR=l.60,95％ CI:1.31-1.95) higher risk of high TG than women smoking less than 20 years.Conclusions Prevalence rates of certain chronic diseases were seen higher in smokers of both genders.People with longer history of smoking or being heavier smokers,appeared at advanced risk on developing chronic diseases.
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Objective To analyze the rates on prevalence,awareness,status on treatment and control of type 2 diabetes mellitus among Chinese premenopausal women aged 18-49,in 2013.Methods Data on China Chronic and Non-Communicable Disease Surveillance in year 2013 was used for analysis.Source of data covered 302 surveillance points which were selected by Multi-stage cluster random sampling method that including 176 534 adults over 18 years of age,with 46 674 premenopausal women aged 18-49.Plasma glucose and hemoglobin A 1 c levels were determined after a 10-hour overnight fast for all the participants,before a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes.Diabetes was defined according to the 1999 WHO diagnostic criteria-fasting blood glucose level as ≥7.0 mmol/L and/or 2 hours oral glucose tolerance test (OGTT-2 h) level as ≥ 11.1 mmol/L.After being weighed,according to complex sampling scheme and post-stratification,the sample was used to estimate the rates of prevalence,awareness,treatment and control of type 2 diabetes mellitus by age,education,urban and rural areas,and geographic locations.Results The overall prevalence of type 2 diabetes mellitus was 5.6％ among the Chinese premenopausal women aged 18-49.No statistical difference on the prevalence rates (5.7％ and 5.4％,respectively) was seen,between participants from the rural or the urban areas.Prevalence rates in the eastern,central or western geographic areas were 5.8％,6.2％ and 4.4％ respectively.The rates of awareness,treatment and control of diabetes appeared as 29.3％,27.9％ and 29.4％ in childbearing women aged 18-49.The rate of treatment was 95.4％ among those who knew their diabetic situation in childbearing women aged 18-49 years.The control rate of diabetes was 38.9％ among those who had taken measures to control glucose,in 18-49-year-old childbearing women.The rate of awareness on diabetes in childbearing women aged 18-49 years in urban areas was higher than that in the rural areas.There were significantly statistical differences on the treatment rates among groups of different education levels but not in the trend test.Conclusion The prevalence of type 2 diabetes mellitus in childbearing women aged 18-49 appeared high,but with low rates on awareness,treatment and control.However,statistical difference was seen on awareness,between urban and rural areas.
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Objective To estimate the cervical and breast cancer screening coverage and related factors among women aged 35-69 years who were in the National Cervical and Breast Screening Program,to provide evidence for improving cervical and breast cancer control and prevention strategy.Methods Data used in this study were abstracted from the 2013 Chinese Chronic Diseases and Risk Factors Surveillance Program.A total of 66 130 women aged 35-64 years and 72 511 women aged 35-69 years were included for this study.Weighted prevalence,(with 95％ confidence interval,CI) was calculated for complex sampling design.Rao-Scottx2 method was used to compare the screening coverage among subgroups.A random intercept equation which involved the logit-link function,was fitted under the following five levels:provincial,county,township,village and individual.Fix effects of all explanatory variables were converted into OR with 95％CI.Results In 2013,26.7％ (95％CI:24.6％-28.9％) of the 35-64 year-old women reported that they ever had been screened for cervical cancer and 22.5％ (95％ CI:20.4％-24.6％) of the 35-69 year-olds had ever undergone breast cancer screening.Lower coverage was observed among women residing in rural and central or western China than those in urban or eastern China (P＜0.000 1).The coverage among women aged 50 years or older was substantially lower than those aged 35-49 years.Those who were with low education level,unemployed,low household income and not covered by insurance,appeared fewer number on this cervical or breast cancer screening program (P＜0.000 1).Women living in rural and western China were having less chance of receiving the breast cancer screening (P＜0.05),but the difference was not statistically significant.Conclusion It is essential to strengthen the communitybased cervical and breast cancer screening programs,in order to increase the coverage.More attention should be paid to women aged 50 years or older,especially those socioeconomically disadvantaged ones.
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Objective To study the relationship between blood pressure level and major risk factors for cardiovascular diseases in adults in China.Methods A total of 179 347 adults aged ≥18 years were recruited from 298 surveillance points in 31 provinces in China in 2013 through complex multistage stratified sampling.The survey included face to face interview and physical examination to collect information about risk factors,such as smoking,drinking,diet pattern,physical activity,overweight or obesity,and the prevalence of hypertension.The blood pressure was classified into 6 levels (ideal blood pressure,normal blood pressure,normal high blood pressure and hypertension phase Ⅰ,Ⅱ and Ⅲ).The relationship between the prevalence or co-prevalence of risk factors for cardiovascular disease and blood pressure was analyzed.Results The adults with ideal blood pressure,normal blood pressure,normal high pressure,hypertension phase Ⅰ,Ⅱ and Ⅲ accounted for 36.14％,22.77％,16.22％,16.43％,5.97％ and 2.48％,respectively.Among them,the blood pressure was higher in men,people in Han ethnic group and those married,and the blood pressure was higher in those with older age,lower income level and lower education level,the differences were all significant (P＜0.05).Whether taking antihypertensive drug or not,co-prevalence of risk factors influenced the blood pressure levels of both sexes (P＜0.05),and the blood pressure levels of those taking no antihypertensive drug was influenced more by the co-prevalence of risk factors.Finally,multiple logistic analysis showed that the risks for high blood pressure in adults with 1,2 and ≥3 risk factors were 1.36,1.79 and 2.38 times higher,respectively,than that of the adults without risk factor.Conclusion The more the risk factors for cardiovascular disease in adults,the higher their blood pressure were.It is necessary to conduct comprehensive behavior intervention targeting ≥ 2 risk factors for the better control of blood pressure in general population.
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Objective To explore the relations between the prevalence of multiple chronic diseases and cigarette smoking behavior in the Chinese adults.Methods Based on the results from the 2013 Chronic Disease Risk Factor Surveillance (NCD Surveillance),176 534 Chinese residents aged 18 years and above,covering 298 counties (districts) in 31 provinces,was randomly recruited,using the multi-stage stratified clustering sampling method.Information on demographics,cigarette smoking (status,quantity and period) was obtained through face-to-face interviews and questionnaires.Anthropometric data and blood samples were collected and properly stored for analysis.Results In total,175 386 adults were included for statistical analyses,with 42.7％ as males and 57.3％ as females.The prevalence rates of hypertension,high total cholesterol and high triglycerides were 30.4％,7.2％ and 18.0％ in male smokers,35.6％,14.0％,10.3％ and 15.9％ in female smokers respectively,which were all higher than those in the respective non-smokers.Male smokers were found under lower risk on hypertension,but 19％ higher on total glycerides when compared with non-smokers of the same sex (OR=1.19,95％CI:1.10-1.30),when multiple risk factors were under control.Male current smokers with more than 20 cigarettes per day have 41％ (OR=1.41,95％CI:1.28-1.55) higher risk of high TG than non-smokers.Female smokers presented 40％ (OR=1.40,95％CI:1.15-1.70) higher risk in high glycerides than the non-smokers.Specifically,women smoking longer than 20 years have 60％(OR=l.60,95％ CI:1.31-1.95) higher risk of high TG than women smoking less than 20 years.Conclusions Prevalence rates of certain chronic diseases were seen higher in smokers of both genders.People with longer history of smoking or being heavier smokers,appeared at advanced risk on developing chronic diseases.
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Objective To analyze the rates on prevalence,awareness,status on treatment and control of type 2 diabetes mellitus among Chinese premenopausal women aged 18-49,in 2013.Methods Data on China Chronic and Non-Communicable Disease Surveillance in year 2013 was used for analysis.Source of data covered 302 surveillance points which were selected by Multi-stage cluster random sampling method that including 176 534 adults over 18 years of age,with 46 674 premenopausal women aged 18-49.Plasma glucose and hemoglobin A 1 c levels were determined after a 10-hour overnight fast for all the participants,before a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes.Diabetes was defined according to the 1999 WHO diagnostic criteria-fasting blood glucose level as ≥7.0 mmol/L and/or 2 hours oral glucose tolerance test (OGTT-2 h) level as ≥ 11.1 mmol/L.After being weighed,according to complex sampling scheme and post-stratification,the sample was used to estimate the rates of prevalence,awareness,treatment and control of type 2 diabetes mellitus by age,education,urban and rural areas,and geographic locations.Results The overall prevalence of type 2 diabetes mellitus was 5.6％ among the Chinese premenopausal women aged 18-49.No statistical difference on the prevalence rates (5.7％ and 5.4％,respectively) was seen,between participants from the rural or the urban areas.Prevalence rates in the eastern,central or western geographic areas were 5.8％,6.2％ and 4.4％ respectively.The rates of awareness,treatment and control of diabetes appeared as 29.3％,27.9％ and 29.4％ in childbearing women aged 18-49.The rate of treatment was 95.4％ among those who knew their diabetic situation in childbearing women aged 18-49 years.The control rate of diabetes was 38.9％ among those who had taken measures to control glucose,in 18-49-year-old childbearing women.The rate of awareness on diabetes in childbearing women aged 18-49 years in urban areas was higher than that in the rural areas.There were significantly statistical differences on the treatment rates among groups of different education levels but not in the trend test.Conclusion The prevalence of type 2 diabetes mellitus in childbearing women aged 18-49 appeared high,but with low rates on awareness,treatment and control.However,statistical difference was seen on awareness,between urban and rural areas.
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Objective To estimate the cervical and breast cancer screening coverage and related factors among women aged 35-69 years who were in the National Cervical and Breast Screening Program,to provide evidence for improving cervical and breast cancer control and prevention strategy.Methods Data used in this study were abstracted from the 2013 Chinese Chronic Diseases and Risk Factors Surveillance Program.A total of 66 130 women aged 35-64 years and 72 511 women aged 35-69 years were included for this study.Weighted prevalence,(with 95％ confidence interval,CI) was calculated for complex sampling design.Rao-Scottx2 method was used to compare the screening coverage among subgroups.A random intercept equation which involved the logit-link function,was fitted under the following five levels:provincial,county,township,village and individual.Fix effects of all explanatory variables were converted into OR with 95％CI.Results In 2013,26.7％ (95％CI:24.6％-28.9％) of the 35-64 year-old women reported that they ever had been screened for cervical cancer and 22.5％ (95％ CI:20.4％-24.6％) of the 35-69 year-olds had ever undergone breast cancer screening.Lower coverage was observed among women residing in rural and central or western China than those in urban or eastern China (P＜0.000 1).The coverage among women aged 50 years or older was substantially lower than those aged 35-49 years.Those who were with low education level,unemployed,low household income and not covered by insurance,appeared fewer number on this cervical or breast cancer screening program (P＜0.000 1).Women living in rural and western China were having less chance of receiving the breast cancer screening (P＜0.05),but the difference was not statistically significant.Conclusion It is essential to strengthen the communitybased cervical and breast cancer screening programs,in order to increase the coverage.More attention should be paid to women aged 50 years or older,especially those socioeconomically disadvantaged ones.
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Objective@#To assess the impact of Chinese Cervical Cancer Screening Program for Rural Area (NACCSPRA) on population-based screening rates.@*Methods@#The subjects were selected from 2013-2014 Chinese Chronic Diseases and Risk Factors Surveillance (CDRFS2013), which adopting multi-stage stratified cluster sampling from 31 provinces. A total of 169 632 participants aged 18 years and older in 297 surveillance points were interviewed, of whom 65 476 women aged 35-64 years were included in the analysis. The surveillance points in CDRFS 2013 were divided into the screening areas and the control areas by matching points in CDRFS2014 with counties in NACCSPRA. The difference in socioeconomic status between areas was compared. The screening rates and 95% confidence interval (95%CI) were estimated by Tylar series variance method. The Propensity Score was evaluated for individuals by multivariate logistic regression and the greedy matching method based on propensity score value was used to conduct 1∶1 matching sample for the screening areas and the control areas. After matching, multivariate conditional logistic regression model was fitted to assess the impact of national cervical cancer screening intervention on the likelihood of undergoing cervical cancer screening at population level.@*Results@#Among 65 476 subjects, 48.6% (n=31 794) was in the screening areas. Before matching, in the rural area the screening rate in the screening areas (24.0% (4 763/19 838), 95%CI: 21.8%-26.3%) was higher than that in the control areas (15.6% (2 331/14 942), 95%CI: 13.4%-17.8%); whereas in the urban area the screening rate in the screening areas (28.5% (3 413/11 956), 95%CI: 26.1%-31.0%) was similar to that in the control areas (26.3% (4 923/18 740), 95%CI: 24.1%-28.4%). After matching, in rural area the screening rate in the screening areas (23.2% (3 454/14 875), 95% CI: 20.9%-25.5%) was higher than that in the control areas (15.6% (2 315/14 875), 95% CI: 13.3%-17.8%); in urban area the screening rate in the screening areas (28.7% (3 202/11 146), 95% CI: 26.2%-31.2%) was higher than that in the control areas (23.1% (2 571/11 146), 95%CI: 20.9%-25.3%). Multivariate conditional logistic regression model showed that the cervical cancer screening rates in intervention areas significantly increased among women aged 35-64 years both in urban areas (OR=1.44, 95%CI: 1.34-1.54) and rural areas (OR=1.78, 95%CI: 1.67-1.90) as compared with those in control areas.@*Conclusion@#The implementation of Chinese cervical cancer screening program during the five years substantially increased the population-based screening rates both in urban and rural areas.
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Objective@#To evaluate the provincial representativeness of China Non-communicable and Chronic Disease Risk Factor Surveillance System, 2013.@*Methods@#The Sixth National Population Census data which was collected by National Bureau of Statistics of People's Republic of China was used to calculate proportion of population who aged 65 and above, mortality rate, the proportion of non-agriculture population, the illiteracy rate and urbanization rate in order to evaluate the surveillance system in each province. The Mann-Whitney U test was used to determine the statistically differences between the surveillance system and corresponding general population.@*Results@#Among the 298 disease surveillance points (DSPs) in China Non-communicable and Chronic Disease Risk Factor Surveillance System, there were 111, 85, and 102 DSPs located in the east, middle, and west area of China, which covering 13.90%, 11.48%, and 12.28% of the total population, respectively. The surveillance system covered 169 million of the population of China, accounting for 12.70% of Chinese population. The number of DSPs by provinces ranges from 6 (Hainan, Qinghai, and Ningxia) to 14 (Shandong, Guangdong and Henan). It indicated that mortality rate (DSP: 0.238%; Province: 0.482%) and the illiteracy rate (DSP: 15.54%; Province: 26.22%) among DSPs in Tibet were significantly lower than the provincial level, on the other hand, the proportion of non-agriculture population among DSPs (40.6%) was significantly higher than the provincial level (18.8%). The urbanization rate among Jiangxi DSPs (43.4%) was significantly lower than the provincial level (59.9%). The proportion of non-agriculture population among Shandong DSPs (32.8%) was significantly higher than the provincial level (24.2%), however, the illiteracy rate among Shandong DSPs (3.86%) was significantly lower than the provincial level (5.25%). Other than the provinces mentioned above, there was no statistical differences (P>0.05) among proportions of population who aged 65 and above, mortality rates, the proportions of non-agriculture population, the illiteracy rates and urbanization rate between provincial surveillance system and corresponding area.@*Conclusion@#Other than 3 provinces, in general, China Non-communicable and Chronic Disease Risk Factor Surveillance System had provincial representativeness.
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Objective@#To investigate the geographical variation of prediabetes in adults in different regions of China, and to analyze the related factors of prediabetes.@*Methods@#Data was obtained from China Chronic Disease and Related Risk Factor Surveillance in 2013. The surveillance adopted multiple-stage stratified cluster random sampling method, which sampled 177 099 residents aged above 18 years old among 298 surveillance points in 31 provinces of Chinese Mainland. Questionnaire interview was used to obtain demographic variables, personal living style, and socio-economical information. Physical examination was conducted and fasting venous blood sample and (oral glucose tolerance test-2 hours, OGTT-2 h) venous blood sample were obtained from the participants. A total of 171 567 residents aged 18 and above were included in the analysis. The prevalence of prediabetes was analyzed by provinces and by China's geographical regions, after complex weighting. Multilevel logistic models were established to explore the related factors of prediabetes on the area level and individual level.@*Results@#The prevalence of prediabetes among residents aged 18 and above was 16.6% (95%CI: 15.6%-17.6%) in China. The prevalence of prediabetes was the highest (18.3%) in the south China and lowest (13.1%) in the northwest area. The difference of the prevalence in different areas were not statistically significant (P=0.510). If categorized the prevalence of prediabetes into 5 groups by quintile, Hainan, Jilin, Shandong, Anhui, Hunan and Chongqing were in the highest group of prevalence of prediabetes (18.6%-22.7%), and Tibet, Qinghai, Gansu, Ningxia, Guizhou, and Jiangxi were in the lowest group (7.6%-12.6%). The variance of prevalence of prediabetes on the county level (MOR: 1.60 (95%CI:1.53-1.67)) was more diverse than the province level (MOR: 1.21(95%CI:1.08-1.29)) and higher than the street level (1.23 (95%CI:1.14-1.30)). Several factors increased risk of pre-diabetes, including smoking, hazardous drinking and harmful drinking, drinking in the past 30 days, overweight, obesity, central obesity, sugary drink intake, hypertension, high total cholesterol, high triglycerides, high blood low-density lipoprotein cholesterol, low blood high-density lipoprotein cholesterol (all P<0.05). After adjusted the above variables, 92.5% of variance of prediabetes prevalence conld be explained on the provincial level.@*Conclusion@#The geographical distribution of prediabetes in adults in China differed by geographic areas, and it significantly varied on the county level. The related variables included demographic variables, personal behavior, and geographic related variables.
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Objective@#To investigate the prevalence of hypercholesterolemia among Chinese adults in different geographic areas, and to analyze the related factors.@*Methods@#China Chronic and Non-Communicable Disease and Risk Factor Surveillance was conducted in 2013, based on 298 counties/districts in 31 provinces of Chinese mainland. The adults aged 18 years old were randomly selected using multi-stage stratified clustering sampling method. Information on chronic disease and risk factors was collected using face-to-face questionnaire interview and physical measurement. Blood samples were collected by local staffs. Serum total cholesterol (TC) was determined using standard method in a central laboratory. After excluding 565 participants missing key variables and 1 558 participants with abnormal TC values, a total of 174 976 participants were included. Weighted prevalence of hypercholesterolemia was calculated. Hypercholesterolemia related individual or geographic determinants were defined using multilevel logistic regression.@*Results@#The prevalence of hypercholesterolemia in Chinese adults age 18 years old and above was 6.9% (95%CI: 6.4%-7.3%), ranged from 3.0% (95%CI: 2.5%-3.4%) in the northwest of China to 14.2% (95%CI: 12.9%-15.5%) in the south (χ2=183.42, P<0.001). The prevalence of hypercholesterolemia was higher in 6 provinces including Tianjin, Liaoning, Fujian, Guangdong, Guangxi, and Hainan (≥9.0%), but lower in 7 provinces including Shanxi, Shannxi, Gansu, Qinghai, Ningxia, Xinjiang, and Tibet (<3.9%). There was a 1.27 fold variation in hypercholesterolemia prevalence by provincial level, and 72.5% of the geographical variation in hypercholesterolemia prevalence was account for by area-level determinants. With multilevel logistic analysis, the individual risk factors associated with hypercholesterolemia included aging, higher education level or annual household income per capita, regular drinking, too much red meal intake, inactivity, overweight or obesity. For geographic factors, residents living at south China, counties/districts with higher urbanization rates, higher education level or lower standardized death rates were more likely to have hypercholesterolemia (all P<0.05).@*Conclusion@#The prevalence of hypercholesterolemia was high in Chinese adults, it was different between regions and related with characteristics of population, individual behaviors and geographical regions.
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Objective To assess the mortality attributable to low fruit intake among people over 25 years old in China,2013,and its effect on life expectancy.Methods Based on data collected from China Chronic Disease and Risk Factor Surveillance in 2013,the average fruit intake in different genders and areas were calculated.Potential impact fraction (PIF) was used to examine the impact on deaths,mortality and life expectancy.Results The average daily fruit intake was (113.3 ± 168.9)g among people over 25 years old,with (103.6± 160.1) g for men and (122.7± 176.6) g for women,in China in 2013.Fruit intake for urban residents was significantly higher than that in rural residents and higher in eastern regions than that in central or western regions.Scores that attributable to low fruit intake accounted for 15.21％ of the total deaths and the population attributable fraction of inadequate intake of fruits to associated diseases was 35.00％.PIF for all the deaths in rural residents (16.50％)appeared higher than that of the urban residents (13.88％),and higher in the residents living in the eastern region (15.48％) than that in the central (16.27％) or western (13.75％) regions.Number of deaths that attributable to low fruit intake was 1.348 4 million.Deaths caused by related diseases appeared as:ischemic heart disease (472.5 thousands),hemorrhagic stroke (338.8 thousands),ischemic stroke (259.0 thousands),lung cancer (208.4 thousands),esophageal cancer (60.7 thousands),laryngeal cancer (5.4 thousands) and oral cancer (3.6 thousands).Numbers of all deaths and related diseases for urban residents were lower than that of the rural residents,with central regions (452.7 thousands) higher than that in the eastern (531.1 thousands) or western (364.6 thousands) regions.The average life expectancy loss caused by low fruit intake was 1.73 years,1.80 years for men and 1.58 years for women,in this country.Loss of life expectancy in the rural residents was higher than that of the urban residents,and higher in central regions than that in the eastern or western regions.Conclusions The intake of fruit was far lower than the recommended standard set for the Chinese people.Population attributable fraction was related to the associated diseases caused by inadequate intake of fruits which also made serious impact on life expectancy.
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Objective To analyze the attribution of mortality and impact on life expectancy caused by insufficient physical activity in different gender and areas in adults aged ≥25 years among Chinese people.Methods Data from the programs related to Chinese death surveillence,risk factors of chronic survey,health outcomes of physical activity as well as relative risk (RR) on Global Burden of Disease (GBD) study were used.Population attributable fraction (PAF) of different health outcomes attributable to deaths that caused physical activity and the influence of life expectancy in adults aged ≥25 years in Chinese people were calculated.Results The overall PAF for all cause of death due to physical activity in adults aged ≥25 years was 4.24％,with 4.86％ in females and 3.82％ in males.The health outcomes of inadequate physical activity would include breast cancer,colorectal cancer,ischemic heart disease,ischemic stroke and diabetes with relative PAFs as 9.04％,13.96％,14.96％,17.80％ and 16.92％,respectively.The attribution of death on Physical activity was 388 954.The most attributed death was ischemic heart disease,followed by ischemic stroke.With the elimination of physical inactivity,the total life expectancy was expected to lose by 0.43 years,with 0.47 years in women,and 0.39 years in men.Conclusion The increase of physical activity may benefit on health condition so to reduce the burden of chronic diseases and increase the life expectancy.
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Objective To quantitatively estimate the deaths and life expectancy losses attributable to diet high in sodium in China,and examine the gains and shifts under different control scenarios of sodium consumption.Methods Based on data from the cause-of-death through the National Mortality Surveillance System,and 24 hours urinary sodium values from Global Burden of Disease study on Chinese's estimates,population attributable fractions with the framework of comparative risk assessment were used to analyze the deaths and life expectancy losses due to diet high in sodium.The same methods were followed to examine the gains and shifts under different control scenarios of sodium consumption.Results In 2013,1 430 (940 for men and 490 for women)thousand deaths were attributable to diet high in sodium,accounting for 15.6％ (17.4％ for men and 13.0％ for women) of all-cause deaths in China,which causing 2.17 (2.49 for men and 1.71 for women) years of life expectancy loss.Diet with high sodium in 2013 caused 1 200,50 and 180 thousand deaths from cardiovascular disease,chronic kidney disease and stomach cancer respectively,accounting for 31.5％,30.8％ and 64.8％ of those specific causes.Comparing to the baseline in 2013,if the targets of 10％ decrease of sodium consumption by 2020 and 15％ by 2030 for Chinese chronic disease prevention and treatment planning,and 30％ decrease by 2030 for WHO non-communicable disease monitoring framework are achieved,220,340 and 730 thousand deaths will be averted,which may gain 0.30,0.45 and 0.95 years of life expectancy,respectively.Conclusions As one of the leading risk factors,diet high in sodium had caused heavy burden of disease from cardiovascular disease,chronic kidney disease and stomach cancer on Chinese residents.Intervention programs on sodium-reductionare urgently needed in China and related cost-effectiveness is highly expected.