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Objective@#To investigate the mortality of colorectal cancer and its trend from 1999 to 2015 in Tianjin, China, and to explore the mortality features in different populations in order to provide data for prevention and control strategies of colorectal cancer.@*Methods@#Colorectal cancer mortality data between 1999 and 2015 were collected from Tianjin population - based mortality surveillance system maintained by the Tianjin Centers for Disease Control and Prevention (CDC). Population data of permanent residents were collected from Tianjin Municipal Public Security Bureau. The number of new cases and deaths, incidence [including crude incidence, age-adjusted standardized incidence and 95% confidence interval (95% CI)], and mortality (including crude mortality, age-adjusted standardized mortality and 95% CI) of colorectal cancer were calculated. Standardized incidence and mortality of colorectal cancer were calculated using the Segi′s world standard population, adjusted with age and gender. JoinPoint regression and Cochran-Armitage trend test were used to determine the statistical significance of differences in mortality trend.@*Results@#A total of 31 376 new onset cases and 14 893 death cases of colorectal cancer were observed in Tianjin from 1999 to 2015. Colorectal cancer incidence increased from 1999 to 2015 with a standardized rate from 9.66/100 000 to 15.36/100 000 [annual percent change(APC)=3.48%, Z=23.21, P<0.001]. Colorectal cancer mortality increased from 1999 to 2015 with a standardized rate from 5.18/100 000 to 6.11/100 000 (APC=1.24%, Z=5.69, P<0.001). Both showed an increasing trend. The death proportion of colon cancer increased (39.67% in 1999 and 50.33% in 2015), while the death proportion of rectal caner decreased (60.33% in 1999 and 48.57% in 2015). The median age of colorectal cancer onset fluctuated steadily around 66 years old (APC=0.16, T=1.75, P=0.100); the median age of death increased from 69 to 73 years old (APC=0.43, T=8.81, P<0.001). From 1999 to 2015, the mortality of colorectal cancer showed a downward trend (all P<0.05) in the age groups of <35 and 35-44 years, while an upward trend (all P<0.05) in the age groups of 45-54 years, 55-64 years and ≥ 65 years. Colorectal cancer mortality in males increased with a standardized rate of 5.53/100 000 in 1999 to 7.33/100 000 in 2015(APC=2.29%, Z=7.86, P<0.001), while colorectal cancer mortality in females flatted with a standardized rate of 4.83/100 000 in 1999 to 4.89/100 000 in 2015 (APC=0.10%, Z=-0.30, P=0.752). Colorectal cancer mortality increased with a standardized rate of 6.75/100 000 in 1999 to 7.33/100 000 in 2015 (APC=0.54%, Z=1.98, P=0.048) in urban areas and of 3.18/100 000 in 1999 to 4.38/100 000 in 2015 (APC=2.47, Z=6.46, P<0.001) in rural areas, whose differences were significant. Standardized mortality rate in rural area was lower but the rising velocity was faster as compared to urban area.@*Conclusions@#Crude mortality and standardized mortality of colorectal cancer increase from 1999 to 2015 in Tianjin population. The people of elder, male and urban area have higher mortality. The mortality in people of male and rural area presents a faster rising state. Further efforts to reduce colorectal cancer mortality in Tianjin are needed to prevention and control of colorectal cancer.
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From 1999 to 2015, there were 6 186 cases of leukemia deaths in tianjin residents, the males accounted for 58.28% (3 605) and 52.31% (3 236) deaths lived in urban areas; the crude mortality rate of Leukemia increased from 3.47/100 000 to 4.28/100 000 [t=7.09, P<0.001, annual percent change (APC)=1.30%] and the standardized mortality rate decreased from 3.15/100 000 to 3.01/100 000 (t=-2.95, P=0.006, APC=-0.65%). Special attention should be focused on children, the elderly, males and rural residents.
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Objective@#To explore the trends and distribution of chronic obstructive pulmonary disease (COPD) mortality of the residents with different characteristics from 2000 to 2016 in Tianjin.@*Methods@#COPD mortality data in 2000-2016 were from Tianjin population based mortality surveillance system. The mortality rate of COPD, difference in the rate by gender, age, and geographic distribution, and the trend over years were analyzed. Age-sex-standardized mortality rates of COPD were calculated using the year 2000 world standard population. Joinpoint regression and Cochran-Armitage trend analysis were used to examine the trend of mortality.@*Results@#The crude COPD mortality rate in Tianjin decreased from 57.57/100 000 in 2000 to 28.23/100 000 in 2016 (annual percent change (APC)=-5.01%, Z=-64.76, P<0.001), and the standardized mortality rate decreased from 56.53/100 000 in 2000 to13.88/100 000 in 2016 (APC=-9.17%, Z=-100.83, P<0.001). The crude COPD mortality rate of males decreased from 54.57/100 000 to 27.77/100 000 (APC=-4.89%, Z=-43.63, P<0.001) and the standardized mortality rate decreased from 57.52/100 000 to 14.63/100 000 (APC=-9.07%, Z=-71.48, P<0.001). The crude COPD mortality rate of females decreased from 60.63/100 000 to 28.68/100 000 (APC=-5.12%, Z=-47.92, P<0.001) and the standardized mortality rate decreased from 55.53/100 000 to 13 13/100 000 (APC=-9.27%, Z=-71.13, P<0.001). The crude mortality rate of COPD in urban areas decreased from 45.07/100 000 to 19.54/100 000 (APC=-5.35%, Z=-42.38, P<0.001) and the standardized mortality rate decreased from 39.24/100 000 to 7.45/100 000 (Z=-63.97, P<0.001, APC=-10.22%). The crude mortality rate of COPD in rural areas decreased from 70.20/100 000 to 37.24/100 000 (APC=-4.77%, Z=-48.77, P<0.001) and the standardized mortality rate decreased from 78.88/100 000 to 25.70/100 000 (APC=-7.59%, Z=-72.43, P<0.001). The COPD mortality rate in rural areas was higher than that in urban areas (P<0.001). The COPD mortality rate in 35 years old and over decreased from 2000 to 2016 (P<0.001).@*Conclusion@#The COPD mortality in Tianjin decreased from 2000 to 2016. More efforts are need to reduce COPD mortality in Tianjin, in particular people in rural areas.
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Objective To explore the trends and distribution of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases,cancer,chronic respiratory disease and diabetes in different sex and residential areas in Tianjin so as to provide basis for setting up prevention and control programs on premature mortality.Methods Population data on premature mortality in 1999-2015 were from the'Tianjin population based mortality surveillance system'maintained by Tianjin Centers for Disease Control and Prevention (CDC).Data related to permanent residents was from the Tianjin Municipal Public Security Bureau.Standardized premature mortality rates were calculated and adjusted for age and gender according to the ‘2000 world standard population'.Premature mortality probabilities were analyzed according to the methods recommended by WHO.Joinpoint regression and Cochran-Armitage trend methods were used to determine the significance of differences on the trends of mortality.Results From 1999 to 2015,the prematmre mortality appeared consistent (P＜0.001) declining in the above-said four diseases with the APC of probabilities as-2.92％,-1.13％,-9.51％ and-3.39％,respectively.The probabilities of premature mortality were all declining consistently in both men and women and in both urban and rural areas in Tianjin.From 1999 to 2015,the probabilities of the four main NCDs were between 19.67％ and 12.85％ (APC=-2.49％,P＜0.001),higher in women (from 17.02％ to 9.17％,APC=-3.84％,P＜0.001) than that in men (from 22.27％ to 16.47％,APC=-1.59％,P＜0.001),in urban (from 21.04％ to 12.34％,APC=-3.26％,P＜0.001) than that in rural areas (from 17.80％ to 13.54％,APC=-1.54％,P＜0.001).Conclusion Our findings suggested that premature mortality in Tianjin was decreasing during 1999-2015 but attention should still be called for on males and people living in the rural areas to further reducing the premature mortality.
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We described the time trend of acute myocardial infarction (AMI) from 1999 to 2013 in Tianjin incidence rate with Cochran-Armitage trend (CAT) test and linear regression analysis,and the results were compared.Based on actual population,CAT test had much stronger statistical power than linear regression analysis for both overall incidence trend and age specific incidence trend (Cochran-Armitage trend P value＜linear regression P value).The statistical power of CAT test decreased,while the result of linear regression analysis remained the same when population size was reduced by 100 times and AMI incidence rate remained unchanged.The two statistical methods have their advantages and disadvantages.It is necessary to choose statistical method according the fitting degree of data,or comprehensively analyze the results of two methods.
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Objective@#To observe the incidence of acute myocardial infarction (AMI) between 1999 and 2013 in Tianjin residents and analyze the incidence differences on residents with various age, gender and living in urban or rural areas. The data might help for targeted prevention strategies among Tianjin residents.@*Methods@#AMI incidence data between 1999 and 2013 were obtained based on Tianjin cardiovascular disease incidence surveillance registry established by the Tianjin Centers for Disease Control and Prevention (CDC). Related information such as permanent residents′ population data were obtained from Tianjin Municipal Public Security Bureau. The Chinese population data in 2000 were used for age-sex-standardized rates estimation. Difference between two (or more) independent groups was compared by the Chi Square statistics. The Chi-square test for trend was used for computing the incidence trend in years and ages.@*Results@#AMI incidence rate in Tianjin declined from the year 1999 to 2013 with the rude incidence rate of 80.46/100 000 to 81.29/100 000, and with the standardized incidence rate of 64.85/100 000 to 44.57/100 000 (Z=-35.767, P<0.001). AMI incidence decreased gradually in residents aged over 45 years old (P<0.01), but increased in residents younger than 45 years old (P<0.001) from 1999 to 2013. The AMI incidence rate is consistently higher in male residents (rude incidence 99.89/100 000-102.98/100 000, standardized incidence rate 78.53/100 000-56.61/100 000) than in female residents (rude incidence 61.18/100 000-59.44/100 000, standardized incidence rate 50.31/100 000-31.76/100 000, both P<0.001) and higher in urban residents (rude incidence rate 133.98/100 000-98.02/100 000, standardized incidence rate 99.89/100 000-50.12/100 000) than in rural residents (rude incidence rate 35.57/100 000-66.19/100 000, standardized incidence rate 32.68/100 000-43.51/100 000, Z=6.217, P<0.001). AMI incidence decreased significantly in the urban residents (rude incidence rate 133.98/100 000-98.02/100 000, standardized incidence rate 99.89/100 000-50.12/100 000, Z=-46.968, P<0.001), while significantly increased in rural residents (rude incidence rate 35.57/100 000-66.19/100 000, standardized incidence rate 32.68/100 000-43.51/100 000, Z=6.217, P<0.001) during the study period.@*Conclusions@#The general incidence of AMI decreased during the study period in Tianjin residents. However, AMI incidence significantly increased in young male residents and rural residents. It is necessary to develop corresponding strategies for AMI control for Tianjin residents with different age/gender and living in different areas.
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Objective To explore the trends and distribution of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases,cancer,chronic respiratory disease and diabetes in different sex and residential areas in Tianjin so as to provide basis for setting up prevention and control programs on premature mortality.Methods Population data on premature mortality in 1999-2015 were from the'Tianjin population based mortality surveillance system'maintained by Tianjin Centers for Disease Control and Prevention (CDC).Data related to permanent residents was from the Tianjin Municipal Public Security Bureau.Standardized premature mortality rates were calculated and adjusted for age and gender according to the ‘2000 world standard population'.Premature mortality probabilities were analyzed according to the methods recommended by WHO.Joinpoint regression and Cochran-Armitage trend methods were used to determine the significance of differences on the trends of mortality.Results From 1999 to 2015,the prematmre mortality appeared consistent (P＜0.001) declining in the above-said four diseases with the APC of probabilities as-2.92％,-1.13％,-9.51％ and-3.39％,respectively.The probabilities of premature mortality were all declining consistently in both men and women and in both urban and rural areas in Tianjin.From 1999 to 2015,the probabilities of the four main NCDs were between 19.67％ and 12.85％ (APC=-2.49％,P＜0.001),higher in women (from 17.02％ to 9.17％,APC=-3.84％,P＜0.001) than that in men (from 22.27％ to 16.47％,APC=-1.59％,P＜0.001),in urban (from 21.04％ to 12.34％,APC=-3.26％,P＜0.001) than that in rural areas (from 17.80％ to 13.54％,APC=-1.54％,P＜0.001).Conclusion Our findings suggested that premature mortality in Tianjin was decreasing during 1999-2015 but attention should still be called for on males and people living in the rural areas to further reducing the premature mortality.
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We described the time trend of acute myocardial infarction (AMI) from 1999 to 2013 in Tianjin incidence rate with Cochran-Armitage trend (CAT) test and linear regression analysis,and the results were compared.Based on actual population,CAT test had much stronger statistical power than linear regression analysis for both overall incidence trend and age specific incidence trend (Cochran-Armitage trend P value＜linear regression P value).The statistical power of CAT test decreased,while the result of linear regression analysis remained the same when population size was reduced by 100 times and AMI incidence rate remained unchanged.The two statistical methods have their advantages and disadvantages.It is necessary to choose statistical method according the fitting degree of data,or comprehensively analyze the results of two methods.
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Objective To investigate the change of incidence and age distribution of cervical cancer in Tianjin from 2007 to 2013.Methods The incidence data of cervical cancer and population data were collected from the cancer registry system of Tianjin Center for Disease Control and Prevention and Tianjin Municipal Public Security Bureau,respectively.The crude incidence,and age-standardized incidence of cervical cancer were calculated by using SPSS software.The Join Point Regression Program software was used to detect the trend of cervical cancer incidence.Results A total of 3 362 cervical cancer patients were diagnosed during 2007 to 2013.The average age of the patients was 48.11 years.The crude incidence was 9.85/100 000.The annual world standard age specific incidence was 6.65/100 000.The incidence in urban area was higher than that in rural area,but the proportion of the cases in urban area showed a downward trend (trendx2=21.92,P=0.001) and the proportion of the cases in rural area showed a upward trend (trend x2=12.70,P=0.048).The difference was significant.The incidence was generally stable in urban area,the APC value was 2.7％ (95％CI:-9.1％-16.2％),the difference was not significant (Z=0.564,P=0.597);The incidence rate in rural area showed an upward trend,APC value was 13.4％ (95％CI:3.5％-24.2％),the difference was significant (Z=3.549,P=0.016).The two incidence peaks were in age groups 40-44 years and 75-79 years.Conclusion The overall incidence of cervical cancer in Tianjin was still stable during 2007-2013,and the disease mainly occurred in middle-aged and elderly population.More attention should be paid to the increased incidence of cervical cancer in rural area.
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Objective To explore the causes of death and life expectancy after elimination of main causes of disease in residents of Tianjin. Methods The death registry data of Tianjin residents in 2014 were collected and coded in“international classification of disease, 10th edition”. The crude death rate and life expectancy after elimination of main causes of disease were calculated, respectively. Results In 2014, the crude death rate in Tianjin residents was 70.708 per million, while in male and female were 78.728 and 62.637 per million respectively. The main cause of death in Tianjin residents was non-communicable disease. The top four death causes were heart disease, cancer, cerebrovascular disease and respiratory disease, accounting for 31.5%, 23.6%, 22.2% and 8.3% of the total death. The top four life expectancy lost diseases were heart disease, cerebrovascular disease, cancer and respiratory disease, with a 6.46 year, 3.28 year, 3.11 year and 1.25 year life increase respectively. Conclusion Non-communicable diseases are the major reason of death and life expectancy lost disease in Tianjin residents, which needs urgent effective intervention to control.
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Objective To investigate the change of incidence and age distribution of cervical cancer in Tianjin from 2007 to 2013.Methods The incidence data of cervical cancer and population data were collected from the cancer registry system of Tianjin Center for Disease Control and Prevention and Tianjin Municipal Public Security Bureau,respectively.The crude incidence,and age-standardized incidence of cervical cancer were calculated by using SPSS software.The Join Point Regression Program software was used to detect the trend of cervical cancer incidence.Results A total of 3 362 cervical cancer patients were diagnosed during 2007 to 2013.The average age of the patients was 48.11 years.The crude incidence was 9.85/100 000.The annual world standard age specific incidence was 6.65/100 000.The incidence in urban area was higher than that in rural area,but the proportion of the cases in urban area showed a downward trend (trendx2=21.92,P=0.001) and the proportion of the cases in rural area showed a upward trend (trend x2=12.70,P=0.048).The difference was significant.The incidence was generally stable in urban area,the APC value was 2.7％ (95％CI:-9.1％-16.2％),the difference was not significant (Z=0.564,P=0.597);The incidence rate in rural area showed an upward trend,APC value was 13.4％ (95％CI:3.5％-24.2％),the difference was significant (Z=3.549,P=0.016).The two incidence peaks were in age groups 40-44 years and 75-79 years.Conclusion The overall incidence of cervical cancer in Tianjin was still stable during 2007-2013,and the disease mainly occurred in middle-aged and elderly population.More attention should be paid to the increased incidence of cervical cancer in rural area.
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<p><b>OBJECTIVE</b>To understand the smoking-attributed mortality by inclusion of smoking information into all causes of death surveillance.</p><p><b>METHODS</b>Since 2010, the information about smoking status, smoking history and the number of cigarettes smoked daily had been added in death surveillance system. The measures of training, supervision, check, sampling survey and telephone verifying were taken to increase death reporting rate and reduce data missing rate and underreporting rate. Multivariate logistic regression analysis was conducted to identify risk factors for smoking-attributed mortality.</p><p><b>RESULTS</b>During the study period (2010-2014), the annual death reporting rates ranged from 6.5‰ to 7.0‰. The reporting rates of smoking status, smoking history and the number of cigarettes smoked daily were 95.53%, 98.63% and 98.58%, respectively. Compared with the nonsmokers, the RR of males was 1.38 (1.33-1.43) for all causes of death and 3.07 (2.91-3.24) for lung cancer due to smoking, the RR of females was 1.46 (1.39-1.54) for all causes of death and 4.07 (3.81-4.35) for lung cancer due to smoking, respectively.</p><p><b>CONCLUSION</b>The study of smoking attributed mortality can be developed with less investment by using the stable and effective all causes of death surveillance system in Tianjin.</p>
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Female , Humans , Male , Cause of Death , China , Epidemiology , Logistic Models , Lung Neoplasms , Mortality , Multivariate Analysis , Population Surveillance , Methods , Risk Factors , Smoking , MortalityABSTRACT
Objective To understand the distribution of reported road traffic injuries case in Tianjin from January to December 2013.Methods The injury data was collected from the disease surveillance system which covered all the areas in Tianjin.All the reported injury cases were at their first medical care seeking in sentinel hospitals from 1 January 2013 to 31 December 2013.Results A total of 26 405 injury cases were reported,including 103 deaths (0.4％),during this period with the incidence of 263.01/100 000.The male to female ratio of the cases was 1.68 ∶ 1 and average age of the cases was (40.24 ± 17.58) years.The injuries caused by motor vehicle traffic accident accounted for 74.0％ (19 547 cases) and the non-motor vehicle traffic accident caused cases accounted for 26.0％ (6 858).The first four areas with higher incidence were Binhai (684.86/100 000),Dongli (634.03/100 000),Xiqing (519.83/100 000) and Jinnan (504.12/100 000) districts.The three districts with lower incidence were Heping (44.69/100 000),Nankai (52.36/100 000) and Hedong (64.34/100 000) districts.The mild,moderate and serious cases accounted for 59.7％ (15 771 cases),33.1％ (8 747 cases) and 6.8％ (1 783 cases) respectively.The differences in incidence among different districts and age groups were statistical significant (P＜0.005).The death number in Tanggu district was highest,accounting for (26.21％) of the total,and age specific death number was highest in age group 45-64 years,accounting for 46.60％ of the total.Conclusion The case number and severity of road traffic accident caused injury varied with area and age group in Tianjin.It is necessary to develop targeted prevention and control measures to reduce the incidence of road traffic accident related injuries.
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<p><b>OBJECTIVE</b>To evaluate the integrated effects of tobacco control programs through comparing the pre- and post-implementation of the Tianjin Tobacco Control Act (Act), in 4 successive years.</p><p><b>METHODS</b>Case-related data on myocardial infarction was collected by Tianjin Surveillance System, New Case Registry. Both the representative sample size of indoor working places and public places for observation and PM2.5 monitored were selected through the calculation of Survey System, while the representative sample size of people involved in the survey for interview was under the Door to Door and Intercept.</p><p><b>RESULTS</b>Through comparing the pre- and post-implementation programs on Act, the posting of "No Smoking Sign" had become much more visible in hospitals, schools, governmental buildings and the waiting areas of public transportation. People smoked much less in the main public places, excepting for hotels and public bath rooms (P < 0.05). Exposure to secondhand smoking (SHS) had a 26.5% (P < 0.01) decline, than the Act was implemented in workplace and public place. Despite the number of cases increased in the entire population in Tianjin (β = -0.061, P = 0.00; β = 0.059, P = 0.00), cases with myocardial infarction presented at the hospitals were declining annually, among the indoor workers.</p><p><b>CONCLUSION</b>Act showed a positive effect in decreasing the number of smokers in public places thus protecting people from the negative effects on SHS. Message on health effect and social benefits on tobacco control should be disseminated to facilitate the comprehensive implementation of the Act.</p>
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Humans , China , Hospitals , Schools , Smoking , Smoking Prevention , Tobacco Smoke Pollution , WorkplaceABSTRACT
Objective: To explore the acute effect of air pollution on mortality for patients with cardio cerebral vascular disease and to provide the basis for disease prevention and control. Methods: The Mortality for patients with cardio cerebral vascular disease from 2001-01 to 2009-12 was from Tianjin Centers for Disease Control and Prevention, the meteorological and air pollution data were from Tianjin meteorological bureau and Tianjin environmental monitoring station respectively. The Single and multiple generalized additive model (GAM) extended poisson regression analysis was performed to calculate the relationship between air pollution and cardio-cerebral vascular disease mortality by controlling the time trends, weather, the day of week and air population. Results: Results: Single GAM analysis indicated that when the effect of SO2, NO2 and PM10 in the air reached the maximum in the day, the RR values for the mortality in patients with cardio-cerebral vascular disease increased 1.13%[95%CI (0.76-1.51)%], 0.78% [95%CI ( 0.41-1.15)%] and 0.61% [95%CI ( 0.51-0.71)%] respectively; when the average concentration of SO2, NO2 and PM10 increasing 10μg/m3 per day, after 0-5 days, the RR values for the mortality elevated 0.70% [95%CI (0.47-0.94)%], 0.51% [95%CI (0.27-0.74)%] and 0.16% [95%CI (0.06-0.27)%] respectively. Multiple GAM analysis presented that when SO2, NO2 and PM10 increasing 10 μg/m3 per day, the RR values for the mortality elevated 0.77% [95%CI (0.58-0.97)%], 0.41% [95%CI (0.05-0.78) %] and 0.38% [95%CI (0.12-0.64%)%] respectively. Conclusion: The air pollution could increase the mortality risk in patients with cardio-cerebral vascular disease, it is necessary to establish the prevention system in order to decrease the mortality risk in those patients.