Analysis of mortality and years of life lost of malignant tumors among inhabitants in rural area of Feicheng city from 2000 to 2010 / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the mortality trends and disease burden of malignant tumors in rural area of Feicheng city from 2000 to 2010, and to provide basic information for the prevention and treatment of malignant tumors in this area.</p><p><b>METHODS</b>The data of cancer mortality from 2000 to 2010 from Feicheng Cancer Registry database were checked. Mortality rate, standardized mortality rate, potential years of life Iost (PYLL), standardized potential years of life lost (SPYLL), average years of life lost (AYLL) and other indexes were calculated and analyzed. The trend of the standardized rates transformed by the natural logarithm over time was assessed by Prais-Winsten regression method in which the errors was assumed to follow a first-order autoregressive process. STATA 12.0 was used to analyze the data.</p><p><b>RESULTS</b>In average, the crude mortality rate was 199.67 per 100 000 (264.69 per 100 000 in males and 137.24 per 100 000 in females), and the standardized mortality rate was 157.00 per 100 000 (200.49 per 100 000 in males and 101.31 per 100 000 in females). There were no significant changes in the trends of all standardized rates. For males, the mortality rates of lung and colorectal cancers increased significantly, and for females, the rates of lung and breast cancers had increased trend while the rate of esophageal cancer showed a downward trend. There were no statistically significant changes in other main malignant tumors. During 2000 to 2010, the PYLL of malignant tumors in Feicheng was 183 685.0 person-years, and PYLL rate was 23.3 per 1000. The SPYLL was 153 091.0 person-years, SPYLL rate was 19.4 per 1000, and AYLL was 14.8 years.</p><p><b>CONCLUSIONS</b>There are no obvious changes in the trends of standardized mortality rates in rural area of Feicheng over the past 11 years. For males, the mortality of lung cancer and colorectal cancer is increasing, and for females, the rates of lung and breast cancers have an increasing trend while the rate of esophageal cancer shows a decreasing trend. The prevention and control of digestive malignant tumors, lung cancer and breast cancer are getting seriously important and should be the focal point in this issue.</p>

Analysis of risk factors for upper gastrointestinal cancer in China: a multicentric population-based case-control study / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the major risk factors for upper gastrointestinal cancer in high occurrence areas of esophageal and gastric cancer in China.</p><p><b>METHODS</b>Four high occurrence areas of esophageal cancer, namely Cixian and Shexian from Hebei province, Linxian from Henan province, Feicheng from Shandong province, and Zhuanghe from Liaoning province, which is a high occurrence area of gastric cancer, were selected for the study. The newly-diagnosed cases whose date of onset were after January 1st, 2009 were selected from the Cancer Registration Database in each district, and 751 cases diagnosed as cancers in lower segment of esophagus, cardiac and other subsite of stomach were randomly recruited. 2253 matched controls were selected to pair the cases at the ratio of 3:1. The relative information of the study objects were collected from the face-to-face interviews with trained staff by designed questionnaires, and the data was input by EpiData software. Statistic software SPSS 13.0 was applied to conduct both univariate and multivariate logistic regression analysis to evaluate odd ratios (OR) and 95% confident interval (CI).</p><p><b>RESULTS</b>As univariate analysis shown, 66 objects in case group had irregular diet habit; while 90 in control group had (OR = 3.177; 95%CI: 2.127 - 4.745). A higher percentage in case group (83 objects) preferred fried food in comparison with only 214 in control group did (OR = 3.190; 95%CI: 2.061 - 4.927). 369 objects in case group, but only 119 in control group had history of gastrointestinal diseases (OR = 14.660; 95%CI: 11.342 - 18.948). 282 objects in case group had history of gastroesophageal reflux disease (GERD), which was much higher than the percentage in control group (432 objects), with OR = 3.137 (95%CI: 2.546 - 3.864). All the above factors could increase the risk for upper gastrointestinal cancer. 387 objects in case group and 1278 in control group reported they preferred fresh vegetables in daily diet, which was found to be a protective factor (OR = 0.609; 95%CI: 0.473 - 0.785). As multivariate analysis shown, history of gastrointestinal tract diseases (OR = 21.420; 95%CI: 15.484 - 29.632), irregular food diet (OR = 3.097; 95%CI: 1.740 - 5.514), pickled food (OR = 3.005; 95%CI: 1.873 - 4.819), and GERD (OR = 2.261; 95%CI: 1.673 - 3.057) were found to be risk factors for upper gastrointestinal cancer; while frequent fresh-vegetable diet was a protective factor (OR = 0.562; 95%CI: 0.396 - 0.800).</p><p><b>CONCLUSION</b>Irregular lifestyle and unhealthy diet habit could be the major risk factors for upper gastrointestinal cancers among the residents from high occurrence areas of esophageal cancer and gastric cancer in China.</p>

A population-based matched case-control study on the risk factors of gastric cardia cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To find the major risk factors associated with gastric cardia cancer.</p><p><b>METHODS</b>We selected five high incidence areas of esophageal cancer and gastric cancer which have cancer registration system, i.e. Cixian and Shexian of Hebei Province, Linxian of Henan Province, Feicheng of Shandong Province and Zhuanghe of Liaoning Province. Fifty newly diagnosed cases of cardiac cancer after January 1, 2008 were selected from each cancer registration database. A uniform questionnaire, which was fully consulted by experts, was used. Population-based 1:3 case-control study was conducted in those areas. The study recruited 250 cases of cardiac cancer and 750 matched controls, which were investigated with the uniform questionnaire. The data were statistically analyzed by fitting-conditional Logistic analysis.</p><p><b>RESULTS</b>Smoking, passive smoking, alcohol drinking, irregular meal, improper dining posture, heavy taste, dried food, pickled food, fried food, hot food, gastrointestinal history, gastroesophageal reflux disease (GERD) can increase the risk of cardiac cancer. To eat more bean and high BMI are protective factors of the single factor logistic analysis. Gastrointestinal history (OR = 42.899), dried food (OR = 5.932), irregular meal (OR = 4.911), hot food (OR = 4.144), pickled food (OR = 3.287), passive smoking (OR = 2.355), and GERD (OR = 1.930) can increase the risk of cardiac cancer, eat more bean (OR = 0.254) and BMI ≥ 25 (OR = 0.492) are protective factors of the mixture factors logistic analysis.</p><p><b>CONCLUSIONS</b>Gastric cardia cancer is caused by environmental risk factors and genetic factors. Health education in high cardiac cancer incidence areas and primary prevention popularized into people's daily life will be beneficial to decreasing the incidence of gastric cardia cancer.</p>

The distribution of the pre-cancerous condition and pathological changes of esophageal cancer of the community residents in high-incidence area / 中华预防医学杂志

<p><b>OBJECTIVE</b>To observe the distribution of the pre-cancerous condition and pathological changes of esophageal cancer of the community residents in high-incidence area, and to provide etiological evidences for secondary prevention.</p><p><b>METHODS</b>An iodine-staining endoscope census was conducted in 9536 residents with high-risk factors at Feicheng, a high esophageal cancer incidence community in Shandong province. Of which, 1507 pathologic biopsies were performed and chi2 test administrated.</p><p><b>RESULTS</b>There was no statistical significance found in biopsy pathologic diagnosis between females and males among 1507 samples. The mild and medium atypical hyperplasia was taken as pre-cancerous condition and severe atypical hyperplasia was taken as pre-cancerous lesion. Taking all the population attending census as denominator, the detection rate of the precancerous state and precancerous lesion were 6.98% (294/4214) and 1.23% (52/4214) for the males, and 3.68% (196/5322) and 0.47% (25/5322) for the females, respectively. A statistical significance was observed when comparing males with females (chi2 were 52.349 and 15.267, respectively, P < 0.05). Analyzed by age group, severe atypical hyperplasia pathological changes were mainly distributed in the age group of 50- and 65-. The constituent ratio between 45 - and 50 - was the highest for CIS. Early carcinoma was mainly distributed in five age groups from 45- to 65-. It showed that high incidence town had a high detection rate of cancer and pathological changes of esophageal cancer in the analysis of urban and rural distribution.</p><p><b>CONCLUSION</b>The distribution of the pre-cancerous state and pathological changes of esophageal cancer of the residents should have provided a scientific basis for the primary and secondary prevention.</p>

The risk factors related to esophageal squamous cell cancer in Feicheng county, China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the risk factors related to the esophageal squamous cell cancer in Feicheng county in Shandong province.</p><p><b>METHODS</b>A case-control study was carried out in Feicheng county. There were two parts consisted in the cases. 253 cases, aged from 40 to 69 years old, were recruited from the screened endoscopic survey program from January 2004 to December 2006. The other part of cases was recruited from the people's Hospital of Feicheng city. 8159 subjects whose had normal endoscope test result were recruited as the control group. Besides cardiograph and ventral ultrasound examination the screening program also included an endoscope test during which mucosal stain with 1.2% iodine solution. The biopsies were taken from the screen and underwent pathologic evaluation by two pathologists; A self-administrative questionnaire survey was conducted in all the subjects to collect information about smoking, alcohol consumption and dietary. The binary Logistic regression was used to estimate odds ratio (OR) and 95% confidence interval (95% CI). The study protocol was approved by the local ethics committee and the study was conducted with the informed consents of all the study subjects.</p><p><b>RESULTS</b>There were 235 esophageal cancers cases (70 identified in screening program, 183 were hospitalized patients) and 8159 controls in the case-control study. Three potential confounders were detected after univariate analysis. After adjusted the three confounders, age, sex and education, we found, smoking, alcohol drinking were the top ranked risk factors for esophageal cancer. When combing smoking and alcohol drinking, the or was 2.73 (95% CI: 1.54 - 4.82) for male, and the proportional attribute relative risk was 51.47%. We also observed that more dietary cellulose and vitamin C intake have protective effects.</p><p><b>CONCLUSION</b>Smoking and alcohol drinking could increase the risk of esophageal cancer, and taking more dietary cellulose and vitamin C might decrease the risk.</p>

Role of serum angiopoietin-2 level in screening for esophageal squamous cell cancer and its precursors / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Angiopoietin-2 (Ang-2) is one of the critical regulators of tumor angiogenesis. Studies have shown a significant correlation of Ang-2 expression to tumor invasion and metastasis in various human cancers, but little is known about the serum Ang-2 (sAng-2) levels in esophageal squamous cell cancer (ESCC) and its precursors. In this study, we aimed to investigate its role in screening for ESCC and its precursors.</p><p><b>METHODS</b>We carried out a free endoscopic screening in Feicheng City, a high ESCC incidence area in Shandong Province of China. Serum samples were collected as follows: 91 from normal subjects, 44 from patients with esophagitis, 85 from patients with hyperplasia, and 13 from patients with early ESCC. In addition, 28 serum samples were obtained from patients with invasive ESCC undergoing surgery in People's Hospital of Feicheng City. All the subjects of the five groups were diagnosed by histopathology. The sAng-2 levels were tested and compared, and the diagnostic power in early or/and invasive ESCC was calculated in terms of sensitivity and other parameters.</p><p><b>RESULTS</b>The sAng-2 levels were (22.0 +/- 5.5), (21.3 +/- 3.2), (20.5 +/- 3.3), (24.0+/- 5.0), and (29.8 +/- 5.0) U/ml in normal, esophagitis, hyperplasia, early ESCC, and invasive ESCC groups respectively. It was significantly higher in early ESCC than inhyperplasia group (P = 0.009). The invasive ESCC group showed the highest Ang-2 level among all groups (all P = 0.000). The sensitivities of sAng-2 to early and invasive ESCC were 23.1% and 78.6% respectively.</p><p><b>CONCLUSION</b>sAng-2 level is related to carcinogenesis and progression of ESCC, but it can not be used to screen for early ESCC.</p>