ABSTRACT
Gastric cancer (GC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demons-trated that screening, early detection and early treatment are effective in reducing the incidence and mortality of GC. The development of the guideline for GC screening, early detection and early treatment in line with epidemic characteristics of GC in China will greatly promote the homogeneity and standardization, and improve the effect of GC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of GC screening, China′s national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of GC screening and provide scientific evidence for the GC prevention and control in China.
ABSTRACT
Esophageal cancer (EC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demons-trated that screening and early detection are effective in reducing the incidence and mortality of EC. The development of the guideline for EC screening and early detection in line with epidemic characteristics of EC in China will greatly promote the homogeneity and standardization, and improve the effect of EC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of EC screening, China′s national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of EC screening and provide scientific evidence for the EC prevention and control in China.
ABSTRACT
Objective To explore the expression and significance of serum DKK1 in patients with gastric cancer. Methods We selected 170 gastric cancer patients (gastric cancer group) and 170 subjects with non-gastric cancer during the same period (control group). ELISA was used to detect the DKK1 level. The ROC curve was used to evaluate the diagnostic performance, and we analyzed the relation between DKK1 level and age, gender, family history of gastric cancer, cigarette smoking, alcohol consumption, tumor size, TNM stage, infiltration depth, lymph node metastasis, liver metastasis, vascular invasion, perineural invasion. Results The serum DDK1 level in GC patients was higher than that in control group (P < 0.0001). ROC curve showed that the possible optimal cut-off value of DKK1 for gastric cancer patients was 167.8 pg/ml, AUC was 0.908, sensitivity was 80.59%, and specificity was 84.71%. There was no significant relation between the serum DKK1 level and age, gender, family history of gastric cancer, cigarette smoking, alcohol consumption, tumor size, liver metastasis, vascular invasion or distant metastasis (all P > 0.05). However, DKK1 level was significantly related with TNM stage, infiltration depth, lymph node metastasis and perineural invasion (all P < 0.05). Conclusion Serum DKK1 level is higher in gastric cancer patients than that of control group and related with the severity of lesions, which indicates that serum DKK1 may be a potential biomarker for gastric cancer screening.
ABSTRACT
Objective To analyze the literatures about artificial intelligence in cancer research in Web of Science (WOS) core collection database in 2010-2019 and summarize research hot spots and development trends. Methods Through bibliometrics methods and CiteSpace information visualization software, we applied the visual analysis of relevant literature on artificial intelligence in the field of cancer research retrieved from the Web of Science core collection database from 2010 to 2019. Results The number of published articles about artificial intelligence in the field of cancer research had been increasing year by year. The United States ranked first in the number of published articles in this field, the number of citations and cooperation capabilities. Although the number of published articles in China ranked the second, the number of citations was low. The hot spots of artificial intelligence in cancer research were mainly breast cancer and lung cancer. Machine learning, neural network and other methods were used to build models, which were used in basic cancer research, clinical diagnosis, treatment and prognosis prediction. The research frontiers were the methodological research of artificial intelligence, the research on the occurrence and classification of cancer and the research of protein in this field. Conclusion It will effectively promote the development of artificial intelligence in cancer research in China by learning the hot spots and cutting-edge technologies of international research, focusing on international cooperation and cooperation among national institutions and strengthening cross-disciplinary research.
ABSTRACT
The health literacy refers to the ability of individuals to acquire and understand basic health information and services and use them to make the right decisions to maintain and promote their health. Health literacy data focusing on cancer prevention and control was limited in China. In order to understand the health literacy and awareness of cancer risk factors and the cancer screening, early diagnosis and treatment in Chinese urban residents and compare the effect of different stages of the cancer intervention, the Cancer Screening Program in Urban China (CanSPUC) program, supported by the National Key Public Health Program, conducted a survey on the health literacy of the cancer prevention and treatment among urban residents in 16 provinces nationwide from 2015 to 2017. Four subgroups were designed in this survey, including (1) general population who have never participated in any cancer screening programs at a community-level; (2) individuals who have previously attended the CanSPUC program for cancer risk assessment or screening intervention; (3) cancer patients who were receiving treatment in local hospitals; (4) a special group from employees of government and public institutions (non-health system), state-owned enterprises and private enterprises (to have better understand on the impact of socioeconomic factors). The self-designed questionnaire covered six parts, including basic information, consciousness of common risk factors to cancer, awareness of early detection, awareness of early diagnosis, awareness of early treatment, and the needs and approaches for knowledge of cancer prevention and treatment. A total of 32 257 individuals were included in the final analyses. This paper landscaped the overall design of the survey, including participants, domains of the instrument, quality control, basic characteristics of the included individuals. These descriptions are applicable to each individual report of the current special issue of "Health Literacy of Cancer Control in Urban China" and future reports, in which more detailed results are and will be reported. The findings of this survey could provide some useful implications for similar researches in the future.
ABSTRACT
Objective@#To investigate the demand and access to the cancer prevention and treatment knowledge and related factors among urban residents in China from 2015 to 2017.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of general demographic characteristics, the demand and access to cancer prevention and treatment knowledge, and the influencing factors of the attitude. The Chi-square test was used to analyze the difference of the demand of the cancer prevention knowledge among different groups and the corresponding factors of the cancer prevention and treatment knowledge were analyzed by using the logistic regression model.@*Results@#The proportion of residents who need the cancer prevention and treatment knowledge was 79.5%. The demand rate of the inducement, symptom and diagnosis methods of cancer in the occupational population was highest, about 66.8%, 71.0% and 20.8%, respectively. The demand rate of treatment methods and cost in current cancer patients was the highest, about the 45.9% and 21.9%, respectively. The top three sources to acquire the cancer prevention and treatment knowledge were "broadcast or television" (69.5%), "books, newspapers, posters or brochures" (44.7%) and "family and friends" (33.8%). The multivariate analysis showed that compared with public institution personnel/civil servants, unmarried/cohabiting/divorced/widowed and others, annual household income less than 20 000 CNY, from the eastern region, people without cancer diagnosis and people with self-assessment of cancer risk, the demand rate of cancer prevention and treatment knowledge was higher in enterprise personnel/workers, married, annual household income between 60 000 CNY and 150 000 CNY, from the central region, people with cancer and people with unclear cancer risk (all P values <0.05).@*Conclusion@#There was a high demand for the cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017. The main access to the knowledge is from the radio or television. The occupation, marital status, annual household income, residential region, health status and risk of disease were the main factors of the demand of the cancer prevention and treatment knowledge.
ABSTRACT
Objective@#To understand the health literacy of the cancer prevention and treatment among urban residents of China, and explore the related factors.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The health literacy of the cancer prevention, early discovery, early diagnosis, early treatment and the demands of cancer prevention and treatment knowledge was analyzed. The level of health literacy among different groups were calculated and compared. The binary logistic regression model was used to analyze the influencing factors of the health literacy of the cancer prevention and treatment.@*Results@#The level of health literacy of the cancer prevention and treatment was 56.97% among all study population; in each group it was 55.01% for community residents, 59.08% for cancer risk assessment/screening population, 61.99% for cancer patients and 57.31% for occupational population, respectively (P<0.001). The level of health literacy of the cancer prevention and treatment of residents aged 50 to 69 years old, other occupational groups, unmarried, the central and western region residents and the group with unclear self-assessment of cancer risk was significantly lower than that of residents younger than 40 years old, personnel of public institutions/civil servants, married, the eastern region residents and the group whose self-assessment without cancer risk (P<0.05) . The level of health literacy of cancer prevention and treatment of females, people who went to high school or over, cancer risk assessment/screening population, cancer patients and occupational population was significantly higher than that of males, people who had an education level of primary school or below and community residents (P<0.05) .@*Conclusion@#The health literacy of the cancer prevention and treatment of urban residents in China was relatively high, but there was still room for improvement. Gender, age, educational level, occupation, region, marital status, self-assessment of cancer risk, and type of respondents were the key influencing factors of the health literacy of the cancer prevention and treatment. Male, 50-69 years old, lower educational level, central and western regions, unclear cancer risk self-assessment, and without specific environmental exposure to cancer prevention and treatment knowledge or related risk factors were the characteristics of the key intervention group of the health literacy of the cancer prevention and treatment.
ABSTRACT
Objective@#To understand the consciousness of the cancer early treatment and its demographic and socioeconomic factors.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The questionnaire collected personal information, the consciousness of the cancer early treatment and relevant factors. The Chi square test was used to compare the difference between the consciousness of the cancer early treatment and relevant factors among the four groups. The logistic regression model was used to analyze the influencing factors related to the consciousness of the cancer early treatment.@*Results@#With the assumption of being diagnosed as precancer or cancer, 89.97% of community residents, 91.84% of cancer risk assessment/screening population, 93.00% of cancer patients and 91.52% of occupational population would accept active treatments (P<0.001). If the immediate family members were diagnosed as precancer or cancer, people who would encourage their family members to receive early treatment in the four groups accounted for 91.96%, 91.94%, 92.44% and 91.55%, respectively (P<0.001). The company employees, annual household income with 40 000 yuan and more and other three groups had a relatively better consciousness of the cancer early treatment (P<0.05). Male, widowed, unemployed and from the central and western regions had a relatively worse consciousness of the cancer early treatment (P<0.05).@*Conclusion@#Residents in urban China participants had a good consciousness of the cancer early treatment. The marital status, occupation, annual household income and residential regions were major factors related to the consciousness of the cancer early treatment.
ABSTRACT
Objective@#To understand the consciousness of the cancer early diagnosis among urban residents and identify the related factors from 2015 to 2017.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The general demographic characteristics, the consciousness of the cancer early diagnosis (whether people would have a willingness or encourage their relatives/friends to confirm the abnormal results once which were detected from the physical examination) and other information were collected by using the self-designed questionnaire. The non-conditional logistic regression model was used to identify the relateol factors related to the consciousness of the cancer early diagnosis.@*Results@#As for residents with abnormal result from the physical examination, 89.29% (28 802) of residents would choose to seek medical treatment for further diagnosis. If their relatives/friends had abnormal results from the physical examination, 89.55% (28 886) of residents would encourage their relatives/friends to confirm the diagnosis in time. The non-conditional logistic regression model analysis showed that compared with the public institution staff/civil servants, annual household income less than 20 000 CNY, the western region and the cancer risk assessment/screening intervention population, the company staff, annual household income about 40 000 CNY and more, and the residents from the middle and eastern region had a stronger consciousness to seek further diagnosis; while the unemployed residents and community residents were less likely to seek further diagnosis (P<0.05).@*Conclusions@#From 2015 to 2017, the Chinese urban residents had a good consciousness of the cancer early diagnosis. Occupation, annual household income, residential region and population group were related to the consciousness of the cancer early diagnosis.
ABSTRACT
Objective@#To understand the consciousness of the cancer early detection among urban residents and identify the influencing factors from 2015 to 2017.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. Self-designed questionnaires were used to collect population, socioeconomic indicators, self-cancer risk assessment, regular participation in physical examination and other information. The multivariate logistic regression model was used to identify the factors of people who had not regularly participated in the regular physical examination in the past five years.@*Results@#The self-assessment results of 32 357 residents showed that there were 27.54% (8 882) of total study population with self-reported cancer risk, 45.48% (14 671) without cancer risk and 26.98% (8 704) with unclear judgement on their own cancer risk. Among population with cancer risk, 79.84% (7 091) considered physical examination accounted. In the past five years, there were 21 105 (65.43%) residents participated in regular physical examination and 11 148 (34.56%) participated in non-scheduled one, respectively. The multivariate logistic regression analysis showed that compared with unmarried and western region residents, divorced, middle and eastern region residents had a stronger consciousness to participate in the regular physical examination (P<0.05). Compare with residents with annual household income less than 20 000 CNY in 2014, cancer risk assessment/screening intervention population, and self-assessment with cancer risk, residents with annual household income between 20 000 CNY and 59 000 CNY in 2014, occupational population, community residents, cancer patients, self-reported cancer-free risk, and self-assessment with unclear judgement of cancer risk were less likely to participate in the regular physical examination (all P values <0.05).@*Conclusion@#From 2015 to 2017, the Chinese urban residents had a acceptable consciousness of the cancer early detection. The marital status, annual household income, population group and self-assessment of cancer risk were related to the consciousness of the cancer early detection of people who had not participated in the regular physical examination in the past five years.
ABSTRACT
Objective@#To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017.@*Methods@#A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors.@*Results@#The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05).@*Conclusion@#The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.
ABSTRACT
Objective To determine the acceptance and willingness to pay for breast cancer screening among populations at high risk of breast cancer in urban China. Methods From 2012 to 2014, a cancer screening program in urban China (CanSPUC) was carried out in 13 provinces. The current survey was conducted among participants who were evaluated as having"high?risk for breast cancer"using a Harvard model (community?based) and then underwent breast mammography or ultrasonography screening procedure (hospital-based). The study mainly focused on their acceptance and willingness to pay under certain self?payment assumption for breast cancer screening. Results A total of 3 049 participants, with a mean age of 52.4±7.0 years, were included. The group aged 45 to 55 years accounted for 50% of the patients, and the median annual income per capita in the recent 5 years was 22 000 (15 000-34 000) Chinese yuan (CNY). Educational level, occupation, and marital status may affect their full acceptance and voluntary payment (P<0.05). Of all the participants, 99% (3 016 participants) could totally or substantially accept the breast cancer screening. When the breast cancer screening was assumed to be conducted every 3 years in the low?cost self?paid context, 85% (2 581 participants) of the participants had the willingness to pay, while only 17% were willing to pay >100 CNY. The remaining 15% of the residents showed no willingness to pay, and the unaffordable expenditure (70%, 438 participants) and unnecessary screening (24%, 112 participants) were the primary considerations. Significant differences in acceptance, willingness to pay, and payment were found among the provinces. Conclusion Almost all high?risk populations for breast cancer could accept breast cancer screening. The willingness to pay was relatively high, but the amount of payment was limited and low.
ABSTRACT
Objective To estimate the mean annual expenditure of patients with prevalent liver cancer in China on the perspective of the natural progression of the disease and to provide baseline information for liver cancer?related disease burden estimation and evaluation of prevention strategies. Methods A multicenter survey on liver cancer was conducted between 2012 and 2014 in 13 sites where the cancer screening program was conducted in Urban China, by face?to?face interviews with hospitalized patients. Data on basic information, clinical diagnosis and treatment, direct medical expenditure, and direct non?medical expenditure were collected. By?year expenditure and number of visits from the first visit to the end of the survey were analyzed. The trend for the two indicators in each year was analyzed. The subgroup analysis of factors such as sex and age was conducted. All the expenditure data were discounted to the year 2014 and presented in Chinese yuan. The statistical analysis was performed using the SAS 9.4 software. Results A total of 2 222 patients with liver cancer, with a mean age of 55.7±11.2 years, were included. Men accounted for 79.2% (1 759 cases) of the patients, women accounted for 20.8% (463 cases) of the patients, and 75.6% (1 679 cases) of the cases were from cancer hospitals. Stage Ⅰ cases only accounted for 14.1% (299 cases) of all the cases, and most cases were stageⅢorⅣ(62.6%, 1 325 cases). Of the cases, 64.4% (1 430 cases) had pathological information, and 83.6%(1 195 cases) were pathologically hepatocellular carcinoma. The sample sizes for the first 3 years from the first visit were 2 222, 149, and 57, respectively (by?year sample sizes thereafter were<50). The annual total medical expenditures for the first 3 years were 49 091 yuan (95% confidence interval [CI]: 47 376-50 806), 30 506 yuan (95% CI: 26 462-34 549), and 32 100 yuan (95% CI: 25 917-38 283) (P<0.001). The corresponding number of visits were 1.9, 1.6, and 1.5 (P<0.001). The trend for each province was consistent with the overall trend, while the down trend from years 1 to 2 varied among provinces, ranging from 1.4 (Zhejiang province) to 5.6 times (Henan province). For the trend in the first 3 years, differences were found in subgroups such as region (P<0.001) and treatment (P<0.05), instead of sex, age, stage, and other subgroups. Conclusions For liver cancer patients in China, the annual expenditure for the first year in the whole disease course was 1.6 times higher than that for the second year, which varied among provinces. However, information on annual expenditure for the later course of liver cancer is still limited.
ABSTRACT
Objective@#To investigate whether elevated levels of C-reactive protein (CRP) and neutrophil (NE) in the blood is associated with an increased risk of lung cancer incidence.@*Methods@#From 2006 to 2007, all employees and retirees from Kailuan (Group) Limited liability Corporation were included in this Kailuan Cohort study. The last follow-up date was December 2015. Data on new cases of lung cancer were collected, and multivariable Cox proportional hazards regression models were used to the relationship between baseline CRP and NE at baseline and risk of lung cancer.@*Results@#A total of 92 735 participants were enrolled in this study. During the follow-up, 850 new cases of lung cancer were identified. All subjects were divided into four groups according to the combination level of CRP and NE at baseline: CRP≤3 mg/L and NE≤4×109/L(Group A), CRP≤3 mg/L and NE>4×109/L(Group B), CRP>3 mg/L and NE≤4×109/L(Group C), CRP>3 mg/L and NE>4×109/L(Group D). The cumulative incidence of lung cancer were 950/100 000, 1 030/100 000, 1 081/100 000 and 1 596/100 000 in these four groups, respectively (P<0.001). Multivariate Cox proportional risk model showed that participants from Group D had an significantly increased 72% risks of lung cancer when compared to Group A (95% CI: 1.40~2.12, P<0.001). Stratified analyses gender showed that males in Group D had higher risk of lung cancer when compared with participants in Group A (HR=1.73, 95% CI: 1.40~2.15, P<0.001).@*Conclusion@#Elevated levels of CRP and NE might increase the risk of lung cancer.
ABSTRACT
Objective@#To systematically review the quality and reporting quality of colorectal cancer screening guidelines, and to provide reference for the update of colorectal cancer screening guidelines and colorectal cancer screening in China.@*Methods@#"Colorectal cancer", "colorectal tumor", "screening", "screening", "guide", "consensus", "Colorectal cancer", "Colorectal neoplasms", "Screening", "Early Detection of Cancer", "Guideline" and "recommendation" were used as search keywords. The literature retrieval for all the Chinese and English guidelines published before April 2018 was conducted by using PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, China Biology Medicine disc (CBMdisc), Cochrane Library, Guideline International Network, China Guidelines Clearinghouse (CGC) and the official website of the US Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), International Agency for Research on Cancer (IARC), Australia Cancer Council (ACC) and Association of Coloproctology of Great Britain & Ireland (ACPGBI). The inclusion criteria were independent guidance documents for colorectal cancer screening. The language is limited to Chinese and English. The exclusion criteria were literature on interpretation, evaluation, introduction, etc., as well as the translated version of the guide and old guides. The quality and reporting norms of colorectal cancer screening guidelines were compared and evaluated using the European Guideline Research and Assessment Tool (AGREE Ⅱ) and the Practice Guideline Reporting Standard (RIGHT).@*Results@#A total of 15 guides were included. The results of the AGREE Ⅱ quality evaluation showed that the overall quality of 15 guides was high. Among them, there were 9 guides with an overall score of 50 or more, 10 with a recommendation level of "A", and 2 with a rating of "B". There were 3 guides for "C"; each guide scores higher in scope and purpose, and clarity, and scores vary greatly in the areas of participants, rigor, applicability, and independence. The results of the RIGHT evaluation showed that 15 guides were insufficient in six areas except for background information, evidence, recommendations, reviews and quality assurance, funding and conflict of interest statements and management, and other aspects.@*Conclusion@#The overall quality of included guidelines for colorectal cancer screening is high, but the normative nature needs to be strengthened.
ABSTRACT
Gastric cancer is one of the most common cancer. Studies have been conducted to evaluate the association between anthropometric indicators and gastric cancer, but the results were inconsistent. Therefore, a literature retrieval was conducted by using PubMed and Wanfang databases to summarize the latest research progress in the cohort study of the association between anthropometric indicators and the risk for gastric cancer. It was found that both general obesity and abdominal obesity might increase the risk for gastric cancer, while the association between underweight and gastric cancer needs further study. This paper summarizes the progress in the cohort study of association between anthropometric indicators for the risk for gastric cancer in order to provide evidence for the prevention and control of gastric cancer.
ABSTRACT
Objective@#To investigate the association between BMI and gastric cancer risk in Chinese males.@*Methods@#Data on body weight, body height and incidence of gastric cancer were collected on a biennial basis in males in Kailuan Cohort during 2006-2015. In addition, electronic databases of hospitals affiliated to Kailuan Group, insurance system of Kailuan Group and medical insurance system of Tangshan were used for supplementary information. Males with normal body weight (18.5 kg/m2≤BMI<24.0 kg/m2) were used as controls. Cox proportional hazards regression model was used to evaluate the association between baseline BMI and the risk of gastric cancer in males through the calculations of hazard ratio and 95% confidence interval.@*Results@#A total of 109 600 males were included and 272 new gastric cancer cases were identified in Kailuan male cohort study, with a follow-up of 860 399.79 person-years during 2006-2015. The median follow-up period was 8.8 years. When compared with normal weight, the hazard ratios (HR) of underweight (BMI≤18.5 kg/m2) for gastric cancer risk were 2.11 (95%CI: 1.23-3.62) after adjusting for potential confounding factors (age, education level, smoking status, alcohol drinking status, dust exposure, salty food intake, tea drinking status). However, overweight or obesity showed no significant association with gastric cancer risk. The stratified analyses based on age, education level, status on smoking, alcohol drinking, tea drinking and dust exposure indicated that underweight showed significant association with gastric cancer risk in those with older age, those with high education level, non-smokers, non-alcohol drinkers, non-tea drinkers and those with dust exposure.@*Conclusion@#Underweight might increase the risk of gastric cancer in males in China, and this positive association might be associated with age, education level, status on smoking, alcohol-drinking, tea-drink, and dust exposure.
ABSTRACT
Objective To investigate the association between alcohol consumption and lung cancer risk in Chinese males.Methods Information on alcohol consumption and outcomes were collected on a biennial basis among males in Kailuan Cohort (2006-2015).In addition,electronic databases of hospitals affiliated to Kailuan Community,Insurance Systems of Kailuan Community and Tangshan were also used for supplementary information retrieval.Cox proportional hazards regression models were used to evaluate the hazard ratio (HR) and 95％ CI of baseline frequency and type of alcohol consumption associated with lung cancer risk in males.Non-drinkers were used as control group.Results A total of 101 751 males were included and 913 new lung cancer cases were identified in the Kailuan male cohort study,with a total follow-up time of 808 146.56 person-years and a median follow-up time of 8.88 years by 31 December 2015.After adjusting for potential confounding factors,the HR of former drinkers,occasional drinkers (＜ 1/day) and drinkers (≥ 1/day) were 1.30 (95％CI:0.90-1.88),0.80 (95％CI:0.64-1.01) and 1.04 (95％CI:0.85-1.27),respectively,compared with non-drinkers.In addition,drinking beer/red wine (HR=0.91,95％CI:0.69-1.20) and white wine (HR=0.99,95％ CI:0.83-1.19) showed no significant association with lung cancer.The results were similar when stratified analysis were conducted.Conclusion Our study results don't support the hypothesis that alcohol consumption is significantly associated with the risk of lung cancer in males.
ABSTRACT
Objective To assess the association and intensity of baseline TC level with the incidence of lung cancer in men in China.Methods Since May 2006,all the male workers,including the employees and the retirees in Kailuan Group were recruited in the Kailuan male dynamic cohort study.Information about demographics,medical history,anthropometry and TC level were collected at the baseline interview,as well as the information of newly-diagnosed lung cancer cases during the follow-up period.According to guidelines for blood lipids in Chinese adults and the distribution in the population,TC level was classified into five groups as followed:＜ 160,160-,180-,200-and ≥240 mg/dl,with the second quintile group (160-mg/dl) serving as the referent category.Cox proportional hazards regression model and restricted cubic spline (RCS) model were used to evaluate the association and the nonlinear association between baseline TC level and the risk of lung cancer in the men.Results By December 31,2014,for the 109 884 men,a follow up of 763 819.25 person-years was made with a median follow-up period of 7.88 years.During the follow up,808 lung cancer cases were identified.After adjustment for age,education level,income level,smoking status,alcohol consumption level,history of dust exposure,FPG level and BMI,HR (95％CD of lung cancer for men with lower TC level (＜160 mg/dl) and higher TC level (≥240 mg/dl) were 1.34 (1.04-1.72) and 1.45 (1.09-1.92),respectively,compared with men with normal TC level (160-mg/dl).The results didn't change significantly after exclusion of newly diagnosed cancer cases within 2 years of follow up and subjects with the history of hyperlipidemia.Conclusion Our results showed that TC might be associated with higher risk of lung cancer.Men with lower TC level or higher TC level had higher risk for lung cancer.Keep moderate TC level might be one of the effective precaution for the prevention of lung cancer.
ABSTRACT
Objective To investigate the association between alcohol consumption and lung cancer risk in Chinese males.Methods Information on alcohol consumption and outcomes were collected on a biennial basis among males in Kailuan Cohort (2006-2015).In addition,electronic databases of hospitals affiliated to Kailuan Community,Insurance Systems of Kailuan Community and Tangshan were also used for supplementary information retrieval.Cox proportional hazards regression models were used to evaluate the hazard ratio (HR) and 95％ CI of baseline frequency and type of alcohol consumption associated with lung cancer risk in males.Non-drinkers were used as control group.Results A total of 101 751 males were included and 913 new lung cancer cases were identified in the Kailuan male cohort study,with a total follow-up time of 808 146.56 person-years and a median follow-up time of 8.88 years by 31 December 2015.After adjusting for potential confounding factors,the HR of former drinkers,occasional drinkers (＜ 1/day) and drinkers (≥ 1/day) were 1.30 (95％CI:0.90-1.88),0.80 (95％CI:0.64-1.01) and 1.04 (95％CI:0.85-1.27),respectively,compared with non-drinkers.In addition,drinking beer/red wine (HR=0.91,95％CI:0.69-1.20) and white wine (HR=0.99,95％ CI:0.83-1.19) showed no significant association with lung cancer.The results were similar when stratified analysis were conducted.Conclusion Our study results don't support the hypothesis that alcohol consumption is significantly associated with the risk of lung cancer in males.