Incidence and survival of neuroendocrine neoplasms in China with comparison to the United States / 中华医学杂志(英文版)

BACKGROUND@#Neuroendocrine neoplasms (NENs) are rare tumors characterized by variable biology and delayed diagnosis. However, the nationwide epidemiology of NENs has never been reported in China. We aimed to estimate the incidence and survival statistics of NENs in China, in comparison to those in the United States during the same period.@*METHODS@#Based on the data from 246 population-based cancer registries covering 272.5 million people of China, we calculated age-specific incidence on NENs in 2017 and multiplied by corresponding national population to estimate the nationwide incidence in China. The data of 22 population-based cancer registries were used to estimate the trends of NENs incidence from 2000 to 2017 through the Joinpoint regression model. We used the cohort approach to analyze the 5-year age-standardized relative survival by sex, age group, and urban-rural area between 2008 and 2013, based on data from 176 high-quality cancer registries. We used data from the Surveillance, Epidemiology, and End Results (SEER) 18 program to estimate the comparable incidence and survival of NENs in the United States.@*RESULTS@#The overall age-standardized rate (ASR) of NENs incidence was lower in China (1.14 per 100,000) than in the United States (6.26 per 100,000). The most common primary sites were lungs, pancreas, stomach, and rectum in China. The ASRs of NENs incidence increased by 9.8% and 3.6% per year in China and the United States, respectively. The overall 5-year relative survival in China (36.2%) was lower than in the United States (63.9%). The 5-year relative survival was higher for female patients than male patients, and was higher in urban areas than in rural areas.@*CONCLUSIONS@#The disparities in burden of NENs persist across sex, area, age group, and site in China and the United States. These findings may provide a scientific basis on prevention and control of NENs in the two countries.

Associations between cancer family history and esophageal cancer and precancerous lesions in high-risk areas of China / 中华医学杂志(英文版)

BACKGROUND@#Family clustering of esophageal cancer (EC) has been found in high-risk areas of China. However, the relationships between cancer family history and esophageal cancer and precancerous lesions (ECPL) have not been comprehensively reported in recent years. This study aimed to provide evidence for identification of high-risk populations.@*METHODS@#This study was conducted in five high-risk areas in China from 2017 to 2019, based on the National Cohort of Esophageal Cancer. The permanent residents aged 40 to 69 years were examined by endoscopy, and pathological examination was performed for suspicious lesions. Information on demographic characteristics, environmental factors, and cancer family history was collected. Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL.@*RESULTS@#Among 33,008 participants, 6143 (18.61%) reported positive family history of EC. The proportion of positive family history varied significantly among high-risk areas. After adjusting for risk factors, participants with a family history of positive cancer, gastric and esophageal cancer or EC had 1.49-fold (95% confidence interval [CI]: 1.36-1.62), 1.52-fold (95% CI: 1.38-1.67), or 1.66-fold (95% CI: 1.50-1.84) higher risks of ECPL, respectively. Participants with single or multiple first-degree relatives (FDR) of positive EC history had 1.65-fold (95% CI: 1.47-1.84) or 1.93-fold (95% CI: 1.46-2.54) higher risks of ECPL. Participants with FDRs who developed EC before 35, 45, and 50 years of age had 4.05-fold (95% CI: 1.30-12.65), 2.11-fold (95% CI: 1.37-3.25), and 1.91-fold (95% CI: 1.44-2.54) higher risks of ECPL, respectively.@*CONCLUSIONS@#Participants with positive family history of EC had significantly higher risk of ECPL. This risk increased with the number of EC positive FDRs and EC family history of early onset. Distinctive genetic risk factors of the population in high-risk areas of China require further investigation.@*TRIAL REGISTRATION@#ChiCTR-EOC-17010553.

Analysis of incidence and mortality of esophageal cancer in China, 2015 / 中华预防医学杂志

Objective@#To estimate the incidence and mortality rates of esophageal cancer in China in 2015. @*Methods@#Based on the data quality review and assessment, the esophageal cancer data from 368 cancer registries in 31 provinces (autonomous regions and municipalities) in China were included in this study. According to the national population data in 2015, the nationwide incidence and mortality of the esophageal cancer were estimated. Chinese standard population in 2000 and world Segi′s population were used to calculate the age-standardized (ASR) incidence and mortality rates (ASR China and world, respectively). @*Results@#The 368 cancer registries covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. There were 245 651 new esophageal cancer cases estimated in China in 2015, with a crude incidence rate of 17.87/100 000. The ASR China and ASR world were 11.14/100 000 and 11.28/100 000, respectively. The estimated number of esophageal cancer death was 188 044 in China in 2015, with a crude mortality rate of 13.68/100 000; The ASR China and ASR world mortality rates were 8.33/100 000 and 8.36/100 000, respectively. The ASR China incidence and mortality of esophageal cancer in males were higher in males (16.50/100 000 and 12.66/100 000) than those in females (5.92/100 000 and 4.17/100 000), and they were higher in rural areas (15.95/1100 000 and 11.67/100 000) than those in urban areas (7.59/100 000 and 5.87/100 000). @*Conclusion@#The incidence and mortality of esophageal cancer in China are higher than the global average. The disparity of the incidence and mortality rates of esophageal cancer significantly differed in genders and areas.

Epidemiological characteristics of gastric cancer in China, 2015 / 中华流行病学杂志

Objective@#To estimate the morbidity and mortality of gastric cancer and its distribution in China in 2015 and provide information for future cancer prevention and control study and policy decision.@*Methods@#In 2018, a total of 501 cancer registry systems reported data to the office of National Central Cancer Registry, and the data from 368 cancer registry systems met the criteria. The overall, gender specific, age specific and area specific morbidity and mortality rates of gastric cancer in China were estimated based on national population data in 2015. Chinese standard population in 2000 and World Segi’s population data were used to calculate the age-standardized rates (ASR) of morbidity and mortality, including ASR of China and the world.@*Results@#In 2015, the qualified 368 cancer registry system covered a total of 309 553 499 population in China, including 156 934 140 males and 152 619 359 females. We estimated that there were 403 000 new gastric cancer cases, with the crude morbidity rate of 29.31 per 100 000, ASR China of 18.68 per 100 000, ASR world of 18.57 per 100 000, and a cumulative rate of 2.29% for 0-74 years. There were 290 900 new gastric cancer deaths, with the crude mortality rate of 21.16 per 100 000, ASR China of 13.08 per 100 000, ASR world of 12.92 per 100 000, and a cumulative rate of 1.5% for 0-74 years. Gastric cancer ranked second as the most common cancers and third as the most common cancer causes of death in China. In general, both the morbidity rate (ASR China, male: 26.54 per 100 000; female: 11.09 per 100 000; rural area: 21.82 per 100 000; urban area: 16.37 per 100 000) and mortality rate (ASR China, male: 18.75 per 100 000; female: 7.72 per 100 000; rural area: 15.84 per 100 000; urban area: 11.05 per 100 000) were higher in males than those in females, and higher in rural area than those in urban area. The morbidity and mortality rates of gastric cancer increased from the age of 40 years and peaked in age group of 80-years. The case number of gastric cancer significantly increased from the age group of 50-years, peaked at 60-70 years, and the majority of cases occured in age group of 55-80 years. There was an overall consistent trend of the age-specific morbidity and mortality rates across different subgroups by sex and geographic areas, with the rates were higher in males than those in females, and higher in rural area than that in urban area.@*Conclusions@#The incidence of gastric cancer varied with sex, age and areas (urban area and rural area). The present analysis provides the latest data on the prevalence of gastric cancer in China, which can help optimize the current screening guidelines and the prevention and control strategies of gastric cancer to reduce the disease burden caused by gastric cancer in China.

Liver cancer epidemiology in China, 2015 / 中华肿瘤杂志

Objective@#Using updated population-based cancer registration (PBCR) data, we estimated nation-wide liver cancer statistics overall, by sex and by areas in China.@*Methods@#Qualified PBCR data of liver cancer in 2015 which met the data quality criteria were stratified by geographical locations, sex, and age groups. Age-specific incidence and mortality rates by sex and area were calculated. The burden of liver cancer was evaluated by multiplying these rates by the year of 2015 population. Chinese standard population in 2000 and World Segi′s population were used for the calculation of age-standardized rates (ASR) of incidence and mortality.@*Results@#Qualified 368 cancer registries covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. It is estimated that there were 370 000 new cases (274 000 males and 96 000 females) of liver cancer in China. The age-standardized incidence rates by Chinese standard population (ASR China) and World Segi′s population (ASR World) were 17.64 per 100 000 and 17.35 per 100 000, respectively. Rural areas showed higher incidence (ASR China: 20.07 per 100 000, ASR World: 19.67 per 100 000) than urban areas (ASR China: 15.90 per 100 000, ASR world: 15.67 per 100 000). Subgroup analysis showed that western areas of China had highest incidence rate of liver cancer, with the ASR China of 20.65 per 100 000 and 20.22 per 100 000 for ASR world, respectively. For new cases of liver cancer deaths, there were 326 000 new deaths (242 000 males and 84 000 females) in China, with age-standardized mortality rate by Chinese standard population and World Segi′s population of 15.33 per 100 000 and 15.09 per 100 000, respectively. Rural areas showed higher mortality (ASR China: 17.17 per 100 000, ASR world: 16.86 per 100 000) than urban areas (ASR China: 14.00 per 100 000, ASR World: 13.81 per 100 000).@*Conclusions@#There is still a heavy burden of liver cancer in China. Rural residents have higher incidence and mortality of liver cancer compared with urban counterparts. It is likely that many factors such as hepatitis virus infection, and aflatoxin exposure play a dominating role. Prevention and control strategies should be enhanced in the future.

Report of cancer epidemiology in China, 2015 / 中华肿瘤杂志

Objective@#Data from local cancer registries were pooled to estimate cancer incidence and mortality in China, 2015.@*Methods@#Data submitted from 501 cancer registries were checked & evaluated according to the criteria of data quality control, and 368 registries′ data were qualified for the final analysis. Data were stratified by area (urban/rural), sex, age group and cancer sites, and combined with national population data to estimate cancer incidence and mortality in China, 2015. Chinese population census in 2000 and Segi′s population were used for age-standardized.@*Results@#Total population covered by 368 cancer registries were 309 553 499 (148 804 626 in urban and 160 748 873 in rural areas). The percentage of morphologically verified cases (MV) and the percentage of death certificate-only cases (DCO) accounted for 69.34% and 2.09%, respectively, and the mortality to incidence ratio was 0.61. About 3 929 000 new cancer cases were reported in 2015 and the crude incidence rate was 285.83 per 100 000 population (males and females were 305.47 and 265.21 per 100 000 population). Age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 190.64 and 186.39 per 100 000 population, respectively, with the cumulative incidence rate (0-74 age years old) of 21.44%. The cancer incidence and ASIRC were 304.96/100 000 and 196.09/100 000 in urban areas and 261.40/100 000 and 182.70/100 000 in rural areas, respectively. About 2 338 000 cancer deaths were reported in 2015 and the cancer mortality was 170.05/100 000 (210.10/100 000 in males and 128.00/100 000 in females). Age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 106.72/100 000 and 105.84/100 000, respectively, with the cumulative incidence rate (0-74 age years old) of 11.94%. The cancer mortality and ASMRC were 172.61/100 000 and 103.65/100 000 in urban areas and 166.79/100 000 and 110.76/100 000 in rural areas, respectively. The most common cancer cases including lung, gastric, colorectal, liver and female breast, the top 10 cancer incidence accounted for about 76.70% of all cancer new cases. The most common cancer deaths including lung, liver, gastric, esophageal and colorectal, the top 10 cancer deaths accounted for about 83.00% of all cancer deaths.@*Conclusions@#The burden of cancer showed a continuous upward trend in China. Cancer prevention and control faces the problem of the disparity in different areas and different cancer burden between men and women. The cancer pattern in China presents the coexistence of the cancer patterns in developed and developing countries. The situation of cancer prevention and control is still serious in China.

The incidence and mortality of lung cancer in China, 2014 / 中华肿瘤杂志

Objective@#To estimate lung cancer incidence and mortality in China using population-based cancer registry data in 2014 collected by National Central Cancer Registry of China (NCCRC).@*Methods@#449 cancer registries submitted cancer registry data in 2014. All datasets were evaluated and 339 registries′ data which met the quality control criteria of NCCRC were analyzed. Numbers of new lung cancer cases and deaths were estimated using calculated incidence and mortality rates and corresponding national population stratified by areas, sexes and age groups. The standard population of Chinese census in 2000 and world Segi′ s population were applied to calculate age-standardized incidence and mortality rates in China and worldwide, respectively.@*Results@#A total of 781, 500 new lung cancer cases were diagnosed in 2014. The crude incidence rate was 57.13 per 100 000 and the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 36.71 per 100 000 and 36.63 per 100 000, respectively. The cumulative incidence rate (0-74 years old) was 4.50%. Lung cancer was the most common cancer in male (ASIRW: 50.04 per 100 000) and the second most common cancer in female (ASIRW: 23.63 per 100 000). The incidence rates were slightly similar in urban areas and in rural areas (ASIRW: 36.64 per 100 000 vs 36.56 per 100 000). A total of 626 400 lung cancer deaths were reported. The crude mortality rate was 45.80 per 100 000 and the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 28.49 per 100 000 and 28.31 per 100 000, respectively. The cumulative mortality rate (0-74 years old) was 3.32%. Lung cancer was the most common cause of cancer deaths both in male (ASMRW: 40.21 per 100 000) and female (ASMRW: 16.88 per 100 000). The mortality rate was slightly higher in rural areas than in urban areas (ASMRW: 28.63 per 100 000 vs 28.04 per 100 000). Both lung cancer incidence and mortality rates increased with age, and the peak age was 80-84 years group.@*Conclusions@#The disease burden of lung cancer is heavy in China. Efficient national health policies and prevention and control strategies against lung cancer should be promoted.

Incidence and mortality of laryngeal cancer in China, 2014 / 中华肿瘤杂志

Objective@#To estimate the incidence and mortality of laryngeal cancer in China based on the cancer registration data in 2014, collected by the National Central Cancer Registry (NCCR), and to provide support data for the control and prevention of laryngeal cancer.@*Methods@#The incident and death data of laryngeal cancer in 2014 from 339 cancer registries met the quality criteria of NCCR, and then adopted for analysis. The incident and death number, crude rate, age standardized rate, truncated rate and proportion which stratified by areas (urban/rural) and age were calculated. The nationwide incidence and mortality of laryngeal cancer in 2014 were estimated by combining with those data on national population in 2014. Chinese population census in 2000 and Segi′s population were used for age-standardized incidence/mortality rates.@*Results@#It was estimates that 23.4 thousand new cases of laryngeal cancer occurred in China in 2014. There were 20.8 thousand males and 2.6 thousand females. And 14.5 thousand occurred in urban areas, while 8.9 thousand in rural areas. The age standardized rates of incidence by world standard population (ASRs world) in male, female and both genders were 2.05/100, 000, 0.24/100, 000 and 1.14/100, 000, respectively, whereas those were 1.22/100, 000 and 1.03/100, 000 for urban and rural areas. The incidence was much higher in males than females, and slightly higher in urban areas than those in rural areas. Moreover, it was estimates that 13.2 thousand death cases of laryngeal cancer occurred in China in 2014. There were 11.5 thousand males and 1.7 thousand females. And 7.8 thousand occurred in urban areas, while 5.4 thousand in rural areas. The age standardized rates of mortality by ASRs world in male, female and both genders were 1.08/100, 000, 0.14/100, 000 and 0.60/100, 000, respectively, whereas those were 0.60/100, 000 and 0.59/100, 000 for urban and rural areas. The mortality was much higher in males than females, and slightly higher in urban areas than those in rural areas. In males, the age specific incidence and mortality of laryngeal cancer increased greatly from 40-44 and 45-44 years old, respectively, and peaked at age group of 75-79 and >85 years old. In females, the age specific incidence and mortality increased slowly from 50-54 and 60-64 years old, respectively, and peaked at age group of 80-84 and >85 years old. The trends remained similar in urban and rural areas, except for the different peak ages.@*Conclusions@#The incidence and mortality of laryngeal cancer in China are at middle-low levels worldwide, and there are obvious differences between urban and rural areas with distinct gender disparity. Comprehensive prevention and control strategies should be carried out according to local status and age groups.

Incidence and mortality of nasopharyngeal carcinoma in China, 2014 / 中华肿瘤杂志

Objective@#To estimate the incidence and mortality of nasopharyngeal carcinoma in China based on cancer registration data in 2014, collected by the National Central Cancer Registry (NCCR).@*Methods@#449 cancer registries submitted nasopharyngeal carcinoma incidence and deaths occurred in 2014 to NCCR. After evaluating the data quality, 339 registries′ data were accepted for analysis and stratified by area (urban/rural) and age group. Combined with data on national population in 2014, the nationwide incidence and mortality of nasopharyngeal carcinoma were estimated. Chinese population census in 2000 and Segi′s population were used for age-standardized incidence and mortality rates.@*Results@#The estimates of new nasopharyngeal carcinoma incident cases and deaths were 44.6 thousands and 24.2 thousands, respectively. The crude incidence rate was 3.26/100 000 (Male 4.51/100 000, Female 1.94/100 000). Age-standardized incidence rates by Chinese standard population (ASIRC, 2000) and by world standard population (ASIRW) were 2.48/100 000 and 2.33/100 000, respectively. Male to female ratio was 2.32∶1. The ASIRC in urban and rural areas were all 2.48/100 000. The crude mortality rate of nasopharyngeal carcinoma was 1.77/100 000 (Male 2.55/100 000, Female 0.95/100 000). Age-standardized mortality rates by Chinese standard population (ASMRC, 2000) and by world standard population(ASMRW) were 1.23/100 000 and 1.20/100 000, respectively. The ASMRC in urban and rural areas were all 1.23/100 000. The cumulative incidence and mortality rates(0-74 years old)were 0.25% and 0.14%, respectively.@*Conclusions@#Incidence and mortality of nasopharyngeal carcinoma in China in 2014 were at high levels in the world. Corresponding prevention and control measures should be established according to the epidemic characteristics and risk factors of nasopharyngeal carcinoma.

Analysis on the trend of cancer incidence and age change in cancer registry areas of China, 2000 to 2014 / 中华预防医学杂志

Objective@#To analyze the trends of cancer incidence and age changes in China with using cancer registration data, and to provide evidence for the development of cancer prevention and control.@*Methods@#Twenty-two cancer registries with continuous (2000-2014) data were selected. The incidence of different sex and regional population, the standardized incidence rate by Chinese population, the average annual change percentage (AAPC) and annual change percentage(APC) were calculated. Age-period-cohort model were used to analyze the changes of cancer incidence, age-adjusted mean ages. The age-standardized proportion of 2000 and 2014 with were compared.@*Results@#The cancer incidence in China increased by 3.9% (95%CI: 3.7%-4.1%) from 2000 to 2014 in APC, and the age-standardized incidence rate increased by 1.2% (95%CI: 1.0%-1.4%) in AAPC. The age-specific incidence showed that each age groups increased significantly in female, ranged between 0.9% to 6.0%. The APC in male aged from 60 years old showed decline trend, the APC in 60-69, 70-79, ≥80 years old were -0.2, -0.3, -0.3, while in the population aged 0-29, 30-39 years old increased dramatically, APC were 3.5, 2.0. Female under 60 also increased, and APC in 0-29, 30-39, 40-49, 0-59 years old were 5.7, 6.0, 3.4, 2.9, respectively. The mean age of patients diagnosed with cancer were increased during the past 15 years, with about 0.11 years per year increased. However, the mean age of the patients diagnosed with cancer showed decreased trend by 0.13 years after age structure adjusted.@*Conclusion@#The trend of mean age for cancer incidence in China were getting younger than before, and the trend in women is more obviously than in man.

Analysis on the trend of prostate cancer incidence and age change in cancer registration areas of China, 2000 to 2014 / 中华预防医学杂志

Objective@#To analyze the trend of cancer incidence and age changes among men in cancer registration areas of China from 2000 and 2014.@*Methods@#We select the information of national cancer registry with continuous data from 2000 to 2014, review and organize the monitoring data at the above registries. A total of 22 monitoring registries were included in this study. The covering population of male were about 314 330 648 person years. The information on the incidence of all male prostate cancer patients with C61 was extracted from the International Classification of Diseases-10th Revision (ICD-10). To understand the incidence of male prostate cancer in each year, the age-standardized rate by Chinese population (ASR), average annual percent change (AAPC), adjusted mean age at onset were calculated. Incidence rates stratified by regions and age groups were also calculated. The linear regression model was employed to analyze the relationship between mean age at onset and year.@*Results@#The prostate cancer incidence in China increased by 11.5% (95%CI: 10.3%-12.7%) from 2000(4.62/100 000) to 2014(21.62/100 000), the age-standardized incidence rate increased by 7.1% (95%CI: 6.0%-8.1%) and the growth of rural was greater than that of urban. The age-specific incidence showed that the incidence rate increased significantly among the age group of 50 years; the incidence rates in men who have the same age but with different birth years showed a significant increase as birth years increased. The adjusted mean age at diagnosis of prostate cancer in cancer registry areas was 74.09 years old in the year of 2000, reduced by 0.13 year old to 72.35 years old in 2014 (β=-0.13, P<0.001). The adjusted mean age at onset declined significantly over time in urban areas (β=-0.13, P<0.001).@*Conclusion@#The trend of prostate cancer incidence among men in cancer registry regions generally increased, and the average age at diagnosis declined slightly from 2000 to 2014.

Trend analysis on incidence and age at diagnosis for lung cancer in cancer registration areas of China, 2000-2014 / 中华预防医学杂志

Objective@#To analyze the incidence trend and mean age at diagnosis for lung cancer in cancer registration areas of China from 2000 to 2014.@*Methods@#The data of lung cancer incidence used in this study were from 22 registries submitted to National Central Cancer Registry with continuous data during 2000 and 2014, covering about 621 593 469 person-years. All cancer cases were coded as C33-C34 according to the International Classification of Diseases-10th Revision (ICD-10) were extracted for this analysis with about 343 663 patients. The incidence of different sex and regional population, the standardized incidence rate by Chinese population, the average annual change percentage (AAPC), the mean age and adjusted mean age of cancer incidence were calculated. The incidence of each year was described by regional and age groups, and the linear regression model was employed to analyze the relationship between mean age at onset and year.@*Results@#The crude incidence rate and age-standardized incidence rate (ASR) of lung cancer for men in cancer registry areas in 2000 were 56.98 per 100 000 and 48.43 per 100 000, respectively. The rates were 89.51 per 100 000 and 46.85 per 100 000 in 2014, respectively. For women in the same areas, the rates were 27.77 per 100 000 and 20.17 per 100 000 in 2000; while 51.31 per 100 000 and 25.44 per 100 000 in 2014, respectively. The crude incidence rate increased along with the age. In 2000-2014, the trend of crude rate and ASR of lung cancer were significantly increased (CR: AAPC=3.8%, 95%CI: 3.5%-4.1%; ASR: AAPC=0.4%, 95%CI: 0.2%-0.7%). The rise of crude rate in females was higher than that in males (Male: AAPC=3.5%, 95%CI: 3.2%-3.7%; Female: AAPC=4.5%, 95%CI: 4.1%-5.0%). However, the rise of the ASR declined for both male and female (Male: AAPC=-0.2%, 95%CI:-0.4%-0.0%; Female: AAPC=1.4%, 95%CI: 1.0%-1.9%). The average age at diagnosis of lung cancer in rural areas was 64.35 years old in 2000, and increased to 65.97 years old in 2014 (β=0.11, P<0.001), while adjusted mean age at onset remained stable in all areas and urban areas (P>0.05). And the average age at onset increased significantly over time in male (β=-0.02, P=0.014), which was not seen in female (β=-0.01, P=0.522).@*Conclusion@#The crude incidence rate of lung cancer in cancer registry areas in China increased slowly during 2000-2014; and the standardized average age of male at diagnosis decreased slightly, while the age in rural areas increased during 2000-2014. Lung cancer will still be the focus of cancer prevention and control in the near future.

Incidence trend and change in the age distribution of female breast cancer in cancer registration areas of China from 2000 to 2014 / 中华预防医学杂志

Objective@#To estimate the incidence trend and change in the age distribution of female breast cancer in cancer registry areas in China from 2000 to 2014.@*Methods@#22 cancer registries in China with continuous monitoring data from 2000 to 2014 were selected. All datasets were checked and evaluated based on data quality control criteria and were included in the analysis. The cancer registries covered 675 954 193 person-years, including 342 010 930 person-years of male and 333 943 263 person-years of female. Female breast cancer cases (International Classification of Diseases-10th Revision: C50) were extracted. Crude incidence rate (CR), age-standardized incidence rate by Chinese standard population(ASIRC), annual percent change (APC), crude and adjusted mean age at onset were calculated. Incidence rates stratified by regions and age groups were calculated.@*Results@#Female breast cancer incidence rate significantly increased from 31.90/100 000 in 2000 to 63.30/100 000 in 2014. Incidence rate increased rapidly from 2000 to 2008 (CR: APC=6.5%, 95%CI: 5.3%-7.8%; ASIRC: APC=4.6%, 95%CI: 3.6%-5.7%). Its increment slowed down from 2008-2014 (CR: APC=3.2%, 95%CI: 1.4%-5.1%; ASIRC: APC=1.4%, 95%CI:-0.1%-2.9%). The crude mean age at onset increased from 54.4 in 2000 to 57.0 in 2014. Adjusted mean age at onset remained around 54.3 in 2014. Crude mean age at onset increased significantly over time in all registry areas (β=0.192, P<0.001), urban (β=0.205, P<0.001) and rural (β=0.092, P=0.014) areas, while adjusted mean age at onset remained stable in all registry areas (β=0.009, P=0.289), urban (β=0.017, P=0.139) and rural (β=-0.054, P=0.109) areas.@*Conclusion@#Female breast cancer incidence rate in China increased from 2000 to 2014. Aging of the population resulted in a significant increase in crude mean age at onset. After age adjustment, no significant changes in age distribution were found.

Incidence and mortality of cervical cancer in China, 2014 / 中华肿瘤杂志

Objective@#To estimate the incidence and mortality of cervical cancer in China based on the cancer registry data in 2014, collected by the National Central Cancer Registry (NCCR).@*Methods@#There were 449 cancer registries submitted cervical cancer incidence and deaths in 2014 to NCCR. After evaluating the data quality, 339 registries′ data were accepted for analysis and stratified by areas (urban/rural) and age group. Combined with data on national population in 2014, the nationwide incidence and mortality of cervical cancer were estimated. Chinese population census in 2000 and Segi′s population were used for age-standardized incidence/mortality rates.@*Results@#Qualified 339 cancer registries covered a total of 288 243 347 populations (144 061 915 in urban and 144 181 432 in rural areas). The percentage of morphologically verified cases and death certificate-only cases were 86.07% and 1.01%, respectively. The mortality to incidence ratio was 0.30. The estimates of new cases were about 102 000 in China in 2014, with a crude incidence rate of 15.30/100 000. The age-standardized incidence rates by China standard population (ASR China) and world standard population (ASR world) of cervical cancer were 11.57/100 000 and 10.61/100 000, respectively. Cumulative incidence rate of cervical cancer in China was 1.11%. The crude and ASR China incidence rates in urban areas were 15.27/100 000 and 11.16/100 000, respectively, whereas those were 15.34/100 000 and 12.14/100 000 in rural areas. The estimates of cervical cancer deaths were about 30 400 in China in 2014, with a crude mortality rate of 4.57/100 000. The ASR China and ASR world mortality rates were 3.12/100 000 and 2.98/100 000, respectively, with a cumulative mortality rate (0-74 years old) of 0.33%. The crude and ASR China mortality rates were 4.44/100 000 and 2.92/100 000 in urban areas, respectively, whereas those were 4.72/100 000 and 3.39/100 000 in rural areas.@*Conclusions@#There is still a heavy burden of cervical cancer in China. The burden and patterns of cervical cancer shows different characters of urban and rural people. Prevention and control strategies should be implemented referring to local status.

Incidence and mortality of female breast cancer in China, 2014 / 中华肿瘤杂志

Objective@#To estimate the incidence and mortality of female breast cancer in China based on the cancer registration data in 2014, collected by the National Central Cancer Registry (NCCR), and to provide support data for breast cancer prevention and control in China.@*Methods@#There were 449 cancer registries submitting female breast cancer incidence and deaths data occurred in 2014 to NCCR. After evaluating the data quality, 339 registries′ data were accepted for analysis and stratified by areas (urban/rural) and age group. Combined with data on national population in 2014, the nationwide incidence and mortality of female breast cancer were estimated. Chinese population census in 2000 and Segi′s population were used for age-standardized incidence/mortality rates.@*Results@#Qualified 339 cancer registries covered a total of 288 243 347 populations (144 061 915 in urban and 144 181 432 in rural areas) in 2014. The morphology verified cases (MV%) accounted for 87.42% and 0.59% of incident cases were identified through death certifications only (DCO%), with mortality to incidence ratio of 0.24. The estimates of new breast cancer cases were about 278 900 in China in 2014, accounting for 16.51% of all new cases in female. The crude incidence rate, age-standardized rate of incidence by Chinese standard population (ASRIC), and age-standardized rate of incidence by world standard population (ASRIW) of breast cancer were 41.82/100 000, 30.69/100 000, and 28.77/100 000, respectively, with a cumulative incidence rate (0-74 age years old) of 3.12%. The crude incidence rates and ASRIC in urban areas were 49.94 per 100 000 and 34.85 per 100 000, respectively, whereas those were 31.72 per 100 000 and 24.89 per 100 000 in rural areas. The estimates of breast cancer deaths were about 66 000 in China in 2014, accounting for 7.82% of all the cancer-related deaths in female. The crude mortality rate, age-standardized rate of mortality by Chinese standard population(ASRMC) and age-standardized rate of mortality by world standard population (ASRMW) of breast cancer were 9.90/100 000, 6.53/100 000, and 6.35/100 000, respectively, with a cumulative mortality rate of 0.69%. The crude mortality rates and ASRMC in urban areas were 11.48 per 100 000 and 7.04 per 100 000, respectively, whereas those were 7.93 per 100 000 and 5.79 per 100 000 in rural areas. The incidence and mortality rates of breast cancer were higher in areas than those in rural areas. The age-specific incidence rates of breast cancer increased greatly after 20 years old and peaked at the age group of 55-60. The age-specific mortality rates increased rapidly with age, particularly after 25 years old. They remained at a relative stable level from 55 to 65 years of age, and then increased dramatically and peaked in the age group of 85 and above.@*Conclusions@#Breast cancer is still one of the most common malignant tumor threatening to famale health in China. The disease is more prevalent in urban areas at the age group of 55-60. Comprehensive prevention and control strategies referring to local status and age groups should be carried out to reduce the burden of breast cancer.

Report of Cancer Incidence and Mortality in China, 2014 / 中华肿瘤杂志

Objective@#The registration data of local cancer registries in 2014 were collected by National Central Cancer Registry (NCCR)in 2017 to estimate the cancer incidence and mortality in China.@*Methods@#The data submitted from 449 registries were checked and evaluated, and the data of 339 registries out of them were qualified and selected for the final analysis. Cancer incidence and mortality were stratified by area, gender, age group and cancer type, and combined with the population data of 2014 to estimate cancer incidence and mortality in China. The age composition of standard population of Chinese census in 2000 and Segi′s population were used for age-standardized incidence and mortality in China and worldwide, respectively.@*Results@#Total covered population of 339 cancer registries (129 in urban and 210 in rural) in 2014 were 288 243 347 (144 061 915 in urban and 144 181 432 in rural areas). The mortality verified cases (MV%) were 68.01%. Among them, 2.19% cases were identified through death certifications only (DCO%), and the mortality to incidence ratio was 0.61. There were about 3, 804, 000 new cases diagnosed as malignant cancer and 2, 296, 000 cases dead in 2014 in the whole country. The incidence rate was 278.07/100, 000 (males 301.67/100, 000, females 253.29/100, 000) in China, age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population were 190.63/100, 000 and 186.53/100, 000, respectively, and the cumulative incidence rate (0-74 age years old) was 21.58%. The cancer incidence and ASIRC in urban areas were 302.13/100, 000 and 196.58/100, 000, respectively, whereas in rural areas, those were 248.94/100, 000 and 182.64/100, 000, respectively. The cancer mortality in China was 167.89/100, 000 (207.24/100, 000 in males and 126.54/100, 000 in females), age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population were 106.98/100, 000 and 106.09/100, 000, respectively. And the cumulative incidence rate (0-74 age years old) was 12.00%. The cancer mortality and ASMRC in urban areas were 174.34/100, 000 and 103.49/100, 000, respectively, whereas in rural areas, those were 160.07/100, 000 and 111.57/100, 000, respectively. Lung cancer, gastric cancer, colorectal cancer, liver cancer, female breast cancer, esophageal cancer, thyroid cancer, cervical cancer, encephala and pancreas cancer, were the most common cancers in China, accounting for about 77.00% of the new cancer cases. Lung cancer, liver cancer, gastric cancer, esophageal cancer, colorectal cancer, pancreatic cancer, breast cancer, encephala, leukemia and lymphoma were the leading causes of death and accounted for about 83.36% of cancer deaths.@*Conclusions@#The progression of cancer registry in China develops rapidly in these years, with the coverage of registrations is expanded and the data quality was improved steadily year by year. As the basis of cancer prevention and control program, cancer registry plays an important role in making the medium and long term of anti-cancer strategies in China. As China is still facing the serious cancer burden and the cancer patterns varies differently according to the locations and genders, effective measures and strategies of cancer prevention and control should be implemented based on the practical situation.

Discussion on the Development Direction of Drug Circulation Enterprises under "Two Invoice System" / 中国药房

OBJECTIVE: To provide suggestions for the development of drug circulation enterprises under "two invoice system".METHODS: By analyzing the negative effects of "multi invoice system" on drug circulation enterprises and positive effects of "two invoice system" on drug circulation enterprises, the development direction of drug circulation enterprises was investigated under "two invoice system".RESULTS & CONCLUSIONS: The "multi invoice system" formulates the high drug price, causes high drug circulation cost and is difficult to check drug quality. The "two invoice system" standardizes the order of drug circulation field, saves medical drug source, reduce drug price and kept capital chain stable. Under "two invoice system", drug circulation enterprises should actively adapt to the transformation of medical and pharmaceutical market, and reconstruct the chain of drug circulation. The integration of medical circulation network should be established between the relevant departments and various subjects. Drug circulation subjects should promote the check of ticket, account and goods, standardize the date of back account, implement reform stably.

Extra longtime continuous chest compression to rescue cardiopulmonary arrest: a case report and the literature review / 中华危重病急救医学

The new cardiopulmonary resuscitation (CPR) guideline emphasize the importance of chest compression, which was considered as the first step to CPR. The duration for CPR is usually limited to 30 minutes. With the development of new technology and evidence-based medicine, the success of extra longtime CPR has become possible, which is of great significance to some patients with cardiac arrest (CA), but the time limit has not been determined. On February 23rd in 2016, a 76-year-old female patient with respiratory and cardiac arrest who was on the third day after transurethral resection of bladder tumor (TUR-BT) was admitted to the intensive care unit of the General Hospital of Fushun Mining Bureau. On the basis of the comprehensive treatment measures such as ventilator support ventilation, physical cooling with ice cap, 1 mg adrenaline for intravenous injection, low molecular heparin of 5000 U for subcutaneous injection, and the continuous chest compression were carried out in a timely and effective manner for 125 minutes, which make the patient recover to sinus rhythm and her brain function recovered well without any sequelae, and follow-up of the patient in 1 year showed well. The key to success or failure of CPR depend on the patient's condition. If the patients in healthy, single cause, a good response to the resuscitation, the pulsation of the large artery can be seen now and then during the rescue, and the recovery of the spontaneous breathing, CPR should be kept on. In the process of CPR, individualized assessment of the disease progression without the 30-minute time limit, may benefit the patients in maximum. In the future clinical practice, we should actively explore more favorable evidence, so that CA patients can be rescued more.

Relationship between type 2 diabetes mellitus and serum stromal cell derived factor 1 levels / 实用医学杂志

Objective To explore the relationship between type 2 diabetes mellitus(T2DM)and serum stromal cell derived factor-1(SDF-1)levels. Methods A community-based epidemiological field study for T2DM patients and non-T2DM subjects was conducted in Beijing,China. Every subject underwent physical examinations, biochemical tests of stromal cell derived factor 1 and so on,and completed a standardized questionnaire. A total of 756 subjects were recruited in our analysis ,including 267 T2DM patients and 489 non-T2DM subjects ,T2DM patients were further divided into 81 simple T2DM patients and 186 macrovascular complication patients on the basis of the status of macrovascular complication. The correlation between serum SDF-1 levels and T2DM was analyzed. Results Compared with non-T2DM group,the level of SDF-1 in T2DM group was higher(P=0.019). The level of SDF-1 in simple T2DM group was also higher than macrovascular complication group(P=0.044). In the multi-ple linear regression analysis,after adjustment for age,gender,smoking,drinking,dyslipidemia,hypertension and BMI,SDF-1 level in simple T2DM group was higher than macrovascular complication group(P = 0.049), still. Conclusions Simple T2DM patients had a higher serum SDF-1 level than T2DM patients with macrovascular complications as well as those who did not suffer T2DM,suggesting that the stromal cell derived factor-1 may play a certain role in the development of T2DM and macrovascular complications.

Relationship between type 2 diabetes mellitus and serum stromal cell derived factor 1 levels / 实用医学杂志

Objective To explore the relationship between type 2 diabetes mellitus(T2DM)and serum stromal cell derived factor-1(SDF-1)levels. Methods A community-based epidemiological field study for T2DM patients and non-T2DM subjects was conducted in Beijing,China. Every subject underwent physical examinations, biochemical tests of stromal cell derived factor 1 and so on,and completed a standardized questionnaire. A total of 756 subjects were recruited in our analysis ,including 267 T2DM patients and 489 non-T2DM subjects ,T2DM patients were further divided into 81 simple T2DM patients and 186 macrovascular complication patients on the basis of the status of macrovascular complication. The correlation between serum SDF-1 levels and T2DM was analyzed. Results Compared with non-T2DM group,the level of SDF-1 in T2DM group was higher(P=0.019). The level of SDF-1 in simple T2DM group was also higher than macrovascular complication group(P=0.044). In the multi-ple linear regression analysis,after adjustment for age,gender,smoking,drinking,dyslipidemia,hypertension and BMI,SDF-1 level in simple T2DM group was higher than macrovascular complication group(P = 0.049), still. Conclusions Simple T2DM patients had a higher serum SDF-1 level than T2DM patients with macrovascular complications as well as those who did not suffer T2DM,suggesting that the stromal cell derived factor-1 may play a certain role in the development of T2DM and macrovascular complications.