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BACKGROUND@#Screening using low-dose computed tomography (LDCT) is a more effective approach and has the potential to detect lung cancer more accurately. We aimed to conduct a meta-analysis to estimate the accuracy of population-based screening studies primarily assessing baseline LDCT screening for lung cancer.@*METHODS@#MEDLINE, Excerpta Medica Database, and Web of Science were searched for articles published up to April 10, 2022. According to the inclusion and exclusion criteria, the data of true positives, false-positives, false negatives, and true negatives in the screening test were extracted. Quality Assessment of Diagnostic Accuracy Studies-2 was used to evaluate the quality of the literature. A bivariate random effects model was used to estimate pooled sensitivity and specificity. The area under the curve (AUC) was calculated by using hierarchical summary receiver-operating characteristics analysis. Heterogeneity between studies was measured using the Higgins I2 statistic, and publication bias was evaluated using a Deeks' funnel plot and linear regression test.@*RESULTS@#A total of 49 studies with 157,762 individuals were identified for the final qualitative synthesis; most of them were from Europe and America (38 studies), ten were from Asia, and one was from Oceania. The recruitment period was 1992 to 2018, and most of the subjects were 40 to 75 years old. The analysis showed that the AUC of lung cancer screening by LDCT was 0.98 (95% CI: 0.96-0.99), and the overall sensitivity and specificity were 0.97 (95% CI: 0.94-0.98) and 0.87 (95% CI: 0.82-0.91), respectively. The funnel plot and test results showed that there was no significant publication bias among the included studies.@*CONCLUSIONS@#Baseline LDCT has high sensitivity and specificity as a screening technique for lung cancer. However, long-term follow-up of the whole study population (including those with a negative baseline screening result) should be performed to enhance the accuracy of LDCT screening.
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Humans , Adult , Middle Aged , Aged , Lung Neoplasms/diagnostic imaging , Early Detection of Cancer , Sensitivity and Specificity , Mass Screening , Tomography, X-Ray ComputedABSTRACT
Objective:To explore the value of intravoxel incoherent motion (IVIM) DWI in preoperative prediction of angiolymphatic invasion in esophageal squamous cell carcinoma (ESCC).Methods:From April 2016 to April 2019, 63 ESCC patients who planned to undergo resection of esophageal cancer were prospectively collected at Henan Cancer Hospital.According to the postoperative pathological results, 63 patients were divided into angiolymphatic invasion group (30 cases) and no angiolymphatic invasion group (33 cases). All patients underwent IVIM sequence and routine MRI examination before operation. The ADC, true diffusion coefficient (D), pseudodiffusion coefficient (D *) and pseudodiffusion fraction (f) were measured. The differences of parameter values between ESCC with and without angiolymphatic invasion were analyzed using Student′s t test or Wilcoxon rank sum test.The logistic regression was used to analyze the significance of various parameters. For the parameters with statistical significance, the ROC curves were performed to evaluatethe diagnostic performance of parameters for identifying angiolymphatic invasion.The Z test was used to compare the area under the ROC curves(AUC) of parameters. Results:The difference of ADC, D and f values between angiolymphatic invasion group and no angiolymphatic invasion group were statistically signi?cant ( t=4.476, 5.033 and 5.712 respectively, all P<0.001). The D * values showed no statistically signi?cant di?erence ( Z=0.184, P=0.854). The logistic regression analysis showed that D (OR=9.042) and f (OR=26.221) were in correlation with angiolymphatic invasion. The ROC analyses demonstrated that the AUCs of ADC, D and f values in predicting angiolymphatic invasion of ESCC were 0.787, 0.822 and 0.853, respectively. D combined with f had highest AUC (0.917) in predicting the angiolymphatic invasion of ESCC, sensitivity and specificity were 93.3% and 75.8%. D combined with f showed better diagnostic performance than the D and the f value, and the difference were statistically significant ( Z=2.403, 2.289, P=0.016, 0.022). Conclusions:IVIM can be used as an effective functional imaging modality for preoperative evaluation and prediction of the angiolymphatic invasion of ESCC. D value combined with f value can further improve prediction performance of angiolymphatic invasion.
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Objective:To explore the diagnostic value of C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology in the differential diagnosis of thyroid nodules.Methods:A total of 237 thyroid nodules patients (237 thyroid nodules)with ultrasound examination and definitive pathologic results in Henan Cancer Hospital from April to September 2020 were retrospectively analyzed. The nodules were diagnosed according to C-TIRADS guidelines, and then by S-Detect technology combined with C-TIRADS guidelines. The ROC curve was plotted with the pathological results as the gold standard, and the area under the ROC curve, sensitivity, specificity and accuracy of the diagnosis results between the two groups were compared.Results:Among the 237 thyroid nodules, 105 were benign and 132 were malignant.The area under the ROC curve of C-TIRADS diagnosis alone and C-TIRADS diagnosis combined with artificial intelligence were 0.869 and 0.942 respectively, the difference between the two groups was statistically significant (χ 2=36.11, P<0.001); When Category 4A was used as the cutoff value of benign and malignant differential diagnosis, the specificity and accuracy of C-TIRADS classification of artificial intelligence-assisted diagnosis was significantly higher than that of C-TIRADS alone, and the difference was statistically significant(83.81% vs 47.62%, 90.72% vs 75.53%, all P<0.05). Conclusions:C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology has a high efficiency in the diagnosis of thyroid nodules and can improve the specificity and accuracy of thyroid nodules diagnosis and reduce unnecessary biopsy.
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Objective:To evaluate the value of a novel multiphase three-dimensional deep learning neural network of computer-aided diagnosis (CAD) used in LDCT lung cancer screening.Methods:Eight thousand eight hundred and fifty volunteers with 1 111 nodules were enrolled in the lung cancer screening from November of 2013 to December of 2017, and the baseline LDCT imaging data of volunteers accompanied with clinical information were retrospectively analyzed. All volunteers in this study were designed to receive LDCT test at least once. All the imaging of volunteers were read through the methods of visual detectioin (VD), CAD, and VD Combined CAD. The criteria of the true pulmonary nodule was determinated by the consistent opinion of two specialists in chest imaging（in case of disagreement, the decision should made by the third chief physician). In terms of the numbers, types or Lung-RADS categories of nodules, the detection rate, missed diagnosis rate and false positive rate of pulmonary nodules or lung cancer among three methods were compared, and the rates between groups were compared by χ 2test. Results:Compared with VD or CAD ,the detection rate of nodules in the CAD combined VD was significantly increased (95.7% , 94.2%, vs. 80.1% P<0.05 ), and the rate of missed diagnosis was significantly reduced (5.8%, 4.3% vs. 19.9% ，χ2=101.650, 128.500 ，P<0.05); Compared with VD, the methods of CAD or VD combined CAD significantly increased the the detection rates of Lung-RADS categories (χ2 =25.083,23.449, P=0.000, 0.000) or different types of nodules (χ2=6.955,6.821, P=0.031, 0.033), but there was no statistically significant difference between CAD and VD combined CAD for Lung-RADS categories and different types of nodules (all P>0.05); Compared with VD and VD combined CAD, the positive prediction rate of CAD for lung cancer was significantly reduced, and the rate of missed diagnosis and false positive rate were significantly increased, but there was no significant difference between VD and VD combined CAD in the prediction rate, missed diagnosis rate and false positive rate of lung cancer. Conclusion:The method of CAD combined VD can reduce the detection of false positive nodules and improve the detection rate of true pulmonary nodules,which is the preferred method using in LDCT lung cancer screening for city population.
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Objective:To explore the clinical application value of S-Detect intelligent assistant diagnosis technology in the diagnosis of suspicious thyroid nodules.Methods:A total of 153 patients who were diagnosed as TI-RADS 3-4 according to the ACR TI-RADS standard by ultrasound examination in Henan Provincial Cancer Hospital from September 2019 to December 2019 were included in the study. Differential diagnosis of benign and malignant thyroid nodules were made by senior doctors, junior doctors and S-Dectect technology, respectively. Then using pathological results as the standard, receiver operating charateric curve(ROC) curves were plotted to compare the area under curve (AUC), sensitivity, specificity and accuracy of S-Detect, senior and junior doctor groups, as well as their combinations.Results:Of the 153 patients with thyroid nodules, 108 cases(108 nodules) were comfirmed benign and 45 cases(45 nodules) were malignant afeer operation. The diagnostic sensitivity, specificity and accuracy of S-Detect were 77.78%, 87.04%, 84.31%. They were higher than junior doctors(68.89%, 79.63%, 76.47%), but lower than senior doctors(84.44%, 94.44%, 91.50%). The diagnostic sensitivity, specificity and accuracy in junior doctors combined with S-Detect were significantly improved(77.78%, 85.18%, 83.01%). The area under curve of S-Detect diagnosis was higher in the group of junior doctors combined with S-Detect (0.815) than that in the group of junior doctors (0.743), and the difference was statistically significant (χ 2=8.332, P=0.004). There was no statistically significant difference (χ 2=0.095, P=0.756) in the AUC of diagnosis between the group of senior doctors combined with S-Detect(0.901) and senior doctors(0.894). Using pathological results as the "gold standard" , the highest consistency of diagnosis was found in the senior doctors combined with S-Detect(Kappa=0.797). Conclusions:S-Detect technology has a high accuracy in the differential diagnosis of thyroid nodules. With the aid of this technology, it can improve the specificity and accuracy of diagnosis for the junior doctors.
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Objective@#To evaluate the efficacy of lung cancer screening in urban areas of Henan province by low-dose computed tomography (LDCT) from 2013 to 2017.@*Methods@#A cluster sampling method was used to select the residents of 40-74 years old in Henan province to investigate the risk factors and conduct lung cancer risk assessment. Subjects with high risk of lung cancer received LDCT for screening.@*Results@#A total of 179 002 residents completed the lung cancer risk assessment, and 35 672 subjects were identified as high risk of lung cancer, with a high risk rate of 19.93%. A total of 13 383 subjects with high risk received LDCT, and the screening rate was 37.52%. There were 786 cases diagnosed as positive nodules, and the detection rate was 5.87%. Among them, 755 cases of solid/partial solid nodule were ≥5 mm, 23 cases of non-solid nodules were ≥8 mm, 8 cases were intratracheal nodules, and 115 cases were diagnosed as suspicious lung cancer. The detection rate in males was 6.74%, which was higher than 5.02% in females. The detection rate was positively related with age (P<0.05).@*Conclusions@#The application of LDCT is a useful screening method which can elevate the early detection rate of positive nodules and other related diseases in lungs. In the future, males and older populations should be paid more attention to improve screening efficacy.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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Objective@#To systematically review available risk prediction models evidence on construction and verification of colorectal cancer risk prediction models.@*Methods@#"Colorectal neoplasms", "risk assessment", "colorectal cancer", "colorectal tumor", "colon cancer", "colon tumor", "rectal cancer", "rectal tumor", "anal cancer", "anal tumor", "risk prediction", "malignancy", "carcinogenesis", "model" were used as search keywords. Journal papers and grey literature were searched from Chinese electronic databases (CNKI and Wanfang) and English electronic databases (PubMed and Embase) from their inception to 30 Apr 2018. The language of literature was restricted to Chinese and English. The inclusion criteria were human-oriented researches with complete information for model construction,verification and evaluation. The exclusion criteria were informal publications such as conference abstracts, Chinese disertation papers, and non-primary research materials such as reviews,letters,and news reports. Descriptive characteristics,targeted population, study design, model construction method and prediction results were extracted. A total of 36 papers involving 27 models were included. The population characteristics of all included studies,the type of research, the method of model construction and the prediction results of the model were analyzed.@*Results@#As for model construction,there were 13 European and American population based model studies,14 Asian population based model studies,including 7 Chinese mainland based model studies. According to the factors selected into the model, these models can be divided into traditional epidemiological models (17 models), clinical index combined models (4 models),and genetic susceptibility index combined models (6 models). As for model verification,only 9 models were cross-verified in the internal population after model construction, and the extrapolation of model prediction effect was not effectively evaluated; 17 models were verified in an external population; there was only one model verified in two external populations in terms of risk prediction effect; the area under the curve of 27 models was 0.56-0.85.@*Conclusion@#The risk prediction model of colorectal cancer is in the development stage. The external evaluation of model prediction effect is less and the prediction ability is not good, and the existing models have limited exploration of clinical indicators.
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Objective To estimate the incidence and mortality of kidney cancer in China in 2014,based on the cancer registration data.Data was collected through the National Central Cancer Registry (NCCR).Methods All together,449 cancer registries submitted required data on incidence and deaths of kidney cancer occurred in 2014,to the NCCR.After evaluation on the quality of data,339 registries were accepted for analysis and stratified by areas (urban/rural) and age groups.Combined with data from the National population in 2014,the nationwide incidence and mortality of kidney cancer were estimated.Data from the 2000 National census was used,and with Segi's population used for the rates of age-standardized incidence/mortality.Results The qualified 339 cancer registries covered a total population of 288 243 347,with 144 061 915 in urban and 144 181 432 in rural areas.The percentage of morphologically verified cases and cases with only available death certificates were 72.70％ and 1.27％,respectively.The mortality to incidence ratio was 0.37.The estimates of new cases were around 68 300 in whole China,in 2014,with a crude incidence rate as 4.99/100 000 (95％CI:4.95/100 000-5.03/100 000).The age-standardized incidence rates of kidney cancer,estimated by China standard population (ASR China) and world standard population (ASR world)were 3.43/100 000 (95％CI:3.40/100 000-3.46/100 000) and 3.40/100 000 (95％CI:3.37/100 000-3.43/100 000),respectively.The cumulative incidence rate of kidney cancer was 0.40％ in China.The crude and ASR China incidence rates for males appeared as 6.09/100 000 (6.03/100 000-6.15/100 000)and 4.32/100 000 (4.28/100 000-4.36/100 000),respectively,whereas those were 3.84/100 000 (3.79/100 000-3.89/100 000) and 2.54/100 000 (2.50/100 000-2.58/100 000) for females.The crude and ASR China incidence rates in urban areas appeared as 6.60/100 000 (95％CI:6.54/100 000-6.66/100 000) and 4.25/100 000 (95％ CI:4.21/100 000-4.29/100 000),respectively,whereas those were 3.05/100 000 (95％CI:3.01/100 000-3.09/100 000) and 2.29/100 000 (95％CI:2.25/100 000-2.33/100 000) in rural areas.The estimates of kidney cancer deaths were around 25 600 in the country,in 2014,with a crude mortality rate of 1.87/100 000 (95％CI:1.85/100 000-1.89/100 000).The ASR China and ASR world mortality rates appeared as 1.16/100 000 (95 ％ CI:1.14/100 000-1.18/100 000)and 1.16/100 000(95％CI:1.14/100 000-1.18/100 000),respectively,with a cumulative mortality rate (0-74 years old) of 0.12％.The crude and ASR China mortality rates were 2.31/100 000 (95％CI:2.27/100 000-2.35/100 000) and 1.52/100 000 (95％ CI:1.50/100 000-1.54/100 000) for males,respectively,whereas those were 1.41/100 000 (95％CI:1.38/100 000-1.44/100 000) and 0.81/100 000(95％CI:0.79/100 000-0.83/100 000) for females.The crude andASR China mortality rates were 2.49/100 000 (95％CI:2.45/100 000-2.53/100 000) and 1.42/100 000 (95％CI:1.40/100 000-1.44/100 000)in urban areas,respectively,whereas those were 1.12/100 000 (95％CI:1.09/100 000-1.15/100 000)and 0.78/100 000 (95％ CI:0.76/100 000-0.80/100 000) in the rural areas.Conclusions Both the incidence and mortality of kidney cancer seemed low,in China.However,the incidence of kidney cancer had greatly increased.Our findings suggested that prevention and control strategies for kidney cancer should be focused on males in the urban areas.
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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.
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Objective To estimate the incidence and mortality of kidney cancer in China in 2014,based on the cancer registration data.Data was collected through the National Central Cancer Registry (NCCR).Methods All together,449 cancer registries submitted required data on incidence and deaths of kidney cancer occurred in 2014,to the NCCR.After evaluation on the quality of data,339 registries were accepted for analysis and stratified by areas (urban/rural) and age groups.Combined with data from the National population in 2014,the nationwide incidence and mortality of kidney cancer were estimated.Data from the 2000 National census was used,and with Segi's population used for the rates of age-standardized incidence/mortality.Results The qualified 339 cancer registries covered a total population of 288 243 347,with 144 061 915 in urban and 144 181 432 in rural areas.The percentage of morphologically verified cases and cases with only available death certificates were 72.70％ and 1.27％,respectively.The mortality to incidence ratio was 0.37.The estimates of new cases were around 68 300 in whole China,in 2014,with a crude incidence rate as 4.99/100 000 (95％CI:4.95/100 000-5.03/100 000).The age-standardized incidence rates of kidney cancer,estimated by China standard population (ASR China) and world standard population (ASR world)were 3.43/100 000 (95％CI:3.40/100 000-3.46/100 000) and 3.40/100 000 (95％CI:3.37/100 000-3.43/100 000),respectively.The cumulative incidence rate of kidney cancer was 0.40％ in China.The crude and ASR China incidence rates for males appeared as 6.09/100 000 (6.03/100 000-6.15/100 000)and 4.32/100 000 (4.28/100 000-4.36/100 000),respectively,whereas those were 3.84/100 000 (3.79/100 000-3.89/100 000) and 2.54/100 000 (2.50/100 000-2.58/100 000) for females.The crude and ASR China incidence rates in urban areas appeared as 6.60/100 000 (95％CI:6.54/100 000-6.66/100 000) and 4.25/100 000 (95％ CI:4.21/100 000-4.29/100 000),respectively,whereas those were 3.05/100 000 (95％CI:3.01/100 000-3.09/100 000) and 2.29/100 000 (95％CI:2.25/100 000-2.33/100 000) in rural areas.The estimates of kidney cancer deaths were around 25 600 in the country,in 2014,with a crude mortality rate of 1.87/100 000 (95％CI:1.85/100 000-1.89/100 000).The ASR China and ASR world mortality rates appeared as 1.16/100 000 (95 ％ CI:1.14/100 000-1.18/100 000)and 1.16/100 000(95％CI:1.14/100 000-1.18/100 000),respectively,with a cumulative mortality rate (0-74 years old) of 0.12％.The crude and ASR China mortality rates were 2.31/100 000 (95％CI:2.27/100 000-2.35/100 000) and 1.52/100 000 (95％ CI:1.50/100 000-1.54/100 000) for males,respectively,whereas those were 1.41/100 000 (95％CI:1.38/100 000-1.44/100 000) and 0.81/100 000(95％CI:0.79/100 000-0.83/100 000) for females.The crude andASR China mortality rates were 2.49/100 000 (95％CI:2.45/100 000-2.53/100 000) and 1.42/100 000 (95％CI:1.40/100 000-1.44/100 000)in urban areas,respectively,whereas those were 1.12/100 000 (95％CI:1.09/100 000-1.15/100 000)and 0.78/100 000 (95％ CI:0.76/100 000-0.80/100 000) in the rural areas.Conclusions Both the incidence and mortality of kidney cancer seemed low,in China.However,the incidence of kidney cancer had greatly increased.Our findings suggested that prevention and control strategies for kidney cancer should be focused on males in the urban areas.
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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.
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Objective@#To investigate the association between anthropometry and colorectal cancer risk in Chinese males.@*Methods@#Anthropometry and incident colorectal cancer cases were collected on a biennial basis starting in May 2006 among males in Kailuan Cohort (2006-2014). In addition, electronic database of hospitals affiliated to Kailuan Community, Insurance System of Kailuan Community and Tangshan were also searched for supplementary information. Cox proportional hazards regression models and linear models were used to evaluate the association between baseline anthropometry and the risk of colorectal cancer in males.@*Results@#A total of 106 786 males were included and 318 new colorectal cancer cases were identified in the Kailuan male cohort study, with 747 337.60 person-years follow-up by 31 December 2014. The median follow-up time was 7.90 years. Highest quartile waist circumference (≥94.0 cm) or WHtR (≥0.55) had 1.45 (95%CI: 1.05-2.02) and 1.66 (95%CI: 1.15-2.41) higher risk of colorectal cancer when compared with lowest waist circumference (<82.0 cm) or WHtR (<0.48) after adjusting for age, education, smoking, alcohol drinking, sitting time and dust exposure. Subgroup analyses by site indicated that males with BMI ≥26.27 kg/m2, waist circumference ≥94.0 cm or WHtR ≥0.55 had HRs (95%CI) of 2.18(1.27-3.73), 2.20 (1.27-3.78) and 2.42 (1.29-4.56) for colon cancer risk, respectively. Linear models showed the HR of colon cancer and 95%CI would be 1.59 (1.24-2.02) with every 0.1 growth in WHtR.@*Conclusion@#Obesity may be responsible for an increased risk of colorectal cancer in male. Reasonable weight control may be one of the effective measures to prevent colorectal cancer.
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Objective@#To investigate the effect of fried food intake on the pathogenesis of gastric cancer and precancerous lesions.@*Methods@#From 2005 to 2013, the residents aged 40-69 years from 11 counties/cities where cancer screening of upper gastrointestinal cancer were conducted in rural areas of Henan province as the subjects (82 367 cases). The information such as demography and lifestyle was collected. The residents were screened with endoscopic examination. The biopsy sampleswere diagnosed pathologically, according to pathological diagnosis criteria, the subjects with high risk were divided into the groups with different pathological degrees. The multivariate ordinal logistic regression analysis was used to analyze the relationship between the frequency of fried food intake and gastric cancer and precancerous lesions.@*Results@#The study coverd 46 425 males and 35 942 females, with a age of (53.46±8.07)years. The study collected 6 707 cases of normal stomach, 2 325 cases of low grade intraepithelial neoplasia, 226 cases of high grade intraepithelial neoplasia and 331 cases of gastric cancer. Multivariate logistic regression analysis showed that, compared with those whoeat fried food less than one time per week, fried foods intake (<2 times/week: OR=1.89, 95%CI: 1.57-2.28; ≥ 2 times/week: OR=1.91, 95%CI: 1.66-2.20) were a risk factor for gastric cancer and precancerous lesions after adjustment for age, sex, marital status, educational level, body mass index (BMI), smoking and drinking status.@*Conclusion@#The intake of fried food is a risk factor for gastric cancer and precancerous lesions. Therefore, reducing the intake of fried food can prevent the occurrence of gastric carcinoma and precancerous lesions.