Cognition of Colorectal Cancer-related Knowledge and Influencing Factors of Patients with Middle- and Advanced-stage Colorectal Cancer in Inner Mongolia / 肿瘤防治研究

Objective To investigate the cognition of colorectal cancer-related knowledge and influencing factors of patients with middle- and advanced-stage colorectal cancer in ethnic minority areas of Inner Mongolia. Methods According to the national population and the prevalence of colorectal cancer, 277 patients with colorectal cancer were selected by stratified and random sampling in Inner Mongolia. The patients were surveyed in Baotou, Chifeng, Bayannaoer, and other hospitals. The questionnaire included patients' basic information, cognition of colorectal cancer risk factors and screening knowledge, screening information, etc. Results Before suffering from the disease, the patients' knowledge of colorectal cancer (risk factors, early screening knowledge, treatment methods) was low. About 54.9% of patients were unaware of high risk factors for colorectal cancer, 75.8% of patients did not understand the knowledge of early screening of colorectal cancer, and 37.5% of patients did not underst and the treatment of colorectal cancer. The main influencing factors of colorectal cancer cognition were education level and occupation. Patients who work in institutions and enterprises and with higher education level had better cognition. Conclusion Patients with middle- and advanced-stage colorectal cancer in Inner Mongolia have poor knowledge and awareness of risk factors and screening of colorectal cancer before diagnosis. Education level and occupation are factors influencing colorectal cancer cognition, therefore, people with low knowledge rate of colorectal cancer and low education level as well as unemployed laid-off people should be given priority intervention.

Performance of rural practitioners of endoscopic cleaning and disinfection on the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers / 中华消化内镜杂志

Objective:To evaluate the performance of rural practitioners of endoscopic cleaning and disinfection participating in the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers and to analyze the influencing factors.Methods:The questionnaires for skill assessment were designed based on the skill scheme and clinical practice of the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China, and the App Early diagnosis, Early treatment was used as the examination platform. The practitioners in 539 county hospitals from 25 provinces participating in the program in 2019 were assessed for techniques and skills for endoscopic cleaning and disinfection and the excellence rate was calculated. Multivariate logistic regression model was used to analyze the influencing factors for the examination. Results:A total of 1 671 endoscopic cleaning and disinfection practitioners participated in the assessment with the score of 73.41±16.60. The passing rate was 85.82%, and the excellence rate was 44.94%. Among all questions, the correct rate of "opportunistic screening flow chart" was the highest (98.21%), and that of "the evaluation index for mass screening" was the lowest (57.89%). The multivariate logistic regression analysis showed that the excellence rate was high in practitioners who had a bachelor degree or above ( OR=1.627,95% CI:1.319-2.007, P<0.001), the career for 5 to <15 years (5 to <10 years: OR=1.329,95% CI:1.045-1.689, P=0.020; 10 to <15 years: OR=1.384,95% CI:1.026-1.867, P=0.033), working in eastern and central regions (eastern regions: OR=3.476,95% CI:2.368-5.103, P<0.001;central regions: OR=4.028,95% CI:2.679-6.057, P<0.001) and with full understanding of the screening scheme ( OR=1.547,95% CI:1.246-1.921, P<0.001) . Conclusion:Practitioners on the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China have mastered the basic screening scheme and skills for endoscopic cleaning and disinfection. The education background, duration of the career, area and understanding of screening scheme are influencing factors for the excellence rate of endoscopic cleaning and disinfection.

Evaluation the triage performance of p16/Ki-67 dual staining for HR-HPV positive women / 中华预防医学杂志

Objective@#This study aimed to evaluate the clinical performance of p16/Ki-67 dual staining for triage high risk HPV (HR-HPV) infected women.@*Method@#Target objects were women who infected HR-HPV and received colposcopy examination between April and December of 2016 at the Second Affiliated Hospital of Zhengzhou University. Gynecologists collected the cervical exfoliated cells from eligible women for p16/Ki-67 dual staining, LBC testing and HPV DNA testing. Histology diagnosis were used as gold standard. Sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs) of p16/Ki-67 dual staining, LBC testing and HPV16/18 testing for triage of HR-HPV positive population were calculated and compared.@*Results@#A total of 295 HR-HPV infected women were selected, and the mean age was (44.29±11.48) years old. Positive rates of p16/Ki-67 dual staining, HPV16/18 testing and LBC testing were 70.17% (207), 56.95% (168) and 85.76% (253), respectively. When CIN2+as the endpoint, among the three triage methods, sensitivity of p16/Ki-67 dual staining was 90.00% (95%CI: 85.06%-93.43%), higher than the value of HPV 16/18 testing, but lower than the value of LBC testing. Specificity, PPV and NPV of p16/Ki-67 dual staining were the highest [71.58% (95%CI: 61.81%-79.67%), 86.96% (95%CI:81.69%-90.88%) and 77.27% (95%CI: 67.49%-84.78%)]. When detection for CIN3+, sensitivity of p16/Ki-67 dual staining was 92.90% (95%CI: 87.74%-95.99%), lower than the value of LBC testing, but higher than the value of HPV16/18 testing. Specificity of p16/Ki-67 dual staining was 55.00% (95%CI: 46.74%-63.00%), lower than the value of HPV16/18 testing, but higher than the value of LBC testing. PPV of p16/Ki-67 dual staining was 69.57% (95%CI: 62.99%-75.43%), lower than the value of HPV 16/18 testing, but higher than the value of LBC testing. NPV of p16/Ki-67 dual staining was 87.50% (95%CI: 78.99%-92.87%), higher than value of HPV 16/18 testing, but lower than the value of LBC testing.@*Conclusion@#p16/Ki-67 dual staining has better clinical effects than HPV 16/18 testing and LBC testing for triage women with HR-HPV infection.

Analysis of the efficacy of lung cancer screening in urban areas of Henan Province by low-dose computed tomography from 2013 to 2017 / 中华肿瘤杂志

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.

The clinical performance of high risk HPV DNA test among triage women with cytology showing atypical squamous cells of undetermined significance / 中华预防医学杂志

Objective@#To evaluate the performance of high risk human papillomavirus (HR-HPV) DNA test for triage ASC-US in Chinese population.@*Methods@#The study population was from Jiyuan city in Henan Province where a cervical cancer screening cohort (4 026 women) was set up from April to July in 2017. Women with ASC-US and complete recall information of colposcope were selected as the study objects. Self-designed questionnaire was used to survey the general information and medical history of cervical cancer, thencervical cytological speciments were collected for cytodiagnosis and HPV DNA test, followed by colposcopy, lesion biopsy and histology diagnose. The diagnosis of histology was used as the gold standard. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) as well as corresponding 95% confidential interval (CI) were calculated.@*Results@#The average age of the included 393 women with ASC-US were (50.81±9.22) years old. The positivity of high risk human papillomavirus (HR-HPV), HPV16 and HPV18 were 35.6%, 10.69% and 2.80%, respectively. The sensitivity, specificity, PPV and NPV for HR-HPV to detect CIN2+ were 84.38% (68.25%-93.14%), 68.70% (63.74%-73.26%), 19.29% (13.61%-26.61%) and 98.02% (95.46%-99.15%). When compared with HR-HPV, HPV16/18 had a lower sensitivity (59.38% (42.26%-74.48%)) and a higher specificity(91.14% (87.75%-93.65%)), the PPV and NPV were 59.38% (25.32%-50.98%) and 91.14% (93.61%-97.77%).@*Conclusion@#It was more effective for HR-HPV to triage ASC-US than HPV16/18. In order to improve the effect of HPV16/18, it should include more HR-HPV types which were more prevalent in Chinese population.

Multivariate analysis of the association between consumption of fried food and gastric cancer and precancerous lesions / 中华预防医学杂志

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.

Estimation on the incidence and mortality of kidney cancer in China, in 2014 / 中华流行病学杂志

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.

Estimation on the incidence and mortality of kidney cancer in China, in 2014 / 中华流行病学杂志

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.

Multivariate ordinal logistic regression analysis on the association between consumption of fried food and both esophageal cancer and precancerous lesions / 中华流行病学杂志

Objective To investigate the effect of fried food intake on the pathogenesis of esophageal cancer and precancerous lesions.Methods From 2005 to 2013,all the residents aged 40-69 years from 11 counties (cities) where cancer screening of upper gastrointestinal cancer had been conducted in rural areas of Henan province,were recruited as the subjects of study.Information on demography and lifestyle was collected.The residents under study were screened with iodine staining endoscopic examination and biopsy samples were diagnosed pathologically,under standardized criteria.Subjects with high risk were divided into the groups based on their different pathological degrees.Multivariate ordinal logistic regression analysis was used to analyze the relationship between the frequency of fried food intake and esophageal cancer and precancerous lesions.Results A total number of 8 792 cases with normal esophagus,3 680 with mild hyperplasia,972 with moderate hyperplasia,413 with severe hyperplasia carcinoma in situ,and 336 cases of esophageal cancer were recruited.Results from multivariate logistic regression analysis showed that,when compared with those who did not eat fried food,the intake of fried food (＜2 times/week:OR=1.60,95％C1:1.40-1.83;≥2 times/week:OR=2.58,95％ CI:1.98-3.37) appeared a risk factor for both esophageal cancer or precancerous lesions after adjustment for age,sex,marital status,educational level,body mass index,smoking and alcohol intake.Conclusion The intake of fried food appeared a risk factor for both esophageal cancer and precancerous lesions.

Multivariate ordinal logistic regression analysis on the association between consumption of fried food and both esophageal cancer and precancerous lesions / 中华流行病学杂志

Objective To investigate the effect of fried food intake on the pathogenesis of esophageal cancer and precancerous lesions.Methods From 2005 to 2013,all the residents aged 40-69 years from 11 counties (cities) where cancer screening of upper gastrointestinal cancer had been conducted in rural areas of Henan province,were recruited as the subjects of study.Information on demography and lifestyle was collected.The residents under study were screened with iodine staining endoscopic examination and biopsy samples were diagnosed pathologically,under standardized criteria.Subjects with high risk were divided into the groups based on their different pathological degrees.Multivariate ordinal logistic regression analysis was used to analyze the relationship between the frequency of fried food intake and esophageal cancer and precancerous lesions.Results A total number of 8 792 cases with normal esophagus,3 680 with mild hyperplasia,972 with moderate hyperplasia,413 with severe hyperplasia carcinoma in situ,and 336 cases of esophageal cancer were recruited.Results from multivariate logistic regression analysis showed that,when compared with those who did not eat fried food,the intake of fried food (＜2 times/week:OR=1.60,95％C1:1.40-1.83;≥2 times/week:OR=2.58,95％ CI:1.98-3.37) appeared a risk factor for both esophageal cancer or precancerous lesions after adjustment for age,sex,marital status,educational level,body mass index,smoking and alcohol intake.Conclusion The intake of fried food appeared a risk factor for both esophageal cancer and precancerous lesions.

Analysis of the efficacy of gastric cancer screening in rural population in Henan Province / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the efficacy of endoscopic screening for gastric cancer in rural population in high risk areas of upper gastrointestinal cancer in Henan province.</p><p><b>METHODS</b>Subjects aged 40-69 years in the high risk areas were selected to participate in the endoscopic screening based on the cluster sampling, and screening-positive subjects were sampled for pathological examination. The data of screening were summarized and the detection rates of severe chronic atrophic gastritis, severe intestinal metaplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia, early and middle-late cancer were calculated, and the constituent ratio of early cancer cases was calculated. The detection rates and early diagnosis rates for the first round screening and follow-up screening were compared.</p><p><b>RESULTS</b>In the 5 years, a total of 88 263 subjects were endoscopically examined in the first round screening and 4 004 subjects were diagnosed with low grade intraepithelial neoplasia or above (the detection rate was 4.54%), in which 3 256 cases were with low grade intraepithelial neoplasia (the detection rate of 3.69%), 366 cases with high grade intraepithelial neoplasia (the rate of 0.41%), 199 cases with early cancer (the rate of 0.22%) and 183 cases with middle-late cancer (the rate of 0.21%). The number of cases of high grade intraepithelial neoplasia and early cancer was 565 and the early diagnosis rate was 75.53%. 1 894 subjects with severe chronic atrophic gastritis, severe intestinal metaplasia and low grade intraepithelial were followed up with a compliance of 66.32%. A total of 45 cases of early cancer were diagnosed, with a detection rate of 2.38% and early diagnosis rate of 100%. The detection rate and early diagnosis rate in the follow-up screening were both statistically significantly higher than that in the first round screening (P<0.01 for both).</p><p><b>CONCLUSION</b>The efficacy of endoscopic screening for gastric cancer is significant in high risk areas of upper gastrointestinal cancer, and improving the quality of follow-up screening will achieve a better performance of the screening.</p>

A meta-analysis of body mass index and the risk of lung cancer in the Chinese population / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the association between obesity and the risk of lung cancer and evaluate a dose-response relationship between body mass index (BMI) and incidence risk of lung cancer in the Chinese population.</p><p><b>METHODS</b>A systematic literature search for BMI and incidence risk of lung cancer in the Chinese population, as well as through the reference lists of retrieved articles. The literature databases including Chinese National Knowledge Infrastructure, Wanfang, PubMed, Embase and Google Scholar. Time range was from the founding of each database to September 2014 and a total of 93 research papers were collected. Meta-analysis was conducted to calculate pooled odds ratio and corresponding 95% CI. Generalized least-squares regression methods were used to make a dose-response meta-analysis between BMI and incidence risk of lung cancer.</p><p><b>RESULTS</b>Seven studies were included in the meta-analysis, with a number of 2 351 lung cancer cases. Results showed that obesity was inversely associated with lung cancer incidence (OR = 0.68, 95% CI: 0.59-0.79) (heterogeneity test: I² = 0, P = 0.594). The association did not change with stratification by study design, sex, smoking status, BMI measurement method and study population. A linear dose-response association between BMI and risk of lung cancer was visually significant, and lung cancer risk would be reduced 21% for per 5 kg/m² BMI increase (OR = 0.79, 95% CI: 0.71-0.89) (heterogeneity test: q = 22.43, P = 0.002).</p><p><b>CONCLUSION</b>The results of this meta-analysis indicated that higher BMI was a protective factor against lung cancer, but smoking may play a stronger role as a confounding factor for the most important role with lung cancer incidence.</p>

Analysis of effect of screening of esophageal cancer in 12 cities and counties of Henan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate effect of screening of esophageal cancer at rural areas in Henan province.</p><p><b>METHODS</b>At rural areas with high incidence of upper gastrointestinal carcinoma in Henan province total of 88,263 persons with 40 to 69 years old were set to the target population of the screening by the 12 cities and countries and endoscope and pathology diagnosis were performed during 2009-2013. For patients with precancerous lesions, follow-up visits were conducted and defined as follows: once in three years for patients with mild dysplasia, once per year for moderate hyperplasia patients, the patients with severe intraepithelial neoplasia/carcinoma in situ should be treat, at least once per year for those one who didn't under treatment. The result data of screening were summarized and detection rates of esophagus hyperplasia, carcinoma in situ, early and middle-late cancer were calculated, as well as the early diagnosis rate. The result between first round and follow-up screening was compared.</p><p><b>RESULTS</b>Target population were examined in first round screening. There were 8,434 persons with above mild dysplasia and the detection rate was 9.56%, among them there were 7,224 (8.18%) cases with light-middle hyperplasia, 789 (0.89%) cases with serious dysplasia or cancer in situ, 239 (0.27%) cases with early cancer and 182 (0.21%) cases with middle-late cancer. The sum of serious dysplasia or cancer in situ and early cancer was 1 028 and the early detection rate was 84.96% (1,028/1,210). From 2012 to 2013, the follow-up screening for persons with light-middle hyperplasia which should be followed 4,230 cases, there were 2 853 people to take in screening and compliance was 67.45%. Total of 94 cases were diagnosed with cancer in situ or early cancer. The detection rate and the early detection rate were 3.29% and 100%, respectively. The rates of detection and early detection in phase of follow-up screening were statistically significantly higher than that in first round screening respectively (P<0.001).</p><p><b>CONCLUSION</b>At rural areas of high incidence upper gastrointestinal carcinoma in Henan province, the screening with endoscope had good effect and strengthening the follow-up screening could increase the effect.</p>

Investigation of knowledge and acceptability of human papillomavirus vaccine and assessment of health education among employed urban women in China / 肿瘤研究与临床

Objective To investigate knowledge of cervical cancer,human papillomavirus (HPV) and HPV vaccine and attitude to HPV vaccine among employed urban women in China,and to assess willingness to vaccinate their children.Methods This study was conducted in women from 16 factories or companies in Beijing,Hangzhou,Changsha,Chcngdu and Guangzhou.A questionnaire on cervical cancer,HPV knowledge and HPV vaccine acceptability was administered to participants before and after educational intervention.Results A total of 1 146 women were surveyed from August to November,2011.The awareness rates of cervical cancer,HPV and HPV vaccine were 95.06 ％,27.98 ％ and 12.82 ％,respectively.Only 20.68 ％ knew that HPV was related to cervical cancer.After educatioual instruction,89.26 ％ understood the relationship between HPV and cervical cancer (x2 =93.414,P ＜ 0.001).Only 19.25 ％ women were unwilling to allow their children to be vaccinated.The main reasons were as follows:worried about vaccine safety (23.52 ％),belief that their child was not at risk (21.92 ％),lack of scientific evidence for the vaccine (13.01％),and worricd about vaccine efficacy (12.79 ％).Conclusions In general,there is a high acceptability of HPV vaccine to prevent cervical cancer among employed urban Chinese women after educational intervention.However,some women remain reluctant to vaccinate their children due to concern about vaccine safety and efficacy.

Distribution of serum antibodies against human papillomavirus 16 and 18 among high-risk women to cervical cancer / 中华流行病学杂志

Objective To explore the distribution of serum antibodies against human papillomavirus(HPV)16/18 among women at high-risk for cervical cancer. Methods All women when tested positive for anyone of the cervical cancer screening programs,from Xinmi county of Henan province in 2011,were recruited as the subjects of this study. Cervical exfoliated cells were collected,using cervical brush for HPV DNA testing,and 10 ml venous blood was drawn for HPV-16, 18 serum antibodies testing,by enzyme-linked immunosorbent assay. Results Among the 952 women unders study,230 cases(24.2%)showed HPV DNA positive,with positivity rates of HPV16 and 18 L1 virus-like particle(VLP)antibodies as 23.2%and 6.5%,respectively. The overall positivity rate of any type of HPV16,18 VLP antibodies was 26.8%. Geometric means of HPV16,18 VLP antibody titers were 79.1(Yangshengtang Unit,YU/ml)and 125.0(YU/ml). Positivity rate of HPV16 antibody was significantly associated with age,viral load of HPV DNA,and cervical lesion severity (P<0.05). Seropositvity of HPV18 was also increasing with the increase of viral load (P<0.01) with different cervical lesion significantly showing different titer of HPV18 antibody (P<0.01). Based on the results of HPV DNA detection among the two years of study,women with HPV persistent infection showed significant higher positive rate of HPV16/18 antibodies than women who did not have HPV infection or emerging infection (P<0.001). When comparing to those women without HPV infection,the ones with transient infection showed higher seropositivity rates on both HPV16 antibodies and titer of HPV16 antibody (P<0.001). Conclusion Seroprevalence rates on HPV16 and 18 among the unvaccinated high-risk women in Henan were high. Prevalence of both HPV16 and 18 antibodies were correlated with age,viral load,cervical lesion and history of infection. Women with high viral load,high grade cervical lesion or history of infection would more likely to be seropositive.

Distribution of serum antibodies against human papillomavirus 16 and 18 among high-risk women to cervical cancer / 中华流行病学杂志

Objective To explore the distribution of serum antibodies against human papillomavirus(HPV)16/18 among women at high-risk for cervical cancer. Methods All women when tested positive for anyone of the cervical cancer screening programs,from Xinmi county of Henan province in 2011,were recruited as the subjects of this study. Cervical exfoliated cells were collected,using cervical brush for HPV DNA testing,and 10 ml venous blood was drawn for HPV-16, 18 serum antibodies testing,by enzyme-linked immunosorbent assay. Results Among the 952 women unders study,230 cases(24.2%)showed HPV DNA positive,with positivity rates of HPV16 and 18 L1 virus-like particle(VLP)antibodies as 23.2%and 6.5%,respectively. The overall positivity rate of any type of HPV16,18 VLP antibodies was 26.8%. Geometric means of HPV16,18 VLP antibody titers were 79.1(Yangshengtang Unit,YU/ml)and 125.0(YU/ml). Positivity rate of HPV16 antibody was significantly associated with age,viral load of HPV DNA,and cervical lesion severity (P<0.05). Seropositvity of HPV18 was also increasing with the increase of viral load (P<0.01) with different cervical lesion significantly showing different titer of HPV18 antibody (P<0.01). Based on the results of HPV DNA detection among the two years of study,women with HPV persistent infection showed significant higher positive rate of HPV16/18 antibodies than women who did not have HPV infection or emerging infection (P<0.001). When comparing to those women without HPV infection,the ones with transient infection showed higher seropositivity rates on both HPV16 antibodies and titer of HPV16 antibody (P<0.001). Conclusion Seroprevalence rates on HPV16 and 18 among the unvaccinated high-risk women in Henan were high. Prevalence of both HPV16 and 18 antibodies were correlated with age,viral load,cervical lesion and history of infection. Women with high viral load,high grade cervical lesion or history of infection would more likely to be seropositive.

Feasibility of HEV vaccine as control in HPV vaccine study and comparison of serological and risk factors between HEV and HPV infection among females / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Investigating the distribution of anti-hepatitis E virus (HEV-IgG), anti-human papillomavirus (HPV L1-IgG) and risk factors among female residents in Xinmi County, to explore the influencing factors of HPV vaccine study using HEV vaccinated population as a control.</p><p><b>METHODS</b>A screening study of cervical cancer in Xinmi County, Henan Province, was performed. The information of demographic characteristics and risk factors was collected using standard questionnaire. Nine ml blood was drawn from each woman for enzyme-linked immunosorbent assay to detect HEV-IgG and HPV L1-IgG antibody. Percentile, histogram and binary logistic regression model were used to describe the distribution of risk factors and their correlation to HPV and HEV infection.</p><p><b>RESULTS</b>The average age of the Xinmi female residents was 47.2 years, their positive rate of HPV L1 antibody was 26.8%, and that of HEV-IgG antibody was 31.0%, both of which were raised with age (P < 0.001). Single factor analysis showed that non-education, low-income and growing age were associated with HEV-IgG antibody positivity, and non-education, lowering ages of first sexual life and growing age were associated with HPV L1-IgG antibody positivity. Multivariable analysis showed that growing age, low-income and work as peasantry were independent risk factors for HEV-IgG antibody positivity, and lowering ages of first sexual life, non-education and growing age were independent risk factors for HPV L1-IgG antibody positivity.</p><p><b>CONCLUSIONS</b>Both the HEV-IgG and HPV L1-IgG antibodies positive rates increase with age. Age is the common risk factor of HEV-IgG and HPV L1-IgG antibodies in female residents in Xinmi County. The risk factors of HEV-IgG and HPV L1-IgG antibodies have no statistical association, neither cross reaction was found in the HEV-IgG and HPV L1-IgG detection.</p>

Serum anti-hepatitis E virus IgG antibody and risk factors among female residents of Xinmi in Henan Province / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine the distribution of anti-hepatitis E virus (HEV) IgG antibody and anti-human papilloma virus (HPV) IgG antibody among female residents of Xinmi and investigate the risk factors of HEV infection.</p><p><b>METHODS</b>A questionnaire was used to collect data on the demographic characteristics and suspected risk factors of HEV infection, including behavioral habits. All questionnaire responders also provided peripheral blood samples for investigation by enzyme-linked immunosorbent assay to detect HEV-IgG. Demographic data were statistically evaluated by t-test and univariate analysis, and HEV infection risk factors were statistically evaluated by a binary logistic regression model.</p><p><b>RESULTS</b>The average age of the 952 questionnaire responders was 47.16 + 8.09 years. The demographic parameters of education level, income, experience of stillbirth, and age were associated with HEV-IgG positivity (all P less than 0.05). Age, occupation, and income were identified as independent risk factors for HEV-IgG positivity (all P less than 0.05). No statically association was found between sexual behavior and anti-HEV or anti-HPV levels, or HEV infection.</p><p><b>CONCLUSION</b>The female population surveyed in Xinmi, Henan Province showed a higher HEV-IgG positive rate than generally reported in the literature, and this rate shows an increasing trend with age, Risk factors for HEV infection among this group are age, income and occupation.</p>

Evaluation of screening performance of HPV DNA test on specimens from different sites of the female genital tract / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic performance of different specimens for detecting CIN2(+), and to find the solution of the problem that why the performance of self-collected specimen is worse than cervical specimen collected by physician.</p><p><b>METHODS</b>The cervix, lower 1/3 vagina, upper 1/3 vagina and self-collected specimens from each of the 806 women who took part in this multi-center screening program from May 2006 to April 2007 were tested by hybrid capture 2 (HC2) technique. The diagnostic performance of HC2 on the four specimens for detecting CIN2(+) lesions was calculated. Linear array was performed on the four specimens from 489 out of the 806 women and the diagnostic performance of linear array on the four specimens for detecting CIN2(+) lesions was also calculated. Z test was used to compare the area under ROC and McNemar or χ(2) test was used to compare the sensitivity and specificity of different specimens.</p><p><b>RESULTS</b>The area under ROC of the cervix, 1/3 upper vagina, 1/3 lower vagina and self-collected samples testing by HC2 for detecting CIN2(+) lesions were 0.902, 0.793, 0.769 and 0.773, respectively (P < 0.001). Using 1 RUL/CO as the cut-point of HC2, the sensitivity of the cervix, upper vagina, lower vagina and self-collected samples were 98.0%, 91.8%, 83.7% and 81.6%. Compared with the cervical specimen, the sensitivity of self-collected specimen for detecting CIN2(+) lesions was significantly lower (P = 0.008). Lowering the cutoff value for HC2 test could improve the sensitivity of self-collected specimen, but it significantly compromised the specificity. The sensitivity of self-collected specimen tested by linear array for detecting CIN2(+) lesions was 95.7% and it was not significantly different compared with the sensitivity of cervical specimen (97.9%) tested by HC2.</p><p><b>CONCLUSIONS</b>The performance of self-collected specimen tested by HC2 for detecting CIN2(+) lesions is lower than that of physician-collected cervical specimen, and lowering the cutoff value can't improve its diagnostic performance. Using linear array as the HPV DNA test can significantly improve the screening diagnostic performance of self-collected specimens.</p>

Implication of inverse-probability weighting method in the evaluation of diagnostic test with verification bias / 中华流行病学杂志

To evaluate and adjust the verification bias existed in the screening or diagnostic tests.Inverse-probability weighting method was used to adjust the sensitivity and specificity of the diagnostic tests,with an example of cervical cancer screening used to introduce the Compare Tests package in R software which could be implemented.Sensitivity and specificity calculated from the traditional method and maximum likelihood estimation method were compared to the results from Inverse-probability weighting method in the random-sampled example.The true sensitivity and specificity of the HPV self-sampling test were 83.53％ (95％CI:74.23-89.93) and 85.86％ (95％ CI:84.23-87.36).In the analysis of data with randomly missing verification by gold standard,the sensitivity and specificity calculated by traditional method were 90.48％ (95％CI:80.74-95.56) and 71.96％ (95％CI:68.71-75.00),respectively.Thc adjusted sensitivity and specificity under the use of Inverse-probability weighting method were 82.25％ (95％ CI:63.11-92.62) and 85.80％ (95％ CI:85.09-86.47),respectively,whereas they were 80.13 ％ (95％ CI:66.81-93.46) and 85.80％ (95％ CI:84.20-87.41) under the maximum likelihood estimation method.The inverse-probability weighting method could effectively adjust the scnsitivity and specificity of a diagnostic test when verification bias existed,especially when complex sampling appeared.