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ObjectiveTo investigate the epidemiological traits and potential years of life lost associated with lung cancer mortality among inhabitants of Shanghai's Pudong New Area from 1995 to 2021， in order to serve as a reference for developing intervention approaches. MethodsThe death surveillance system was used to gather statistics on lung cancer deaths. Crude mortality rate （CMR）， standardized mortality rate （SMR）， potential years of life lost （PYLL）， average years of life lost （AYLL）， annual percent change （APC） of the lung cancer deaths were analyzed. The impact of age-structural and non-age-structural factors on changes in lung cancer mortality was quantified using difference decomposition. ResultsThe CMR and SMR of lung cancer among residents in Pudong New Area between 1995 and 2021 were 58.21/105 and 26.75/105， respectively. The CMR of lung cancer increased over the years （APC=1.91%， 95%CI=1.60%‒2.30%； Z=11.487， P<0.001）， and the SMR of lung cancer declined over the years （APC=-1.50%， 95%CI=-1.80%‒-1.20%； Z=-9.006， P<0.001）. Age structure factors and gender factors contributed to the increase of lung cancer mortality， while non-population age structure factors overall appeared to play a protective role which might be related to the improvements in factors such as tobacco control and environmental management. The PYLL of lung cancer was 160 296 person years， the PYLL rate was 2.24‰， and the AYLL was 3.86 years per person. ConclusionAge structure factors are a significant contributor to the disease burden and result in the increase in the crude lung cancer mortality rate of Pudong residents of shanghai. Comprehensive monitoring， preventive， and control methods should be implemented.
ABSTRACT
Objective@#To describe the mortality trend of major malignant tumors in Shandong province, from 1970 to 2013.@*Methods@#Data related to cancer mortality were obtained from the Shandong Death Registration System and three nationwide retrospective cause-of-death surveys. Trends of overall mortality and major causes of death were described using the indicators as: mortality rates and age-standardized mortality rates, through comparing the three large-scale mortality surveys in Shandong province. Difference decomposing method was applied to estimate the contribution of demographic and non-demographic factors for the change of mortality.@*Results@#From 1970 to 2013, the crude mortality rate of malignant tumors in Shandong was increasing. The age standard mortality rate was increasing and then decreasing. The composition of cancer deaths in the all-cause-deaths was seen increasing and then decreasing as well. Both demographic and non-demographic factors contributed to the increase of crude cancer mortality rate. With the gradual increase of the proportion of population, its role exceeded the non-demographic factors. The age-standardized mortality rate of malignant tumors in 2011-2013 was lower than that in 2004-2005. Lung cancer mortality rose from the fifth to the first place, with an increase of 6.81 times from 1970-1974 to 2011-2013. Ranking of gastric cancer mortality dropped from first to the third place, with esophageal cancer dropped from second to the fourth. After adjusted by China’s standard population in 1964, the mortality rate of lung cancer was still rapidly increasing, but the age-standardized mortality rates of esophageal cancer was gradually decreasing. The crude and age-standardized mortality rates of cervical cancer showed a rapid downward trend, reduced 87.00% and 93.00% respectively from 1970-1974 to 2011-2013.@*Conclusions@#Malignant tumors were still major threats to the residents of Shandong province. The changing trend of different malignant tumors presented an inconsistent nature which called for different intervention strategies be carried out, accordingly.
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Objective To explore the mortality trends of cerebrovascular diseases and to quantitatively estimate the influence of population factors on cerebrovascular disease mortality between 1993 to 2016 in Kunshan city, Jiangsu province. Methods Records of cerebrovascular disease deaths were obtained from a register of all causes of death. Crude death rate and age standardized rate (ASR) were calculated, and annual percentage change (APC) based on sex and age were estimated. Difference decomposition was used to estimate the contribution of demographic and non?demographic factors to the change in cerebrovascular disease mortality. Results Between 1993 and 2013, the ASR of cerebrovascular diseases declined significantly for both sexes (APC=-4.9%, 95% CI:-5.5% to-4.3%), males alone (APC=-4.8%, 95% CI:-5.5% to-4.1%), and females alone (APC=-5.5%, 95% CI:-5.7% to-4.3%). However, from the year 2013 to 2016, the ASR of cerebrovascular diseases increased for both sexes together (APC=7.5%, 95% CI: 3.8% to 11.2%) and men alone (APC=10.2%, 95% CI: 4.3% to 16.1%), but there was no significant change for women (APC=4.3%, 95% CI:-1.2% to 9.8%). The overall decrease in mortality due to cerebrovascular disease was mainly due to non?demographic changes; the proportions of its contribution in men, women, and both sexes were 238.78%, 241.09%, and 245.89%, respectively. Conclusion The mortality due to cerebrovascular disease decreased substantially in the past two decades, and this decline was hindered by some demographic factors. It is imperative to explore the causes of this decline to decrease the burden caused by cerebrovascular disease.
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Objective To explore the temporal trend of cancer death rates in different age and the influencing factors in Kunshan,Jiangsu province,1981 to 2015.Methods Data were derived from cancer rcgistry and vital registration system.The Chinese age structure in 2000 was used to calculate age-standardized death rates (ASR),and annual percentage changes (APC) and 95％ confidence interval (Cl) were used to estimate the temporal trend of cancer death rates.Difference decomposition method was applied to analyze the contribution of demographic and non-demographic factors for the change of cancer mortality.Results Between 1981 and 2015,the age standardized all cancers death rate decreased from 162.49 to 93.74 per 100,000 (APC=-l.6％,95％ CI:-1.8％--1.5％).However,the ASR for those aged 70 years or above was stable over time (APC=0.2％,95％ CI:-0.2％-0.5％),whereas aged 30-69 years was decreased from 240.01 in 1981 to 93.28 in 2015 (APC=-2.8％,95％ CI:-3.0％--2.6％).In addition,the proportion of leading cancers were changed obviously.The proportion of lung cancer increased from 1981 to 2015,while gastric cancer,liver cancer,esophageal cancer and colorectal cancer decreased.Compared with the crude cancer mortality in 1993,the effect of the demographic and non-demographic factors to the increased death rate in 2015 were 308.93％ and-208.93％,respectively.Conclusion The ASR death rate of all cancers was decreasing,and the rate in those aged 30 to 69 years decreased significantly,whereas stable in those aged 70 years or above.The effect of demographic characteristics on cancer mortality was significantly greater than that of non-demographic characteristics.