Spatio-temporal trend of female breast cancer mortality in Shandong Province from 1970 to 2013 / 中华预防医学杂志

The mortality of female breast cancer in Shandong Province has increased since the 1970. The differential decomposition analysis found that the slight decline in the crude mortality of breast cancer among women was entirely due to non-demographic factors during the 1970-1990, and the significant increase in the crude mortality was due to a combination of demographic and non-demographic factors since the 1990. The contribution rate of demographic factor has gradually increased from 53.5% in 2004-2005 to 59.5% in 2011-2013, while that of non-demographic factor has decreased from 46.5% to 40.5%. The women aged 45-64 years old were the major population of female breast cancer deaths, accounting for 40%-60% of total breast cancer deaths in different times, and then the mortality in female aged 55-64 years old increased rapidly, with increases of 52.12%, 115.19% and 29.01% in 2011-2013 over the 1970-1974, 1990-1992 and 2004-2005, respectively (Z=-7.342,P<0.001). Compared with 1970-1974, the age-standardized mortality rate of rural women increased by 41.86% in 2011-2013 (Z=-17.933, P<0.001), and that of urban women increased by 18.62% in 2011-2013 (Z=-25.642, P<0.001). The age-standardized mortality rate of breast cancer in urban women was higher than that in rural women in different times (all P<0.05). The spatial scan analysis found that eastern Shandong Province was found to be a sustained high-risk area for death, and other high-risk areas were transferred from north to southwest of Shandong between 1970 and 2013.

Inaccuracy of Self-reported Low Sodium Diet among Chinese: Findings from Baseline Survey for Shandong & Ministry of Health Action on Salt and Hypertension (SMASH) Project / 生物医学与环境科学（英文）

This study was aimed to evaluate the agreement between the self-reported sodium intake level and 24-h urine sodium excretion level in Chinese. The 24-h urine collection was conducted among 2112 adults aged 18-69 years randomly selected in Shandong Province, China. The subjects were asked whether their sodium intake was low, moderate, or high. The weighted kappa statistics was calculated to assess the agreement between 24-h urine sodium excretion level and self-reported sodium intake level. One third of the subjects reported low sodium intake level. About 70% of the subjects had mean 24-h sodium excretion>9 g/d, but reported low or moderate sodium intake. The agreement between self-reported sodium intake level and 24-h urine sodium excretion level was low in both normotensive subjects and hypertensive subjects. These findings suggested that many subjects who reported low sodium intake had actual urine sodium excretion>9 g/d. Sodium intake is often underestimated in both hypertensive and normotensive participants in China.

Dietary sodium intake and its impact factors in adults of Shandong province / 生物医学与环境科学（英文）

Dietary sodium intake and its impact factors in 2 140 adults aged 18-69 years were analyzed. The mean daily sodium intake was 5745.0 (5427.6-6062.5) mg per day, which was higher in males than in females (P<0.01). After having been adjusted for gender, age and urban/city areas, the mean daily sodium intake was significantly higher in participants with a lower education level, drinkers and smokers than in those with a higher education level, nondrinkers and nonsmokers (P<0.01). The dietary sodium intake in adults of Shandong Province is higher than the recommended standards.

The status of awareness, treatment and control of hypertension in adult population in Shandong province in 2011 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To identify the status of awareness, treatment and control of hypertension in adult population in Shandong province in China.</p><p><b>METHODS</b>A total of 15 350 representative subjects aged 18 to 69 in Shandong province were selected with multistage stratified and clustered sampling design. Questionnaire investigation and physical examination including measurement of blood pressure, height and weight, were taken for all of them. The prevalence was estimated by weighted SURVEYFREQ model.</p><p><b>RESULTS</b>In Shandong province, 34.5% of the hypertensive patients were aware of their high blood pressure (31.1% in male, 38.5% in female), 27.5% of them were taking antihypertensive medications (24.1% in male, 31.7% in female), and 14.9% of them (13.7% in male, 16.4% in female) were under control for their blood pressure (<140/90 mm Hg).</p><p><b>CONCLUSION</b>The rates of awareness, treatment and control of hypertension in adult hypertensive population in Shandong province, China were low, and it is urgently needed to take steps for intervention and control for hypertension prevention, particularly in rural areas.</p>

Evaluation on the effectiveness of community intervention on hypertension related knowledge in mid-western rural area of Shandong province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the intervention effect of health education on hypertension knowledge in mid-western rural area of Shandong province.</p><p><b>METHODS</b>A project was launched on chronic disease control in mid-western rural area of Shandong province from 2007 to 2010. The baseline survey was performed using multi-stage random sampling method in 8 counties of mid-western rural area of Shandong province in April, 2007. A total of 20 087 participants aged 25 and above were recruited in the survey to study the relationship between awareness of hypertension and diet, smoking, obesity. Health education focusing on balance diet, physical activity promotion and tobacco control was performed among intervention population. The final evaluation survey using same questionnaire was performed in 2010, classified in intervention (4071 participants) and control (2145 participants) group. Control group was selected from non-intervention town in same county. Intervention and control group shared the same baseline data in 2007 for evaluation. By comparing the changes of hypertension knowledge before and after intervention, the intervention effect was evaluated.</p><p><b>RESULTS</b>Awareness of the relationship between hypertension and diet rose from 34.0% (6830/20 087) at baseline in 2007 to 69.3% (2821/4071) (χ(2) = 1757.30, P < 0.01) of intervention group and 44.8% (961/2145) (χ(2) = 99.30, P < 0.01) of control group in 2010. Awareness of hypertension associated to smoking rose from 25.6% (5142/20 087) at baseline in 2007 to 55.2% (2247/4071) (χ(2) = 1396.59, P < 0.01) in intervention group, 30.9% (662/2145) (χ(2) = 27.83, P < 0.01) in control group in 2010. Awareness of hypertension related to obesity rose from 37.2% (7472/20 087) of the baseline in 2007 to 68.3% (2780/4071) (χ(2) = 1339.27, P < 0.01) in intervention group, 45.1% (967/2145) (χ(2) = 51.14, P < 0.01) in control group in 2010.</p><p><b>CONCLUSION</b>Community comprehensive intervention showed significant effects on hypertension related knowledge improvement in mid-western rural area of Shandong province.</p>

Changes of mortality and causes of death from 1970 to 2005 and decomposition analysis in Shandong province / 中华流行病学杂志

Objective To describe the trend of overall mortality and major causes of death in Shandong population from 1970 to 2005,and to quantitatively estimate the influential factors.Methods Trends of overall mortality and major causes of death were described using indicators such as mortality rates and age-adjusted death rates by comparing three large-scale mortality surveys in Shandong province.Difference decomposing method was applied to estimate the contribution of demographic and nondemographic factors for the change of mortality.Results The total mortality had had a slight change since 1970s,but had increased since 1990s.However,both the mortality rates of age-adjusted and age-specific decreased significantly.The mortality of Group Ⅰ diseases including infectious diseases as well maternal and perinatal diseases decreased drastically.By contrast,the mortality of non-communicable chronic diseases (NCDs)including cardiovascular diseases(CVDs),cancer and injuries increased.The sustentation of recent overall mortality was caused by the interaction of demographic and non-demographic factors which worked oppositely.Non-demographic factors were responsible for the decrease of Group Ⅰ disease and the increase of injuries.With respect to the increase of NCDs as a whole.demographic factors might take the full responsibility and the non-demographic factors were the opposite force to reduce the mortality.Nevertheless,for the increase of some leading NCD diseases as CVDs and cancer,the increase was mainly due to non-demographic rather than demographic factors.Conclusion Through the interaction of the aggravation of ageing population and the enhancement of non-demographic effect,the overall mortality in Shandong would maintain a balance or slightly rise in the coming years.Group Ⅰ diseases in Shandong had been effectively under control.Strategies focusing on disease control and prevention should be transferred to chronic diseases,especially leading NCDs,such as CVDs and cancer.

Estimation of disability weights on malignant neoplasms in Shandong province / 中华流行病学杂志

Objective To determine stage-specific and average disability weights (DWs) of malignant neoplasm and provide support and evidence for study on burden of cancer and policy development in Shandong province. Methods Health status of each cancer patient identified during the cancer prevalence survey in Shandong, 2007 was investigated. In line with the GBD methodology in estimating DWs, the disability extent of every case was classified and evaluated according to the Six-class Disability Classification version and then the stage-specific weights and average DWs with their 95 % confidence intervals were calculated, using SAS software. Results A total of 11 757 cancer cases were investigated and evaluated. DWs of specific stage of therapy, remission, metastasis and terminal of all cancers were 0.310, 0.218, 0.450 and 0.653 respectively. The average DW of all cancers was 0.317(95 % CI:0.312-0.321). Weights of different stage and different cancer varied significantly, while no significant differences were found between males and females. DWs were found higher (>0.4) for liver cancer, bone cancer, lymphoma and pancreas cancer. Lower DWs (<0.3) were found for breast cancer, cervix uteri, corpus uteri, ovarian cancer, larynx cancer, mouth and oropharynx cancer. Conclusion Stage-specific and average DWs for various cancers were estimated based on a large sample size survey. The average DWs of 0.317 for all cancers indicated that 1/3 healthy year lost for each survived life year of them. The difference of DWs between different cancer and stage provide scientific evidence for cancer prevention strategy development.

Estimation on the mortality and disease burden attributed to selected risk factors in Shandong province / 中华流行病学杂志

Objective To determine the major health related risk factors and provide evidence for policy-making,using health burden analysis on selected factors among general population from Shandong province.Methods Based on data derived from the Third Death of Cause Sampling Survey in Shandong. Years of life lcrat(YLLs),yearS Iived with disability(YLDs)and disability-adjusted life years(DALYs) were calculated according to the GBD ethodology.Deaths and DALYs attributed to the selected risk factors were than estimated together with the PAF data from GBD 2001 study.The indirect method was employed to estimate the YLDs.Results 5i.09%of the total dearlls and 31.83%of the total DALYs from the Shandong population were resulted from the 19 selected risk factors.High blood pre.ure,smoking,low fruit and vegetable intake,aleohol consumption,indoor smoke from solid fuels,high cholesterol,urban air pollution,physical inactivity,overweight and obesity and unsafe injections in health care settings were identified as the top 10 risk faetors for mortality which together caused 50.21%of the total deaths.Alcohol use,smoking,high blood pressure,Low fruit and vegetable intake,indoor smokc from solid fuels,overweight and obesity,high cholesterol,physical inactivity,urban air pollution and iron-deficiency anemia were proved as the top 10 risk factors related to disease burden and were responsible for 29.04%of the total DALYs.Conclusion Alcohol use.smoking and high blood pressure were determined as the major risk factors which influencing the health of residents in Shandong.The mortality and burden of disease could be reduced significantly if these major factors were effectively under control.

Study on Dietary Pattern and Nutrition Status among Rural Residents in Midwestern Rural Area of Shandong Province / 中国慢性病预防与控制

Objective To determine the dietary nutritional status of rural residents in Midwestern Shandong Province,in order to improve the dietary pattern and health status of them.Method 11 987 residents,from 10 273 households,were included in this study by multi-stage randomized cluster sampling in 8 counties located in Midwestern Shandong Province.Questionnaire of Food Frequency (QFF) was applied to collect the information about the amount and frequency of food consumed by the subjects in the past year.Results The average intake of cereal,vegetable,fruit,meat,egg,milk,bean,oil and salt per reference man per day was 553.9 g,310.6 g,58.2 g, 36.3 g,50.1 g,16.7 g,34.4 g,44.8 g and 12.3 g,respectively.The average intake of energy,carbohydrate,protein,fat and dietary fiber per reference man per day was 12 095.6 kJ,451.8 g,85.6 g,78.8 g and 18.7 g as well Cereal food provides 66.1% of total energy; however,the meat provides only 6.6% of that.Carbohydrate,protein and fat amount to around 63.2%,12.0% and 24.8% of total energy, respectively.24.0% of fat intake was from animal food,while 76% of that was from vegetable food.Conclusions The intake of energy, protein,fat was sufficient for these subjects;however,the intake of vegetable,fruit,bean and meat was lower than the dietary reference intake.Moreover,oil and salt intake in these subjects was much higher than Chinese Recommended Nutrient Intakes.Thus,the amelioration of dietary pattern in rural residents will be an important task for nutrition workers in rural area of Midwestern part of Shandong Province in the future.