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Objective:To obtain the temporal and spatial trends on prostate cancer mortality in China from 2004 to 2018. Methods:The data of prostate cancer mortality was collected from 605 national disease surveillance sites and age-standardized according to the demographic structure of China in 2000. The crude mortality rate （CMR） and age-standardized mortality rate （ASMR）， and the ratio of ASMRs of rural to urban areas（RR）， were calculated to analyze the distributions of the mortality of prostate cancer stratified by age， sex， region （rural/urban areas， eastern/central/western areas） or time. Results:The temporal trend on the CMR of prostate cancer from 2004 to 2018 increased significantly （APC=5.23%，P<0.001）， whereas the trend on the ASMR did not change （APC=0.65%，P=0.336）. The ASMR of urban areas was higher than that of rural areas（P<0.05）. The temporal trend on the ASMR of urban or rural did not change（P>0.05）. The same trend was detected for the RR value （P>0.05）. The ASMR of eastern urban areas was higher than that of the central or the western urban areas. The ASMR of eastern rural areas was higher than that of central and western areas. In the eastern areas， both the temporal trends for the ASMRs of the urban and the rural increased （The urban： APC=1.6%， P=0.015； the rural： APC=1.02%， P=0.013）. However， the RR values for the East， the Center or the West did not change. The ASMR of the people over 60 years old was higher than that of the people under 60 years old. However， the temporal trends on the ASMRs of the group under 60 years old or the group over 60 years did not change （P>0.05）. The ASMR of the people under 60 years old in 2018 was significantly lower than that in 2004（P=0.004）. Conclusion:A significant correlation exists between the death of prostate cancer and age. The mortality of prostate cancer in urban is higher than that in rural. The current screening strategy for prostate cancer has a limited impact on the prognosis of prostate cancer patients in China. Stratified refinement of prostate cancer screening strategies for people aged over 60 years in urban areas and the causal prophylaxis of prostate cancer are priorities for future prostate cancer prevention and control.
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Objective:To analyze the trend of mortality from lung cancer in urban and rural areas of Chinese mainland from 2004 to 2018. Methods:Cancer cases from 2004 to 2018 coded as C33-C34 according to the International Classification of Diseases-10th Revision （ICD-10） were collected from the Chinese national mortality surveillance system. The crude mortality rate （CMR）， age-standardized mortality （ASMR） and annual percentage change （APC） were calculated to analyze the mortality trend of lung cancer in rural and urban areas. Results:From 2004 to 2018， the CMR of lung cancer was 41.11/105， and the ASMR was 27.91/105， with no significant tendency of upward or downward. The CMR of lung cancer in urban areas was 46.03/105， and the ASMR was 30.33/105， with an APC of -0.82%. The CMR of lung cancer in rural areas was 38.54/105， and the ASMR was 26.66/105， with an APC of 1.73%. The difference between urban and rural CMR was significant. The CMR of lung cancer in urban eastern， central and western areas were 50.27/105， 44.59/105 and 40.64/105， respectively. The APC of eastern and central urban areas were -1.05% and -1.08%， respectively. The CMR of lung cancer in rural eastern， central and western areas were 45.82/105， 38.26/105 and 28.90/105， respectively， with an increasing trend. The CMR of lung cancer was significantly different between urban and rural areas of eastern， central and western areas of China. The CMR of lung cancer in urban males and females were 63.17/105 and 28.42/105， respectively. The CMR of lung cancer in rural males and females were 52.83/105 and 23.62/105， respectively. The ASMR of lung cancer in rural men and women increased by 1.18% and 1.09%， respectively. The ASMR of lung cancer in urban men and women decreased by 0.61% and 1.35%， respectively. The CMR of lung cancer between males and females in urban and rural was significantly different. The CMR rate of lung cancer increased with age， with the peak in the age group above 60 years old. The ASMR rate of lung cancer showed a decreasing trend in the group under 60 years old in both urban and rural areas. While in rural areas， the ASMR of lung cancer showed an increasing trend in the group over 60 years old. There were significant variations in lung cancer CMR between rural and urban areas in groups aged 0-19， 40-59， and over 60 years. Conclusion:The CMR of lung cancer in China is different between urban and rural areas from 2004 to 2018， which may be affected by smoking， ageing， industrialization and gender. Identifying high-risk populations， especially those in rural areas and providing early intervention can help to reduce the mortality rate of lung cancer.
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Objective:To analyze bladder cancer mortality in China from 2004 to 2018. Methods:The dataset of bladder cancer mortality from 2004 to 2018， based on 605 national surveillance sites and regularly published by the Chinese Center for Disease Control and Prevention， was collected and age-standardized according to the demographic structure of China in 2000. The crude mortality rate （CMR）， the age-standard mortality rate （ASMR）， and the ratio of ASMRs of rural to urban areas（RR）were calculated to analyze the distributions of the mortality of bladder cancer stratified by age， sex， region （rural/urban areas， eastern/central/western areas） or time. Results:The CMR of bladder cancer in China from 2004 to 2018 was 1.69/105， and the ASMR was 1.09/105. The temporal trend on the CMR of bladder cancer from 2004 to 2018 increased significantly （APC=2.91%，P<0.001）， whereas the trend on the ASMR decreased a little （APC=-1.29，P=0.008）. The temporal trend on the CMR of bladder cancer in the males increased （APC=3.29%，P<0.001）， whereas the trend on the ASMR did not change. The temporal trend on the CMR of bladder cancer in the female increased （APC=2.12%，P<0.001）， whereas the trend on the ASMR decreased （APC=-1.94，P=0.008）. Both the CMR and ASMR of urban areas were higher than those of rural areas （P<0.05）. However， the temporal trend on the ASMR of bladder cancer in the urban decreased significantly （APC=-2.05%，P=0.002）， mainly exhibited in eastern and western urban. The ASMR of eastern urban areas was higher than that of western urban areas. The temporal trend on the ASMR of bladder cancer in the rural did not change （P>0.05）， and no differences in the ASMR were detected between eastern， central and western rural areas. The gaps between rural and urban areas in the eastern （P<0.001） or western （P=0.002） region reduced. Although the temporal trend on the ASMR in urban people over 40 years old decreased significantly， the ASMR of urban people over 60 years old was much higher than that of other age groups in the urban or any age groups in rural areas. Conclusion:The age group over 60 years old in the urban is the major target population for bladder cancer prevention and treatment. Screening， diagnosis and treatment for bladder cancer in rural should be strengthened.
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Objective:To determine the mortality and changing trend of primary liver cancer by using the death data of Chinese mainland from 2004 to 2018. Methods:The death certificate data was collected from China National Mortality Surveillance System from 2004 to 2018. The crude mortality rate（CMR）and age-standardized mortality rate（ASMR）of primary liver cancer in different ages， regions and living environments were calculated by Joinpoint regression model to analyze the basic situation and mortality trend. Results:From 2004 to 2018， there were 556 241 primary liver cancer deaths in China， with a CMR of 25.18/105 and an ASMR of 17.98/105. It suggested that the mortality of primary liver cancer was on a decreasing trend. During the 15 years， the ASMR of primary liver cancer was 15.56/105 in urban areas and 19.29/105 in rural areas. In urban areas， CMR was 32.89/105 in males and 12.14/105 in females， respectively； while in rural areas， CMR was 38.39/105 in males and 14.02/105 in females， respectively. The CMR in eastern， central and western urban regions was 22.25/105， 22.66/105 and 23.50/105， respectively. The CMR in the rural areas of these three regions was 27.82/105， 26.98/105 and 23.85/105， respectively. The patients were divided into four age groups： 0-19 years old， 20-39 years old， 40-59 years old， and more than 60 years old. The CMR of four groups in urban areas was 0.14/105， 2.59/105， 24.51/105 and 91.80/105. In rural areas， the CMR of four groups was 0.17/105， 4.05/105， 32.16/105 and 103.02/105. Conclusion:From 2004 to 2018， the mortality rate of liver cancer in China has a decreasing trend. However， the primary liver cancer death burden is still serious because of the large population base， severe aging population problem， and significant urban-rural and male-female disparities in China.
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<p><b>OBJECTIVE</b>To study the operative procedures, indicatrions and short-term effects of the artificial femoral head replacement for the treatment of unstable intertrochanteric fracture in aged patients.</p><p><b>METHODS</b>From January 2001 to October 2008, 40 patients with unstable intertrochanteric fractures were treated with artificial femoral head replacement. Among the patients, 9 patients were male and 31 patients were female, ranging in age from 75 to 95 years, averaged 81.1 years. The duration from injured to the hospitalization ranged from 3 to 48 hours, with a mean of 11.5 h. According to Evans classification, 8 patients were type II , 21 type III, and 11 type IV. The duration from hospitalization to operation ranged from 4 to 8 days, averaged 4.8 day. After the operation, the hip motion was observed and the preoperative and postoperative Harris scores were compared.</p><p><b>RESULTS</b>All the patients were operated successfully, and were kept in bed about 4 to 7 days, 5.9 days in average. Thirty-one patients were followed up for 6 months without loose or dislocation of prothesis, periprosthetic fractures. Fourteen patients resumed to normal activity of the hip joint while 17 patients showed the declination of hip movement. Their hip movements recovered to (66.67+/-26.35)% at 4 months after operations and (76.08+/-25.62)% at 6 months. Among 10 patients with normal ability of hip joints before their injuries were valuated with Harris system at 6 mouths after operations, the results were:5 excellent, 3 good and 2 poor.</p><p><b>CONCLUSION</b>Artificial femoral head replacement for unstable intertrochanteric fractures in aged patients is effective in the recovery of hip joint function in short time with earlier walking and decreased complications.</p>