摘要
Objective:To summarize the trend of disease burden of esophageal cancer in 4 countries with high incidence of esophageal cancer and analyse the proportion of death attribution of three common risk factors, which helps to provide reference for the prevention and control of esophageal cancer.Methods:Based on the 2019 Global Burden of Disease Study (GBD2019) database and visualization platform, the absolute number and age-standardized rates of incidence, mortality and disability adjusted life years (DALY) of esophageal cancer in 4 countries with high incidence of esophageal cancer (China, Iran, Russia and South Africa) from 1990 to 2019 were described. The Joinpoint regression model was used for time trend analysis, and the annual percentage change (APC) and average annual percentage change (AAPC) of age-standardized incidence, age-standardized mortality, and age-standardized DALY rate of esophageal cancer were calculated. The proportion of death attribution of three common risk factors (smoking, alcohol consumption and low fruit intake) in 2019 was compared, and the differences in the population attributable fraction (PAF) for risk factors globally and in 4 countries were analyzed. The incidence and mortality of esophageal cancer under different socio-demographic index (SDI) were analyzed by drawing fitting curves.Results:From 1990 to 2019, the age-standardized incidence, mortality and DALY rates of esophageal cancer showed an overall decreasing trend globally and in 4 countries with high incidence of esophageal cancer. The age-standardized incidence rate of esophageal cancer in China decreased from 21.0/100 000 to 13.9/100 000 (AAPC = -1.4%, 95% CI -1.3% - -1.1%), the age-standardized mortality rate decreased from 22.1/100 000 to 13.1/100 000 (AAPC = -1.8%, 95% CI -1.9% - -1.7%), and the age-standardized DALY rate decreased from 507.0/100 000 to 227.5/100 000 (AAPC = -2.1%, 95% CI -2.2% - -1.9%). These rates in China had been decreasing at a much faster rate than the other 3 countries. Both Chinese men and Russian men had higher rates of esophageal cancer deaths due to smoking and alcohol consumption than the global average (PAF smoking: 59.2%, 56.7% vs. 51.2%; PAF alcohol consumption: 29.7%, 38.3% vs. 28.4%). The proportion of alcohol-related esophageal cancer deaths in Russian women was higher than the global average for women (PAF: 14.9% vs. 7.3%). Attributing low fruit intake to esophageal cancer deaths in South African men and women were higher than the global average for men and women (PAF men: 20.8% vs. 9.8%; PAF women: 21.3% vs. 11.7%). The age-standardized incidence and mortality rates in China and South Africa were consistently higher than would be expected for the same level of SDI, while those in Iran were consistently lower than would be expected, and Russia was broadly in line with expectation. Conclusions:Although the disease burden of countries with high incidence of esophageal cancer in the world has been effectively controlled, the disease burden of esophageal cancer in China is still higher than that in other countries. Targeted prevention measures should be made according to the epidemiological characteristics of esophageal cancer in Chinese population.
摘要
Esophageal cancer (EC) is one of the most fatal cancers worldwide. According to GLOBOCAN 2020, it was estimated that there were 600, 000 new EC cases and 540 000 EC deaths, while nearly half of all newly diagnosed cases of EC and associated deaths worldwide occurred in China. The annual incidence and mortality of EC have been reduced in the last 20 years in China. However, the early symptoms and signs of EC are not easily distinguished and the disease tends to be within the middle and late stage of pathogenesis when identified, leading to its low 5-year survival rate. Therefore, it could help effectively reduce the burden of EC by clarifying its etiology and risk factors, as well as taking preventive and early diagnosis measures. This article reviews the epidemiology, etiology, screening and early diagnosis of EC in China, to provide systematic references for EC prevention and control.
摘要
Pancreatic cancer (PC) is one of most fatal cancers worldwide. According to the 2020 cancer registry data, PC was the 12th common cancer and the 7th leading cause of cancer deaths globally. PC is a rare cancer, but the 5-year survival is very low because of its rapid progress and poor prognosis. The disease burden of PC in China is quite different from western countries, indicating that the distribution of genetic factors, lifestyle and environmental factors varies from different regions. This article reviews the epidemiology, etiology and screening of PC in China, to provide systematic references for PC prevention and control.
摘要
Objective:To investigate the long-term risk of esophageal cancer from fresh fruit consumption. Methods:In 1985, a total of 29,479 participants aged between 40 and 69 years old were recruited for this study. Demographic characteristics, lifestyle, history of diseases, and food intake frequency were surveyed at the baseline and were then followed up. Through December 31, 2015, a median of 31.79 years of observation was obtained. The primary endpoint was death from esophageal cancer. The hazard ratio and 95%confi-dence intervals for fresh fruit consumption were calculated using a Cox proportional hazard model. Results:Overall, 31.09%of partici-pants reported consuming fresh fruit more than once every week. Compared with participants who never or rarely consumed fresh fruit, those who consumed fresh fruit more than once a week had a lower long-term risk of esophageal cancer. Death rate decreased to 7%among those who ate fresh fruit more than once a week, especially among males (11%) and those with positive smoking history (13%). Conclusion:Fresh fruit consumption is associated with a lower risk of death from esophageal cancer, but the etiological mecha-nism needs to be investigated further.
摘要
BACKGROUND: Linxian County of China is one of the areas with the highest incidence of esophageal cancer and gastric cardia cancer in the world, and nutrition-deficiency is widely existing in local people. In recent years, many researches around the world revealed that the cause of Parkinson disease (PD) is related to factors of gene, age, environment, diet, nutrition and smoking. More and more studies confirmed that primary hypertension may be in relation to vascular Parkinsonism (VP) and long-term hypertension was apt to VP.OBJECTIVE: To investigate the relationship between hypertension and clinical probable Parkinson disease (PPD) in nutrition-deficient population of Linxian County and provide a theoretical basis for early prevention and treatment of PD.DESIGN: Cross-sectional study.PARTICIPANTS: A total of 4 335 subjects aged over 55 years were selected. These subjects have taken part in the nutritional intervention study of Linxian County and first entered in the cohort study in 1985. They were enrolled in the nutritional intervention study in Linxian County in 1985.METHODS: A prospective cohort study was conducted. ①Case screening: PD questionnaire (used in American Gebai County) combined with general neurological examination were adopted. ②The diagnosis of PD: Clinical diagnostic criteria of UK Parkinson Disease Society Brain Bank were taken as the criteria for screening PD. Further evaluations were undertaken for clinical PPD and clinical possible PD on subjects who had PD symptoms.The diagnostic criteria of clinical PPD: Subjects were diagnosed as having clinical PPD if they presented any two of the following two cardinal features (resting tremor, hypermyotonia, bradykinesia and impairment of postural reflexes) or presented any one of the following features (resting tremor, hypermyotonia and bradykinesia). Diagnostic criteria of clinical possible PD: Subjects were diagnosed as having clinical possible PD when presented any one of the following four cardinal features (resting tremor, hypermyotonia, bradykinesia, and impairment of postural reflexes).③Definition of hypertension: Hypertension was defined as the systolic blood pressure (SBP) ≥ 140 mm Hg or the diastolic blood pressure (DBP) ≥ 90 mm Hg. Data were processed with linear trend test and nonconditional logistic regression.MAIN OUTCOME MEASURES: Status of final diagnoses on patients and relationship between hypertension and clinical PPD.RESULTS: A total of 4 335 subjects including 2 008 males (46.32%)and 2 327 females (53.68%) participated in the screening of PD.①Results of final diagnosis on patients: Among all the 4 459 survival participants,46 subjects were diagnosed as having PD, 118 as having clinical PPD and 78 as having clinical possible PD. After excluding patients with PD or clinical possible PD, only 118 patients were diagnosed as having clinical PPD. These patients and 4 217 normal controls were analyzed and a total of 2 035 patients had hypertension. ②There were statistical correlation between hypertension and clinical PPD, RR was 1.648 (1.147-2.638), which was 1.668 (1.145-2.432) after being adjusted by possible confounding factors including age, gender, smoking, drinking and so on, the association mentioned above still existed (χ2=7.463,P=0.006). Analysis of gender showed statistically significant differences between female patients with hypertension and clinical PPD(χ2=9.669 P=0.002), and RR before adjust ment was 2.347 (1.347-4.091), which was 2.346 (1.327-4.150) after being adjusted and correlation still existed. While there were no statistical corre lations between male patients with hypertension and clinical PPD (χ2 =0.697 ,P=0.404)but there was also an ascending trend in RR value. ③ With the blood pressure increasing, the RR value correspondingly in creased with the linear trend test (χ2=11.325 ,P=0.003). And there was sta tistical significance in raw and adjusted RR value of hypertension with the BP ≥ 140/90 mm Hg. Respective statistics of SBP and DBP showed a dose-response relationship between SBP and clinical PPD; When the SBP ≥ 140 mm Hg, there were statistical significances in values of raw RR or adjusted RR of hypertension (χ2=8.007 ,P=0.018). While there were no sta tistical significances in RR values before and after adjustment of DBP (χ2 =2.569,P=0.227). CONCLUSION: Hypertension is one of the risk factors of clinical PPD in female residents older than 55 and the incidence of getting clinical PPD is increased with the heightening of BP.
摘要
<p><b>OBJECTIVE</b>To investigate the relationship between angiotensin I converting enzyme gene insertion/deletion polymorphism and Alzheimer disease (AD), as well as the effect of hypertension on the relationship.</p><p><b>METHODS</b>This case-control study, included 96 AD patients meeting the DSM-IV diagnosis, and 96 subjects as controls coming from the same area and in the same environmental condition. Using the polymerase chain reaction (PCR) amplified the DNA segments, and the PCR products were identified by 2% agarose gel and visualized by ethidium bromide staining.</p><p><b>RESULTS</b>There was significant difference between AD patients and controls in ACE genotypes and alleles distribution, as well as between AD patients with high blood pressure and controls with high blood pressure. But between normotensive AD patients and normotensive controls, there was no significant difference in ACE genotypes distribution (P>0.05).</p><p><b>CONCLUSION</b>ACE genotypes associated with the risk of AD, but II genotype as risk genetic factor only restricted in subjects with high blood pressure.</p>