Mortality and years of life lost of colorectal cancer in China, 2005-2020: findings from the national mortality surveillance system.

BACKGROUND: Colorectal cancer (CRC) is the fourth cause of cancer death in China. We aimed to provide national and subnational estimates and changes of CRC premature mortality burden during 2005-2020. METHODS: Data from multi-source on the basis of the national surveillance mortality system were used to estimate mortality and years of life lost (YLL) of CRC in the Chinese population during 2005-2020. Estimates were generated and compared for 31 provincial-level administrative divisions in China. RESULTS: Estimated CRC deaths increased from 111.41 thousand in 2005 to 178.02 thousand in 2020; age-standardized mortality rate decreased from 10.01 per 100,000 in 2005 to 9.68 per 100,000 in 2020. Substantial reduction in CRC premature mortality burden, as measured by age-standardized YLL rate, was observed with a reduction of 10.20% nationwide. Marked differences were observed in the geographical patterns of provincial units, and they appeared to be obvious in areas with higher economic development. Population aging was the dominant driver which contributed to the increase in CRC deaths, followed by population growth and age-specific mortality change. CONCLUSIONS: Substantial discrepancies were observed in the premature mortality burden of CRC across China. Targeted considerations were needed to promote a healthy lifestyle, expand cost-effective CRC early screening and diagnosis, and improve medical treatment to reduce CRC mortality among high-risk populations and regions with inadequate healthcare resources.

Hypertension Prevalence, Awareness, Treatment, and Control and Their Associated Socioeconomic Factors in China: A Spatial Analysis of A National Representative Survey.

OBJECTIVE: We aimed to investigate and interpret the associations between socioeconomic factors and the prevalence, awareness, treatment, and control of hypertension at the provincial level in China. METHODS: A nationally and provincially representative sample of 179,059 adults from the China Chronic Disease and Nutrition Surveillance study in 2015-2016 was used to estimate hypertension burden. The spatial Durbin error model was fitted to investigate socioeconomic factors associated with hypertension indicators. RESULTS: Overall, it was estimated that 29.20% of the participants were hypertensive nationwide, among whom, 34.32% were aware of their condition, 27.69% had received antihypertensive treatment, and 7.81% had controlled their condition. Per capita gross domestic product (GDP) was associated with hypertension prevalence (coefficient: -2.95, 95% CI: -5.46, -0.45) and control (coefficient: 6.35, 95% CI: 1.36, 11.34) among adjacent provinces and was also associated with awareness (coefficient: 2.93, 95% CI: 1.12, 4.74) and treatment (coefficient: 2.67, 95% CI: 1.21, 4.14) in local province. Beds of internal medicine (coefficient: 2.66, 95% CI: 1.08, 4.23) was associated with control in local province. Old dependency ratio (coefficient: -3.58, 95% CI: -5.35, -1.81) was associated with treatment among adjacent provinces and with control (coefficient: -1.69, 95% CI: -2.42, -0.96) in local province. CONCLUSION: Hypertension indicators were not only directly influenced by socioeconomic factors of local area but also indirectly affected by characteristics of geographical neighbors. Population-level strategies should involve optimizing supportive socioeconomic environment by integrating clinical care and public health services to decrease hypertension burden.

Association between Selenium in Soil and Diabetes in Chinese Residents Aged 35-74 Years: Results from the 2010 National Survey of Chronic Diseases and Behavioral Risk Factors Surveillance.

OBJECTIVE: To explore the association between soil selenium levels and the risk of diabetes in Chinese adults aged 35-74 years. METHODS: Data for this study were derived from the China Chronic Diseases and Behavioral Risk Factors Surveillance 2010 survey. Selenium concentrations in soil were obtained from the Atlas of Soil Environmental Background Values in China. A two-level binary logistic regression model was used to determine the association between soil selenium concentrations and the risk of diabetes, with participants nested within districts/counties. RESULTS: A total of 69,332 participants aged 35-74 years, from 158 districts/counties were included in the analysis. Concentrations of selenium in soil varied greatly across the 158 districts/counties, with a median concentration of 0.219 mg/kg ( IQR: 0.185-0.248). The results showed that both Quartile 1 (0.119-0.185 mg/kg) and Quartile 4 (0.249-0.344 mg/kg) groups were positively associated with diabetes compared to a soil selenium concentration of 0.186-0.219 mg/kg (Quartile 2), crude odds ratios ( ORs) (95% CI) were 1.227 (1.003-1.502) and 1.280 (1.048-1.563). The P values were 0.045 and 0.013, for Quartile 1 and Quartile 4 groups, respectively. After adjusting for all confounding factors of interest, the Quartile 1 group became non-significant, and the Quartile 4 group had an adjusted OR (95% CI) of 1.203 (1.018-1.421) relative to the reference group (Quartile 2), the P values was 0.030. No significant results were seen for the Quartile 3 group (0.220-0.248 mg/kg) compared to the reference group. CONCLUSION: Excessive selenium concentrations in soil could increase the risk of diabetes among Chinese adults aged 35-74 years.

The nationwide impact of injury-related deaths on average life expectancy in China.

To expand the evidence base to inform future public policy aimed at accident prevention, we investigated the impact of different categories of injury on average life expectancy in China. We used data from the National Death Cause Registration Information System and National Maternity and Children Health Surveillance databases, as well as 2010 population data from the National Bureau of Statistics. We then calculated the average life expectancy of the Chinese population, in addition to life expectancy after eliminating injury-related mortality. The average life expectancy of the Chinese population in 2010 was 74.93 years. After eliminating deaths due to injuries, the fourth leading cause of mortality in China, average life expectancy increased by 1.36 years. When this was broken down by population sub-groups, these gains were 1.76 and 0.79 years in men and women, 0.94 and 1.56 years in urban and rural residents, and 1.11, 1.30, and 1.67 years for residents in the Eastern, Central and Western regions respectively. After eliminating all categories of injury, the average life expectancy of the Chinese population was found to increase by 1.36 years. This figure was higher for males and residents of rural areas and Western China.

[Analysis on the clustering of liver cancer mortality in Lingbi county, Anhui province, from 2005 to 2010].

OBJECTIVE: To observe the mortality and its changes on liver cancer in the past 30 years as well as to describe the spatial distribution of liver cancer deaths between 2005 and 2010 in Lingbi, Anhui province. METHODS: Using the mortality data from 1973-1975 and from 2005 to 2010 in Lingbi to compare with the relative national and historical data, to observe the trend of rapid increase on liver cancer mortality in Lingbi. Using the Poisson model, BYM model and hotspot detection method, standardized mortality ratio(SMR), relative risk(RR)value of liver cancer deaths of each village were calculated and the clustering of high liver cancer deaths was identified. RESULTS: Through an increase of 223.7% on the SMR of liver cancer in the past 30 years, the standardized mortality of liver cancer in Lingbi had an increase of 74.1 percent than the national level in 2005-2010 but it was 22.7% lower than the country level in 1973-1975. The SMR and RR values and their P values were higher in the villages which were located along the Kuisui River. Data from the clustering analysis showed that there had been significantly positive autocorrelation at the altitude of 5300 meters, and a very obvious hot spot of liver cancer deaths existing along the Kuisui River, especially at the bifurcation of the old Sui River and new Sui River was observed. CONCLUSION: There was an alarming increase of liver cancer mortality in the past 30 years in Lingbi. The high mortality area mainly covered the villages along the Kuisui River, suggesting that there were common risk factors for hepatocellular carcinoma in the population at risk.

[Association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Anhui province].

OBJECTIVE: To explore the association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Suzhou, Anhui province. METHODS: Using the disease mapping and spatial statistical analysis techniques,we described the spatial distributions of the mortality rate of hepatic carcinoma from 2005 to 2010 in Lingbi county. Taking the distance between villages and polluted rivers as proxy variable of environmental exposure, mortality rate of hepatic carcinoma in each village as dependant variable, and using the Glimmix model and Bayesian spatial model (BYM) to undertake the univariate and multivariate analysis, we investigatived the association between mortality rate of hepatic carcinoma and the water pollution of Suihe River in Lingbi county. RESULTS: Obvious clustering of high mortality rate of hepatic carcinoma along the polluted river was observed in Lingbi county. Results of Glimmix model showed that whether spatial autocorrelation was considered or not, closer to the polluted river has higher mortality rate of hepatic carcinoma. Results of univariate analysis of the BYM model showed that, compared with the villages far from the polluted river more than 12 km (the mortality rate of hepatic carcinoma was 33.12/100 000(1068/3 224 562) ), the RR values of the hepatic carcinoma mortality was 1.38(95%CI:1.06-1.82) for the villages apart from the polluted river within 6 km (the mortality rate of hepatic carcinoma was 42.48/100 000(777/1 829 064)), and 1.13 (95%CI:0.92-1.39) for villages apart from the river between 6 and 12 km (the mortality rate of hepatic carcinoma was 35.65/100 000(651/1 825 848)). In the BYM model multivariate analysis, adding the volume of fertilizer and pesticides used per cultivated area, GDP per capita to do multivariate analysis were, the relation between mortality rate of hepatic carcinoma and distance from polluted rivers remains unchanged. CONCLUSION: The mortality rate of hepatic carcinoma was associated with the exposure to the polluted river in Lingbi county. The polluted river may increase the hepatic carcinoma mortality of nearby residents.

[Effects of electroacupuncture of different acupoint groups on sevoflurane anesthesia in patients undergoing resection of supratentorial tumors].

OBJECTIVE: To observe the effect of electroacupuncture (EA) of different acupoint groups on the sevoflurane anesthetic requirement for resection of supratentorial tumors and the speed of post-operation recovery. METHODS: A total of 120 cases of supratentorial tumor resection patients were randomly and equally allocated into general anesthesia (GA) group, EA-proximal acupoints group (EA-PA group) and EA-distant acupoints group (EA-DA group). The supratentorial tumor patients were anesthetized with sevoflurane for surgery. Proximal acupoints used were Fengchi (GB 20), Tianzhu (BL 10), Cuanzhu (BL 2) and Yuyao (EX-HN 4) that the former 2 acupoints and the latter 2 acupoints were for penetrative needling; and distant acupoints used were Hegu (LI 4), Waiguan (TE 5), Jinmen (BL 63), Taichong (LR 3), Zusanli (ST 36) and Qiuxu (GB 40) on the craniotomy side, and stimulated with EA (2 Hz/100 Hz, a tolerable electric stimulating strength), beginning from the anesthesia induction till the end of surgical operation. All patients were anesthetized by inhalation of propofol (2 mg/kg), sufentanil (0.3 microg/kg) and vecuronium bromide (0.1 mg/kg) and maintained with sevoflurane. The end-tidal sevoflurane concentration, minimum alveolar concentration (MAC), bispectral index (BIS), and the speed of recovery were recorded. RESULTS: In comparison with the GA group, the end-tidal concentrations during anesthesia maintenance at the time-points of post skull drilling, dura incising, intracranial operation in EA-PA group, the time-points of post skull drilling, skull opening, dura incising, and intracranial operation in EA-DA group, and the MAC of sevoflurane at the time-points of skull drilling in EA-DA group, and skull opening, dura incising, intracranial operation and dura suturing in both EA-PA and EA-DA groups were significantly lower (P < 0.05, P < 0.01). Compared to the GA group, the BIS values of EA-DA group at the time-points of skull drilling and opening, and dura incising were significantly higher (P < 0.05), while during the recovery stage of anesthesia, in comparison with the GA group, the autonomous respiration recovery time, tracheo-tube removing time, eye-opening time, voluntary motion recovery time, orientation force recovery time, and operating room-departure time of both EA-PA and EA-DA groups were significantly shorter (P < 0.05, P < 0.01). No significant differences were found between the EA-PA and EA-DA groups in the aforementioned indexes (P > 0.05). CONCLUSION: EA of both proximal and distant acupoints can reduce the expired concentration and MAC of sevoflurane during anesthesia maintenance, and accelerate the recovery after cease of anesthesia in supratentorial tumor resection patients.