Fatal, non-fatal burden of cancer in the elderly in China, 2005-2016: a nationwide registry-based study.

BACKGROUND: As populations age, cancer burden becomes increasingly conspicuous. This study quantified the cancer burden of the elderly (≥ 60 years) in China, based on the China Cancer Registry Annual Report to provide epidemiological evidence for cancer prevention and control. METHODS: Data on cancer cases and deaths among the elderly aged ≥ 60 years were collected from the China Cancer Registry Annual Report, 2008-2019. Potential years of life lost (PYLL) and disability-adjusted life years (DALY) were calculated to analyze fatalities and the non-fatal burden. The time trend was analyzed using the Joinpoint model. RESULTS: From 2005 to 2016, the PYLL rate of cancer in the elderly was stable between 45.34‰ and 47.62‰, but the DALY rate for cancer decreased at an average annual rate of 1.18% (95% CI: 0.84-1.52%). The non-fatal cancer burden in the rural elderly was higher than that of the urban elderly. Lung, gastric, liver, esophageal, and colorectal cancers were the main cancers causing the cancer burden in the elderly, and accounted for 74.3% of DALYs. The DALY rate of lung cancer in females in the 60-64 age group increased (annual percentage change [APC] = 1.14%, 95% CI: 0.10-1.82%). Female breast cancer was one of the top five cancers in the 60-64 age group, with DALY rates that also increased (APC = 2.17%, 95% CI: 1.35-3.01%). With increasing age, the burden of liver cancer decreased, while that of colorectal cancer rose. CONCLUSIONS: From 2005 to 2016, the cancer burden in the elderly in China decreased, mainly reflected in the non-fatal burden. Female breast and liver cancer were a more serious burden in the younger elderly, while colorectal cancer burden was mainly observed in the older elderly.

Burden of cardiovascular disease attributable to dietary lead exposure in adolescents and adults in China.

Lead is a naturally occurring metal with a range of industrial applications; however, it can cause adverse health effects upon human exposure. Even if blood lead levels (BLLs) in the human body are in the acceptable range, it is independently associated with cardiovascular disease (CVD), which is the leading cause of death in China. However, the role of lead exposure in CVD outcomes has not been quantified well. A top-down approach was adopted in this study to calculate the population attribution fraction (PAF) by combining pooled BLLs in the Chinese population reported between 2001 and 2022 with the relative risk (RR) of lead-induced CVD. Subsequently, the disease burden (DB) of lead-induced CVD was estimated and expressed in disability-adjusted life years (DALYs), and the attribution analysis about various sources of lead exposure was performed. Among Chinese adolescents and adults, BLLs of 5.50 ±â€¯2.45 µg/dL resulted in an estimated total DB (×106 DALYs) of 2.21 (2.07-2.32) for CVD, including 1.18 (1.12-1.25), 0.71 (0.69-0.74), 0.23 (0.15-0.26), and 0.02 (0.02-0.02) for stroke, and ischemic, hypertensive, and rheumatic heart diseases, respectively. Dietary lead intake was a major contributor to the DB (68.1%), and lead ingested through food was responsible for 15.1 × 105 DALYs of the CVD burden. Guangxi, Hunan, and Yunnan regions in China reported higher BLLs in adolescents and adults, and the DB of lead-induced CVD was higher in Hunan, Henan, and Sichuan. Lead is a risk factor for CVD that can cause significant DB. Further practical and cost-effective efforts to reduce lead exposure are urgently needed.