Knowledge and practices related to salt consumption in China: findings from a national representative cross-sectional survey.

There is limited information on the knowledge and practice of salt-reduction in China. The purpose of this study was to describe the status of the knowledge and practice of salt-reduction among the Chinese population from a nationally representative survey stratified according to hypertension status. The association between hypertensive status and salt-reduction knowledge and practice was calculated using multivariate hierarchical logistic regression adjusting for related confounders. The study included 179,834 participants; 51.7% were women, and the mean age was 44 years. The levels of overall salt-reduction knowledge (7.9%) and practice (37.1%) were low. The percentage of the use of salt-control spoons and low-sodium salt was 10.7% and 12.2%. The aging population (≥60 years) had the lowest levels of salt-reduction knowledge (5.7%) than other age groups (P < 0.0001). People living in rural areas (OR = 0.64; 95% CI: 0.51, 0.81) had lower odds of using salt-control spoons. Females (OR = 1.23; 95% CI: 1.10, 1.36) had higher odds of using salt-control spoons. People living in rural areas (OR = 0.48; 95% CI: 0.36, 0.63) had lower odds of using low-sodium salt. Females (OR = 1.26; 95% CI: 1.13, 1.41) and people living in the southern region (OR = 1.43; 95% CI: 1.11, 1.83) had higher odds of using low-sodium salt. Our work highlights the need to promote education related to hypertension, salt-reduction knowledge and methods among the public and the need to strengthen strategies for the popularization of salt-reduction knowledge and practices among males, people living in rural areas, people living in the northern region and the aging population in China.

Trends in insufficient physical activity among adults in China 2010-18: a population-based study.

BACKGROUND: The global prevalence of insufficient physical activity (PA) was reported to be 27.5% in 2016, and there were stable levels of insufficient PA worldwide between 2001 and 2016. The global target of a 10% reduction in insufficient PA by 2025 will not be met if the trends remain. The relevant data for trends in China were still scarce. This study aimed to determine nationwide temporal trends in insufficient PA among adults in China from 2010 to 2018. METHODS: 645 903 adults aged 18 years or older were randomly selected from four nationally representative cross-sectional surveys of the China Chronic Disease and Risk Factor Surveillance conducted in 2010, 2013, 2015, and 2018. PA was measured using the Global Physical Activity Questionnaire. Temporal changes in insufficient PA prevalence and participation of domain-specific moderate- to vigorous-intensity PA (MVPA) were analyzed using logistic regression. RESULTS: From 2010 to 2018, the age-adjusted prevalence of insufficient PA in China increased from 17.9% (95% confidence interval 16.3% to 19.5%) in 2010 to 22.3% (20.9% to 23.8%) in 2018 (P for trend < 0.001). By age group, with a significant increase in insufficient PA in adults aged 18-34 years (P for trend < 0.001), which rose more rapidly than in adults aged ≥ 35 years (P for interaction < 0.001). Insufficient PA has increased significantly among adults engaged in agriculture-related work, non-manual work, and other manual work (all P for trend < 0.05). And among the occupational groups, those engaged in agriculture-related work had the fastest increase (P for interaction = 0.01). The percentage of adults participating in work-related MVPA decreased from 79.6% (77.8% to 81.5%) to 66.8% (64.9% to 68.7%) along with a decrease in time spent on work-related MVPA, while percentages of adults participating in recreation-related MVPA increased from 14.2% (12.5% to 15.9%) to 17.2% (16.0% to 18.4%) (all P for trend < 0.05). CONCLUSIONS: Among Chinese adults, an increasing trend was found in insufficient PA from 2010 to 2018, with more than one-fifth of adults failing to achieve the recommendation of adequate PA. More targeted PA promotion strategies should be developed to improve population health.

Prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy in adults with diabetes in China.

The current epidemic status of diabetic retinopathy in China is unclear. A national prevalence survey of diabetic complications was conducted. 50,564 participants with gradable non-mydriatic fundus photographs were enrolled. The prevalence rates (95% confidence intervals) of diabetic retinopathy and vision-threatening diabetic retinopathy were 16.3% (15.3%-17.2%) and 3.2% (2.9%-3.5%), significantly higher in the northern than in the southern regions. The differences in prevalence between those who had not attained a given metabolic goal and those who had were more pronounced for Hemoglobin A1c than for blood pressure and low-density lipoprotein cholesterol. The participants with vision-threatening diabetic retinopathy had significantly higher proportions of visual impairment and blindness than those with non-vision-threatening diabetic retinopathy. The likelihoods of diabetic retinopathy and vision-threatening diabetic retinopathy were also associated with education levels, household income, and multiple dietary intakes. Here, we show multi-level factors associated with the presence and the severity of diabetic retinopathy.

Breast Cancer Screening Coverage - China, 2018-2019.

What is already known about this topic?: In 2015, only 18.9% of adult women underwent breast cancer screening in China. What is added by this report?: Breast cancer screening coverage for women aged 20 years and above in China reached 22.3% during 2018-2019. Women with lower socioeconomic status had lower screening coverage. There were significant variations across the provincial-level administrative divisions. What are the implications for public health practice?: The promotion of breast cancer screening requires the maintenance of national and local policies, as well as financial support for screening services. In addition, there is a need for the strengthening of health education and the improvement of accessibility to health services.

Prevalence and risk factors of allergic rhinitis among Chinese adults: A nationwide representative cross-sectional study.

Background: The prevalence of allergic rhinitis (AR) has been increasing steadily worldwide, especially in countries with increasing industrialization such as China. However, available evidence regarding AR prevalence among Chinese adults is scarce and limited to regional data collected in earlier years. We therefore aimed to provide a more recent and robust estimate of AR prevalence using a nationwide representative cross-sectional study in China. Methods: Data of 184 326 participants aged 18 years or older were obtained from the China Chronic Disease and Risk Factor Surveillance conducted in 2018-2019. AR was determined by self-reported sneezing, nasal itching, obstruction, or rhinorrhea symptoms for at least 1 h in the absence of a cold or flu within the last 12 months. Multivariable logistic model was used to examine the risk factors of AR, and a possible non-linear relationship was further tested by restricted cubic spline. Potential additive interactions of risk factors with sex, residence, and geographic region were assessed by relative excess risk due to interaction (RERI). Results: The weighted prevalence of AR was 8.1% (95% confidence interval [CI], 7.4%-8.7%), of whom 23.7% (95% CI, 21.3%-26.0%) were aware of their diagnosis. Increased odds of AR were associated with younger age, men, living in urban area or north region, more education, smoking, underweight, and higher income. Despite the nonsignificant linear trend, the spline regression demonstrated a non-linear association between AR and sleep duration, with higher odds at both ends. Additionally, the observed associations were generally stronger among men and people living in urban area and north region, with significant RERI ranging from 0.07 (95% CI, 0.00-0.14) to 0.40 (95% CI, 0.12-0.67). Conclusions: AR is prevalent in China and the associated factors and interactions are helpful to design targeted preventive strategies towards certain subpopulations. The low awareness of AR calls for a national effort on AR screening.

The Status of Blood Lipids Among Children and Adolescents - China, 2016-2017.

What is already known about this topic?: Dyslipidemia is attributed to cardiovascular disease (CVD). A recent report suggests dyslipidemia prevalence has increased among children and adolescents. What is added by this report?: Dyslipidemia prevalence was 19.43% among Chinese children and adolescents aged 6-17 years in 2016-2017. The abnormal blood lipid prevalence and the average blood lipid levels showed a diversified distribution across demographics. What are the implications for public health practice?: Continued monitoring of abnormal blood lipids among Chinese children and adolescents, especially triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C), may inform public health interventions to promote long-term cardiovascular health and prevent CVD in adulthood.

Sleep Status Among Children and Adolescents Aged 6-17 Years - China, 2016-2017.

What is already known about this topic?: There has been little to no description of sleep status among children and adolescents nationwide in recent years. What is added by this report?: This report assesses the sleep duration and sleep patterns of children and adolescents in China. Approximately half of the adolescents did not get the recommended amount of sleep on school days, and more than half overslept on weekends. What are the implications for public health practice?: The importance of children and adolescents meeting recommended sleep durations needs greater emphasis, especially among older age groups and those in urban areas.

Prevalence of Chronic Kidney Disease in China: Results From the Sixth China Chronic Disease and Risk Factor Surveillance.

Importance: To our knowledge, there has been no update on the prevalence of chronic kidney disease (CKD) in China since 2012. Objective: To provide periodic nationwide data on the prevalence of CKD and the associated behavioral and metabolic risk factors in China. Design, Setting, and Participants: This nationally representative cross-sectional study included data from 176 874 adults from all 31 provincial-level administrative divisions in mainland China, as reported in the sixth China Chronic Disease and Risk Factor Surveillance conducted from August 2018 to June 2019. Data analysis was performed in 2021 to 2022. Exposures: Serum creatinine, urinal creatinine, and urine albumin were measured for all participants. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine using the CKD-EPI equation. Main Outcomes and Measures: The primary outcome was weighted prevalence of CKD in the overall population and different strata, defined as presence of impaired kidney function (eGFR of <60 mL/min/1.73m2) or albuminuria (urine albumin-to-creatinine ratio of ≥30 mg/g). Secondary outcomes were awareness of CKD and control of comorbidities. Logistic regression was used to examine the association of sociodemographic characteristics, behavioral and dietary habits, physical activity, and comorbidities with CKD. Results: A total of 184 876 participants contributed data to this study, and of the 176 874 adults 18 years and older with measurements of eGFR and urine albumin-to-creatinine ratio in 2018 to 2019, the mean age was 43.8 years and the weighted proportion of women was 44.6%. The estimated prevalence of CKD, impaired kidney function, and albuminuria were 8.2%, 2.2%, and 6.7%, respectively. A higher prevalence of CKD was observed in the subgroups characterized by older age, female gender, non-Han ethnicity, residency of rural or north and central parts of China, receiving less education or lower income, former smoking, no alcohol drinking, lacking physical activity, and presence of risk factors such as obesity, hypertension, diabetes, dyslipidemia, and self-reported cardiovascular disease. Among the adults with CKD, 73.3%, 25.0%, and 1.8% were at stage 1 to 2, 3, and 4 to 5, respectively, and the awareness of CKD was 10.0%. Conclusions and Relevance: This cross-sectional study found a weighted estimated of 82 million adults with CKD in China in 2018 to 2019. The prevalence appears to have decreased by 30% in the past decade. Better environmental protection, integration of CKD into the national public health surveillance program, and control of common CKD comorbidities appear to be associated with reducing the disease burden of CKD.

Prevalence, awareness, treatment, and control of hypertension in China, 2004-18: findings from six rounds of a national survey.

OBJECTIVE: To assess the recent trends in prevalence and management of hypertension in China, nationally and by population subgroups. DESIGN: Six rounds of a national survey, China. SETTING: China Chronic Disease and Risk Factors Surveillance, 2004-18. PARTICIPANTS: 642 523 community dwelling adults aged 18-69 years (30 501 in 2004, 47 353 in 2007, 90 491 in 2010, 156 836 in 2013, 162 293 in 2015, and 155 049 in 2018). MAIN OUTCOME MEASURES: Hypertension was defined as a blood pressure of ≥140/90 mm Hg or taking antihypertensive drugs. The main outcome measures were hypertension prevalence and proportion of people with hypertension who were aware of their hypertension, who were treated for hypertension, and whose blood pressure was controlled below 140/90 mm Hg. RESULTS: The standardised prevalence of hypertension in adults aged 18-69 years in China increased from 20.8% (95% confidence interval 19.0% to 22.5%) in 2004 to 29.6% (27.8% to 31.3%) in 2010, then decreased to 24.7% (23.2% to 26.1%) in 2018. During 2010-18, the absolute annual decline in prevalence of hypertension among women was more than twice that among men (-0.83 percentage points (95% confidence interval -1.13 to -0.52) v -0.40 percentage points (-0.73 to -0.07)). Despite modest improvements in the awareness, treatment, and control of hypertension since 2004, rates remained low in 2018, at 38.3% (36.3% to 40.4%), 34.6% (32.6% to 36.7%), and 12.0% (10.6% to 13.4%). Of 274 million (95% confidence interval 238 to 311 million) adults aged 18-69 years with hypertension in 2018, control was inadequate in an estimated 240 million (215 to 264 million). Across all surveys, women with low educational attainment had higher prevalence of hypertension than those with higher education, but the finding was mixed for men. The gap in hypertension control between urban and rural areas persisted, despite larger improvements in diagnosis and control in rural than in urban areas. CONCLUSIONS: The prevalence of hypertension in China has slightly declined since 2010, but treatment and control remain low. The findings highlight the need for improving detection and treatment of hypertension through the strengthening of primary care in China, especially in rural areas.

Long-term disability in common mental disorders in Chinese community: evidence from a five-year follow-up study.

BACKGROUND: Common mental disorders are general term for mental disorders with high disability rates and significant social burden. The purpose of this study was to determine the degree of long-term disability associated with common mental disorders and to interpret the relationship between common mental disorders and long-term disability. METHODS: Participants in the 2013 China Mental Health Survey were followed up by telephone between April and June 2018. This study evaluated long-term disability over a five-year period using the World Health Organization's Disability Assessment Schedule 2.0. Poisson regression was used to analyze the relationship between common mental disorders and long-term disability. RESULTS: A total of 6269 patients were followed up by telephone. In patients with common mental disorders, the prevalence of disability ranged from 7.62% to 43.94%. The long-term disabilities were significantly associated with dysthymic disorder (DD, RR:2.40; 95% CI:1.87-3.03), major depressive disorder (MDD, RR:1.63; 95% CI:1.34-1.98), generalized anxiety disorder (GAD, RR:1.95; 95% CI:1.15-3.09), obsessive-compulsive disorder (OCD, RR:1.68; 95% CI:1.24-2.22) and alcohol use disorder (AUD, RR: 1.42; 95% CI:0.99-1.96). CONCLUSIONS: In China, common mental disorders raise the risk of long-term disability, and there is a critical need for monitoring patients with DD, MDD, GAD, OCD, and AUD. For improved quality of life and reduced disability levels, more resources need to be dedicated to mental health in the future.

Trends in smoking prevalence in urban and rural China, 2007 to 2018: Findings from 5 consecutive nationally representative cross-sectional surveys.

BACKGROUND: Tobacco smoking is a leading cause of premature death in China, especially among adult men. Since the implementation of the Framework Convention on Tobacco Control in 2005, nationwide tobacco control has been strengthened, but its long-term impact on smoking prevalence is unclear. METHODS AND FINDINGS: Five nationally representative surveys of the China Chronic Disease and Risk Factor Surveillance (CCDRFS) were conducted in 2007, 2010, 2013, 2015, and 2018. A total of 624,568 adults (278,605 men and 345,963 women) aged 18 to 69 years were randomly selected from 31 provinces (or equivalent) in China. Temporal changes in smoking prevalence and patterns (e.g., percentages of those smoking manufactured cigarettes, amount smoked, and age at smoking initiation) were analyzed, overall and by sex, urban or rural residence, year of birth, education and occupation, using linear regression methods. Among men, the standardized prevalence of current smoking decreased from 58.4% (95% confidence interval [CI]: 56.1 to 60.7) to 50.8% (95% CI: 49.1 to 52.5, p < 0.001) between 2007 and 2018, with annual decrease more pronounced in urban (55.7% [95% CI: 51.2 to 60.3] to 46.3% [95% CI: 43.7 to 49.0], p < 0.001) than rural men (59.9% [95% CI: 57.5 to 62.4] to 54.6% [95% CI: 52.6 to 56.6], p = 0.05) and in those born before than after 1980. Among rural men born after 1990, however, the prevalence increased from 40.2% [95% CI: 34.0 to 46.4] to 52.1% ([95% CI: 45.7 to 58.5], p = 0.007), with the increase taking place mainly before 2015. Among women, smoking prevalence remained extremely low at around 2% during 2007 to 2018. No significant changes of current smoking prevalence (53.9% to 50.8%, p = 0.22) were observed in male patients with at least 1 of major chronic diseases (e.g., hypertension, diabetes, myocardial infarction, stroke, chronic obstructive pulmonary disease (COPD)). In 2018, 25.6% of adults aged ≥18 years smoked, translating into an estimated 282 million smokers (271 million men and 11 million women) in China. Across 31 provinces, smoking prevalence varied greatly. The 3 provinces (Yunnan, Guizhou, and Hunan) with highest per capita tobacco production had highest smoking prevalence in men (68.0%, 63.4%, and 61.5%, respectively), while lowest prevalence was observed in Shanghai (34.8%). Since the children and teenage groups were not included in the surveys, we could not assess the smoking trends among youths. Furthermore, since the smoking behavior was self-reported, the smoking prevalence could be underestimated due to reporting bias. CONCLUSIONS: In this study, we observed that the smoking prevalence has decreased steadily in recent decades in China, but there were diverging trends between urban and rural areas, especially among men born after 1980. Future tobacco control strategies should target rural young men, regions with high tobacco production, and patients suffering from chronic diseases.

Association between physical activity energy expenditure and cardiometabolic risk factor clustering among Chinese adults in 2015.

To understand the association between cardiometabolic risk factor (CMRF) clustering and physical activity (PA) levels, we included 86520 Chinese adults aged 18-64 years having at least one CMRF (hypertension, diabetes, dyslipidemia, or obesity) from the China Chronic Disease and Nutrition Surveillance survey in 2015, a nationally and provincially representative investigation with a multistage clustering sampling design. Self-reported PA information was collected with the Global Physical Activity Questionnaire through face-to-face interviews. In view of the obesity epidemic in CMRF patients, PA energy expenditure (PAEE) per kilogram body weight was used, and was defined into four categories: (i) inactivity: 0 â€‹kJ/kg/day; (ii) low activity: 0-5 â€‹kJ/kg/day; (iii) moderate activity: 6-11 â€‹kJ/kg/day; and (iv) vigorous activity: ≥ 12 â€‹kJ/kg/day. The estimated weighted prevalence (95% confidence interval [CI]) of having 1, 2, 3, and 4 CMRFs was 60.57% (59.48%-61.67%), 28.10% (27.40%-28.79%), 9.82% (9.22%-15.42%) and 1.50% (1.37%-1.63%), respectively. The rate (95%CI) of inactivity, low activity, moderate activity, and vigorous activity was 34.52% (32.69%-36.35%), 22.22% (21.37%-23.37%), 15.98% (15.38%-16.58%) and 27.28% (26.02%-28.53%), respectively. For those having 2, 3 and 4 CMRFs (compared to those having 1 CMRF), the adjusted odds ratio (95%CI) for moderate activity and vigorous activity were 0.91 (0.85-0.98) and 0.92 (0.85-0.99), 0.87 (0.80-0.95) and 0.84 (0.77-0.92), and 0.77 (0.67-0.89) and 0.85 (0.72-1.00), respectively. In conclusion, CMRF clustering was a pandemic among Chinese adults in 2015 and was inversely associated with PA level. PAEE (in kJ/kg/day) may be introduced into PA management practice, especially for populations with high body weight.

Association Between Urinary Sodium and Potassium Excretion and Blood Pressure Among Non-Hypertensive Adults - China, 2018-2019.

What is already known about this topic?: High sodium and low potassium in 24 h urinary excretion were associated with elevated blood pressure. What is added by this report?: With increasing body mass index levels, decreasing unit urinary sodium excretion was more effective in reducing systolic and diastolic blood pressure, and increasing unit urinary potassium excretion was more effective in reducing diastolic blood pressure. What are the implications for public health practice?: Reducing sodium and increasing potassium intake was more effective in reducing blood pressure in overweight and obese non-hypertensive adults compared to underweight and normal weight adults.

Disability and Comorbidity of Mood Disorders and Anxiety Disorders With Diabetes and Hypertension: Evidences From the China Mental Health Survey and Chronic Disease Surveillance in China.

Background: The China Mental Health Survey was carried out using the same sampling frame with the China Chronic Diseases and Risk Factors Surveillance. This paper explores the relationship between the disability and the comorbidity of mood disorders and anxiety disorders with diabetes and hypertension. Methods: A large-scale nationally representative sample with both mental disorders and chronic diseases was collected from 157 Disease Surveillance Points in 31 provinces across China. Face-to-face interviews were conducted by trained lay interviewers to make diagnoses of mood disorders and anxiety disorders using the Composite International Diagnostic Interview. Diabetes and hypertension were diagnosed from self-report and blood examination or body measurement. Sampling design weights, non-response adjustment weights, and post-stratification adjustment weights were applied during the analyses of comorbidity and disability. Results: Totally 15,000 respondents had information of mental disorders and physical diseases. In the patients with mood disorders or anxiety disorders, the weighted prevalence rates of diabetes or hypertension were not higher than those in persons without the above mental disorders, but the weighed disability rates increased when having the comorbidity of hypertension (P < 0.05). The severity of disability was higher among patients with comorbidity of diabetes and anxiety disorders, or hypertension and mood disorders, compared with that among patients without the physical comorbidity (P < 0.05). After adjusted by age, gender and education, patients with comorbidity of mental disorders and physical disorders had the highest disability, followed by the patients with mental disorders only, and physical diseases only. Conclusions: The disability of mood disorders and anxiety disorders comorbid with diabetes and hypertension are more serious than that of any single disease. The relationship of mental and physical diseases is worth exploring in depth for comprehensive and integrated intervention to decrease the disability.

Cervical Cancer Screening Coverage - China, 2018-2019.

What is already known about this topic?: The World Health Organization set a 2030 target of 70% cervical cancer screening coverage for women aged 35-45 years. Coverage stood at 37% in China in 2015. What is added by this report?: In 2018-2019, China's cervical cancer screening coverage reached 43.4% in women aged 35-44 years and 36.8% in women aged 35-64 years. Screening coverage was still lower in rural areas as well as central and western regions; large variations existed across provincial-level administrative divisions. What are the implications for public health practice?: National and local policy and financial support should be maintained for cervical cancer screening, along with more targeted health education and outreach efforts and strengthened accessibility of health services in the rural areas and central and western regions.

Future Trends in Disability and Its Determinants Among Chinese Community Patients With Anxiety Disorders: Evidence From a 5-Year Follow-Up Study.

Background: Anxiety disorders (ADs) are a group of disorders with a high disability rate and bring a huge social burden. In China, information on future trends in the disability among community ADs patients and its determinants are rare. The objectives of this study are to describe the future trends in the disability among ADs patients living in community and to investigate the determinants of the disability. Methods: Participants diagnosed with 12-month ADs in the China Mental Health Survey (CMHS) were followed up by telephone from April to June 2018 to assess the future trends in the disability in a 5-year interval using the World Health Organization's Disability Assessment Schedule 2.0. The disability rate was reported and its determinants were analyzed by complex sample design multivariate logistic regression. Results: Totally 271 patients were interviewed by telephone and 33 informants finished proxy interviews. The disability rates were 45.9% and 14.3% among ADs patients at baseline and during the follow-up. Patients with general anxiety disorder (GAD) or agoraphobia with/without panic disorder (AGP) had the lower decrease and higher disability during the follow-up than patients with other subtypes. Patients aged in middle age (aged 40-49 years old, OR = 11.12, 95% CI: 4.16-29.72), having disability at baseline (OR = 7.18, 95% CI: 1.37-37.73), having comorbidity with three or more physical diseases (OR = 9.27, 95% CI: 2.48-34.71), and having comorbidity with other mental disorders (OR = 3.97, 95% CI: 1.13-13.96) had higher disability during the follow-up. Conclusions: The disability rate tends to decrease among ADs patients living in communities. Treatment priority should be given for ADs patients with disability and those in middle age. Treatments for the comorbidity of other mental disorders or physical diseases should be considered when treating anxiety.

Prevalence and Treatment of Diabetes in China, 2013-2018.

Importance: Recent data on prevalence, awareness, treatment, and risk factors of diabetes in China is necessary for interventional efforts. Objective: To estimate trends in prevalence, awareness, treatment, and risk factors of diabetes in China based on national data. Design, Setting, and Participants: Cross-sectional nationally representative survey data collected in adults aged 18 years or older in mainland China from 170 287 participants in the 2013-2014 years and 173 642 participants in the 2018-2019 years. Exposures: Fasting plasma glucose and hemoglobin A1c levels were measured for all participants. A 2-hour oral glucose tolerance test was conducted for all participants without diagnosed diabetes. Main Outcomes and Measures: Primary outcomes were diabetes and prediabetes defined according to American Diabetes Association criteria. Secondary outcomes were awareness, treatment, and control of diabetes and prevalence of risk factors. A hemoglobin A1c level of less than 7.0% (53 mmol/mol) among treated patients with diabetes was considered adequate glycemic control. Results: In 2013, the median age was 55.8 years (IQR, 46.4-65.2 years) and the weighted proportion of women was 50.0%; in 2018, the median age was 51.3 years (IQR, 42.1-61.6 years), and the weighted proportion of women was 49.5%. The estimated prevalence of diabetes increased from 10.9% (95% CI, 10.4%-11.5%) in 2013 to 12.4% (95% CI, 11.8%-13.0%) in 2018 (P < .001). The estimated prevalence of prediabetes was 35.7% (95% CI, 34.2%-37.3%) in 2013 and 38.1% (95% CI, 36.4%-39.7%) in 2018 (P = .07). In 2018, among adults with diabetes, 36.7% (95% CI, 34.7%-38.6%) reported being aware of their condition, and 32.9% (95% CI, 30.9%-34.8%) reported being treated; 50.1% (95% CI, 47.5%-52.6%) of patients receiving treatment were controlled adequately. These rates did not change significantly from 2013. From 2013 to 2018, low physical activity, high intake of red meat, overweight, and obesity significantly increased in prevalence. Conclusions and Relevance: In this survey study, the estimated diabetes prevalence was high and increased from 2013 to 2018. There was no significant improvement in the estimated prevalence of adequate treatment.

Breast Cancer Screening Rates Among Women Aged 20 Years and Above - China, 2015.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Breast cancer is the most common cancer in women in China and around the world. By 2019, 121 countries have instituted a national screening program as a secondary prevention measure for breast cancer. WHAT IS ADDED BY THIS REPORT?: Breast cancer screening rates in China were 18.9% in women aged 20 years and above, and 25.7% in women aged 35-64 years in 2015. The screening rate for women aged 20 years and above was significantly higher in urban areas than in rural areas (24.6% vs. 15.0%), and in the eastern region than in the central and western regions (24.0% vs. 15.1% and 15.3%). WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Continued efforts should be made to strengthen national and local policy initiatives and financial support for population-based, organized screening programs for breast cancer. Health education and accessibility of screening services to women across the country should be strengthened, especially for women aged 50 years and above.