Projection of Premature Cancer Mortality in Hunan, China, Through 2030: Modeling Study.

BACKGROUND: The United Nations Sustainable Development Goals for 2030 include reducing premature mortality from noncommunicable diseases by one-third. Although previous modeling studies have predicted premature mortality from noncommunicable diseases, the predictions for cancer and its subcategories are less well understood in China. OBJECTIVE: The aim of this study was to project premature cancer mortality of 10 leading cancers in Hunan Province, China, based on various scenarios of risk factor control so as to establish the priority for future interventions. METHODS: We used data collected between 2009 and 2017 from the Hunan cancer registry annual report as empirical data for projections. The population-attributable fraction was used to disaggregate cancer deaths into parts attributable and unattributable to 10 risk factors: smoking, alcohol use, high BMI, diabetes, physical inactivity, low vegetable and fruit intake, high red meat intake, high salt intake, and high ambient fine particulate matter (PM2.5) levels. The unattributable deaths and the risk factors in the baseline scenario were projected using the proportional change model, assuming constant annual change rates through 2030. The comparative risk assessment theory was used in simulated scenarios to reflect how premature mortality would be affected if the targets for risk factor control were achieved by 2030. RESULTS: The cancer burden in Hunan significantly increased during 2009-2017. If current trends for each risk factor continued to 2030, the total premature deaths from cancers in 2030 would increase to 97,787 in Hunan Province, and the premature mortality (9.74%) would be 44.47% higher than that in 2013 (6.74%). In the combined scenario where all risk factor control targets were achieved, 14.41% of premature cancer mortality among those aged 30-70 years would be avoided compared with the business-as-usual scenario in 2030. Reductions in the prevalence of diabetes, high BMI, ambient PM2.5 levels, and insufficient fruit intake played relatively important roles in decreasing cancer premature mortality. However, the one-third reduction goal would not be achieved for most cancers except gastric cancer. CONCLUSIONS: Existing targets on cancer-related risk factors may have important roles in cancer prevention and control. However, they are not sufficient to achieve the one-third reduction goal in premature cancer mortality in Hunan Province. More aggressive risk control targets should be adopted based on local conditions.

Trends and risk factors of anaemia among the nutrition improvement program for rural compulsory education students aged 6-15 years, Hunan Province / 中国学校卫生

Objective@#To investigate the prevalence of anemia among students aged 6-15 years old participated in the Nutrition Improvement Program for Rural Compulsory Education Program in 2012-2021 in Hunan Province, and to explore associated factors.@*Methods@#A cluster random sampling method was used. The survey was conducted among compulsory education students who came from counties in Hunan Province where nutrition improvement plan and key surveillance were carried out. Height and weight were measured, hemoglobin, dietary habits and health knowledge were collected.@*Results@#Since the implementation of nutrition improvement plan in 2012, the anemia rate decreased from 12.8% to 9.3%, the average hemoglobin content decreased from 133.9 g/L to 130.0 g/L. The proportion of students eating meat every day increased from 20.4% to 47.3%. Students eating three or more servings of table tennis ball size of meal increased from 21.4% to 47.3%. The proportion of students eating more than three kinds of vegetables per day was 39.1% in 2016 and 32.6% in 2019, and less than 30% in other years. The proportion of students eating three or more servings of table tennis ball size of vegetables increased from 19.5% to 39.6%, and the proportion of students eating snack less than once a day increased from 13.1% to 76.9%. The proportion of students drinking beverages less than once a day increased from 36.5% to 90.7%. Girls, older than 12 years, not eating meat every day, and who eat less than 1 serving of table tennis ball size of meat, eat less than 3 servings of table tennis ball size of vegetables and fruit at one time, and who eat less than 3 kinds of vegetables every day, and those who grow slowly had higher risk of anemia. Potential factors of anemia in students varied by survey year.@*Conclusion@#The implementation of the compulsory education has improved the nutritional status of compulsory education students in rural areas of Hunan Province, but anemia still occurs. Potential factors associated with childhood anemia are changing. Child health literacy education should adapt to the changing social and economic enviornment, as well as lifestyles. Targeted and appropriate nutritional education and intervention are greatly needed.

[Association between mild cognitive impairment and serum uric acid levels among people aged 55 and above in 4 provinces of China].

OBJECTIVE: To explore the association between mild cognitive impairment and hyperuricemia among people aged 55 and above. METHODS: Based on the baseline survey data of "community cohort study on neurological diseases" from 2018 to 2019, 4272 residents aged 55 and above with complete data of individual socioeconomic status, lifestyle, mild cognitive impairment and serum uric acid level were selected as the research objects. The Montreal cognitive assessment(MoCA) was used to evaluate the mild cognitive impairment of the research objects. The relationship between serum uric acid level and MoCA score was analyzed. Multivariate Logistic regression model was used to analyze the association of serum uric acid level and mild cognitive impairment. RESULTS: The prevalence of cognitive impairment in the normal and high serum uric acid groups were 38. 6% and 38. 4%, respectively. In the normal serum uric acid level group, the serum uric acid level of the non-cognitive impairment group was significantly higher(291. 4 µmol/L)than that of the cognitive impairment group(283. 7 µmol/L)(F=16. 12, P<0. 05), and the MoCA score of the subjects in this group was significantly positively correlated with the serum uric acid level(r=0. 103, P<0. 05). In the hyperuricemia group, no significant difference was found in serum uric acid level between non-cognitive impairment group(450. 9 µmol/L) and cognitive impairment group(442. 4 µmol/L)(F=2. 44, P>0. 05), and there was no correlation between MoCA score and serum uric acid level(r=0. 064, P>0. 05). Logistic regression analysis showed that hyperuricemia was not a risk factor for cognitive impairment in people aged 55 and above(OR=1. 04, 95% CI 0. 87-1. 25, P=0. 630). CONCLUSION: Within the normal range of serum uric acid, appropriate increase of serum uric acid may play a protective role in cognitive impairment. Hyperuricemia has not been found to increase the risk of cognitive impairment in people 55 years and older.

Differences in nutrient and energy contents of commonly consumed dishes prepared in restaurants v. at home in Hunan Province, China.

OBJECTIVE: Eating away from home is associated with poor diet quality, in part due to less healthy food choices and larger portions. However, few studies account for the potential additional contribution of differences in food composition between restaurant- and home-prepared dishes. The present study aimed to investigate differences in nutrients of dishes prepared in restaurants v. at home. DESIGN: Eight commonly consumed dishes were collected in twenty of each of the following types of locations: small and large restaurants, and urban and rural households. In addition, two fast-food items were collected from ten KFC, McDonald's and food stalls. Five samples per dish were randomly pooled from every location. Nutrients were analysed and energy was calculated in composite samples. Differences in nutrients of dishes by preparation location were determined. SETTING: Hunan Province, China. SUBJECTS: Na, K, protein, total fat, fatty acids, carbohydrate and energy in dishes. RESULTS: On average, both the absolute and relative fat contents, SFA and Na:K ratio were higher in dishes prepared in restaurants than households (P < 0·05). Protein was 15 % higher in animal food-based dishes prepared in households than restaurants (P<0·05). Quantile regression models found that, at the 90th quantile, restaurant preparation was consistently negatively associated with protein and positively associated with the percentage of energy from fat in all dishes. Moreover, restaurant preparation also positively influenced the SFA content in dishes, except at the highest quantiles. CONCLUSIONS: These findings suggest that compared with home preparation, dishes prepared in restaurants in China may differ in concentrations of total fat, SFA, protein and Na:K ratio, which may further contribute, beyond food choices, to less healthy nutrient intakes linked to eating away from home.

Curative versus palliative treatments for colorectal cancer with peritoneal carcinomatosis: a systematic review and meta-analysis.

The objective of this study was to provide an up-to-date summary of the current evidence that may be useful for updating guidelines. We comprehensively searched the published literatures and conferences for studies that compared curative with palliative treatments in colorectal cancer patients with peritoneal metastasis. The primary outcomes considered in this study were three- and five-year overall survival rates. We pooled data across studies and estimated summary effect sizes. Overall, patients who received curative treatments had improved three-year survival (hazard ratio (HR), 2.19 [95% CI, 1.83 to 2.62]) and five-year survival (HR, 2.22 [95% CI, 1.83 to 2.69]) compared with those who received palliative treatments. Patients who received curative treatments had an increased risk of treatment-related morbidity (odds ratio (OR), 2.90 [95% CI, 2.02 to 4.17]), but there was no significant difference in treatment-related mortality between patients who received curative treatments and those who received palliative treatments (OR, 1.46 [CI, 0.62 to 3.47]). Curative treatments improved overall survival in colorectal cancer patients with peritoneal metastasis and did not increase the risk of treatment-related mortality. Curative treatments were associated with a higher risk of treatment-related morbidity. These data highlight the importance for further investigation aimed at prevention of treatment-associated morbidity.

Early versus Delayed Antiretroviral Therapy for HIV and Tuberculosis Co-Infected Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: To compare important clinical outcomes between early and delayed initiation of antiretroviral therapy (ART) in adults who had a co-infection of human immunodeficiency virus (HIV) and tuberculosis (TB). METHODS: We performed a systematic search for relevant publications on PubMed, EMBASE, and the International Clinical Trials Registry Platform. We included randomized controlled trials (RCTs) that compared early ART initiation (within four weeks after anti-TB treatment starting) and delayed ART initiation (after eight weeks but less than twelve weeks of anti-TB treatment starting) in the course of TB treatment. Pooled estimates with corresponding 95% confidence interval (95%CI) were calculated with random-effects model. Sensitivity analysis was performed to investigate the stability of pooled estimates. RESULTS: A meta-analysis was evaluated from six RCTs with 2272 participants. Compared to delayed ART initiation, early ART initiation significantly reduces all-cause mortality in HIV-positive patients with TB [incidence rate ratio (IRR) 0.75, 95%CI 0.59 to 0.95; I2 = 0.00%; p = 0.67], even though there is an increased risk for IRD [IRR 2.29, 95%CI 1.81 to 2.91; I22 = 0.00%; p = 0.56]. Additionally, early ART initiation was not associated with an increased risk for grade 3-4 drug-related adverse events [IRR 0.99, 95%CI 0.83 to 1.18; I2 = 0.00%; p = 0.56]. CONCLUSIONS: Although limited evidence, our results provide support for early ART initiation in the course of anti-TB treatment. However, more well-designed cohort or intervention studies are required to further confirm our findings.

[Dietary patterns of urban residents from 1982 to 2012 in Hunan].

OBJECTIVE: To determine the change in the dietary patterns of Hunan urban residents from 1982 to 2012. METHODS: A 24 hour dietary recall method was used for 3 consecutive days to collect information on food intake, and the condiment intake was collected by weighting method. RESULTS: Rice products and potato consumption were 449.0 g per person per day and 44.0 g per person per day in 1982, and dropped to 150.0 g per person per day and 9.0 g per person per day in 2012. In 2012, vegetable (277.1 g per person per day), fruits (47.8 g per person per day), milk and dairy products (16.6 g per person per day) consumption were still insufficient. Fat (59.3 g per person per day) and salt (10.1 g per person per day) consumption was still high. CONCLUSIONS: : The dietary quality of urban residents in Hunan has been greatly improved, but is still seriously imbalanced. To consume more fruits, milk and dairy products and reduce fat and salt intake are very important.