Objective To summary the incidence rate and trends of cancers in China. MethodsBy compiling and analyzing the Chinese Cancer Registry Annual Report from 2008 to 2021, we summarized the regional and population distribution characteristics of overall and high-incidence rate cancers in China and analyzed influencing factors. ResultsFrom 2005 to 2018, the overall crude incidence of cancers in China showed a continuous upward trend. The incidence rate in the eastern region (incidence rate was 353.26/100 000 in 2018, the following data were crude incidence rate in 2018) was significantly higher than those in the central (269.47/100 000) and western regions (253.71/100 000), while the incidence rates in the central and western regions were closer. 2005–2018, the incidence rates of male was higher than that of female, and the population aged 80 years old or older (2 741.02/100 000) had the highest incidence rate of cancers, and the incidence rate of people aged 0–14 years old (41.38/100 000) was the lowest. From 2005–2018 (except for 2009), lung cancer (65.05/100 000), gastric cancer (27.03/100 000), liver cancer (27.42/100 000), colorectal cancer (30.51/100 000), and breast cancer (43.02/100 000) were the top 5 highest incidence rates of China’s cancers, of which lung cancer ranked the first in different regions, and the ranking of other cancers varied in different regions. The top 5 cancers in males’ incidence rates from 2005 to 2018 were lung cancer (83.45/100 000), gastric cancer (37.12/100 000), liver cancer (40.02/100 000), colorectal cancer (35.32/100 000) and esophageal cancer (26.30/100 000); the top 5 cancers in females’incidence rates had changed a lot in different years, breast cancer, lung cancer, colorectal cancer, gastric cancer, liver cancer, thyroid cancer and cervical cancer had all been in the top 5, for example, in 2018, the top 5 cancers in female were lung cancer (46.10/100 000), breast cancer (43.02/100 000), colorectal cancer (25.56/100 000), thyroid cancer (24.60/100 000) and cervical cancer (18.10/100 000).ConclusionsThe crude incidence rate of cancers in China continues to rise, with the cancer spectrum showing new characteristics that combine high-incidence rate cancers in developed countries (e.g., breast cancer, colorectal cancer) with common cancers in developing countries (e.g., gastric cancer, liver cancer). The situation of cancer prevention and control remains challenging.
"Global cancer statistics 2022" based on the latest GLOBCAN data from the International Agency for Research on Cancer (IARC) was recently released, providing a systematic analysis of the incidence and mortality of 36 types of cancer across 185 countries worldwide. The international burden of cancer is expected to continue to increase over the next 30 years, posing a severe public health and social challenge for many countries, including China. This article offers a key point interpretation of the "Global cancer statistics 2022", focusing on the evolution of cancer epidemiology and future development trends. The aim is to broaden the international perspective on cancer prevention and treatment, with the hope of providing reference and guidance for cancer prevention and treatment efforts in our country.
ObjectiveBy comparing the epidemiological characteristics of the incidence and death of female breast cancer in China and the United States, the differences in prevention and screening strategies between China and the United States were analyzed to explore the prevention and control measures of female breast cancer in China. MethodsBased on the relevant data released by the Global Burden of Disease in 2020, the National Cancer Center of China, and the China Health Statistical Yearbook, the new cases and deaths of breast cancer in Chinese and American women in 2023 were estimated respectively, and the incidence, mortality and time trend of breast cancer in Chinese and American women were analyzed. ResultsIn China, 376 789 new cases of female breast cancer and 116 791 deaths were expected in 2023. In the United States, approximately 297 790 women were expected to be newly diagnosed with breast cancer in 2023, representing approximately 15.2% of new cancer cases. About 43 170 women died from breast cancer, accounting for about 7.1% of all cancer deaths. The incidence of breast cancer in women in the United States during the period 1975–2020 gradually increased and then stabilized; In contrast, the incidence of breast cancer among Chinese women increased year by year during the period 1990–2020. In recent years, the incidence and mortality rates of breast cancer in Chinese women had increased more than those in the United States, and there was a large difference between urban and rural areas in China. ConclusionsBoth China and the United States face a large burden of female breast cancer, and the characteristics of female breast cancer in China are similar to those in the United States. To reduce the burden of breast cancer in Chinese women, further efforts should be made in various aspects, such as strengthening breast cancer education, raising public health awareness, improving diet structure, cultivating healthy lifestyle, increasing screening efforts, and improving medical level.
ObjectiveTo investigate the incidence, pathogens, risk factors and clinical outcomes for ventilator- associated pneumonia (VAP) in children after tetralogy of Fallot (TOF) surgical correction, in order to offer reliable data for the prevention of VAP.MethodsThis was a retrospective study performed in Guangdong General Hospital and 181 children (121 males, 60 females, mean age of 11.2±10.4 months) undergoing surgical correction for TOF were included. ALL the children who received mechanical ventilation for 48 hours or longer between January 2013 and December 2017 were classified into a VAP group (n=44) and a non-VAP group (n=137). T test, χ2 test and multiple logistic regression analysis were used to identify the possible risk factors for VAP.ResultsThis study enrolled 181 patients , of which 44 were diagnosed as VAP. And the incidence of VAP was 24.3%. The most frequent isolated pathogen was Gram-negative bacteria (69.7%). Single factor analysis showed that the variables significantly associated with a risk factor of VAP were: hypoxic spells, preoperative pneumonia, preoperative mechanical ventilation support, cardiopulmonary bypass (CPB) time, reintubation, pulmonary atelectasis, low cardiac output syndrome (LCOS), intra-abdominal drainage and transfusion of fresh frozen plasma. The multiple logistic regression showed CPB time (OR=1.011), reintubation (OR=14.548), pulmonary atelectasis (OR=6.139) and LCOS (OR=3.054) were independent risk factors for VAP in children after TOF surgical correction. Patients with VAP had prolonged duration of mechanical ventilation, a longer ICU stay and longer hospitalization time.ConclusionsThe VAP rate in this population is higher than that reported abroad, which leads to prolonged duration of mechanical ventilation and a longer hospital stay. The effective measures for prevention of VAP should be taken according to the related risk factors for VAP to decrease the incidence of VAP in children after TOF surgical correction.
ObjectiveTo investigate the value of smart phone Scoliometer software in obtaining optimal lumbar lordosis (LL) during L4-S1 fusion surgery.
MethodsBetween November 2014 and February 2015, 20 patients scheduled for L4-S1 fusion surgery were prospectively enrolled the study. There were 8 males and 12 females, aged 41-65 years (mean, 52.3 years). The disease duration ranged from 6 months to 6 years (mean, 3.4 years). Before operation, the pelvic incidence (PI) and Cobb angle of L4-S1 (CobbL4-S1) were measured on lateral X-ray film of lumbosacral spine by PACS system; and the ideal CobbL4-S1 was then calculated according to previously published methods [(PI+9°)×70%]. Subsequently, intraoperative CobbL4-S1 was monitored by the Scoliometer software and was defined as optimal while it was less than 5° difference compared with ideal CobbL4-S1. Finally, the CobbL4-S1 was measured by the PACS system after operation and the consistency was compared between Scoliometer software and PACS system to evaluate the accuracy of this software. In addition, value of this method in obtaining optimal LL was validated by comparing the difference between ideal CobbL4-S1 and preoperative one with that between ideal CobbL4-S1 and postoperative one.
ResultsThe CobbL4-S1 was (36.17±1.53)° for ideal one, (22.57±5.50)° for preoperative one, (32.25±1.46)° for intraoperative one measured by Scoliometer software, and (34.43±1.72)° for postoperative one, respectively. The observed intraclass correlation coefficient (ICC) was excellent [ICC=0.96, 95% confidence interval (0.93, 0.97)] and the mean absolute difference (MAD) was low (MAD=1.23) between Scoliometer software and PACS system. The deviation between ideal CobbL4-S1 and postoperative CobbL4-S1 was (2.31±0.23)°, which was significantly lower than the deviation between ideal CobbL4-S1 and preoperative CobbL4-S1 (13.60±1.85)° (t=6.065, P=0.001).
ConclusionScoliometer software can help surgeon obtain the optimal LL and deserve further dissemination.
ObjectiveTo analyze and compare the incidence, mortality, temporal trends, and cancer spectrum differences between China and the United States (US), providing theoretical support for cancer prevention and control in China. MethodsAge standardized incidence rate (ASIR), age standardized mortality rate (ASMR), and cancer site composition were extracted from GLOBOCAN, Cancer Statistics 2025, the China Cancer Registry Annual Report, and other epidemiological sources. Spatial (urban-rural, sex specific) and temporal distributions were described, and average annual growth rate (AAGR) were calculated. ResultsFrom 2005 onward, China exhibited a modest rise in ASIR, whereas the US showed a decline (AAGR: 0.58 vs –0.42); nevertheless, China’s overall incidence remained lower (2022 ASIR = 201.61/100 000) than that of the US (303.60/100 000). Both countries experienced decreasing ASMR (AAGR: –1.03 vs –1.72). In both nations, male ASIR and ASMR were higher than female. Since 2005, the top three US cancers had remained prostate (men) or breast (women), lung and colorectal cancer. In China, incidences of lung, colorectal, female breast and thyroid cancers had continued to rise, while stomach and liver cancer incidences had declined yet still rank high among men. Urban ASIR in China exceeded rural rates, whereas rural ASMR was higher than urban counterparts. ConclusionsAccelerating population ageing and lifestyle transitions have driven an upward incidence trend in China, accompanied by a shift towards a mixed pattern of traditional and emerging cancer risks. Drawing on US experience, China should intensify tobacco control measures, expand organized screening and early detection programs, implement comprehensive interventions for priority cancers, strengthen primary level capacity and improve treatment access in rural areas, thereby establishing a more effective national cancer prevention and control system.
Objective To analyze the incidence and mortality of liver cancer in China between 1992 and 2021, in order to provide data support for the prevention and treatment of liver cancer in the country. MethodsUsing the Global Burden of Disease (2021) database, we analyzed the trends and performed an age-period-cohort model analysis on the incidence and mortality of liver cancer by gender in China between 1992 and 2021. An autoregressive integrated moving average model was employed to forecast the age-standardized incidence and mortality rates of liver cancer in China from 2022 to 2030. ResultsCompared with 1992, the number of incident cases and deaths from liver cancer in China in 2021 increased significantly in the total population, males, and females. The percentage changes in the number of cases were 93.94% (101 392→196 637), 94.01% (74 113→143 788), and 93.73% (27 279→52 848), respectively. The corresponding percentage changes in the number of deaths were 75.26% (98 179→172 068), 72.16% (71 133→122 463), and 83.42% (27 045→49 605). The rate of change in incidence for the total population, males, and females in 2021 was 64.33% (8.41 per 100 000→13.82 per 100 000), 66.11% (11.89 per 100 000→19.75 per 100 000), and 62.61% (4.68 per 100 000→7.61 per 100 000), respectively; the rate of change in mortality rate was 48.53% (8.14 per 100 000→12.09 per 100 000), 47.41% (11.41 per 100 000→16.82 per 100 000), and 53.88% (4.64 per 100 000→7.14 per 100 000), respectively. The standardized incidence rates decreased compared to 1992, with changes of –9.16% (10.48 per 100 000→9.52 per 100 000), –4.14% (14.96 per 100 000→14.34 per 100 000), and –17.54% (5.93 per 100 000→4.89 per 100 000) for the total population, males, and females, respectively; the standardized mortality rates decreased by –20.32% (10.48 per 100 000→8.35 per 100 000), –16.61% (14.87 per 100 000→12.40 per 100 000), and –24.84% (6.08 per 100 000→4.57 per 100 000), respectively. The age effect showed significant variations in liver cancer risk with age, with the highest incidence risk in the 65–69 age group for the total population and females, and the 50–54 age group for males. The period effect overall showed an upward trend, with the most significant increase occurring from 2017 to 2021. Cohort effect analysis revealed an inverted U-shaped trend in liver cancer incidence and mortality across birth cohorts, with the peak risk for the total population occurring in the 1932 to 1936 cohort and that for both males and females occurring in the 1952 to 1956 cohort. The incidence and mortality risk for those born between 2017 and 2021 showed a significant downward trend. The prediction results indicated a continuous decline in standard liver cancer incidence and mortality rates for the total population, males, and females in China from 2022 to 2030. ConclusionsFrom 1992 to 2021, the incidence and mortality rates of liver cancer in China increased, while the standardized incidence and mortality rates showed a decreasing trend. Age, period, and cohort are significant factors influencing liver cancer. It is essential to further strengthen liver cancer prevention and control strategies and vaccine implementation.
ObjectiveTo investigate the incidence of perioperative anemia and the influencing factors of preoperative anemia in patients with colorectal cancer.MethodsThe clinicopathological data of 1 250 patients with colorectal cancer who underwent surgery in our hospital from January 1, 2019 to December 31, 2019 were analyzed retrospectively. According to the preoperative hemoglobin level, patients were divided into anemia group and non-anemia group. Univariate analysis and multivariate logistic regression analysis were used to explore the influencing factors of preoperative anemia in patients with colorectal cancer, and the effects of preoperative anemia on intraoperative blood transfusion, postoperative complications, and postoperative hospital stay were analyzed.ResultsThe incidence of preoperative anemia in patients with colorectal cancer was 40.6% (508/1 250), and the incidence of preoperative anemia in patients with right colon cancer, left colon cancer, and rectal cancer was 66.0% (192/291), 41.1% (139/338), and 28.5% (177/621), respectively. The incidence of postoperative anemia in patients with colorectal cancer was 69.4% (867/1 250), and the incidence of postoperative anemia in patients with right colon cancer, left colon cancer, and rectal cancer was 81.8% (238/291), 68.9% (233/338), and 63.8% (396/621), respectively. Multivariate logistic regression analysis showed that age >60 years old, nutritional risk screening 2002 ≥3, right colon cancer, T3–4 stage, and M1 stage were risk factors for preoperative anemia in patients with colorectal cancer (P<0.05). The rate of intraoperative blood transfusion and the incidence of postoperative complications in the preoperative anemia group of patients with colorectal cancer were higher than those in the non-anemia group (P<0.05). The postoperative hospital stay in the preoperative anemia group of patients with colon cancer was longer than that in the non-anemia group (P<0.05).ConclusionsThe incidence of perioperative anemia in patients with colorectal cancer is high. Advanced age, high nutritional risk, right colon cancer, T3–4 stage, and distant metastasis were the risk factors of preoperative anemia in patients with colorectal cancer. Preoperative anemia can increase the demand for intraoperative blood transfusion and the incidence of postoperative complications in patients with colorectal cancer, and prolong postoperative hospital stay of colon cancer patients.
ObjectiveTo interpret and compare the epidemiologic data of gastric cancer incidence and mortality in the world and China during 2018–2022, and to evaluate the disease burden of gastric cancer in China. MethodBased on the GLOBOCAN 2018–2022 cancer registry data released by the International Agency for Research on Cancer (IARC), both the crude and the age-standardized incidence and mortality data of gastric cancer were retrieved, while the situation of gastric cancer incidence and mortality was compared between China and the world. ResultsComparing with the global incidence and mortality of gastric cancer, although the incidence and mortality of gastric cancer in China showed a consistently declining trend, the numbers of incident cases and deaths kept the greatest in the world, which was one of the important cancer disease burdens in China. In the 2022 report, there were 968 350 incident cases and 660 175 deaths from gastric cancer worldwide. Therein, China had the greatest number of incident cases and deaths from gastric cancer, i.e. 358 000 (37.0% of the global total) and 260 000 (39.5% of the global total), respectively. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for gastric cancer worldwide were 9.2/100 000 and 6.1/100 000, respectively; in China, the ASIR and ASMR were 13.7/100 000 and 9.4/100 000, respectively, both of which were higher than the global average levels. Similarly, in terms of the assessment on population morbidity index (PMI), the risk of death from gastric cancer in China appeared a declining trend, but it was still at a higher level compared to the global average. In very high and high human development index (HDI) countries/regions, the ASIR and ASMR of gastric cancer were higher than those in medium and low HDI countries/regions, while the trend was similar when stratified by gross national income (GNI) per capita. In countries/regions with very high HDI or high GNI per capita, the PMI was lower than those in other stratified countries/regions. There were certain geographic disparities in the ASMR of gastric cancer in China. The western region, especially the Qinghai-Tibet Plateau region, had the heaviest burden of gastric cancer deaths, and a few provinces in the central and eastern regions also faced a heavy burden of gastric cancer deaths. Similar to the global situation, the incidence and death risk of gastric cancer were higher among males in China. The ASIR and ASMR in males were more than two times to those in females, while the PMI in males and females were comparable. Globally, subpopulation ≥50 years old entered the age-groups with high incidence of gastric cancer, while in China, the high incidence age-groups were since 45 years old. ConclusionsThe burden of gastric cancer is still heavy in China and higher than the global level. HDI, GNI per capita, regional distribution, gender, and age are associated with the incidence and death risks of gastric cancer. The key points of gastric cancer prevention and control in China should be focused on raising awareness of cancer prevention among the public population, establishing tertiary prevention system in subnational areas, supporting large-scale population screening projects, systematically surveilling the high-risk subpopulation, promoting standardized cancer diagnosis and treatment, and whole-life managing and caring cancer patients.
Objective To explore the effect of multimodal interventions in improving the compliance rate of core infection control measures on reducing the incidence rate of vessel catheter associated infection (VCAI). Methods Inpatients with intravascular catheters in 5 departments with high rates of vascular catheterization and infection of Dongguan People’s Hospital between January 2021 and December 2022 were selected. According to the hospital stay, patients were divided into a pre-intervention group (January to December 2021) and a post-intervention group (January to December 2022). The core infection control measures assessment pass rates of medical staff between the two periods and the differences in the incidence rate of VCAI, average catheterization days, and catheterization rate before and after intervention in both groups were compared. Results A total of 8174 patients were included. Among them, there were 3915 patients in the pre-intervention group and 4259 patients in the post-intervention group. In the pre-intervention group, the total length of hospital stay was 122885 days, the total number of catheterization days was 48028 days, and 28 cases of VCAI occurred. In the post-intervention group, the total length of hospital stay was 126966 days, the total number of catheterization days was 51253 days, and 12 cases of VCAI occurred. After intervention, the compliance rate of VCAI core infection control measures was improved [69.21% (2907/4200) vs. 91.24% (3832/4200); χ2=642.090, P＜0.001], the pass rate of medical staff’s core infection control measures assessment was improved [53.33% (128/240) vs. 91.67% (220/240); χ2=88.443, P＜0.001], the catheterization rate was increased [39.08% (48028/122885) vs. 40.37% (51253/126966); χ2=42.979, P<0.001], and the incidence rate of VCAI was reduced [0.58‰ (28/48028) vs. 0.23‰ (12/51253); incidence-rate ratios =0.40, 95% confidence interval (0.20, 0.79), P=0.008]. Conclusions Improving the compliance rate of VCAI core infection control measures through multimodal interventions can significantly improve the passing rates of core infection control measures of medical staffs. This will help to reduce the incidence of VCAI and ensuring patient safety, provide evidence-based support for the prevention and control of VCAI.
