Objective To analyze the risk factors for complications in elderly patients with cardiac surgery under cardiopulmonary bypass.Methods From July 2004 to June 2012,64 patients aged ≥ 60 years undergoing cardiac operations were selected.Clinical data were collected.The complications after cardiac operation and the risk factors were evaluated by single factor analysis and multivariate Logistic regression analysis with SPSS software.Results The postoperative complication rate in all patients was 34.4％ (22/64).The complications occurred in 42 subjects and operative mortality was 6.3％ (4/64).The single factor analysis showed that chronic obstructive pulmonary disease combined before operation (P=0.001),diabetes combined before operation (P=0.009),cardiopulmonary bypass time ≥2 h (P=0.000),aortic cross clamping time ≥90min (P=0.001),and blood transfusion volume ≥2000 ml (P =0.000) were the important risk factors for postoperative complications.Multivariate Logistic regression analysis revealed that chronic obstructive pulmonary disease (P=0.007) and diabetes combined before operation (P=0.028),cardiopulmonary bypass time ≥2 h (P=0.003),and blood transfusion volume ≥2000 ml (P=0.030) were the significant independent predictive risk factors for postoperative complications.Conclusions Chronic obstructive pulmonary disease,diabetes,cardiopulmonary bypass time ≥2 h,aortic cross clamping time ≥90 min,and blood transfusion volume ≥2000 ml are the independent predictive risk factors for postoperative complications in elderly patients with cardiac surgery under cardiopulmonary bypass.

Objective: To investigate the survival rate and changing trends of kidney cancer patients in Qidong City from 1972 to 2016, so as to provide insights into kidney cancer control. Methods: Data pertaining to the incidence of kidney cancer in Qidong City from 1972 to 2016 were captured from the Qidong Municipal Cancer Registration System, and the final follow-up period was December 31, 2021. The observed survival rate, relative survival rate and standardized relative survival rate of kidney cancer were calculated to analyze the survival of kidney cancer, and the trends in survival were analyzed among kidney cancer patients from 1972 to 2016 using annual percent change (APC). Results: A total of 554 kidney cancer patients were reported in Qidong City from 1972 to 2016. The 1-, 3- and 5-year observed survival rates, relative survival rates and standardized relative survival rates were 62.27%, 50.54% and 44.04%; 64.31%, 55.71% and 51.93%; and 61.71%, 51.90%, and 51.68%, respectively. The 5-year observed survival rate, relative survival rate and standardized relative survival rate of kidney cancer appeared a tendency towards a rise in Qidong City from 1972 to 2016, with APC of 2.83% (t=4.303, P=0.004), 2.82% (t=3.978, P=0.005) and 3.96% (t=5.898, P=0.001), and the 5-year relative survival rate of kidney cancer was comparable between men and women (53.05% vs. 50.40%; χ2=4.872, P=0.676). There was an age-specific 5-year relative survival rate of kidney cancer (χ2=35.144, P<0.001), with the greatest among patients at ages of 35 to 44 years (64.49%) and the lowest at ages of 75 years and older (30.11%). Conclusion The 5-year survival rate of kidney cancer cases appeared a tendency towards a rise in Qidong City from 1972 to 2016. Further specific interventions, depending on age, are needed for management of kidney cancer.

Objective:To analyze the survival of pancreatic cancer cases in Qidong County, Jiangsu Province from 1972 to 2016, and provide a basis for the prognosis evaluation and prevention of pancreatic cancer.Methods:Data from a total of 4 341 registered pancreatic cancer patients in Tumor Registry of Qidong from January 1972 to December 2016 were selected, and all the patients were followed up until December 31, 2021. 1-, 3- and 5-year observed survival rate (OSR) and relative survival rate (RSR) were calculated and tested by Hakulinen likelihood ratio test method using SURV (3.01) software. Age-standardized relative survival rate (ARSR) was calculated according to the International Cancer Survival Standard (ICSS). Joinpoint (4.7.0.0) software was used to conduct the annual percentage change (APC) of pancreas cancer survival rate.Results:1-, 3- and 5-year OSR of pancreatic cancer were 13.82%, 5.87% and 4.70%, and 1-, 3- and 5-year RSR were 14.50%, 6.80% and 6.02%, respectively. 1-, 3- and 5-year RSR increased from 11.76%, 4.84% and 3.29% in 1972—1976 to 18.80%, 7.39% and 6.49% in 2012—2016. The uptrends of RSR were statistically significant (χ 2=59.84, P<0.001). 1-, 3- and 5-year RSR for male were 14.31%, 6.40% and 5.82%, and 1-, 3- and 5-year RSR for female were 14.74%, 7.28% and 6.26%, respectively. There was no statistically significant difference on RSR between male and female (χ 2=6.68, P=0.463). The 5-year RSR for the age group of 45-54, 55-64, 65-74, and ≥75 years old were 8.14%, 6.74%, 4.69% and 5.24%, respectively, and the survival rate was decreased with age. There was a statistically significant difference on RSR among different age groups (χ 2=19.52, P=0.012). 1-, 3- and 5-year ARSR of pancreas cancer were 14.67%, 6.84% and 6.04%. For male, 1-, 3- and 5-year ARSR were 14.36%, 6.42% and 5.79%, and for female were 15.25%, 7.55% and 6.47%, respectively. Period trend analysis showed that the APC of 1-, 3- and 5-year ARSR was 0.91% ( t=1.94, P=0.094), -0.22% ( t=-0.30, P=0.774) and -0.77% ( t=-0.95, P=0.374) from 1972 to 2016 in Qidong. The APC of 5-year ARSR in male and female were -1.50% ( t=-1.31, P=0.232) and 1.11% ( t=0.37, P=0.722); there were no statistically significant increase or decrease for both male and female among ARSR in nine periods (5 years as a period). The APC of 5-year RSR among 45-54, 55-64, 65-74 and ≥75 years old were 2.46% ( t=0.57, P=0.588), 3.16% ( t=0.87, P=0.413), 0.95% ( t=0.26, P=0.805) and -2.56% ( t=-2.61, P=0.035), respectively. Except for ≥75 years old age group who had a statistically significant downward trend, there were no statistically significant upward trend in the other age groups. Conclusions:The overall survival rate of pancreatic cancer in Qidong from 1972 to 2016 has been at a low level, and it is necessary to introduce a standardized multi-disciplinary treatment mode to improve treatment efficacy and survival rate.

Objective:To analyze the survival rate of malignant tumor in the elderly over 60 years old in Qidong city from 1972 to 2016, and to provide basis for prognosis evaluation and prevention.Methods:Based on the data of 66 386 patients with malignant tumor in the elderly over 60 years old in the Qidong cancer registration and reporting system, the survival outcome was tracked by the method of active follow-up and passive follow-up.All of these data were then analyzed by stratification of sex, age, tumor site and hospital level.Results:During the period of 1972 to 2016, the total number of patients with malignant tumors in the elderly were 66 386 cases, accounting for 56.66% of patients in all age groups.The observed survival rate(OSR)of 5 and 10 years were 14.52% and 9.53% and relative survival rate(RSR)of 5 and 10 years were 19.76% and 18.92%, respectively, in the elderly in Qidong.The 5-year RSR was 16.98% for males and 23.91% for females, being a statistically significant( χ2=339.83, P<0.001). The 5-year RSRs of elderly patients in males and females increased from 7.53% and 15.83% in 1972-1976 to 28.06% and 39.01% in 2012-2016, respectively.The 5-year RSR of 60-64, 65-69, 70-74, 75-79, 80-84 and 85 years old and over were 22.84%, 20.53%, 17.74%, 18.30%, 18.02% and 14.06%, respectively, with a statistically significant difference( χ2=694.27, P<0.001). Among the top 10 major malignancies, the ranks of 5-year RSR from high to low were breast cancer, prostate cancer, bladder cancer, colorectal cancer, malignant lymphoma, gastric cancer, liver cancer, esophageal cancer, lung cancer, and pancreatic cancer, respectively.A comparison between 2002--2016 and 1972--1986 showed that the increased rank of absolute values of RSR from highest to lowest were prostate cancer, colorectal cancer, female breast cancer, bladder cancer, gastric cancer, malignant lymphoma, liver cancer, esophageal cancer, lung cancer, and pancreatic cancer, respectively.The 5-year RSR of patients diagnosed in the district / township hospitals, county hospitals, city-level 3A hospitals and provincial-level 3A hospitals were 13.97%, 23.71%, 26.12% and 28.55%, respectively, with a statistically significant difference( χ2=841.93, P<0.001). In the 45 years, the average annual percentage change(AAPC)ratio of 5-year OSR was 3.88%( t=6.75, P<0.001), and the 5-year RSR was 3.69%( t=7.44, P=0.001); the AAPC of the 5-year RSR was 3.91%( t=9.66, P<0.001)in males and 3.42%( t=6.08, P=0.001)in females.The AAPC ratio of 5-year RSR in each age group were 4.08% for 60-64 years, 4.18% for 65-69 years, 3.91% for 70-74 years, 3.12% for 75-79 years, 3.81% for 80-84 years, 0.51% for 85 years old and over, respectively.Except for age group of 85 years old and over( P=0.615), significant rising trends were observed in all age groups( P<0.01). Conclusions:Malignant tumors in the elderly have become the major cancer burden in Qidong, and there are significant gender and age differences.The overall survival rate in elderly patients with malignant tumors has been significantly improved in the past 45 years, which may be related to the improvement in the level of diagnosis and treatment and the service capacity of hospitals.

Crude mortality rate (CR) for lung cancer in Qidong increased from 11.50/10 5 in 1972-1976 to 76.61/10 5 in 2012-2016, China age-standardized rate (CASR) from 13.11/10 5 in 1972-1976 to 34.27/10 5 in 2012-2016, and World age-standardized rate (WASR) from 13.40/10 5 in 1972-1976 to 34.30/10 5 in 2012-2016. The average annual percentage change (AAPCs) of CR, CASR, WASR were 4.87% (95% CI: 4.63%-5.12%), 2.17% (95% CI: 1.96%-2.38%), 2.12% (95% CI: 1.92%-2.33%) (all P values <0.001), respectively. AAPCs for 45-54, 55-64, 65-74 and over 75 age groups were 0.74% (95% CI: 0.36%-1.11%), 1.23% (95% CI: 0.92%-1.53%), 2.55% (95% CI: 2.20%-2.90%), 4.26% (95% CI: 3.56%-4.96%) (all P values <0.001), respectively.

Objective:To describe the trend of upper gastrointestinal cancer mortality in Qidong between 1972 and 2016, and to provide guidelines for prevention and control measures and strategies.Methods:The upper gastrointestinal data was collected in Qidong cancer registration from 1972 to 2016. Crude mortality rate (CR), China age-standardized rate (CASR), world age-standardized rate (WASR), truncated rate (35-64 years old), cumulative rate (0-74 years old) and cumulative risk were calculated. Annual percent change (APC) was calculated by Joinpoint software. Age-period-cohort model was used to analyze the influence of age, period and birth cohort on the changes in the mortality trend of upper gastrointestinal cancer patients.Results:From 1972 to 2016, there were 20 658 deaths of upper gastrointestinal cancer in Qidong, accounting for 20.89% of all cancer deaths. The CR, CASR, WASR, truncated rate (35-64 years old), cumulative rate (0-74 years old) and cumulative risk were 40.85/100 000, 27.96/100 000, 27.69/100 000, 36.01/100 000, 3.30% and 3.25%, respectively. There were 13 429 male deaths, the CR, CASR, and the WASR were 53.81/100 000, 37.62/100 000, and 39.93/100 000; the female deaths were 7 229, and the CR, CASR, and WASR were 28.23/100 000, 18.87/100 000, 17.25/100 000, respectively. The APCs of the 45-year-old, 55-year-old and 65-year-old age groups were -2.94% (95% CI: -3.32%, -2.56%), -2.94% (95% CI: -3.22%, -2.66%) and -2.04% (95% CI: -2.39%, -1.69%), with significant difference ( P<0.05), while without significance of 75-year-old group ( P>0.05). From 1972 to 2016, the APCs of CR, CASR, and WASR in the gastrointestinal cancer were 0.65% (95% CI: 0.43%, 0.87%), -2.01% (95% CI: -2.24%, -1.77%) and -2.05% (95% CI: -2.28%, -1.81%). The age-period-cohort model showed that the mortality of upper gastrointestinal cancer was increased with age ( P<0.05). Conclusions:The crude mortality of upper gastrointestinal cancer increases slightly in Qidong, while the CASR and WASR decrease significantly. However, with aged tendency of population, the early diagnosis and treatment of upper gastrointestinal cancer is still needed to be paid attention.

Objective:To describe the epidemiological characteristics and trends of leukemia incidence in Qidong between 1972 and 2021, and provide guidelines for prevention and control measures and strategies.Methods:The cancer registry data was collected and analyzed on leukemia incidence during 1972—2021 in Qidong by sex, age and time. Crude incidence rate (CR), China age-standardized rate (ASRC), world age-standardized rate (ASRW), and average annual change percentage (AAPC) was calculated by Joinpoint software. Age-period-cohort (APC) model was used to analyze the influence of age, period and birth cohort on the changes in the incidence trend of leukemia patients.Results:From 1972 to 2021, there were 2 948 patients with leukemia in Qidong, accounting for 2.00% of all cancer new cases, CR of leukemia was 5.26/10 5, ASRC was 4.34/10 5, ASRW was 4.35/10 5. The truncated incidence of 35—64 years old was 5.29/10 5, the cumulative incidence rate between the ages of 0 and 74 years old was 0.40%, the cumulative risk was 0.40%. There were 1 608 male patients, the CR, ASRC, and the ASRW were 5.81/10 5, 4.88/10 5 and 4.85/10 5. The number of female patients were 1 340, and the CR, ASRC, and the ASRW were 4.71/10 5, 3.86/10 5 and 3.91/10 5, respectively. Temporal trends indicated significant upward trends in ASRC among both gender, males and females with AAPC values of 1.41% ( P＜0.001), 1.15% ( P＜0.001), and 1.73% ( P＜0.001), respectively. The results of the APC model showed that the average net drift value of leukemia incidence in all age groups was 1.57% (95% CI, 1.24%-1.89%), and the highest value of local drift was 3.20% (95% CI, 1.63%-4.78%) in the 80~ years old group. The incidence of leukemia increased with age. With the passage of time, the risk of leukemia incidence increased gradually compared with the rate ratio of leukemia incidence (risk ratio [ RR], 1.00) in 1992—1996, the RR of leukemia incidence increased from 0.70 during 1972—1976 to 1.57 during 2017—2021. The later the cohort was born, the greater the risk of leukemia incidence compared with the relative risk of leukemia incidence ( RR, 1.00) in 1952—1956 cohort, the RR of leukemia incidence increased from 0.24 in the 1892—1896 cohort to 2.73 in the 2017—2021 cohort. Conclusions:The incidence of the leukemia has presented a rising trend in the past fifty years. Leukemia incidence increased with age, and the period and cohort effects on the risk of incidence increase. Further research is needed to investigate the risk factors related to leukemia.

Crude mortality rate (CR) for lung cancer in Qidong increased from 11.50/10 5 in 1972-1976 to 76.61/10 5 in 2012-2016, China age-standardized rate (CASR) from 13.11/10 5 in 1972-1976 to 34.27/10 5 in 2012-2016, and World age-standardized rate (WASR) from 13.40/10 5 in 1972-1976 to 34.30/10 5 in 2012-2016. The average annual percentage change (AAPCs) of CR, CASR, WASR were 4.87% (95% CI: 4.63%-5.12%), 2.17% (95% CI: 1.96%-2.38%), 2.12% (95% CI: 1.92%-2.33%) (all P values <0.001), respectively. AAPCs for 45-54, 55-64, 65-74 and over 75 age groups were 0.74% (95% CI: 0.36%-1.11%), 1.23% (95% CI: 0.92%-1.53%), 2.55% (95% CI: 2.20%-2.90%), 4.26% (95% CI: 3.56%-4.96%) (all P values <0.001), respectively.

Objective:To describe the trend of upper gastrointestinal cancer mortality in Qidong between 1972 and 2016, and to provide guidelines for prevention and control measures and strategies.Methods:The upper gastrointestinal data was collected in Qidong cancer registration from 1972 to 2016. Crude mortality rate (CR), China age-standardized rate (CASR), world age-standardized rate (WASR), truncated rate (35-64 years old), cumulative rate (0-74 years old) and cumulative risk were calculated. Annual percent change (APC) was calculated by Joinpoint software. Age-period-cohort model was used to analyze the influence of age, period and birth cohort on the changes in the mortality trend of upper gastrointestinal cancer patients.Results:From 1972 to 2016, there were 20 658 deaths of upper gastrointestinal cancer in Qidong, accounting for 20.89% of all cancer deaths. The CR, CASR, WASR, truncated rate (35-64 years old), cumulative rate (0-74 years old) and cumulative risk were 40.85/100 000, 27.96/100 000, 27.69/100 000, 36.01/100 000, 3.30% and 3.25%, respectively. There were 13 429 male deaths, the CR, CASR, and the WASR were 53.81/100 000, 37.62/100 000, and 39.93/100 000; the female deaths were 7 229, and the CR, CASR, and WASR were 28.23/100 000, 18.87/100 000, 17.25/100 000, respectively. The APCs of the 45-year-old, 55-year-old and 65-year-old age groups were -2.94% (95% CI: -3.32%, -2.56%), -2.94% (95% CI: -3.22%, -2.66%) and -2.04% (95% CI: -2.39%, -1.69%), with significant difference ( P<0.05), while without significance of 75-year-old group ( P>0.05). From 1972 to 2016, the APCs of CR, CASR, and WASR in the gastrointestinal cancer were 0.65% (95% CI: 0.43%, 0.87%), -2.01% (95% CI: -2.24%, -1.77%) and -2.05% (95% CI: -2.28%, -1.81%). The age-period-cohort model showed that the mortality of upper gastrointestinal cancer was increased with age ( P<0.05). Conclusions:The crude mortality of upper gastrointestinal cancer increases slightly in Qidong, while the CASR and WASR decrease significantly. However, with aged tendency of population, the early diagnosis and treatment of upper gastrointestinal cancer is still needed to be paid attention.

Objective:To describe the epidemiological characteristics and trends of leukemia incidence in Qidong between 1972 and 2021, and provide guidelines for prevention and control measures and strategies.Methods:The cancer registry data was collected and analyzed on leukemia incidence during 1972—2021 in Qidong by sex, age and time. Crude incidence rate (CR), China age-standardized rate (ASRC), world age-standardized rate (ASRW), and average annual change percentage (AAPC) was calculated by Joinpoint software. Age-period-cohort (APC) model was used to analyze the influence of age, period and birth cohort on the changes in the incidence trend of leukemia patients.Results:From 1972 to 2021, there were 2 948 patients with leukemia in Qidong, accounting for 2.00% of all cancer new cases, CR of leukemia was 5.26/10 5, ASRC was 4.34/10 5, ASRW was 4.35/10 5. The truncated incidence of 35—64 years old was 5.29/10 5, the cumulative incidence rate between the ages of 0 and 74 years old was 0.40%, the cumulative risk was 0.40%. There were 1 608 male patients, the CR, ASRC, and the ASRW were 5.81/10 5, 4.88/10 5 and 4.85/10 5. The number of female patients were 1 340, and the CR, ASRC, and the ASRW were 4.71/10 5, 3.86/10 5 and 3.91/10 5, respectively. Temporal trends indicated significant upward trends in ASRC among both gender, males and females with AAPC values of 1.41% ( P＜0.001), 1.15% ( P＜0.001), and 1.73% ( P＜0.001), respectively. The results of the APC model showed that the average net drift value of leukemia incidence in all age groups was 1.57% (95% CI, 1.24%-1.89%), and the highest value of local drift was 3.20% (95% CI, 1.63%-4.78%) in the 80~ years old group. The incidence of leukemia increased with age. With the passage of time, the risk of leukemia incidence increased gradually compared with the rate ratio of leukemia incidence (risk ratio [ RR], 1.00) in 1992—1996, the RR of leukemia incidence increased from 0.70 during 1972—1976 to 1.57 during 2017—2021. The later the cohort was born, the greater the risk of leukemia incidence compared with the relative risk of leukemia incidence ( RR, 1.00) in 1952—1956 cohort, the RR of leukemia incidence increased from 0.24 in the 1892—1896 cohort to 2.73 in the 2017—2021 cohort. Conclusions:The incidence of the leukemia has presented a rising trend in the past fifty years. Leukemia incidence increased with age, and the period and cohort effects on the risk of incidence increase. Further research is needed to investigate the risk factors related to leukemia.