Fujian Province is one of the provinces with relatively high incidence of digestive sys-tem tumors,the work of cancer prevention and control began in high-prevalence area in the late 1980s.In the past 30 years,Fujian Province has done a lot of work in the research of tumor etiology,cancer prevention and science popularization,screening and early diagnosis and treatment,and achieved some achievements in tumor prevention and control.The paper summarizes the general situation of cancer prevention and control institutions in Fujian Province,the improvement of can-cer registration system,the progress of main cancer screening,the achievement of prevention in high incidence areas,and prospects the future work.

[Purpose]To analyze the epidemic characteristics and survival trends of upper gas-trointestinal cancer in Fujian cancer registration areas from 2011 to 2020.[Methods]Cancer regi-stration data in Fujian Province was collected to calculate the crude incidence and mortality rate,age-standardized incidence/mortality rates by Chinese standard population(ASIRC,ASMRC)and by world standard population(ASIRW,ASMRW)and cumulative rate of 0～74 years old of upper gastrointestinal cancer(including esophageal and gastric cancers)as well as the corresponding temporal trends from 2011 to 2020.Using the Joinpoint software to calculate the annual percent-age change(APC)and average annual percentage change(AAPC)to analyze the trends.The data were divided into two time periods(2011-2015 and 2016-2020)to compare the 5-year relative survival rates of upper gastrointestinal cancer.[Results]From 2011 to 2020,there were 26 286 new cases of upper gastrointestinal cancer in Fujian cancer registration areas,accounting for 20.28％of all malignant tumors.The incidence rate,ASIRC and ASIRW of upper gastrointestinal cancer was 56.52/105,42.55/105,and 42.75/105,respectively,and the cumulative incidence rate(0～74 years old)was 5.32％.Incidence of upper gastrointestinal cancer was higher in men than that in women.The incidence of upper gastrointestinal cancer showed an decreasing trend from 2011 to 2020,with an AAPC of ASIRC of-4.7％(95％CI:-6.6％～-2.9％).There were 11 680 new cases of esophageal cancer in Fujian cancer registration areas,the crude incidence,ASIRC,ASIRW and cumulative incidence(0～74 years old)of esophageal cancer were 25.12/105,18.67/105,18.97/105,and 2.32％,respectively.There were 14 606 gastric cancer new cases in Fujian cancer registration areas during 2011-2020,the crude mortality,ASMRC,ASIRW and cumulative mortality(0～74 years old)of gastric cancer were 31.41/105,23.88/105,23.78/105,and 3.00％,respectively.There were 20 133 upper gastrointestinal cancer deaths during 2011-2020 in Fujian cancer registration areas,accounting for 26.05％of all cancer deaths.The crude mortality,ASMRC and ASMRW of upper gastrointestinal cancer was 43.29/105,31.95/105,and 31.89/105,respectively,the cumu-lative mortality rate(0～74 years old)was 3.84％.The mortality of upper gastrointestinal cancer was higher in men than that in women.The mortality rate of upper gastrointestinal cancer showed a trend of first increase and then decrease,with an APC of 3.5％(95％CI:-0.5％～11.3％)from 2011 to 2014 and-5.2％(95％CI:-8.4％～3.7％)from 2014 to 2020.There were 9 643 deaths of esophageal cancer during 2011-2020 in Fujian cancer registration areas.The crude mortality,ASMRC,ASMRW and cumulative mortality rate(0～74 years old)of esophageal cancer was 20.74/105,15.20/105,15.35/105,and 1.83％,respectively.There were 10 490 deaths of gastric cancer dur-ing 2011-2020 in Fujian cancer registration areas.The crude mortality,ASMRC,ASMRW and cumulative mortality rate(0～74 years old)of gastric cancer was 22.56/105,16.75/105,16.54/105,and 2.00％,respectively.The 5-year relative survival rate for upper gastrointestinal cancer patients during 2011-2015 and 2016-2020 were 24.74％(95％CI:23.92％～25.56％)and 25.49％(95％CI:24.65％～26.34％),respectively.The 5-year relative survival rate for esophageal cancer patients during 2011-2015 and 2016-2020 were 17.15％(95％CI:16.10％～18.22％)and 18.72％(95％CI:17.59％～19.88％),respectively.The 5-year relative survival rate for gastric cancer patients during 2011-2015 and 2016-2020 were 30.90％(95％CI:29.71％～32.10％)and 30.76％(95％CI:29.56％～31.97％),respectively.There was a decreasing trend in 5-year survival of upper gastroin-testinal patients with increasing age,with lower survival rate in patients over 65 years old.[Con-clusion]The incidence and mortality of upper gastrointestinal cancer in Fujian cancer registration areas showed an overall decreasing trend,and the 5-year relative survival rate improved slightly,while the disease burden of upper gastrointestinal cancer remains heavy.Incidence and mortality of upper gastrointestinal cancer of men were higher than those of women,and the elderly patients with upper gastrointestinal cancer had a poorer prognosis.Fujian should pay close attention to the prevention and control of gastric cancer among key groups,and strengthen its comprehensive pre-vention and control ability of upper gastrointestinal cancer.

[Purpose]To analyze the trends of incidence and mortality of gastric cancer in Changle District of Fuzhou City,Fujian Province during 1991-2020.[Methods]The incidence and mor-tality data of gastric cancer from 1991 to 2020 were collected from cancer registries in Changle District.The crude incidence/mortality rates and age-standardized incidence/mortality rates by Chi-nese standard population(ASIRC/ASMRC)of gastric cancer were calculated.The change trends of gastric cancer incidence and mortality were analyzed by the Joinpoint linear regression model,and the annual percentage change(APC)and the average annual percentage change(AAPC)were cal-culated.[Results]From 1991 to 2020,the crude incidence of gastric cancer in Changle District was 62.28/105,the ASIRC was 55.71/105,the ASIRC decreased from 100.94/105 in 1991 to 26.45/105 in 2020 with an AAPC of-4.34％(P＜0.01).The crude mortality rate of gastric cancer was 50.58/105,the ASMRC was 44.35/105,the ASMRC decreased from 93.07/105 in 1991 to 20.03/105 in 2020 with an AAPC of-4.71％(P＜0.01).From 1991 to 2020,the incidence of gastric cancer in Changle District decreased in age groups of 0～44,45～54,55～64,65～74 and older than 75 years old,with the most significant decrease in the 45～54 age group.The mortality decreased in age group of 0～44,45～54,55～64 and 65～74 with the most significant decrease in 45～54 age group;there was no significant change in 75 and above age group.From 1991 to 2020,the median age of gastric cancer onset and death was delayed by 7 years and 13 years,respectively.[Conclusion]The incidence and mortality of gastric cancer had been considerably decreased during 1991-2000,indicating the success of prevention and control in Changle District;but they are still at a high level,so further targeted prevention and control measures are needed.

[Purpose]To analyze the incidence,mortality and survival of cancers in Xiamen City in 2020.[Methods]The data relating to the incidence and mortality of cancers in Xiamen was collected from the Tumor Registration Information Direct Reporting Platform of Fujian Province to calculate the crude rate,age-standardized rate by Chinese standard population(ASRC),cumula-tive rate,truncated rate and their rank.The 5-year survival rate was analyzed by Period Analysis method.[Results]In 2020,the reported incidence rate of cancers in Xiamen residents was 350.46/105.The ASRC,the cumulative rate(0～74 years old),and the truncated rate of incidence(35～64 years old)were 275.12/105,29.70％,477.37/105,respectively.The top five cancers of in-cidence were lung cancer,female breast cancer,thyroid cancer,colorectal cancer and liver cancer.The incidence of cancers in men was higher than that in women(ASRC:280.14/105 vs 271.45/105).The curde mortality rate of cancers was 150.62/105.The ASRC,the cumulative rate(0～74 years old),and the truncated rate(35～64 years old)of mortality were 109.62/105,12.27％,160.38/105,respectively.The top five cancer deaths were lung cancer,liver cancer,colorectal cancer,esoph-agus cancer and stomach cancer.The mortality of caners in men was much higher than that in women(ASRC:155.01/105 vs 69.11/105).The 5-year observed survival rate(OSR),relative sur-vival rate(RSR)and age-standardized relative survival rate(ARSR)were 53.09％(95％C1:51.80％～54.36％),56.30％(95％CI:54.94％～57.65％)and 48.14％(95％CI:46.67％～49.64％),respectively.The 5-year ARSR was lower in men than that in women(40.23％vs 57.75％).[Conclusion]The comprehensive diagnosis and treatment level of cancers in Xiamen is in the middle and above level of the country,but the incidence rate is high.Prevention and control should be strengthened,fo-cusing on the growth trend of thyroid cancer,lung cancer,breast cancer,colorectal cancer and so on.

[Purpose]To analyze the preliminary screening and follow-up results of the early diag-nosis and treatment program for upper gastrointestinal cancer in rural areas of Fujian Province from 2013 to 2022.[Methods]Screening data from the early diagnosis and treatment program for upper gastrointestinal cancer in Fujian Province from 2013 to 2022 were collected and organized.The positive case detection rate,early diagnosis rate,and treatment rate of the screening population were calculated.SPSS 22.0 software was used to test the trend Chi-square test of the annual changes in detection rate,early diagnosis rate and treatment rate.The Chi-square test was used to compare the detection rate and early diagnosis rate between different groups.[Results]From 2013 to 2022,a total of 26 823 screenings and follow-ups were completed in Fujian Province,with de-tection rate,early diagnosis rate,and treatment rate of 1.41％,56.20％,and 92.61％,respec-tively.The early diagnosis rate showed an increasing trend from 2013 to 2022(P＜0.05).The initial screening detected rate and early diagnosis rate were 1.38％and 55.59％,respectively,while fol-low-up detection rate and early diagnosis rate were 5.36％and 75.00％.The detection rates for esophagus,cardia,and stomach cases were 0.70％,0.15％,and 0.58％,respectively,with early diagnosis rates of 64.86％,53.66％,and 46.41％,respectively.The differences in detection rates and early diagnosis rates for each site were statistically significant(all P＜0.05).[Conclusion]With the development of early diagnosis and treatment of upper gastrointestinal cancer in rural areas of Fujian Province and the improvement of residents'awareness of cancer prevention,the detection rate and early diagnosis rate of upper gastrointestinal cancer in Fujian Province have been im-proved,which plays an important role in improving the survival rate of patients.

[Purpose]To estimate the trends in disability-adjusted life years(DALY)caused by gastric cancer(GC)in China from 2000 to 2021.[Methods]Using data from Global Burden of Disease 2021,the DALY and age-standardized DALY rates of gastric cancer from 2000 to 2021 in the Chinese population were analyzed.An age-period-cohort model was used to evaluate the average annual percentage change(AAPC)in DALY rates from 2000 to 2021 in China,and to compare with those in the world,Japan,Korea,and the United States of America.We analyzed the changes in GC DALYs associated with population aging,population growth,and age-specific DALY rates from 2001 to 2021 using a decomposition method,by taking data in 2000 as a refer-ence.[Results]In 2021,GC DALY in the Chinese population were 1 064.21×104 person-years,accounting for 46.70％of the global GC DALY and 14.94％of all cancers DALY in China.The DALY in those aged ≥65 years old accounted for 49.97％.From 2000 to 2021,the total GC DALY in the Chinese population decreased by 4.59％,and the age-standardized rate decreased from 959.29/105 to 501.26/105.From 2000 to 2021,similar decreased trends were observed in China and Japan,with AAPC being-3.58％and-3.72％,respectively.A higher decreased trend was observed in Korea,whereas relatively modest decreased trends were observed in the global levels and in the United States of America,with AAPC being-5.04％,-2.79％,and-1.48％,respectively.From 2000 to 2021,age-specific DALY rates and population aging accounted for the largest decrease and increase in GC DALY.The changes in GC DALY attributed to these two fac-tors were-14.84％(-760.41×104 person-years)and 9.65％(494.56x104 person-years),respectively.[Conclusion]The disease burden of GC in China decreased in the past 20 years.GC DALYs at-tributed to rapidly increased population aging,and population aging has become the first driving factor for the DALY increase in China.The coverage of GC screening population and the inter-vention measures of population aging should be strengthened.

[Purpose]To analyze the incidence and mortality of thyroid cancer in Gansu cancer registration areas in 2019 and the trends from 2010 to 2019.[Methods]The data of thyroid can-cer from 2010 to 2019 were collected from 23 cancer registries in Gansu Province and the data quality was evaluated.The crude incidence/mortality rates,age-standardized incidence/mortality rates by Chinese standard population(ASIRC,ASMRC)and world standard population(ASIRW,ASMRW)and cumulative rate(0～74 years old)were calculated.The annual percentage change(APC)and average annual percentage change(AAPC)were calculated with Joinpoint software to analyze the trends of the incidence and mortality from 2010 to 2019.[Results]In 2019,the crude incidence of thyroid cancer was 6.89/105,the ASIRC was 5.50/105,the ASIRW was 5.33/105 and the cumulative rate(0～74 years old)was 0.48％in 2019.The crude mortality rate of thy-roid cancer was 0.42/105,ASMRC was 0.27/105,ASMRW was 0.31/105,cumulative rate(0～74 years old)was 0.03％.Incidence and mortality rates gradually increasing at age 30 and 55,re-spectively,reaching the peaks in the 45～49 and 60～64 age groups,respectively.Chengguan Dis-trict of Lanzhou City had the highest incidence rate,and Gulang County had the highest mortality rate.From 2010 to 2019,the AAPC of ASIRC of thyroid cancer was 17.12％(95％CI:7.52％～30.42％,P＜0.05)showing an upwards trend;while that of ASMRC was-3.64％(95％CI:-15.67％～10.10％,P＞0.05)showing a downward trend,but the change was not statistically significant.[Conclusion]The overall incidence of thyroid cancer in Gansu cancer registration areas is on the rise,and the prevention of high-risk groups should be strengthened.

[Purpose]To analyze the incidence and mortality trends,and survival of gallbladder cancer in Nantong City of Jiangsu Province from 2013 to 2017.[Methods]The gallbladder cancer incidence and mortality data from 2013 to 2017 were collected from Nantong cancer registries.The crude incidence/mortality rates,age-standardized incidence/mortality rates by Chinese and world standard population(ASIRC/ASMRC,ASIRW/ASMRW)were calculated by sex,age and regions(urban and rural).Joinpoint software was used to analyze the incidence and mortality trends of gallbladder cancer.The observed survival rate and relative survival rate were calculated by using life table method and Ederer Ⅱ method.[Results]From 2013 to 2017,the gallbladder cancer crude incidence and mortality rates were 6.36/105 and 4.91/105,ASIRC and ASMRC were 2.62/105 and 1.94/105,respectively.The crude incidence and mortality,and ASMRC showed an upwards trend(all P＜0.05).The ASIRC for men and women was 2.43/105 and 2.83/105,the ASMRC for men and women was 1.74/105 and 2.16/105,respectively.ASIRC and ASMRC in women were higher than those in men.The ASIRC in urban and rural areas was 2.40/105 and 2.69/105,and the ASMRC was 1.61/105 and 2.05/105,respectively.ASIRC and ASMRC in rural areas were higher than those in urban areas.The average age of onset was 70.33 years old and the average age of death was 71.86 years old.The 5-year observed survival rate was 12.90％,and the 5-year relative survival rate was 14.47％.Both the 5-year observed survival rate and relative survival rate showed an upwards trend(both P＜0.05).[Conclusion]The incidence and mortality rates of gall-bladder cancer in Nantong City are relatively high and the survival rate is generally low.It is sug-gested that targeted prevention and control measures of gallbladder cancer in Nantong City should be strengthened,particularly in rural areas and for middle-aged and elderly women.

[Purpose]To analyze the compliance rates and influencing factors for gastroscopy and colonoscopy in gastrointestinal cancer screening,and to provide evidence and management recom-mendations for gastrointestinal cancer screening programs.[Methods]The study was based on the joint gastrointestinal cancer screening program conducted in Fenghua District of Ningbo City in 2023.The target population underwent risk assessments,following which high-risk individuals were mobilized for gastroscopy and colonoscopy screenings.The x2 test was used to compare the positive rates of gastrointestinal cancer risk assessments and the compliance rates of clinical screenings among populations with different characteristics.Multivariable Logistic regression models were applied to analyze the factors associated with compliance rates of clinical gastroscopy and colonoscopy screenings among high-risk individuals.[Results]A total of 48 587 individuals were included in the analysis,with an average age of(63.95±7.48)years old.Among them,39.45％(19 166 individuals)were male.The positive rates of risk assessment for upper gastrointestinal cancer and colorectal cancer were 39.00％(18 949 individuals)and 16.02％(7 782 individuals),respectively.The compliance rates for gastroscopy and colonoscopy were 59.51％(11 227/18 949)and 50.85％(3 957/7 782),respectively.Multivariable Logistic regression analysis revealed that unmarried in-dividuals and those with an assessment interval of more than 14 d had lower compliance with gas-troscopy(both P＜0.05).High-risk individuals for upper gastrointestinal cancer with BMI≥24 kg/m2,gastrointestinal symptoms,history of upper gastrointestinal diseases,family history of cancers,history of gastroscopy,lower intake of fresh vegetables and fruits,and higher intake of processed meats had higher compliance with gastroscopy(all P＜0.05).High educational levels and an assess-ment interval of more than 14 d were associated with lower compliance with colonoscopy(both P＜0.05).Among individuals at high risk for colorectal cancer,those with gastrointestinal symptoms,history of upper gastrointestinal diseases,higher intake of processed meats and fried or grilled foods,and a positive risk assessment for upper gastrointestinal cancer had higher compliance with colonoscopy(all P＜0.05).[Conclusion]Participants in the joint gastrointestinal cancer screening program exhibit high compliance with both gastroscopy and colonoscopy.Compliance with gas-troscopy and colonoscopy is associated with individual lifestyle,health conditions,disease history,medical history,and family history of cancers.

Metabolites,as the end products of biochemical reactions within organisms,directly reflect the interplay of gene expression,protein function,and environmental factors,offering a comprehensive reflection of the organism's response to inherent genetic variations and external environmental changes.By systematically analyzing changes in human metabolite profiles,metabolomics aids in the identification of potential biomarkers,offering new insights for the early diagnosis,prevention,and personalized treatment of diseases.In recent years,research method-ologies in metabolomics have increasingly been applied to the etiological studies of liver cancer.This paper aims to review existing research reports to understand the application of metabolomics in the study of liver cancer etiology,with a focus on high-level evidence from prospective cohort studies and case-control studies nested within cohorts.By summarizing the current research evi-dence,the paper aims to advance the study of the etiological mechanisms of liver cancer,under-stand the pathogenic mechanisms of known risk factors,and offer a scientific foundation for the prediction of liver cancer.