Objective : To analyze the trends in mortality and life lost due to bladder cancer in Suzhou City, Jiangsu Province from 2003 to 2022, so as to provide the reference for prevention and treatment strategy of bladder cancer. Methods: The data of bladder cancer death in Suzhou City from 2003 to 2022 were collected through Suzhou Residents' Death Registration System, including age, gender, date of death and underlying cause of death. The crude mortality, standardized mortality, years of potential life lost (PYLL), standardized years of potential life lost (SPYLL), years of potential life lost rate (PYLLR), standardized years of potential life lost rate (SPYLLR) and average years of life lost (AYLL) were calculated. The average annual percent change (AAPC) was used to analyze the trends in bladder cancer death and life lost. Results: Totally 2 978 deaths occurred due to bladder cancer in Suzhou City from 2003 to 2022. The crude mortality was 2.22/105, which appeared a tendency towards a rise (AAPC=4.271%, P<0.05). The standardized mortality was 0.91/105, which appeared no significant changing trend (P>0.05). The standardized mortality was 1.58/105 in males and 0.37/105 in females, which appeared no significant tendency in males (P>0.05) and appeared a tendency towards a decline in females (AAPC=-2.331%, P<0.05). The age-specific crude mortality was low among people who aged under 45 years, began to rise among people aged over 45 years and peaked among people aged 60 years and older. The crude mortality of bladder cancer in males aged 60 years and older showed an increasing trend (AAPC=2.864%, P<0.05), but there was no significant tendency in females aged 60 years and older (P>0.05). The PYLL, SPYLL, PYLLR, SPYLLR and AYLL of bladder cancer were 5 020.00 person-years, 2 945.14 person-years, 0.04‰, 0.03‰ and 9.07 years per person. SPYLL, SPYLLR and AYLL showed an decreasing trend (AAPC=-2.867%, -3.321%, -3.738%, P<0.05). Conclusions The mortality of bladder cancer in Suzhou City appeared a tendency towards a rise from 2003 to 2022. The PYLL appeared a downward trend. Males aged 60 years and older are the key groups for the prevention and control of bladder cancer.

Objective: To investigate the mortality trends and life loss due to pancreatic cancer death among residents in Suzhou City from 2006 to 2020, so as to provide insights into the management of pancreatic cancer. Methods : The data pertaining to the death of pancreatic cancer in Suzhou City from 2006 to 2020 were collected from the Jiangsu provincial mortality surveillance system. The crude mortality, standardized mortality, years of potential life lost ( YPL L), rate of YPLL ( YPLLR ), average years of life lost ( AYLL ) and annual percent change (APC) were calculated to analyze the changing trend in mortality and life loss due to pancreatic cancer. Results: The crude mortality of pancreatic cancer was 13.57/105 in Suzhou City from 2006 to 2020, appearing a tendency towards a rise ( P<0.05) with APC of 2.95%. The standardized mortality of pancreatic cancer was 6.39/105. The crude mortality of pancreatic cancer was 15.14/105 in men and 12.06/105 in women, which both showed a tendency towards a rise ( P<0.05 ) with APC of 3.18% and 2.73%. The crude mortality of pancreatic cancer appeared a tendency towards a decline in residents at ages of 30 to 45 years and 45 to 60 years ( P<0.05 ), with APC of -4.93% and -1.63%, and appeared a tendency towards a rise in residents at ages of 60 years and greater ( P<0.05 ), with APC of 0.53%. The YPLL and YPLLR of pancreatic cancer were 55 340 person-years and 0.06% in Suzhou City from 2006 to 2020, while the AYLL of pancreatic cancer was 9.81 years per person, which appeared a tendency towards a decline ( P<0.05 ), with APC of -2.35%. Conclusions The crude mortality of pancreatic cancer appeared a tendency towards a rise in Suzhou City from 2006 to 2020, and the AYLL showed a tendency towards a decline. Health education and screening of pancreatic cancer should be reinforced among men and the elderly.

Objective: To investigate the trends in mortality and life lost due to female breast cancer among in Suzhou City from 2007 to 2021, so as to provide insights into improvements of breast cancer control strategy in Suzhou City. Methods: The epidemiological and clinical data pertaining to dead female breast cancer cases in Suzhou City from 2007 to 2021 were collected from Suzhou Municipal Chronic Disease Surveillance System, including gender, age and cause of death. The crude mortality, standardized mortality, years of potential life lost (YPLL), years of potential life lost rate (YPLLR), standardized YPLL (SYPLL), standardized YPLLR (SYPLLR) and average years of life lost (AYLL) due to female breast cancer were calculated. All data were standardized by the Fifth National Population Census in 2000, and the trends in mortality of breast cancer were estimated using average annual percent change (AAPC). Results: Totally 4 425 death occurred due to female breast cancer in Suzhou City from 2007 to 2021, with a crude mortality rate of 8.67/105, which appeared a tendency towards a rise (AAPC=1.83%, t=5.080, P=0.001), and the standardized mortality was 4.68/105, which appeared no significant changes (AAPC=0.13%, t=0.356, P=0.727). The crude mortality rates of female breast cancer were 0.62/105, 10.33/105 and 21.69/105 among women at ages of 15 to 34, 35 to 64 years and 65 years and older, respectively, which appeared a tendency towards a rise (χ2trend=2 315.683, P=0.001). The crude mortality of female breast cancer was 8.66/105 in urban areas and 8.86/105 in rural areas, both appearing a tendency towards a rise (urban areas: AAPC=1.73%, t=3.290, P=0.006; rural areas: AAPC=2.68%, t=6.565, P=0.001). The YPLL, SYPLL, YPLLR, SYPLLR and AYLL of female breast cancer were 44 485 person-years, 30 387 person-years, 0.99‰, 0.68‰ and 14.94 years per person, and both YPLLR (AAPC=-1.06%, t=-2.193, P=0.047) and AYLL (AAPC=-1.53%, t=-4.783, P=0.001) appeared a tendency towards a reduction, respectively. Conclusion The crude mortality of female breast cancer appeared a tendency towards a rise and the life loss appeared a tendency towards a decline in Suzhou City from 2007 to 2021. The elderly population should be given a high priority for breast cancer control.

Objective : To investigate the prevalence of comorbid chronic obstructive pulmonary disease (COPD) and osteoporosis (OP) and its influencing factors among residents aged 40 years and older in Zhangjiagang City, Jiangsu Province, so as to provide insights into prevention of comorbid COPD and OP. Methods: Permanent residents aged 40 years and older were sampled using a multi-stage stratified cluster random sampling method in Zhangjiagang City in 2019, and their pulmonary functions and bone mineral density were measured. The prevalence of comorbid COPD with OP was estimated. The demographic features, smoking, diet, exercises and physical examinations were collected, and factors affecting the prevalence of comorbid COPD with OP were identified using a logistic regression model. Results: Totally 3 140 subjects were enrolled, including 1 315 men (41.88%) and 1 825 women (58.12%), and a mean age of (62.89±9.13) years. A total of 137 subjects were detected with comorbid COPD and OP, with prevalence of 4.36%. The patients with COPD alone included 19 cases with mild, 133 cases with moderate, 87 cases with severe and 26 cases with very severe COPD, and the patients with comorbid COPD and OP included 10 cases with mild, 56 cases with moderate, 56 cases with severe and 15 cases with very severe COPD. The grade of pulmonary functions was higher in patients with comorbid COPD and OP than in patients with COPD alone (Z=-12.304, P<0.001). Multivariable logistic regression analysis identified ages of 65 years and older (OR=2.703, 95%CI: 1.862-3.923), women (OR=2.897, 95%CI: 1.915-4.384) and physical labor (OR=1.540, 95%CI: 1.083-2.189) as factors affecting the development of comorbid COPD and OP. Conclusion The prevalence of comorbid COPD and OP was 4.36% among residents at ages of 40 years and older in Zhangjiagang City, and moderate and severe degree was the predominant grade of pulmonary functions. The elderly, women and physical labors are at a high risk of developing comorbid COPD and OP.

Objective:To understand the situation and epidemic characteristics of injury deaths among children aged 5 to 24 years in Jiangsu Province from 2012 to 2021 and the trend of annual changes.Methods:The main injury mortality data of children and adolescents was collected, and the crude and standardized mortality rates of road traffic accidents, drowning, suicide, and accidental falls among children and adolescents over a decade and the annual average percentage of change (AAPC) were calculated. The main injury mortality characteristics and trends of children and adolescents of different age groups and genders were analyzed.Results:The total number of injury deaths among 5 to 24 adolescents in Jiangsu Province was 16 052, with a standardized mortality rate of 9.58/100 000. There was no significant trend in the overall standardized mortality rate of injuries (AAPC=-3.450%, P=0.055). The standardized mortality rate of road traffic injuries among children and adolescents showed a decreasing trend over the past decade, with statistical significance (AAPC=-9.406%, P<0.001). The standardized suicide mortality rate showed an upward trend over the past decade, with statistical significance (AAPC=9.000%, P=0.001). The overall injury mortality rate showed an upward trend with age. Suicide rates in males and females were on the rise and both have statistical significance (AAPC=9.420% and AAPC=9.607%, both P<0.05). The standardized mortality rates of female traffic accidents, drowning, and male traffic accidents showed a decreasing trend and were statistically significant (AAPC for female traffic accidents=-7.364%, AAPC for female drowning=-5.352%, and AAPC for male traffic accidents=-10.242%, all P<0.05). The standardized mortality rate of urban and rural traffic accidents showed a decreasing trend and was statistically significant(AAPC=-7.899% and AAPC=-9.421%, both P<0.001). The standardized suicide mortality rate showed an upward trend and statistical significance (AAPC=11.009% and AAPC=7.528%, both P<0.05). Conclusions:The overall injury situation of children and adolescents in Jiangsu Province improved in the past decade from 2012 to 2021, but the suicide mortality rate was on the rise. It is necessary to focus on the mental health issues of this age group and to strengthen the prevention and control of suicide among children and adolescents, in Jiangsu.

Objective:To estimate physical activity level in residents in Suzhou and explore the association between community environment and physical activity level in local residents.Methods:Through multistage stratified random sampling, residents aged 25-64 years in Suzhou were surveyed by face-to face interview in 2017. Physical activity levels were assessed by the international physical activity questionnaire-long version (IPAQ-L). Perceptions of community environment were assessed by Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A).Results:Among the local residents surveyed in Suzhou,the median of weekly total physical activity level was 3 610.42 MET-min/w. The level of occupational physical activity was higher than that of transportation, household and leisure-time related physical activity levels. After controlling for socio-demographic factors, public service access was negatively associated with the overall physical activity level ( OR=0.522,95% CI:0.329-0.830), land-use mix-diversity was negatively associated with the level of occupational physical activity level ( OR=0.701,95% CI: 0.492-0.999), infrastructure of walk and cycle ways was positively associated with occupational physical activity level ( OR=1.603,95% CI:1.004-2.559); traffic hazards were negatively associated with the transportation physical activity level ( OR=0.642,95% CI: 0.416-0.990); residential building density was positively associated with leisure-time physical activity level ( OR=1.001,95% CI: 1.000-1.002), and the perceptions level of community environment were positively associated with the occupational, transportation, household and overall physical activity levels ( OR=1.889,95% CI: 1.176-3.033; OR=1.671,95% CI: 1.120-2.495; OR=1.775,95% CI: 1.143-2.756; OR=1.593,95% CI: 1.079-2.350). Conclusion:Improving infrastructure of walk and cycle ways and beautifying community environment play an important role in increasing the physical activity level of the residents.

[Purpose]To analyze the trend of bladder cancer incidence and age at diagnosis in can-cer registration areas of Jiangsu Province from 2009 to 2019.[Methods]The data of bladder can-cer incidence from 2009 to 2019 were collected from 16 cancer registries in Jiangsu Province,and quality control indicators of the data were evaluated.The crude rate(CR)of incidence,age-standar-dized incidence rate by Segi world standard population(ASIRW),age-specific incidence rate,mean age at diagnosis,mean standardized age at diagnosis,and age-specific incidence composi-tion ratio were calculated.Incidence trends were analyzed using Joinpoint software and the average annual percentage change(AAPC)was calculated.Birth cohort models were constructed and can-cer incidence rates were calculated for people born from 1929 to 2019 and the incidence trends were analyzed.The linear regression models were used to analyze the relationship of average age at onset,standardized average age of onset with year of onset.[Results]The CR of bladder cancer in Jiangsu Province increased from 4.27/105 in 2009 to 7.04/105 in 2019.The CR and ASIRW showed upward trends(CR:AAPC=4.62％,ASIRW:AAPC=1.92％,both P＜0.001).Sex-specific analysis showed that the incidence rate was higher in male(AAPC=5.32％)than that in female(AAPC=1.98％).Birth cohort results indicated a significant upward trend in incidence rates among age groups of 60 years old above,and the fastest increase was in those aged 80 years old and above(AAPC=3.27％,P=0.007).From 2009 to 2019,the average age of bladder cancer onset in Jiangsu Province showed a significant rising trend,increasing by an average of 0.17 years old annually,but the standardized average age of onset showed no significant change after adjusting for age structure.[Conclusion]The incidence rate of bladder cancer showed an increasing trend from 2009 to 2019 in Jiangsu Province,with a significantly higher incidence rate in male than that in female.

Objective To understand the death prevalence of cardiovascular and cerebrovascular diseases and the life expectancy of premature death caused by them in Suzhou, and to provide data basis for the health administrative department to formulate the prevention and control policies of cardiovascular and cerebrovascular diseases. Methods Based on the death data of ischemic heart disease and stroke of residents in Suzhou from 2011 to 2020, the death prevalence of cardiovascular and cerebrovascular diseases during the past decade was calculated. The years of life lost (YLLs), years of life lost per thousand (YLL rate) and annual percentage of change (APC) caused by ischemic heart disease and stroke were calculated. The YLLs and YLL rates of different age groups and different genders were also calculated. Results From 2011 to 2020, the average annual mortality rate of ischemic heart disease in Suzhou was 45.61/100 000, and the mortality rate showed an upward trend in the past decade. The average annual mortality rate of stroke was 174.23/100 000, with a trend of decreasing first and then increasing in the past decade. From 2011 to 2020, the disease burden caused by ischemic heart disease in Suzhou totaled 359,153.97 YLLs, with a YLL rate of 6.77 person years per 1000 people, and an APC of 2.05%. The YLLs caused by stroke death were 1 269,193.8 person years, the YLL rate was 23.91 person years per thousand, and the APC was 1.35%. Conclusion From 2011 to 2020, the prevention and treatment of cardiovascular and cerebrovascular diseases in Suzhou has achieved certain results, but ischemic heart disease and stroke are still important causes affecting the health of people and causing death and life loss of the elderly in Suzhou. The prevention and treatment of cardiovascular and cerebrovascular diseases still has a long way to go, and it is necessary to continue strengthening the screening, monitoring and intervention work.

Objective To analyze the epidemic trend of type 2 diabetes in Suzhou from 2013 to 2022 and the early death and life loss of type 2 diabetes due to outdoor PM_2.5. Methods The indicators of death number, mortality rate, years of early life lost (YLL) and years of life lost per thousand (YLL rate) were selected, and the data of the Global Burden of Disease Study 2021 (GBD2021) were used to analyze the death information of type 2 diabetes in Suzhou. Results The number of deaths, mortality, YLL and YLL rate caused by type 2 diabetes in Suzhou from 2013 to 2022, showed an upward trend, and the number of deaths , YLL and YLL rate of type 2 diabetes attributed to PM_2.5 also showed an upward trend (P<0.001). The death toll of type 2 diabetes attributable to PM_2.5 totaled 3887 cases , the YLL was 61 974 person years, and the YLL rate was 0.89‰. Conclusion Type 2 diabetes has seriously threatened the health of residents in Suzhou , and the disease burden due to outdoor PM_2.5 is on the rise. It is important to carry out three-level prevention and improve air quality for type 2 diabetes to improve the health of residents.

From 1987 to 2017, cardiovascular disease (CVD) had been ranking the first cause of death in Suzhou, and the mortality rate showed an upward trend annual percentage changes (APC=0.62%, P=0.001), while the standardized mortality rate showed a downward trend (APC=-2.65%, P<0.001). The probability of premature death of CVD declined consistently from 7.06% in 1987 to 2.00% in 2017 (APC=-4.45%, P<0.001). When the life expectancy was set at 70, the potential years of life lost rate (PYLLR) decreased from 6.35‰ in 1987 to 3.30‰ in 2017, and the standardized PYLLR decreased from 7.30‰ to 2.68‰. When the life expectancy was set at 75, the PYLLR decreased from 10.12‰ to 5.19‰, and the standardized PYLLR decreased from 11.44‰ to 3.88‰. With the increase of years, all PYLLR and standardized PYLLR showed a significantly downward trend (APC=-2.51%--3.89%, P<0.001).