1.Compliance of Liver Cancer Screening and Related In-fluencing Factors in Inner Mongolia from 2016 to 2018
Yuexin SHI ; Na SHANG ; Liying QIAO ; Shu SHANG ; Yunfeng XI
China Cancer 2025;34(1):58-66
[Purpose]To analyze the compliance of liver cancer clinical screening and related in-fluencing factors in Inner Mongolia from 2016 to 2018.[Methods]The liver cancer screening pro-gram was conducted among permanent residents aged 40~74 years old in Inner Mongolia from 2016 to 2018.The risk factor assessment questionnaire was used for primary screening,and the identified high-risk subjects of liver cancer were subject to undergo clinical screening including ul-trasound examination and serum AFP test.The clinical screening rate of high-risk subjects and de-tection rate were calculated and compared among different groups.Multivariate Logistic regression model was used to analyze influencing factors related to the clinical screening rate of liver cancer.[Results]A total of 70 109 residents completed questionnaires risk assessments from 2016 to 2018,and 11 211 subjects were identified as high-risk of liver cancer with the high-risk rate of 15.99%.Among 11 211 high-risk subjects,4 998 underwent clinical screening with a screening rate of 44.58%.There were 125 cases of AFP positive(2.50%),11 cases of occupying lesions in the liver(0.22%),6 cases of cirrhosis(0.12%),and 2 303 cases of fatty liver(46.08%).Multivariate Logistic regression analysis showed that female,age of 45~54 years old,Mongolians and other ethnic minorities,individuals with vegetables intake<2.5 kg/week and ≥2.5 kg/week,high-fat diet,history of smoking,smoking,alcohol drinking,history of tea-drinking,history of psychologi-cal trauma and stress in recent years,diseases of hepatobiliary system,and chronic hepatitis B were more likely to participate in clinical screening(all P<0.05).[Conclusion]The screening com-pliance of high-risk population for liver cancer is low but the detection rate is high in Inner Mongo-lia from 2016 to 2018.The program mechanism should be improved to increase the liver cancer screening compliance.
2.Yield of Different Quantitative Fecal Immunochemical Test Cut-Offs in the Colorectal Cancer Screening Program
Jinhua YANG ; Jiabei HE ; Xinglin FEI ; Zenghao XU ; Kai GAO ; Mengling TANG ; Jianbing WANG ; Kun CHEN ; Mingjuan JIN
China Cancer 2025;34(1):10-16
[Purpose]To analyze the diagnostic yield of quantitative fecal immunochemical test(FIT)at different cut-offs in colorectal cancer(CRC)screening.[Methods]The sequential screening method was adapted in Jiashan CRC screening program for local residents aged 40~74 years old,which included a quantitative FIT and high-risk factor questionnaire for primary screening and subsequent colonoscopy for the diagnostic screening.Subjects who participated in quantitative FIT were included in this study between September,2021 and August,2023.The positive predictive values(PPVs)for colorectal neoplasms were calculated at the cut-offs of 100,120,140,160,180 and 200 ng/mL of FIT.The Cochran-Armitage trend test was performed to compare the trend of PPVs at different cut-offs.The effects of different starting age and FIT cut-offs on requirement of colonoscopy and advanced neoplasia detection were assessed.[Results]A total of 58 256 individuals completed the quantitative FIT,and 3 106 had fecal hemoglobin concentrations>100 ng/mL,among whom 2 186 underwent colonoscopic examination with a compliance rate of 70.38%.The colonoscopy detected 588 cases of non-advanced adenomas and 355 cases of advanced neoplasms(AN),in-cluding 30 cases of CRC and 325 cases of advanced adenomas.Progressively increasing the cut-off showed a decrease in PPVs of non-advanced adenomas and an increase of AN.The ratio of the rate of reduced requirement of colonoscopy to the missed rate of the progressive lesions was the smallest when the screening start age was 45 years old and the positive FIT threshold was set at 100 ng/mL.[Conclusion]There were significant differences in the diagnostic yield at different cut-offs of FIT.Increasing the cut-offs of FIT will elevate PPVs for the advanced neoplasms.
3.Cancer Incidence and Mortality in Jiashan County of Zhejiang Province from 1991 to 2020 and Prediction of Change Trend from 2021 to 2035
Feiqiong SHEN ; Haijuan XIONG ; Xinglin FEI ; Jinhua YANG ; Kun CHEN ; Mingjuan JIN
China Cancer 2025;34(1):17-25
[Purpose]To analyze the trends of cancer incidence and mortality from 1991 to 2020 in Jiashan County of Zhejiang Province,and to predict trends from 2021 to 2035.[Methods]Cancer cases and deaths from 1991 to 2020 in Jiashan County were collected.The crude inci-dence rate and mortality rate,age-standardized rate(ASR)were calculated.The annual percentage change(APC)and average annual percentage change(AAPC)were calculated by Joinpoint model to analyze the trend of cancer incidence and mortality.The age-period-cohort model was used to predict the trends of cancer incidence and mortality from 2021 to 2035 and the estimated annual percentage change(EAPC)was calculated.[Results]The age-standardized incidence rates by Chinese standard population(ASIRC)in Jiashan were 159.06/105,187.25/105,and 254.37/105 during 1991-2000,2001-2010,and 2011-2020,respectively.The trends in young and middle-aged women and people above 65 years old were more predominant.Lung,stomach,colorectal,liver and female breast cancers were major incident cancers for the period from 1991 to 2020.The cancer incidence showed an increasing trend from 1991 to 2020(AAPC=2.17%,P<0.05)and is expect-ed to continue to increase over 2021 to 2035(EAPC=3.03%,P<0.05).The age-standardized mor-tality rates by Chinese standard population(ASMRC)in Jiashan were 119.74/105,117.79/105,and 100.11/105 during 1991-2000,2001-2010,and 2011-2020,respectively.Lung,liver,stomach,colorectal,esophageal,and pancreatic cancers were leading causes of cancer deaths from 1991 to 2020.The cancer mortality showed a decreasing trend from 1991 to 2020(AAPC=-1.00%,P<0.05)and is expected to continue to decline over 2021 to 2035(EAPC=-1.67%,P<0.05).[Conclusion]The mortality rate from cancers has been gradually declined in Jiashan County,while the incidence rate has increased significantly and will continue to increase in the next 15 years.High incidence of lung cancer,liver cancer,gastric cancer and colorectal cancer makes it crucial to pay close attention to key groups and strengthen the control of risk factors of high inci-dence cancer.
4.Progress on Epidemiological Studies for the Relationship Between Plasma Glucose Indicators and Breast Cancer Risk
Dandan TANG ; Yu JIANG ; Wanwan LIU ; Zhuoyin LI ; Qiuming SHEN ; Qun XU ; Yongbing XIANG
China Cancer 2025;34(1):67-72
Hyperglycemia is a primary biological characteristic of diabetes.It is well known that three key indicators are commonly used in clinical practice to measure plasma glucose levels,such as 2-hour postload glucose(2hPG),fasting plasma glucose(FPG),and glycated hemoglobin(HbA1c).However,the association between these indicators and breast cancer incidence remains unclear.This paper systematically reviews the relationship between plasma glucose levels and breast cancer based on the above three indicators,to provide a reference for the formulation of effective plasma glucose management strategies for the primary prevention of breast cancer.
5.Progress in Application of Evaluation Methods of Treatment Tolerance for Hematological Malignancies
Siman HUANG ; Chaoling WAN ; Depei WU ; Shengli XUE
China Cancer 2025;34(1):73-80
Although standardized diagnosis and treatment procedures and appropriate therapy have been recommended for hematological malignancies under the practice of evidence-based medicine,due to heterogeneity of the disease and individual differences in the population,different patients may get dif-ferent clinical efficacy and treatment-related toxicities under the same therapy.How to predict the toler-ance of an individual with hematological malignancy to a specific regimen accurately is critical.This pa-per reviews the evaluation methods of treatment tolerance in patients with hematological malignancies,assisting clinicians in making scientific evaluation of tolerance for different patients and choosing the most suitable regimen.
6.Survival Analysis of Three Malignant Tumors with the Highest Risk of Death in Jiashan County,Zhejiang Province from 2006 to 2020
Lingling YU ; Xinglin FEI ; Jinhua YANG ; Feiqiong SHEN ; Zepeng ZHANG ; Zhaohui ZHANG
China Cancer 2025;34(1):26-31
[Purpose]To analyze the survival of lung cancer,liver cancer and stomach cancer in Jiashan County,Zhejiang Province from 2006 to 2020.[Methods]From January 1,2006 to De-cember 31,2020,new cases of lung cancer,liver cancer and stomach cancer were collected in Jiashan County,Zhejiang Province.The 5-year observed survival rate(OSR),relative survival rate(RSR)and age-standardized relative survival rate(ARSR)by sex and age were calculated from 2006-2010,2011-2015 and 2016-2020.The observed and relative survivals were calculated using the lifetime table and Ederer Ⅱ methods,respectively,and age standardized using the Inter-national Cancer Survival Standard.Joinpoint software was utilized to compute the average annual percentage change(AAPC)for analyzing trends in various survival rates from 2006 to 2020.[Re-sults]The 5-year RSR of lung cancer,liver cancer and stomach cancer increased from 8.1%,4.8%and 23.2%(2006-2010)to 36.0%,17.6%and 48.2%(2016-2020),showing an increasing trend(AAPC=14.4%,AAPC=11.4%,AAPC=6.4%,respectively,all P<0.05).Accordingly,the 5-year RSR of three types of malignant tumors showed an increasing trend in both men and women(all P<0.05)except liver cancer in women(P>0.05).The 5-year RSR of three types of malignant tu-mors in the age groups of 0~64 and 65+years old showed a significant increasing trend(all P<0.05).The increase of lung cancer and liver cancer was greater in the age group of 0~64 years old,and the increase of gastric cancer was greater in the age group of 65+years old.[Conclusion]The 5-year survival rates of the three types of malignant tumors with the highest mortality risk in Jiashan County,Zhejiang Province all increased significantly from 2006 to 2020,indicating that the pre-vention and treatment effect of malignant tumors is significant,but the survival rate of malignant tumors varied significantly among different populations,so targeted intervention should be carried out.
7.Survival Analysis of Colorectal Cancer in Jiashan County,Zhejiang Province from 1991 to 2020
Feng XUE ; Xinglin FEI ; Jing SUN ; Zepeng ZHANG ; Zhaohui ZHANG
China Cancer 2025;34(1):32-36
[Purpose]To analyze the survival of colorectal cancer patients in Jiashan County of Zhejiang Province from 1991 to 2020.[Methods]The data of newly reported cases of colorectal cancer were collected in Jiashan County from January 1,1991 to December 31,2020,and pa-tients were followed-up till December 2023.The observed survival rate(OSR)and relative survival rate(RSR)were calculated using the life table and Ederer Ⅱ method with 5-year intervals.Rela-tive survival was adjusted using the International Cancer Survival Standards.The Joinpoint re-gression model was used to calculate the average annual percentage change(AAPC)to analyze the change trend of survival rate.[Results]The 5-year RSR of colorectal cancer increased from 21.7%during 1991 to 1995 to 73.4%during 2016 to 2020,showing an increasing trend(AAPC=4.6%,P<0.05),for men it increased from 17.7%to 72.7%and for women it increased from 30.0%to 74.3%,with AAPCs of 3.9%and 4.3%,respectively(P<0.05).The 5-year RSR of colorectal can-cer in all age groups showed an increasing trend(P<0.05 for all age groups,except for 75+),and the highest increase was found in the age group of 65~74 years old(AAPC=4.9%).[Conclusion]From 1991 to 2020,the 5-year survival rate of colorectal cancer in Jiashan County showed a steady increase,for women and those aged 65~74 years old the increase was more significant.The cancer screening of high-risk groups should be focused on to improve colorectal cancer survival rate.
8.Analysis on the Causes of Death and Potential Life Loss of Malignant Tumors in Sichuan Province from 2017 to 2022
Bingjie QI ; Jing ZENG ; Ying DENG ; Ting DONG
China Cancer 2025;34(1):37-42
[Purpose]To analyze the causes of death and potential life loss of malignant tumors in Sichuan Province from 2017 to 2022.[Methods]Data were collected from the death information registration and management system of China Disease Prevention and Control Information System,and national cause of death monitoring sites in Sichuan Province from 2017 to 2022.SAS 9.4 and Joinpoint 4.9.1.0 software were used to calculate crude cancer mortality rate,age-standardized mortality rate by Chinese standerd population(ASMRC),annual percentage change and potential years of life lost(PYLL)and potential years of life lost rate(PYLLR).[Results]From 2017 to 2022,the crude cancer mortality rate in Sichuan Province was 169.32/105,and the ASMRC was 111.26/105.The cancer mortality rate in the general population and that stratified by sex showed an increasing trend(all P<0.05).The top 5 causes of cancer death were lung cancer,liver cancer,esophageal cancer,gastric cancer and colorectum cancer.The mortality rates of lung cancer,colorectum can-cer,female breast cancer,pancreatic cancer,lip,oral and pharyngeal malignancies all increased(all P<0.05).From 2017 to 2022,the PYLL caused by malignant tumors in Sichuan Province was 1 520 175.00 person-year,the PYLLR was 13.98‰.[Conclusion]In Sichuan Province,the mortali-ty rate of malignant tumors is on the rise.Lung cancer and gastrointestinal cancers are the main malignancies causing life loss.Early diagnosis and treatment of key cancers should be strengthened to reduce cancer mortality.
9.Analysis on Screening Results of Breast Cancer Among Women Aged 45~74 in Chongqing from 2012 to 2022
Jia DU ; Zhikai YU ; Shenglin ZHAO ; Yan ZHANG ; Qing GUO ; Xiu LIU ; Hong ZHOU ; Mei HE
China Cancer 2025;34(1):43-51
[Purpose]To analyze the results of breast cancer screening among women aged 45~74 in Chongqing from 2012 to 2022 and compare the risk of breast cancer among women with differ-ent characteristics.[Methods]The Urban Cancer Early Diagnosis and Treatment Program was con-ducted in Chongqing from 2012 to 2022,female residents aged 45~74 years old participated in breast cancer screening.The participants who were assessed as at high risk of breast cancer in the preliminary screening were advised to receive ultrasonography and mammography examination in designated hospitals.The study population was followed up annually to obtain information on their health outcomes.The high risk rate of breast cancer,compliance of further examination,the inci-dence density and breast cancer risk were calculated.[Results]A total of 207 891 women com-pleted the questionnaires survey and risk assessment,and 35 947 were assessed as the individuals with high risk of breast cancer with a high risk rate of 17.29%.Among them 14 713 received the imaging screening with a compliance rate of 40.93%.After a mean follow-up of(5.43±3.01)years,847 cases of breast cancer were diagnosed with a cumulative incidence rate of 407.43/105,an in-cidence density of 75.03/105 person-years(95%CI:70.15/105~80.26/105 person-years).Cox pro-portional hazards regression showed that the risk of breast cancer was higher in obese women than that in normal weight women(HR=1.26,95%CI:1.00~1.59);the risk of breast cancer was signifi-cantly higher in those with family history of breast cancer than that in those without family history(HR=1.69,95%CI:1.36~2.09).Compared with non-high-risk groups of breast cancer,the risk of breast cancer was increased in high-risk individuals who were screened or not screened(HR=1.36,95%CI:1.06~1.73 and HR=1.26,95%CI:1.01~1.56).[Conclusion]The breast cancer screening program combining primary risk assessment with ultrasonography and mammography for the high-risk groups can improve the detection rate,and the compliance rate of imaging screening need to be improved in the future and make accurate screening for people with high risk of breast cancer.
10.Analysis of Upper Gastrointestinal Cancer Screening Results in Rural Areas of Lhasa in Xizang from 2015 to 2019
DANZENGSUOLANG ; CIRENYANGJIN ; DEJI ; Kang LI ; Zhonghua WANG ; WANGJIA ; YUZHEN ; PINGCUOQUZHEN ; OUZHUMEIDUO ; ZHAXI ; Dong WU
China Cancer 2025;34(1):52-57
[Purpose]To analyze the results of upper gastrointestinal cancer screening in rural areas of Lhasa from 2015 to 2019.[Methods]Upper gastrointestinal cancer screening program was conducted among residents aged 40~69 years old from 3 rural project sites in Lhasa selected by cluster sampling method from 2015 to 2019.The detected malignant tumors and precancerous le-sions were treated and confirmed by pathological examination.The detection rate of esophagus and stomach cancer were calculated by region,sex and age and compared by x2 test.[Results]A total of 1 399 people underwent gastroscopy,among whom 1 288 completed pathological biopsy(92.07%).Three cases of esophageal cancer were detected with a detection rate of 0.21%(3/1 399),all of which were advanced squamous cell carcinoma.Eight cases of gastric cancer were detected with a detection rate of 0.57%(8/1 399),and 2 cases were early gastric cancer.The detection rate of low-grade and high-grade epithelial neoplasia of gastric mucosa was 0.64%(9/1 399)and 0.21%(3/1 399),respectively.There was no significant difference in the detection rate among different regions,sexes and age groups(all P>0.05).[Conclusion]The detection rate of upper gastrointesti-nal cancer in screening population in Lhasa is lower than the national average level.Men and the elderly are important target populations for upper gastrointestinal cancer screening,and increasing participation rates is necessary for more effective screening outcomes.

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