Objective:To analyze the effects of changes in the spectrum of deaths from malignant tumors on the life expectancies of residents of different ages, sexes, and regions (urban or rural) in Tianjin from 1999 to 2019.Methods:The Abridged Life Table method and the Arriaga's decomposition method were used to calculate the effects of changes in spectrum of deaths from malignant tumors on the life expectancies of Tianjin residents of different ages, sexes, and regions.Results:During 1999-2019, the life expectancies increased by 4.96 years and 5.69 years for males and females, respectively, in Tianjin. The decreases in the mortalities from malignant neoplasms contributed 0.12 year (3.30%) and 0.03 year (0.77%) for males and females, respectively, to the increase during 1999-2007, and 0.05 year (3.13%) and 0.12 year (6.08%) for males and females, respectively, during 2007-2019. The decreases in the mortality rates of malignant tumors contributed the most to the increase among residents in the 60-69 years group, and the decreases in mortality rates of lung, gastric, esophageal, and liver cancers had relatively larger contribution. Lung cancer had a negative effect on the life expectancies of men and rural residents, but a positive effect on those of women and urban residents. The significant increases in the mortality rates of lung, colorectal, and pancreatic cancers in the ≥85 years group had a large negative effect on the overall life expectancy. Breast and ovarian cancers contributed negatively to the life expectancy of female residents.Conclusion:The overall increase in the life expectancy in Tianjin from 1999 to 2019 was mainly attributed to the elderly and the decreases in the mortality rates of gastric, esophageal, and liver cancers, among other malignancies, while the increases in the mortality rates of lung, colorectal, gallbladder, pancreatic, and breast cancers were the most significant factors hindering the increase of the life expectancy in Tianjin.

Objective:To analyze the effects of changes in the spectrum of deaths from malignant tumors on the life expectancies of residents of different ages, sexes, and regions (urban or rural) in Tianjin from 1999 to 2019.Methods:The Abridged Life Table method and the Arriaga's decomposition method were used to calculate the effects of changes in spectrum of deaths from malignant tumors on the life expectancies of Tianjin residents of different ages, sexes, and regions.Results:During 1999-2019, the life expectancies increased by 4.96 years and 5.69 years for males and females, respectively, in Tianjin. The decreases in the mortalities from malignant neoplasms contributed 0.12 year (3.30%) and 0.03 year (0.77%) for males and females, respectively, to the increase during 1999-2007, and 0.05 year (3.13%) and 0.12 year (6.08%) for males and females, respectively, during 2007-2019. The decreases in the mortality rates of malignant tumors contributed the most to the increase among residents in the 60-69 years group, and the decreases in mortality rates of lung, gastric, esophageal, and liver cancers had relatively larger contribution. Lung cancer had a negative effect on the life expectancies of men and rural residents, but a positive effect on those of women and urban residents. The significant increases in the mortality rates of lung, colorectal, and pancreatic cancers in the ≥85 years group had a large negative effect on the overall life expectancy. Breast and ovarian cancers contributed negatively to the life expectancy of female residents.Conclusion:The overall increase in the life expectancy in Tianjin from 1999 to 2019 was mainly attributed to the elderly and the decreases in the mortality rates of gastric, esophageal, and liver cancers, among other malignancies, while the increases in the mortality rates of lung, colorectal, gallbladder, pancreatic, and breast cancers were the most significant factors hindering the increase of the life expectancy in Tianjin.

To explore the epidemiological characteristics, trends and relevant factors of pre-hospital mortality due to acute myocardial infarction (AMI) from 1999 to 2016 in Tianjin city, based on mortality surveillance information and household registration population information. Standardized mortality rates were calculated using the year 2000 world standard population. From 1999 to 2016, the research result showed that the pre-hospital crude mortality rates of AMI were 39.47/100 000 to 90.64/100 000 and the standardized mortality rates were 30.92/100 000 to 53.90/100 000. The proportion of pre-hospital AMI deaths was 73.96%-81.92% (t=1.09, P>0.05) within the same period. Aged, female, rural residents, unmarried, divorced, widowed, low education level, and outdoor workers have a relative higher proportion of pre-hospital AMI mortality.

From 1999 to 2015, there were 6 186 cases of leukemia deaths in tianjin residents, the males accounted for 58.28% (3 605) and 52.31% (3 236) deaths lived in urban areas; the crude mortality rate of Leukemia increased from 3.47/100 000 to 4.28/100 000 [t=7.09, P<0.001, annual percent change (APC)=1.30%] and the standardized mortality rate decreased from 3.15/100 000 to 3.01/100 000 (t=-2.95, P=0.006, APC=-0.65%). Special attention should be focused on children, the elderly, males and rural residents.

From 1999 to 2015, there were 6 186 cases of leukemia deaths in tianjin residents, the males accounted for 58.28% (3 605) and 52.31% (3 236) deaths lived in urban areas; the crude mortality rate of Leukemia increased from 3.47/100 000 to 4.28/100 000 [t=7.09, P<0.001, annual percent change (APC)=1.30%] and the standardized mortality rate decreased from 3.15/100 000 to 3.01/100 000 (t=-2.95, P=0.006, APC=-0.65%). Special attention should be focused on children, the elderly, males and rural residents.

From 1999 to 2015, there were 6 186 cases of leukemia deaths in tianjin residents, the males accounted for 58.28% (3 605) and 52.31% (3 236) deaths lived in urban areas; the crude mortality rate of Leukemia increased from 3.47/100 000 to 4.28/100 000 [t=7.09, P<0.001, annual percent change (APC)=1.30%] and the standardized mortality rate decreased from 3.15/100 000 to 3.01/100 000 (t=-2.95, P=0.006, APC=-0.65%). Special attention should be focused on children, the elderly, males and rural residents.

Objective: To explore the trends and distribution of intracerebral hemorrhage (ICH) mortality of the residents with different characteristics from 1999 to 2015 in Tianjin. Methods: ICH mortality data in 1999-2015 were from Tianjin population based mortality surveillance system. The mortality rate of ICH, difference in the rate by gender, age, and geographic distribution, and trends over the years were analyzed. Standardized mortality rates of ICH were calculated using the year 2000 world standard population. Joinpoint regression and Cochran-Armitage trend were used to examine the trends in mortality. Results: A total of 102 279 ICH death cases were observed in Tianjin from year 1999 to 2015. The crude ICH mortality rate in Tianjin decreased from 76.35/100 000 in 1999 to 51.46/100 000 in 2015 (annual percent change (APC)=-1.96%, Z=-31.08, P<0.001) , and the standardized mortality rate decreased from 72.41/100 000 to 29.00/100 000 (APC=-5.20%, Z=-70.91, P<0.001). The crude mortality rate of ICH mortality in males decreased from 87.26/100 000 to 59.89/100 000 (APC=-1.79%, Z=-21.71, P<0.001) and the standardized mortality rate decreased from 85.65/100 000 to 35.75/100 000 (APC=-4.93%, Z=-52.32, P<0.001). The crude mortality rate of ICH mortality in females decreased from 65.21/100 000 to 42.98/100 000 (APC=-2.18%, Z=-22.28, P<0.001) and the standardized mortality rate decreased from 59.17/100 000 to 22.26/100 000 (APC=-5.63%, Z=-48.15, P<0.001). The ICH mortality rate under 35 years old increased from 0.78/100 000 to 0.92/100 000 (APC=4.41%, Z=5.07, P<0.001), especially in males increasing from 0.90/100 000 to 1.54/100 000 (APC=6.59%, Z=6.52, P<0.001). The crude mortality rate of ICH in urban areas decreased from 69.74/100 000 to 41.79/100 000 (APC=-3.18%, Z=-31.43, P<0.001) and the standardized mortality rate decreased from 57.56/100 000 to 20.42/100 000 (APC=-6.59%, Z=-53.43, P<0.001). The crude mortality rate of ICH in rural areas decreased from 82.99/100 000 to 61.49/100 000 (APC=-1.10%, Z=-14.06, P<0.001) and the standardized mortality rate decreased from 91.55/100 000 to 43.14/100 000 (APC=-3.78%, Z=-43.21, P<0.001). The ICH mortality rate in rural areas was higher than that in urban areas (P<0.05). Conclusion ICH mortality rate in Tianjin decreased from 1999 to 2015. Further efforts to reduce ICH mortality in Tianjin is needed, in particular males, under 35 years old, and people in rural areas.

Objective: To explore the trends and distribution of chronic obstructive pulmonary disease (COPD) mortality of the residents with different characteristics from 2000 to 2016 in Tianjin. Methods: COPD mortality data in 2000-2016 were from Tianjin population based mortality surveillance system. The mortality rate of COPD, difference in the rate by gender, age, and geographic distribution, and the trend over years were analyzed. Age-sex-standardized mortality rates of COPD were calculated using the year 2000 world standard population. Joinpoint regression and Cochran-Armitage trend analysis were used to examine the trend of mortality. Results: The crude COPD mortality rate in Tianjin decreased from 57.57/100 000 in 2000 to 28.23/100 000 in 2016 (annual percent change (APC)=-5.01%, Z=-64.76, P<0.001), and the standardized mortality rate decreased from 56.53/100 000 in 2000 to13.88/100 000 in 2016 (APC=-9.17%, Z=-100.83, P<0.001). The crude COPD mortality rate of males decreased from 54.57/100 000 to 27.77/100 000 (APC=-4.89%, Z=-43.63, P<0.001) and the standardized mortality rate decreased from 57.52/100 000 to 14.63/100 000 (APC=-9.07%, Z=-71.48, P<0.001). The crude COPD mortality rate of females decreased from 60.63/100 000 to 28.68/100 000 (APC=-5.12%, Z=-47.92, P<0.001) and the standardized mortality rate decreased from 55.53/100 000 to 13 13/100 000 (APC=-9.27%, Z=-71.13, P<0.001). The crude mortality rate of COPD in urban areas decreased from 45.07/100 000 to 19.54/100 000 (APC=-5.35%, Z=-42.38, P<0.001) and the standardized mortality rate decreased from 39.24/100 000 to 7.45/100 000 (Z=-63.97, P<0.001, APC=-10.22%). The crude mortality rate of COPD in rural areas decreased from 70.20/100 000 to 37.24/100 000 (APC=-4.77%, Z=-48.77, P<0.001) and the standardized mortality rate decreased from 78.88/100 000 to 25.70/100 000 (APC=-7.59%, Z=-72.43, P<0.001). The COPD mortality rate in rural areas was higher than that in urban areas (P<0.001). The COPD mortality rate in 35 years old and over decreased from 2000 to 2016 (P<0.001). Conclusion The COPD mortality in Tianjin decreased from 2000 to 2016. More efforts are need to reduce COPD mortality in Tianjin, in particular people in rural areas.

Objective: To explore the trends and distribution of cerebral infarction between sexes, ages and urban-rural areas from 1999 to 2015 in Tianjin, China, and provide data for targeted prevention and control strategies of cerebral infarction in Tianjin. Methods: Cerebral infarction mortality data from January 1, 1999 to December 31, 2015 were obtained from Tianjin population based mortality surveillance system established by the Tianjin Centers for Disease Control and Prevention, and population data of permanent residents were obtained from Tianjin Municipal Public Security Bureau. The trends change and affecting factors including gender, age, and geographic distribution on mortality following cerebral infarction were analyzed. Results: (1) Cerebral infarction mortality rate in Tianjin increased from 1999 to 2015 with the crude mortality rate of 57.06/100 000 to 105.22/100 000 (Z=59.65, P<0.01, annual percent change(APC)=3.39%) and decreased with the standardized mortality rate from 55.59/100 000 to 56.12/100 000 (Z=-5.47, P<0.01, APC=-0.35%). (2) The crude mortality rate (64.23/100 000 to 118.72/100 000) and standardized mortality rate (65.44/100 000 to 67.23/100 000) of male cerebral infarction was higher than that of female (crude: 49.73/100 000 to 91.64/1/100 000, standardized: 45.73/100 000 to 45.01/100 000) from 1999 to 2015. (3) With the increase of age, the mortality of cerebral infarction increased gradually from 1999 to 2015 (all Z>0.00,all P<0.01). (4) The mortality rate of cerebral infarction in urban areas increased with the crude mortality rate from 71.43/100 000 to 103.20/100 000 (Z=17.34, P<0.01, APC=1.30%) and decreased with the standardized mortality rate from 61.04/100 000 to 43.77/100 000 (Z=-32.49, P<0.01, APC=-3.06%) from 1999 to 2015. The mortality rate of cerebral infarction in rural areas increased with the crude mortality rate from 42.63/100 000 to 107.32/100 000 (Z=69.14, P<0.01, APC=5.95%) and with the standardized mortality rate from 48.34/100 000 to 77.09/100 000 (Z=36.88, P<0.01, APC=5.95%) from 1999 to 2015. Conclusions Cerebral infarction crude mortality increased and standardized mortality decreased from 1999 to 2015 in Tianjin. Further efforts to reduce cerebral infarction mortality in Tianjin are needed, special attention should be focused on the elderly, male and rural residents.

We described the time trend of acute myocardial infarction (AMI) from 1999 to 2013 in Tianjin incidence rate with Cochran-Armitage trend (CAT) test and linear regression analysis,and the results were compared.Based on actual population,CAT test had much stronger statistical power than linear regression analysis for both overall incidence trend and age specific incidence trend (Cochran-Armitage trend P value＜linear regression P value).The statistical power of CAT test decreased,while the result of linear regression analysis remained the same when population size was reduced by 100 times and AMI incidence rate remained unchanged.The two statistical methods have their advantages and disadvantages.It is necessary to choose statistical method according the fitting degree of data,or comprehensively analyze the results of two methods.