With population aging and the great improvement in life following economic development, the burden (incidence and mortality) of chronic diseases, particularly malignant tumors, is becoming heavier. Carcinogenesis and tumor progression typically arise from persistent inflammation, necrosis, and proliferation in targeted tissues and/or organs on the basis of systemic low-grade chronic inflammation. Factors facilitating this process are the risk factors of cancer. Large-scale prospective cohort studies have demonstrated that regular physical exercise, especially aerobic exercise, significantly decrease the incidence of inflammation-related cancer types and the mortality of all cancer types by attenuating systemic low-grade chronic inflammation, with a dose-dependent effect. The effect of aerobic exercise at the middle level intensity for 117‒600 min per week on the reduction of cancer mortality can be more effective than that of immunotherapy combinations (50% vs 26%). The mechanisms by which regular physical exercise prevents cancer may lie in the long-term, regular physical activity increasing oxygen supply and optimizing gut probiotics, thereby reducing systemic low-grade chronic inflammation caused by immunosenescence, promoting the renewal of immune cells to enhance levels of non-specific immunity, cellular immunity and humoral immunity. Encouraging public physical exercise and other healthy lifestyles including optimizing food components to decrease systemic low-grade chronic inflammation are the most cost-effective public health strategies against cancer.

Chronic hepatitis B virus （HBV） infection is a major cause of hepatocellular carcinoma （HCC）， with a population-attributable fraction of 57.1% for HCC globally and 76.1% for HCC in China. Identifying the early molecular mechanisms of HBV-driven hepatocarcinogenesis can facilitate precise HCC prevention. Persistent HBV replication， HBV mutation， HBV integration， and the synergistic interplay among them are the main mechanisms of HBV-driven hepatocarcinogenesis. HBV replication activates and sustains a chronic hepatic inflammatory microenvironment， providing conditions for accumulation of viral mutations； under the conditions of chronic inflammation， inflammatory factors cause the imbalance between apolipoprotein B messenger RNA editing enzyme catalytic polypeptide-like 3B and uracil-DNA glycosylase， which promotes HBV mutations and human genomic mutations and enhances the carcinogenic effect of HBV mutations， and the inflammatory microenvironment can promote dedifferentiation of mutated cells and acquisition of stemness； HBV genome integration can cause “gate-keeper” mutations including telomerase reverse transcriptase （TERT） promoter mutation， thereby triggering chromosomal instability and epigenetic reprogramming. The three events of HBV replication， mutation， and integration work synergistically under the evolutionary principle of “variation-selection-adaptation” and jointly drive the development and progression of HCC. The high-risk HBV mutation profile， circulating HBV integration fragments， and the TERT promoter mutations can be used to guide precision HCC prevention via antiviral prophylaxis and assist in early screening and monitoring of postoperative recurrence， which provides a scientific basis for refining stratified prevention and control strategies against HCC.

China is heavily affected by cancer.In 2022,the population in Chinese mainland accounted for 18.66%of the world,but new cancer cases and cancer-related deaths accounted for 24.17%and 26.44%of the world,respectively.Lung cancer,liver cancer,gastric cancer,colorectal cancer,and esophageal cancer are the top 5 histological types,accounting for 67.50%of all cancer-related deaths.The age-standardized incidence rate(ASIR)and age-standardized mortality rate(ASMR)of liver cancer,gastric cancer,and esophageal cancer keep decreasing whereas their corresponding crude rates are increasing.The ASMR of lung cancer keeps decreasing in urban areas but increasing in rural areas.The ASIR and ASMR of colorectal cancer are increasing gradually.These data indicate that aging,movement of industrial pollution to rural areas,and alterations in lifestyle seriously affect cancer burden.Due to the rapid transformation of China's economic,modern lifestyle-related risk factors including physical inactivity,smoking and alcohol consumption,metabolic syndrome,unhealthy diet,and psychological problems continue to increase;furthermore,poverty-related risk factors including environmental pollution,food contamination,and chronic infections(including the infections with hepatitis B virus,human papillomavirus,Helicobacter pylori,and Clonorchis sinensis)still exist,both pushing up the high burden of cancers in China at this stage.These causal factors are carcinogenic either by directly interfering genetic and epigenetic mechanisms,or most frequently induce chronic inflammation to inflammation-cancer transformation.Targeted interventions to the modifiable risk factors,such as improving lifestyle and increasing physical activity can reduce systemic inflammation and improve immunity,so as to decrease cancer occurrence and cancer-related death.In addition,cancer screening is helpful in decreasing the ASMRs of several slowly progressive cancer types including colorectal cancer.Epidemiological cohort study and experimental epidemiology are key to clarify the effects of primary prophylaxis,screening,and clinical treatments on the occurrence and prognosis of cancers,which is the key for improvement of cancer tertiary prophylaxis.Optimal combination of cancer prevention and clinical diagnosis and treatment should be an effective strategy to control the cancer-caused loss of life expectancy in a cost-effective way.

ObjectiveTo determine the association between solid fuel exposure and cancer risk among middle-aged and elderly adults in China, to investigate the underlying biological pathways through selected serological markers, and to examine whether adequate physical activity can mitigate this risk by modulating these pathways. MethodsBased on baseline characteristics, health status indicators and hematological data from the China Health and Retirement Longitudinal Study (CHARLS, 2011‒2018), multivariate logistic regression analyses were conducted to assess the association between solid fuel use and cancer risk, with stratified analyses conducted by physical activity levels. In addition, mediation analyses were performed to evaluate the role of serological markers including hemoglobin concentration and hematocrit in the association between solid fuel use and cancer incidence. ResultsSolid fuel use was significantly associated with an increased cancer risk (OR=1.344, 95%CI: 1.113‒1.615). This association remained significant among individuals with low levels of physical activity ( OR=1.344, 95%CI: 1.067‒1.673 ), but not statistically significant among those with adequate physical activity. Hemoglobin concentration and hematocrit showed a negative mediating effect between solid fuel use and cancer incidence, and this effect was stronger among those with low levels of physical activity. ConclusionIndoor solid fuel use represents an important environmental risk factor for cancer incidence in China’s middle-aged and elderly population, while regular physical activity may reduce carcinogenic risk through modulation of inflammatory levels and hematological indicators such as hemoglobin and hematocrit. Public health strategies should integrate clean energy promotion with exercise interventions to mitigate the cancer burden associated with solid fuel pollution.

Objective To compare the association of the incidence and mortality of leukemia and the human development index(HDI)in different countries or regions in 2022,and the trend of leukemia incidence and mortality with age in countries with different HDI levels.Methods GLOBOCAN 2022 data related to leukemia incidence and mortality in different countries or regions worldwide and HDI were evaluated by Pearson correlation analysis and Kruskal-Wallis test.The incidence and mortality rates of each age and the age change trend were analyzed using the Joinpoint Regression model.Results Age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and mortality to incidence ratio(M/I)were statistically significantly different among the four groups of HDI countries(P<0.001).HDI was positively correlated with ASIR and ASMR and negatively correlated with M/I.Among all ages,ASIR and ASMR of leukemia of the four groups had similar trends with age,and the risk of leukemia was high at ages less than 15 and more than 40.The incidence of leukemia in all age groups in China differed from those in other countries with high HDI,while the mortality rate was lower than those in other countries with high HDI.Conclusion Countries or regions with higher HDI have higher ASIR and ASMR and lower M/I because of their better medical condition.

To establish a disease risk prediction model based on genetic susceptibility genes and environmental risk factors， which can target high-risk population as early as possible， and intervene in the environmental risk factors in this population. Moreover， accurate screening of genetically susceptible populations can enhance the efficiency of health system. In recent years， with the maturation and cost reduction of high-throughput gene testing， gene testing has been widely used in individual clinical decision-making and will play a more important role in medical and health decision-making. The correlation between genetic testing and disease risk prediction is increasing， making it a prominent research topic in this field. This review summarizes the approaches for establishing and evaluating risk prediction models and discusses potential future challenges and opportunities.

When facing two or more choices， sound decision-making is critical. In the field of clinical medical practice and public health， more and more researchers use decision-making analysis as an important tool to assist in making the optimal choices. Public health emergencies have the characteristics of group cases， sudden and uncertain. In addition to causing serious damage to public health， they may also have varying degrees of impact on socio-economic， psychological and even social stability. At present， we have not seen the application of mature and sound decision analysis in public health emergency response. This paper reviewed the development of decision analysis in the medical field and the application of common decision-making models in clinical practice. Combined with the current situation of global infectious disease outbreaks and prevention and control， this paper puts forward the concepts and prospects of establishing an auxiliary decision-making system for public health emergencies， aiming to provide a scientific method for medical and health workers to respond to public health emergencies.

The severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） and its variants are still globally spreading. Vaccines can reduce the mortality， but cannot eliminate the risk of infection. The identification and protection of the high-risk susceptible population remains of great importance for the prevention and control of SARS-CoV2 and other coronavirus infections. Smoking is an important risk factor for many respiratory diseases， and therefore may also influence the risk of SARS-CoV2 infection and the disease progression after infection. This study reviewed the epidemiological and mechanistic evidence supporting the relationship between tobacco exposure and SARS-CoV2 infection， summarized the contributing effects of tobacco exposure to the infection risk， disease severity， and mortality of COVID-19， and analyzed the molecular mechanisms by which cigarette smoking affects COVID-19 through regulating inflammatory microenvironment and gene expression.

Hepatocellular carcinoma （HCC） has emerged as a significant public health concern， posing a serious threat to the lives and health of residents in China. Furthermore， the incidence and mortality rates of HCC are notably higher in males than in females. Androgen receptors （AR） can contribute to the occurrence of male-specific cancers such as prostate cancer， suggesting a potential link to the increased susceptibility of males to HCC. Elucidating the cancer-promoting mechanism of AR and developing specific targeted interventions are effective ways to advance tertiary prevention of HCC and improve patient prognosis. This paper reviews the relevant evidence of AR’s role in promoting the occurrence and development of HCC， summarizes relevant mechanisms discovered to date， including promoting the stemness of HCC cells， altering the immune microenvironment， regulating key signaling pathways， inducing glycolysis in hepatocellular carcinoma， and synergizing with hepatitis B virus to promote HCC. Additionally， research directions for targeted interventions in HCC through AR-related signaling pathways are discussed.

Abstract: Chronic infection of hepatitis B virus (HBV) is the major cause of hepatocellular carcinoma (HCC) in China. The occurrence of HCC through chronic inflammation follows the Darwinian evolutionary law, known as "mutation-selection-adaptation". Inflammatory mutagenic molecules promote the generation of somatic mutations, and the most mutant cells are eliminated by inflammatory microenvironment. However, a minority of mutant cells survive the selective pressure and develop to tumor initial cells by activating oncogenic signaling pathway and acquiring "stemness" characteristics. Alongside this process, HBV also evolves under the pressure of inflammatory microenvironment, which is characterized by the accumulation of cancer-promoting viral mutations, reducing the ability to infect new individuals. The high-risk mutant strains are eliminated with the death of hosts, leading to a phenomenon termed as "dead-end evolution". HBV evolution contributes to cancer evolution by maintaining the inflammatory microenvironment, activating oncogenic pathways, inducing somatic cell mutations, and altering metabolic patterns. The combo mutations of HBV and HBV integrations can be applied to predict the occurrence and prognosis of HCC. Anti-viral treatment reduces the risk of HCC by relieving inflammation. This article reviews the molecular epidemiological evidence and mechanistic advances related to the co-evolution of HBV and HCC. Clarifying the co-evolutionary pattern of virus and cancer and the key molecular events involved, is beneficial for identifying new biomarkers and therapeutic targets, thus improving the prevention and treatment strategies for HCC.