1.Disability-adjusted life years for colorectal cancer in China, 2017-2030: A prevalence-based analysis focusing on the impact of screening coverage and the application of local weights.
Yujie WU ; Yanjie LI ; Xin WANG ; Xinyi ZHOU ; Xinxin YAN ; Hong WANG ; Juan ZHU ; Wanqing CHEN ; Jufang SHI
Chinese Medical Journal 2025;138(8):962-972
BACKGROUND:
Most studies have evaluated disability-adjusted life years (DALYs) of colorectal cancer (CRC) patients based on a set of generic disability weights (DWs). This study aimed to apply local CRC-stage-specific DWs to estimate the burden of DALYs for CRC (CRC-DALYs) in populations in China and consider the influence of local screening coverage of CRC.
METHODS:
A prevalence-based model was constructed using data from various sources. Years lived with disability (YLDs) were estimated mainly via cumulative prevalence data (based on CRC incidence rates, population numbers, and survival rates), stage-specific proportions of CRC, and DWs of the local population. Years of life lost (YLLs) were calculated based on the CRC mortality rates and standard life expectancies. CRC incidence and mortality rates for the years 2020, 2025, and 2030 were estimated by joinpoint regression, and the corresponding DALYs were predicted. The main assumption was made for CRC screening coverage. Sensitivity analyses were used to assess the impact of population, DWs, and coverage.
RESULTS:
In 2017, among the Chinese population, the estimated number of CRC-DALYs was 4,303,314 (11.9% for YLDs). If CRC screening coverage rate in China (2.3%) remains unchanged, the overall DALYs in 2030 are predicted to increase by 37.2% (45.1% of those aged ≥65 years). More optimistically, the DALYs would then decrease by 0.7% in 2030 (from 5,902,454 to 5,860,200) if the coverage could be increased to 25.0%. A sensitivity analysis revealed that using local DWs would change the base-case values by 5.7%.
CONCLUSIONS
The estimated CRC-DALYs in China using population-specific DWs were considerably lower (with a higher percentage of YLDs) than the global burden of disease (GBD) estimates (5,865,004, of 4.6% for YLDs), suggesting the impact extent of applying local parameters. Sustainable scale-up CRC screening needs to be in place to moderate the growth trend of CRC-DALYs in China.
Humans
;
Colorectal Neoplasms/diagnosis*
;
China/epidemiology*
;
Disability-Adjusted Life Years
;
Male
;
Prevalence
;
Female
;
Middle Aged
;
Aged
;
Early Detection of Cancer
;
Quality-Adjusted Life Years
;
Adult
;
Incidence
2.Diagnosis and treatment of adult tumor patients with COVID-19.
Chinese Journal of Oncology 2023;45(3):191-202
After the first outbreak of corona virus disease 2019 (COVID-19) at the end of 2019, it has caused multiple rounds of transmission in many countries around the world. Cancer patients are mainly elderly people, and the immunosuppression state caused by the tumor itself and anti-tumor treatment, more accompanying underlying diseases, and more hospital environmental exposure leading to a higher incidence of COVID-19 infection. The proportion of severe cases after infection is high, and the mortality is high. Therefore, based on the domestic and foreign research and clinical practice, the Expert Committee of Geriatric Cancer Prevention and Treatment of Chinese Society of Clinical Oncology launched a discussion based on the characteristics of cancer patients, including the epidemiology, clinical manifestations, differential diagnosis, definition and risk factors of severe cases, diagnosis and treatment recommendations, recovery of anti-tumor treatment and vaccination recommendations. To provide the corresponding suggestions for the clinical diagnosis and treatment of such patients.
Humans
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Adult
;
Aged
;
COVID-19/diagnosis*
;
Neoplasms/epidemiology*
;
Incidence
;
Disease Outbreaks
;
Diagnosis, Differential
;
COVID-19 Testing
3.Retrospective Analysis of Pathological Diagnosis of Central Nervous System Diseases in Tibet.
Han-Huan LUO ; Qian WANG ; Bula DUO ; Zhen HUO
Acta Academiae Medicinae Sinicae 2022;44(1):24-29
Objective To analyze the disease spectrum and clinicopathological characteristics of central nervous system(CNS)diseases diagnosed based on pathological findings in Tibet. Methods We collected the data of all the cases with CNS lesions in Tibet Autonomous Region People's Hospital from January 2013 to December 2020.The clinicopathological features were analyzed via light microscopy,immunohistochemical staining,and special staining. Results A total of 383 CNS cases confirmed by pathological diagnosis were enrolled in this study,with a male-to-female ratio of 188∶195 and an average age of(40.03±17.39)years(0-74 years).Among them,127(33.2%)cases had non-neoplastic diseases,with a male-to-female ratio of 82∶45 and an average age of(31.99±19.29)years;256(66.8%)cases had neoplastic diseases,with a male-to-female ratio of 106∶150 and an average age of(44.01±14.87)years.The main non-neoplastic diseases were nervous system infectious diseases,cerebral vascular diseases,meningocele,cerebral cyst,and brain trauma.Among the infectious diseases,brain abscess,granulomatous inflammation,cysticercosis,and hydatidosis were common.The main neoplastic diseases included meningioma,pituitary adenoma,neuroepithelial tumor,schwannoma,metastatic tumor,and hemangioblastoma.The meningioma cases consisted of 95.4%(103/108)cases of grade Ⅰ,3.7%(4/108)cases of grade Ⅱ,and only 1(1/108,0.9%)case of grade Ⅲ.Among the neuroepithelial tumor cases,the top three were glioblastoma,grade Ⅲ diffuse glioma,and ependymoma. Conclusions There are diverse CNS diseases confirmed by pathological diagnosis in Tibet,among which non-neoplastic diseases account for 1/3 of all the cases.Infectious and vascular diseases are the most common non-neoplastic diseases in Tibet,and tuberculosis and parasitic infections are relatively common.The types and proportion of brain tumors in Tibet are different from those in other regions of China,and meningioma is the most common in Tibet,with higher proportion than neuroepithelial tumor.
Adolescent
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Adult
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Aged
;
Brain Neoplasms/diagnosis*
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Central Nervous System Diseases/pathology*
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Child
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Child, Preschool
;
Ependymoma
;
Female
;
Humans
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Infant
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Infant, Newborn
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Male
;
Meningeal Neoplasms
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Middle Aged
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Retrospective Studies
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Tibet/epidemiology*
;
Young Adult
4.Prevalence and frequencies of human papilloma virus types in adenocarcinoma in situ of the uterine cervix.
Jun JIN ; Rong Kui LUO ; Jing ZHAO ; Yan NING ; Yu Qing QU ; Xiang TAO ; Xian Rong ZHOU
Chinese Journal of Pathology 2022;51(4):338-343
Objective: To examine the prevalence and frequencies of human papillomavirus (HPV) genotypes in cervical adenocarcinoma in situ (AIS). Methods: The cases of cervical AIS with concurrent tests of cytology and HPV typing from January 2007 to February 2020 in the Obstetrics and Gynecology Hospital of Fudan University were collected and analyzed. Results: A total of 478 cases of cervical AIS were obtained. The average age of the patients was 39.4 years (range, 19-81 years). The largest age group was 30-39 years (44.8%), followed by 40-49 years (34.7%). Among the 478 patients, 355 underwent high-risk HPV (hrHPV) testing and had a hrHPV-positive rate of 93.8%. Of the 355 patients, 277 also underwent HPV typing and were mostly positive for either or both HPV16 and HPV18 (93.1%), with 55.6% positive for HPV18 and 48.7% positive for HPV16. Among the 478 cases, 266 cases (55.6%) were diagnosed with both AIS and squamous intraepithelial lesion (SIL), while 212 cases (44.4%) were diagnosed with only AIS. Patients infected with HPV16 in the AIS and SIL group significantly outnumbered those in the AIS alone group (P<0.05). Moreover, the rate of positive cytology was 55.9% (167/299 cases), while that of negative cytology was 44.1% (132/299). Among the 109 patients with negative cytology results and co-tested hrHPV, there were 101 HPV-positive cases (92.7%), of which 88 cases were subject to HPV typing and showed an HPV16/18 positive rate of 94.3% (83/88 cases). Conclusions: The combination of HPV typing and cytological screening can maximize the detection rate of cervical AIS, and should continue to be utilized, ideally on a larger scale, in the future.
Adenocarcinoma in Situ/epidemiology*
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Adult
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Aged
;
Aged, 80 and over
;
Female
;
Human papillomavirus 16/genetics*
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Human papillomavirus 18/genetics*
;
Humans
;
Middle Aged
;
Papillomaviridae/genetics*
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Papillomavirus Infections/diagnosis*
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Prevalence
;
Uterine Cervical Neoplasms/pathology*
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Young Adult
5.From rural practice to national strategy for colorectal cancer screening in China--Mr. Zheng Shu who is a pioneer and practitioner.
Yun Feng ZHU ; Qi Long LI ; Yan Qin HUANG ; Ying Shuang ZHU ; Qi DONG ; Ke Feng DING
Chinese Journal of Gastrointestinal Surgery 2021;24(1):43-47
Haining City and Jiashan County in Zhejiang Province are the first areas to carry out colorectal cancer screening in China, which started in the early 1970s and has been going on for more than 40 years. Meanwhile, Haining and Jiashan have also become the first batch of National Demonstration Bases for Early Diagnosis and Treatment of Colorectal Cancer. In the past 40 years, owing to Professor Zheng Shu who is brave and innovative, with an indomitable spirit, as well as the unremitting efforts and active exploration of all the team members, colorectal cancer screening which was unknown by the public and implemented with difficulties, has gradually been widely accepted and benefited the population. Today, remarkable achievements have been fulfilled in the colorectal cancer screening of Haining and Jiashan which has become the pioneer power in promoting the progress of colorectal cancer prevention and control in China and has certain influence both on China and the world. Meanwhile, a set of colorectal cancer screening strategies suitable for China has been explored and further promoted to be used nationwide, which is of great significance to the prevention and control of colorectal cancer in China. Looking forward to the future, the prevention and control of colorectal cancer in China is still difficult. We will continue to give full play to our existing advantages, not forget our original intention, move forward, explore innovation, and create greater glories!
China/epidemiology*
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Colonic Neoplasms/diagnosis*
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Colorectal Neoplasms/diagnosis*
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Early Detection of Cancer/statistics & numerical data*
;
History, 20th Century
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Humans
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Mass Screening/methods*
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Rural Population/statistics & numerical data*
8.Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer (2020 edition).
Chinese Journal of Surgery 2020;58(8):561-585
Colorectal cancer (CRC) is one of the most common malignant tumors in China. In recent years, the incidence and mortality of CRC in China have been on the rise. According to the China cancer statistics report in 2018, the incidence and mortality of CRC in China ranked the third and fifth among all malignant tumors, with 376,000 new cases and 191,000 deaths. China has become the country with the highest number of new cases and deaths of CRC every year in the world, which seriously threatens the health of Chinese residents. In 2010, the National Ministry of Health organized colorectal cancer expertise of the Chinese Medical Association to write the Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer (2010 edition) and publish it publicly. Since 2010, the National Health and Family Planning Commission has organized experts to revise the protocol in 2015 and 2017, while the National Health Commission revised it in 2020. The revised part of Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer (2020 edition) involves new progress in the field of imaging examination, pathological evaluation, surgery, chemotherapy and radiotherapy. The 2020 edition of the protocol not only referred to the contents of the international guidelines, but also combined with the specific national conditions and clinical practice in China, and also included many evidence-based clinical data in China recently. The 2020 edition of the protocol would further promote the standardization of diagnosis and treatment of CRC in China, improve the survival and prognosis of patients, and benefit millions of CRC patients and their families.
China
;
epidemiology
;
Colorectal Neoplasms
;
diagnosis
;
epidemiology
;
therapy
;
Humans
;
Practice Guidelines as Topic
9.Young Patients with Hormone Receptor-Positive Breast Cancer Have a Higher Long-Term Risk of Breast Cancer Specific Death
Jianfei FU ; Chenhan ZHONG ; Lunpo WU ; Dan LI ; Tiantian XU ; Ting JIANG ; Jiao YANG ; Jinlin DU
Journal of Breast Cancer 2019;22(1):96-108
PURPOSE: Although it is widely accepted that hormone receptor (HR) status is associated with later post-diagnostic periods, a debate exists as to whether the association is independent of age. The aim of our study was to confirm the impact of HR status on later period breast cancer-specific death (LP-BCSD) and later period non-breast cancer-specific death (LP-non-BCSD) in different age subgroups. METHODS: Surveillance, Epidemiology, and End Results databases were utilized to identify 181,108 breast cancer patients with > 5 years survival. The cumulative incidence of LP-BCSD and LP-non-BCSD was calculated using the Gray method. The subdistribution hazard ratio (SHR) of variables was estimated via the Fine and Gray proportional hazard regression model. Subgroup analyses for LP-BCSD and LP-non-BCSD were performed according to the HR status. RESULTS: The risk of LP-BCSD was exceeded by that of LP-non-BCSD at > 5 years since the diagnosis, particularly in old women. The competing risk regression model indicated that hormone receptor-positive (HR+) was an independent factor for more LP-BCSD (hazard ratio, 1.54; 95% confidence interval, 1.44–1.54; p < 0.001). However, stratified analysis indicated that HR+ was only associated with more LP-BCSD in the young women subgroup. Although HR+ was associated with more LP-non-BCSD, the predictive value of HR+ for LP-non-BCSD was eliminated after adjusting for age. CONCLUSIONS: HR+ was related to LP-BCSD in the premenopausal population. LP-BCSD should be an optimal endpoint in future trials designed to evaluate the role of extended adjuvant endocrine therapy.
Breast Neoplasms
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Breast
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Diagnosis
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Drug Therapy
;
Epidemiology
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Female
;
Humans
;
Incidence
;
Methods
;
Prognosis
;
Receptors, Estrogen
10.Epidemiology of and Risk Factors for Esophageal Cancer in Korea
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2019;19(3):145-148
Esophageal cancer is an aggressive malignant tumor with a poor prognosis because of its typically advanced stage at diagnosis and treatment-related morbidity and mortality. Of the two major subtypes, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma, ESCC is prevalent in more than 90 percent of esophageal cancer patients in Korea. Both the incidence and mortality of esophageal cancer are declining, and the relative survival rate of patients with esophageal cancer has improved. These epidemiological changes are attributed to increase in the detection rate of esophageal cancer at localized and regional stages before distant spread of the disease. And the most well-known risk factors for esophageal adenocarcinoma are obesity and gastro-esophageal reflux disease. The carcinogenesis of ESCC is associated with chronic irritation caused by smoking, heavy alcohol use, drinking very hot beverages, and a low socioeconomic status. Understanding the risk factors for esophageal cancer can lead to the identification of preventative strategies to reduce the risk of developing esophageal cancer or to improve the long-term prognosis.
Adenocarcinoma
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Beverages
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Carcinogenesis
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Carcinoma, Squamous Cell
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Diagnosis
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Drinking
;
Epidemiology
;
Esophageal Neoplasms
;
Gastroesophageal Reflux
;
Humans
;
Incidence
;
Korea
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Mortality
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Obesity
;
Prognosis
;
Risk Factors
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Smoke
;
Smoking
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Social Class
;
Survival Rate

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