To analyze epidemical features, distribution and time trend for nasopharynx cancer deaths in China from 1987 to 2015.
 Methods: Negative binomial regression model was used to explore population-level risk factors for nasopharynx cancer deaths and a joinpoint regression model was used to estimate annual changes in nasopharynx cancer mortality in various populations.
 Results: A falling trend in age-standardized nasopharynx cancer mortality rates was observed among Chinese residents with the average annual percent change (AAPC) at -2.97% among urban female residents and -2.60% among rural female residents (P<0.05), -2.01% among urban male residents, and -1.68% among rural male residents (P<0.05), respectively. It decreased yearly for urban male aged over 85 years with AAPC at -1.54% and the age-specific mortality rates decreased yearly for the urban female aged over 85 years with AAPC at -0.60%, the age-specific mortality rates decreased yearly for rural male residents aged more than 65 years with AAPC at -0.56% and for rural female residents aged more than 85 with AAPC at 1.17%, with no significant difference (P<0.05). The nasopharynx cancer deaths risks were higher in urban residents than those in rural residents (OR=1.11, P<0.01), and they were also higher in male residents than those in female residents (OR=2.34, P<0.01). A 5-year increment in age was associated with a 23% increase in nasopharynx cancer mortality (OR=1.23, P<0.01) and a one year increment in calendar year was related to a 2% decrease in mortality (OR=0.98, P<0.01). 
 Conclusion: There was a significant gender and age difference in a decreased trend of nasopharynx cancer mortality among Chinese residents in a long period; no increased trend was observed in the overall populations over 85 years old.
Age Distribution ; Age Factors ; Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Humans ; Male ; Mortality ; trends ; Nasopharyngeal Neoplasms ; mortality ; Rural Population ; statistics & numerical data ; trends ; Sex Distribution ; Urban Population ; statistics & numerical data ; trends

The adequacy of the urologist work force in Korea has never been investigated. This study investigated the geographic distribution of urologists in Korea. County level data from the National Health Insurance Service and National Statistical Office was analyzed in this ecological study. Urologist density was defined by the number of urologists per 100,000 individuals. National patterns of urologist density were mapped graphically at the county level using GIS software. To control the time sequence, regression analysis with fitted line plot was conducted. The difference of distribution of urologist density was analyzed by ANCOVA. Urologists density showed an uneven distribution according to county characteristics (metropolitan cities vs. nonmetropolitan cities vs. rural areas; mean square=102.329, P<0.001) and also according to year (mean square=9.747, P=0.048). Regression analysis between metropolitan and non-metropolitan cities showed significant difference in the change of urologists per year (P=0.019). Metropolitan cities vs. rural areas and non-metropolitan cities vs. rural areas showed no differences. Among the factors, the presence of training hospitals was the affecting factor for the uneven distribution of urologist density (P<0.001).Uneven distribution of urologists in Korea likely originated from the relatively low urologist density in rural areas. However, considering the time sequencing data from 2007 to 2012, there was a difference between the increase of urologist density in metropolitan and non-metropolitan cities.
Cities/statistics & numerical data ; Health Services Accessibility/*statistics & numerical data/trends ; Korea/epidemiology ; Physicians/*supply & distribution/trends ; Republic of Korea/epidemiology ; Rural Health Services/*manpower/statistics & numerical data/trends ; Rural Population/statistics & numerical data/trends ; Urban Health Services/*manpower/statistics & numerical data/trends ; Urology/*manpower/*statistics & numerical data/trends

OBJECTIVEBased on the cancer registry data to analyze the mortality and survival of liver cancer in China.

METHODSLiver cancer data of 2011 were retrieved from the National Cancer Registry Database.Liver cancer deaths were estimated using age-specific rate by areas and gender according to the national population in 2011. Mortality data from 22 cancer registries during 2000-2011 were used to analyze the mortality trend, and data from 17 cancer registries during 2003-2005 were used for survival analysis.

RESULTSThe estimates of liver cancer deaths were about 322 thousand in 2011 with a crude mortality rate of 23.93/10(5).There was an increasing trend of crude mortality rate of liver cancer during 2000-2011 in 22 Chinese cancer registries with an average annual percentage change of 0.7% (95%CI: 0.2%-1.2%), 1.1% in urban and 0.4% in rural areas. After age standardization with Segi's population, the mortality rate was significantly decreased, with an APC of -2.3%, -1.9% in urban and -2.2% in rural populations. The 5-year age standardized relative survival was 10.1% (95%CI: 9.5% to 10.7%), and the 1-, 3- and the 5-year observed survival rates were 27.2%, 12.7%, and 8.9%, respectively.

CONCLUSIONLiver cancer is a major cancer threatening people's lives and health in China, and the liver cancer burden is still high.

China ; epidemiology ; Databases, Factual ; statistics & numerical data ; Humans ; Incidence ; Liver Neoplasms ; mortality ; Registries ; statistics & numerical data ; Rural Population ; statistics & numerical data ; trends ; Survival Analysis ; Survival Rate ; Urban Population

OBJECTIVEThe national population-based cancer registration data were used to analyze the liver cancer incidence and trend in China, in order to provide advise for making further strategy on liver cancer prevention and control.

METHODSLiver cancer data of 2011 were retrieved from the database of the National Cancer Registry. The incident cases of liver cancer were estimated using age-specific rate by urban or rural areas and gender according to the national population in 2011. Liver cancer incidence data from 22 cancer registries were used to analyze the incidence trend during 2000-2011.

RESULTSThe estimates of new cases of liver cancer were about 356 thousand in China in 2011. The incidence rate was 26.39/10(5,) and the age-standardized incidence rates by Chinese standard population and by world population were 19.48/10(5) and 19.10/10(5,) respectively.There was an increasing trend of incidence rate of liver cancer in China during 2000-2011 with an average annual percentage change(AAPC) of 1.0% (95%CI: 0.5%-1.4%), 1.2% (95%CI: 0.7%-1.8%)in urban areas and 1.1% (95%CI: 0.5%-1.8%) in rural areas. After age standardization, the incidence rate was significantly decreased, with an AAPC of -1.8% (95%CI: -2.4% to -1.2%), -1.6% (95%CI: -2.2% to -0.9%) in urban and -1.4% (95%CI: -2.5% to -0.3%) in rural areas.

CONCLUSIONSLiver cancer is a common cancer in China. As changing in people's dietary habits and implementing neonatal HBV vaccination for years, the exposure to risk factors is reducing, and age-standardized incidence rate is decreasing. While cardinal number of population is big and aging population is growing rapidly in the country, trend of incidence rate is increasing, and the burden of liver cancer is still high in China.

China ; epidemiology ; Databases, Factual ; statistics & numerical data ; Health Transition ; Humans ; Incidence ; Liver Neoplasms ; epidemiology ; prevention & control ; Registries ; statistics & numerical data ; Risk Factors ; Rural Population ; statistics & numerical data ; trends ; Urban Population ; statistics & numerical data ; trends

Health disparities between the western, central and eastern regions of rural China, and the impact of national health improvement policies and programming were assessed. A total of 400 counties were randomly sampled. ANOVA and Logistic regression modeling were employed to estimate differences in health outcomes and determinants. Significant differences were found between the western, central and eastern rural regions in community infrastructure and health outcomes. From 2000 to 2010, health indicators in rural China were improved significantly, and the infant mortality rate (IMR), maternal mortality rate (MMR) and under 5 mortality rate (U5MR) had fallen by 62.79%, 71.74% and 61.92%, respectively. Central rural China had the greatest decrease in IMR (65.05%); whereas, western rural China had the greatest reduction in MMR (72.99%) but smallest reduction in U5MR (57.36%). Despite these improvements, Logistic regression analysis showed regional differences in key health outcome indicators (odds ratios): IMR (central: 2.13; western: 5.31), U5MR (central: 2.25; western: 5.69), MMR (central: 1.94; western: 3.31), and prevalence of infectious diseases (central: 1.62; western: 3.58). The community infrastructure and health outcomes of the western and central rural regions of China have been improved markedly during the first decade of the 21st century. However, health disparities still exist across the three regions. National efforts to increase per capita income, community empowerment and mobilization, community infrastructure, capacity of rural health facilities, and health literacy would be effective policy options to attain health equity.
China ; epidemiology ; Cross-Sectional Studies ; Female ; Health Promotion ; economics ; legislation & jurisprudence ; organization & administration ; Healthcare Disparities ; economics ; trends ; Humans ; Infant ; Infant Mortality ; trends ; Maternal Mortality ; trends ; Mortality ; trends ; Regression Analysis ; Rural Population ; statistics & numerical data ; Socioeconomic Factors

OBJECTIVES: Cigarette smoking prevalence among adolescent males in rural areas of Korea has increased in recent years. The aim of this study was to explore the factors related to increasing trends in cigarette smoking among adolescent males living in rural areas. METHODS: The raw data from the Korea Youth Risk Behavior Web-based Survey from 2006 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Multiple logistic regression models were used to explore the factors affecting cigarette smoking. We evaluated the linear time trends in the prevalence of factors that were related to current smoking status and the linear time trends in cigarette smoking in groups stratified by the exposure to each factor using logistic regression models. Finally, we examined the contributions of the factors to the time trends in cigarette smoking by adjusting for each of those factors in the baseline regression models and changes in the adjusted odds ratio by survey year. RESULTS: A statistically significant increasing trend in smoking was observed after adjusting for the factors affecting cigarette smoking. Significant factors related to cigarette use were perceived stress, experience with depression, current alcohol drinking, exposure to secondhand smoke, and academic performance. The factor related to increasing trends in cigarette smoking was academic performance. CONCLUSIONS: Stress about academic performance is an important factor affecting the increase in cigarette smoking among adolescent males in a rural area of Korea.
Adolescent ; Adolescent Behavior ; Adolescent Psychology ; Alcohol Drinking ; Depression ; Humans ; Internet ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Rural Population ; Smoking/*epidemiology/trends ; Tobacco Smoke Pollution

BACKGROUND/AIMS: The aim of this study was to investigate changes in the clinical and demographical characteristics of gallstone disease in Korea, based on 30 years of surgically treated patients at a single institute. METHODS: In total, 7,949 gallstone patients who underwent surgery between 1981 and 2010 were analyzed. Patients were divided into six time periods: period I (1981 to 1985, n=831), period II (1986 to 1990, n=888), period III (1991 to 1995, n=1,040), period IV (1996 to 2000, n=1,261), period V (2001 to 2005, n=1,651) and period VI (2006 to 2010, n=2,278). RESULTS: The total number and mean age of the patients gradually increased, and the male/female ratio decreased. The proportion of gallbladder (GB)-stone cases increased, whereas the proportions of common bile duct (CBD)- and intrahepatic duct (IHD)-stone cases decreased. Differences in patient geographical origins also decreased. Based on the relationship between changes in the prevalence of gallstone disease and socioeconomic status, the prevalence of CBD stones showed a strong correlation with Engel's coefficient (p<0.001). CONCLUSIONS: Our study indicates that although the total number of cases and the mean age of gallstone patients have continuously increased, there are trends of increasing GB-stone cases and decreasing CBD- and IHD-stone cases.
Adult ; Age Distribution ; Body Mass Index ; Choledocholithiasis/*epidemiology/surgery ; Female ; Gallstones/*epidemiology/surgery ; Humans ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Rural Population/trends ; Sex Ratio ; Socioeconomic Factors ; Urban Population/trends

OBJECTIVEWe aimed to examine the current developments and challenges confronted by old age security in rural China.

DATA SOURCESThis study is based on the data from PubMed, Elsevier, Wiley, EBSCO, EMBASE, SCI Expanded, ProQuest, Google, and CNKI which is the most informative database in Chinese.

STUDY SELECTIONArticles were selected with the search terms "rural", "China", "old", "older", or "elder", "elderly", or "aged", "aging", "security", "culture", "value", "medical insurance" or "community based medical insurance" or "cooperative medical scheme". Related websites and yearbooks were searched as well.

RESULTSThe socio-economic development has made the burden of traditional care for the rural elderly heavier than ever, and new challenges are emerging in rural communities, such as poor economic, deteriorating natural environment and health crisis.

CONCLUSIONSThe governments should improve the scale and caliber of rural old age security and strengthen regulations with great efforts in developing the rural economy and protecting the natural environment of rural communities.

Aged ; Aged, 80 and over ; China ; Female ; Humans ; Male ; Middle Aged ; Old Age Assistance ; legislation & jurisprudence ; statistics & numerical data ; trends ; Rural Population ; statistics & numerical data

OBJECTIVETo analyze the mortality trends and disease burden of malignant tumors in rural area of Feicheng city from 2000 to 2010, and to provide basic information for the prevention and treatment of malignant tumors in this area.

METHODSThe data of cancer mortality from 2000 to 2010 from Feicheng Cancer Registry database were checked. Mortality rate, standardized mortality rate, potential years of life Iost (PYLL), standardized potential years of life lost (SPYLL), average years of life lost (AYLL) and other indexes were calculated and analyzed. The trend of the standardized rates transformed by the natural logarithm over time was assessed by Prais-Winsten regression method in which the errors was assumed to follow a first-order autoregressive process. STATA 12.0 was used to analyze the data.

RESULTSIn average, the crude mortality rate was 199.67 per 100 000 (264.69 per 100 000 in males and 137.24 per 100 000 in females), and the standardized mortality rate was 157.00 per 100 000 (200.49 per 100 000 in males and 101.31 per 100 000 in females). There were no significant changes in the trends of all standardized rates. For males, the mortality rates of lung and colorectal cancers increased significantly, and for females, the rates of lung and breast cancers had increased trend while the rate of esophageal cancer showed a downward trend. There were no statistically significant changes in other main malignant tumors. During 2000 to 2010, the PYLL of malignant tumors in Feicheng was 183 685.0 person-years, and PYLL rate was 23.3 per 1000. The SPYLL was 153 091.0 person-years, SPYLL rate was 19.4 per 1000, and AYLL was 14.8 years.

CONCLUSIONSThere are no obvious changes in the trends of standardized mortality rates in rural area of Feicheng over the past 11 years. For males, the mortality of lung cancer and colorectal cancer is increasing, and for females, the rates of lung and breast cancers have an increasing trend while the rate of esophageal cancer shows a decreasing trend. The prevention and control of digestive malignant tumors, lung cancer and breast cancer are getting seriously important and should be the focal point in this issue.

Breast Neoplasms ; mortality ; China ; epidemiology ; Colorectal Neoplasms ; mortality ; Esophageal Neoplasms ; mortality ; Female ; Humans ; Life Expectancy ; trends ; Lung Neoplasms ; mortality ; Male ; Neoplasms ; mortality ; Rural Population

OBJECTIVECancer is one of the leading causes of death in China. The study aimed to examine the temporal trend of cancer mortality rate during 1989-2008 in urban and rural areas of China.

METHODSThe mortality data of all cancers from 1989 to 2008 from National Cancer Registry database were sorted and checked. Age standardized mortality rates were calculated by the direct methods using the China population of 1982 and World Segi's population. Joinpoint regression was performed to obtain the annual percentage changes (APC) in mortality rates. The top ten cancer sites were calculated and analyzed. The mortality rates were compared with statistics of the United States.

RESULTSFrom 1989 to 2008, the trend of crude cancer mortality increased with an annual percentage change (APC) of 1.0%. After age standardization, the mortality rate was significantly decreased, with an APC of -1.2%. In urban areas, lung cancer was the most common cancer of death, whereas in rural areas, stomach cancer and esophageal cancer remained top cancers of death. Especially, in both urban and rural areas, the mortality of lung cancer was on increase. The mortality rates of stomach and esophageal cancers showed a decrease in urban areas. Compared with the cancer mortality rates of the United States, the Chinese cancer mortality rate in males remained highest. The decreasing trend of cancer mortality in females of China was less obvious than that of the United States.

CONCLUSIONSThe crude mortality rates of cancer in China show an increase whereas the age standardized mortality raters has declined between 1989 and 2008. Cancer is still a major public health issue threatening people's life in China. Effective intervention for cancer control and prevention is needed in the future.

China ; epidemiology ; Esophageal Neoplasms ; mortality ; Female ; Humans ; Lung Neoplasms ; mortality ; Male ; Mortality ; trends ; Neoplasms ; mortality ; Registries ; Rural Population ; Sex Factors ; Stomach Neoplasms ; mortality ; United States ; epidemiology ; Urban Population