1.Trends of Cervical Cancer Incidence in Qidong City of Jiangsu Province from 1977 to 2021
Jianguo CHEN ; Jian ZHU ; Yonghui ZHANG ; Jun WANG ; Yongsheng CHEN ; Lulu DING ; Yuanyou XU
China Cancer 2025;34(2):108-115
[Purpose]To analyze the trends of cervical cancer incidence in Qidong City of Jiangsu Province from 1977 to 2021.[Methods]Based on the cervical cancer registration database in Qi-dong City from 1977 to 2021,the crude incidence rate,the age-standardized rate by the standard Chinese standard population and the world standard population(ASRC and ASRW),the truncated rate of 35~64 years old,the cumulative rate of 0~74 years old,and the cumulative risk were cal-culated;the incidence rates of birth cohorts were analyzed.Joinpoint regression analysis was per-formed with Joinpoint 4.9.0.0 software to calculate the annual percentage change(APC)and the average annual percentage change(AAPC)of cervical cancer incidence.[Results]A total of 2 253 new cases of cervical cancer registered in Qidong City from 1977 to 2021,accounting for 1.62%of the total case numbers of cancer in the whole population,and for 4.03%of the total number of cancers in women.The crude incidence rate was 8.75/105,the ASRC was 4.54/105,the ASRW was 6.01/105,the truncated rate(35~64 years old)was 15.09/105,the cumulative rate(0~74 years old)was 0.63%,and the cumulative risk was 0.63%.The incidence of cervical cancer increased with age from 1977 to 2021.The average incident age was 55.36 years old,with the lowest age of 47.51 years old in 2010.Secular trend analysis showed that the AAPC of the crude incidence of cervical cancer was 6.010%(95%CI:4.951%~7.081%)(P<0.001),among which the trend decreased from 1977 to 1999,with an APC of-2.507%;and then the trend increased from 1999 to 2017,with an APC of 14.436%(P<0.001).The rising and falling trend curves of the AS-RC and ASRW were similar to that of the crude incidence.The age group and time period analysis showed that the peak incidence was in the older age groups before 2006,while the peak inci-dence appeared in the age groups of 45~54 years old from 2007 to 2021.The AAPCs in age groups of 25~64 years old demonstrated upward trends(all P<0.05).The birth cohort analysis showed that the cervical cancer incidence in the 1937-1941 birth cohort was the lowest,and the birth cohort-specific rates in all age groups showed"V-shape"trends.[Conclusion]Long-term monitoring of cervical cancer incidence in Qidong has shown a trend of initially slow decline fol-lowed by a rapid increase,with the peak incident shifting towards younger ages.The rising trends of cervical cancer incidence in last two decades may be associated with the increased HPV infection,suggesting that measures to reduce HPV infection and enhance vaccination should be strengthened.
2.Trends of Cervical Cancer Incidence in Qidong City of Jiangsu Province from 1977 to 2021
Jianguo CHEN ; Jian ZHU ; Yonghui ZHANG ; Jun WANG ; Yongsheng CHEN ; Lulu DING ; Yuanyou XU
China Cancer 2025;34(2):108-115
[Purpose]To analyze the trends of cervical cancer incidence in Qidong City of Jiangsu Province from 1977 to 2021.[Methods]Based on the cervical cancer registration database in Qi-dong City from 1977 to 2021,the crude incidence rate,the age-standardized rate by the standard Chinese standard population and the world standard population(ASRC and ASRW),the truncated rate of 35~64 years old,the cumulative rate of 0~74 years old,and the cumulative risk were cal-culated;the incidence rates of birth cohorts were analyzed.Joinpoint regression analysis was per-formed with Joinpoint 4.9.0.0 software to calculate the annual percentage change(APC)and the average annual percentage change(AAPC)of cervical cancer incidence.[Results]A total of 2 253 new cases of cervical cancer registered in Qidong City from 1977 to 2021,accounting for 1.62%of the total case numbers of cancer in the whole population,and for 4.03%of the total number of cancers in women.The crude incidence rate was 8.75/105,the ASRC was 4.54/105,the ASRW was 6.01/105,the truncated rate(35~64 years old)was 15.09/105,the cumulative rate(0~74 years old)was 0.63%,and the cumulative risk was 0.63%.The incidence of cervical cancer increased with age from 1977 to 2021.The average incident age was 55.36 years old,with the lowest age of 47.51 years old in 2010.Secular trend analysis showed that the AAPC of the crude incidence of cervical cancer was 6.010%(95%CI:4.951%~7.081%)(P<0.001),among which the trend decreased from 1977 to 1999,with an APC of-2.507%;and then the trend increased from 1999 to 2017,with an APC of 14.436%(P<0.001).The rising and falling trend curves of the AS-RC and ASRW were similar to that of the crude incidence.The age group and time period analysis showed that the peak incidence was in the older age groups before 2006,while the peak inci-dence appeared in the age groups of 45~54 years old from 2007 to 2021.The AAPCs in age groups of 25~64 years old demonstrated upward trends(all P<0.05).The birth cohort analysis showed that the cervical cancer incidence in the 1937-1941 birth cohort was the lowest,and the birth cohort-specific rates in all age groups showed"V-shape"trends.[Conclusion]Long-term monitoring of cervical cancer incidence in Qidong has shown a trend of initially slow decline fol-lowed by a rapid increase,with the peak incident shifting towards younger ages.The rising trends of cervical cancer incidence in last two decades may be associated with the increased HPV infection,suggesting that measures to reduce HPV infection and enhance vaccination should be strengthened.
3.Global Epidemic Status of Colorectal Cancer and Rela-tionship of Colorectal Cancer Burden with the Human De-velopment Index
Lulu DING ; Yuanyou XU ; Yongsheng CHEN ; Rong SHEN ; Jian ZHU
China Cancer 2025;34(8):611-617
[Purpose]To analyze global epidemic status of colorectal cancer and explore the rela-tionship between the human development index(HDI)and the burden of colorectal cancer.[Methods]Based on the GLOBOCAN 2022 estimation data,the disease burden of colorectal can-cer in different regions,countries,and levels of HDI were analyzed.Spearman's rank test was used to explore the correlation between HDI and colorectal cancer disease burden.[Results]The estimated global incidence of colorectal cancer in 2022 was 1 926 425 cases(1 069 446 for male and 856 979 for female),with a age-standardized incidence rate of 18.4/105(21.9/105 for male and 15.2/105 for female),and cumulative risk of incidence of 2.10%(2.60%for male and 1.70%for female);the estimated number of deaths was 904 019(499 775 for male and 404 244 for fe-male),with a age-standardized mortality rate of 8.1/105(9.9/105 for male and 6.5/105 for female)and cumulative risk of death of 0.84%(1.00%for male and 0.65%for female).1-crude mortality rate/crude incidence rate(1-M/I)was 0.53(0.53 for male and 0.53 for female).Large disparities were in the disease burden of colorectal cancer between different regions and countries.After grouped by HDI,we found that the age-standardized incidence rates in very high,high,median,and low HDI regions were 28.6/105,18.1/105,6.7/105,and 6.4/105,and the standardized mortality rates were 10.5/105,8.3/105,3.9/105,and 4.5/105,with 1-M/I of 0.57,0.52,0.43 and 0.30,respec-tively;and the incidence and mortality rates were increasing with age.Spearman's correlation analysis showed a strong positive correlation between HDI and colorectal cancer in age-standardized incidence(r=0.84),age-standardized mortality(r=0.71)and 1-M/I(r=0.82)(all P<0.001).[Con-clusion]The global burden of colorectal cancer remains high.There are disparities in the disease burden among countries and regions,which is positively correlated with their HDI levels,indicating that the colorectal cancer prevention and treatment strategies should be developed based on the conditions of each regions and countries accordingly.
4.Incidence Trend of Brain and Other Central Nervous System Tumors in Qidong City of Jiangsu Province from 1972 to 2021
Lulu DING ; Yonghui ZHANG ; Yuanyou XU ; Yongsheng CHEN ; Jun WANG ; Jian ZHU
China Cancer 2025;34(6):471-476
[Purpose]To analyze the incidence trend and age,period,cohort effects of brain and other central nervous system tumors(brain tumor)in Qidong City of Jiangsu Province from 1972 to 2021.[Methods]The incidence data of brain tumor from 1972 to 2021 were collected from the Qidong cancer registry database.The crude incidence rate(CR),age-standardized rate by Chi-nese standard population(ASRC),age-standardized rate by world standard population(ASRW)and average annual percentage change(AAPC)were calculated.The age-period-cohort(APC)model was used to analyze the age,period,and cohort effects of brain tumor incidence in Qidong City from 1972 to 2021.[Results]A total of 2 801 cases of brain tumor occurred in Qidong City from 1972 to 2021,including 1 475 male cases and 1 326 female cases.From 1972-1976 to 2017-2021,the CR increased from 1.81/10 5 to 9.28/10 5,the ASRC increased from 2.07/10 5 to 4.96/10 5,and ASRW increased from 2.00/105 to 4.98/105.From 1972 to 2021 the AAPC of CR,ASRC and ASRW were 3.97%(3.53%for male and 4.37%for female),2.02%(1.66%for male and 2.24%for female)and 2.06%(1.63%for male and 2.24%for female)(all P<0.001).The Wald's Chi-square test of the APC model showed that there were significant differences in the trends of age,period and birth cohort effect of brain tumor risk(all P<0.05).The age effect showed that the incidence of brain tumor increased with age,starting from the age group of 45~49 years old and reaching a peak of 25.84/10 5 in age group of 75~79 years old(95%CI:21.17/10 5~31.53/10 5).The period ef-fect showed that the risk of recent period was higher than that in the early period using 1992-1996 period as the reference,reaching the highest in 2012-2016(RR=1.64,95%CI:1.38~1.95).The birth cohort effect showed that the highest risk was in 2017-2021 births cohort(RR=11.17,95%CI:4.26~29.26)using 1952-1956 birth cohort as the reference.[Conclusion]The incidence of brain tumor in Qidong City has been rising;and age,period and cohort are the main influencing factors,suggesting that the middle-aged and elderly population should be the focus of brain tumor prevention and control.
5.Trend of Non-Hodgkin's Lymphoma Incidence in Qidong City of Jiangsu Province from 1972 to 2021
Jun WANG ; Yongsheng CHEN ; Jian FAN ; Jian ZHU
China Cancer 2025;34(4):297-303
[Purpose]To analyze the trend of non-Hodgkin's lymphoma incidence in Qidong City of Jiangsu Province from 1972 to 2021.[Methods]The data of non-Hodgkin's lymphoma inci-dence collected from Qidong Cancer Registry from 1972 to 2021 were extracted.The crude inci-dence rate(CR),age-standardized rate by Chinese standard population(ASRC)and by world standard population(ASRW),truncated incidence rate(35~64 years old)and cumulative incidence rate(0~74 years old)were calculated.The age-period-cohort model was used to analyze the age,period,and cohort effects of incidence in non-Hodgkin's lymphoma.Joinpoint 4.9.1.0 software was used to calculate the average annual percentage change(AAPC)of non-Hodgkin's lymphoma incidence for trend analysis.[Results]There were a total of 2 681 cases of non-Hodgkin's lymphoma re-ported in Qidong from 1972 to 2021.The CR,ASRC,ASRW,the truncated incidence(35~64 years old)rate and cumulative incidence rate(0~74 years old)were 4.78/105,3.35/105,3.30/105,5.20/105 and 0.37%,respectively.There were 1 589 male cases,with CR,ASRC and ASRW of 5.75/105,4.19/105 and 4.14/105,respectively;and there were 1 092 female cases,with CR,AS-RC and ASRW of 3.84/105,2.60/105 and 2.54/105,respectively.Age-period-cohort analysis showed that the net drift value of non-Hodgkin's lymphoma incidence was 1.65(95%CI:1.19~2.11),and age,period and cohort effects were all important influencing factors of non-Hodgkin's lymphoma incidence rate(all P<0.05).The AAPCs for both sex,male and female of ASRC of non-Hodgkin's lymphoma in Qidong from 1972 to 2021 were 1.71%(95%CI:0.88%~2.54%,t=4.07),1.62%(95%CI:1.14%~2.11%,t=6.77),and 2.01%(95%CI:0.77%~3.26%,t=3.19),respectively,with a significant upward trend,and the differences were statistically significant(all P<0.01).[Conclusion]Non-Hodgkin's lymphoma in Qidong City shows an overall increasing trend in the age-standardized incidence over the past 50 years,with a higher incidence in male and in the el-derly population.
6.Trend of Incidence Rates of Gallbladder Cancer in Qi-dong City of Jiangsu Province from 1972 to 2021
Yuanyou XU ; Yonghui ZHANG ; Lulu DING ; Yongsheng CHEN ; Jun WANG ; Yongfeng YAN ; Jianguo CHEN ; Jian ZHU
China Cancer 2025;34(4):290-296
[Purpose]To analyze the trend of incidence rates of gallbladder cancer in Qidong City of Jiangsu Province from 1972 to 2021.[Methods]The incidence data of gallbladder cancer from 1972 to 2021 were collected from the Qidong Tumour Registry database,the crude incidence rate(CR),age-standardized rate by Chinese standard population(ASRC),age-standardized rate by world standard population(ASRW)of gallbladder cancer were calculated.Trend analysis was per-formed using Joinpoint 4.9.1.0 software to calculate the average annual percentage change(AAPC)of gallbladder cancer incidence rates,and time trend analysis was performed on the overall inci-dence rate by sex and age.[Results]A total of 1 369 cases of gallbladder cancer occurred in Qi-dong City from 1972 to 2021,accounting for 0.93%of all malignant tumors.The overall CR of gallbladder cancer was 2.44/105 in 50 years,ASRC was 0.88/105 and ASRW was 1.45/105.The truncated rate of 35~64 years old was 1.98/105,the cumulative incidence of gallbladder cancer at 0~74 years old was 0.16%,and the risk of cumulative incidence of gallbladder cancer was 0.16%.CR was slightly higher in women than that in men,but after standardization it was slightly higher in men than that in women.The sex ratio of CR,ASRC and ASRW was 0.89,1.07 and 1.06,respectively.With the increase of age,the incidence of gallbladder cancer was also increased.The age of onset was slightly increased in last 50 years.In last 50 years,there was an upward trend in the overall incidence of gallbladder cancer,the incidence both for men and women,and the inci-dence of each age group.[Conclusion]The incidence of gallbladder cancer in Qidong City has increased considerably during the past 50 years,and continuing attention should be paid to the prevention and treatment of gallbladder cancer especially for the key populations.
7.Analysis of Survival Rate of Breast Cancer from 1972 to 2019 and Prediction for Next 10 Years in Qidong City of Jiangsu Province
Junlei WANG ; Jun WANG ; Yongsheng CHEN ; Yuanyou XU ; Lulu DING ; Yonghui ZHANG ; Jianguo CHEN ; Jian ZHU ; Qichao NI
China Cancer 2025;34(4):304-310
[Purpose]To analyze the survival rate of breast cancer in Qidong City of Jiangsu Province from 1972 to 2019 and to predict the trend in the next 10 years.[Methods]The data of breast cancer collected from Qidong Cancer Registry from 1972 to 2019 were extracted.Observed survival rate(OSR),relative survival rate(RSR),age-adjusted relative survival(ARS)and average annual percentage change(AAPC)of breast cancer were calculated.ARIMA model was used to predict the trend of breast cancer survival rate.[Results]The 5-year RSR increased from 57.30%during 1972-1977 to 89.01%during 2014-2019,and the uptrend of RSR in the 8 periods was statistically significant(P<0.001).The 5-year ARS increased from 48.12%during 1972-1977 to 85.64%during 2014-2019 with an AAPC of 1.85%(t=10.113,P<0.001).The 5-year RSR during 1972-2019 for males was 85.22%,and for females was 74.51%.For females,the 5-year RSR in-creased from 56.44%during 1972-1977 to 88.93%during 2014-2019 with an AAPC of 1.29%(t=13.087,P<0.001),and the 5-year ARS increased from 46.14%during 1972-1977 to 85.23%during 2014-2019 with an AAPC of 1.90%(t=10.369,P<0.001).The 5-year RSR in the age groups of 25~34,35~44,45~54,55~64,65~74,and over 75 years old were 66.91%,74.69%,76.97%,75.52%,73.44%and 66.40%,respectively;the corresponding AAPCs of 5-RSR in above age groups were 1.02%(t=3.816,P=0.009),1.03%(t=4.936,P=0.003),1.23%(t=5.826,P=0.001),1.86%(t=5.997,P=0.001),2.13%(t=10.245,P<0.001),and 1.44%(t=6.405,P=0.001),respectively.ARIMA modeling of survival trend prediction showed that 5-RSR and 5-ARS for breast cancer will be ascended to 98.76%and 98.33%by 2028,respectively.[Conclusion]The overall survival rate of registered breast cancer cases in Qidong City has been greatly improved and will be further improved in the future,more attention should be paid to the prevention and treatment of breast cancer.
8.Epidemiological characteristics of liver cancer in China and worldwide
Yongsheng CHEN ; Jun WANG ; Lulu DING ; Yuanyou XU ; Jian ZHU
Chinese Journal of Oncology 2025;47(9):858-866
Objective:To describe and analyze the incidence, mortality and epidemiological trends of liver cancer in China and selected regions worldwide, providing data references for liver cancer prevention and control.Methods:Data on the incidence, mortality, historical trends, and projected estimates for 2050 of liver cancer were extracted from the GLOBOCAN 2022 database. Epidemiological characteristics of liver cancer in China and other region were described and compared by region, age, sex and human development index (HDI). Spearman's test was used to examine the relationships between HDI and age-standardized incidence rate (ASIR) or age-standardized mortality rate (ASMR) across regions. The average annual percentage change (AAPC) in ASIR was calculated using Joinpoint regression analysis.Results:In 2022, the number of new cases and deaths of liver cancer in the global were 866 000 and 759 000 respectively, and the ASIR and ASMR were 8.6/10 5 and 7.4/10 5, respectively. Both ASIR and ASMR were higher in males than in females. In China, there were 368 000 new cases and 317 000 deaths in 2022, with an ASIR of 15.0/10 5 and an ASMR of 12.6/10 5. Globally, the incidence of liver cancer in males peaked in the 65-69 age group, while in Chinese males, two incidence peaks were observed in the 50-54 and 65-69 age groups. Among the elderly (≥65 years), the global ASIR and ASMR were 7.4 and 8.1 times higher, respectively, than those in the working-age population (15-64 years). In China, the ratios of ASIR and ASMR between the elderly and working-age populations were 5.9 and 7.0, respectively. Both ASIR and ASMR were negatively correlated with HDI (ASIR: r=-0.18, P=0.018; ASMR: r=-0.31, P<0.001). From 2002 to 2017, ASIR of liver cancer showed a declining trend in both males and females in China, Japan, and South Korea (all P<0.001), with AAPCs of -1.96% for Chinese males and -2.75% for Chinese females. In contrast, the United States experienced an increasing trend in ASIR, with AAPCs of 3.13% for males and 3.12% for females (both P<0.001). Projections indicate that by 2050, the number of new cases and deaths globally will reach 1.564 million and 1.421 million, representing increases of 80.6% and 87.2% compared to 2022, respectively. In China, the number of new cases and deaths are projected to be 560 000 and 514 000, increases of 52.2% and 62.1% from 2022, respectively. Conclusions:The burden of liver cancer varies significantly across regions, sexes, and age groups worldwide. Incidence and mortality rates are negatively correlated with HDI. The global burden of liver cancer is expected to continue increasing, underscoring the need for enhanced comprehensive prevention and control strategies.
9.Incidence trend and age-period-cohort analysis of lung cancer in Qidong from 1972 to 2021
Jun XU ; Yongsheng CHEN ; Jun WANG ; Jian ZHU ; Yuexia GAO
Chinese Journal of Oncology 2025;47(11):1066-1073
Objective:To describe the epidemiological characteristics and trends of lung cancer incidence in Qidong City, Jiangsu Province, China, between 1972 and 2021, and provide guidelines for prevention and control.Methods:Data on lung cancer with onset from January 1, 1972 to December 31, 2021 and coded as C33-C34 in the International Classification of Diseases (10th edition) were extracted from the tumor registry database of Qidong City. Population data of Qidong City for each year from 1972 to 2021 were extracted from the annual report of household registration of the Public Security Bureau of Qidong City. The crude incidence rate (CR), China age-standardized rate (ASRC), world age-standardized rate (ASRW), 35-64 years truncated rate, 0-74 years cumulative rate, and cumulative risk were calculated. Average annual percentage change (AAPC) was calculated by Joinpoint software for CR, ASRC, and ASRW. The age-period-cohort (APC) model was used to analyze the influence of age, period, and birth cohort on the changes in the incidence trend of lung cancer.Results:From 1972 to 2021, there were 26 996 patients of lung cancer in Qidong, accounting for 18.30% (26 996/147 519) of all cancer new cases. The CR of lung cancer was 48.13/10 5, the ASRC was 29.65/10 5, and the ASRW was 29.67/10 5. The truncated incidence of 35-64 years old was 42.64/10 5, the cumulative incidence rate between the ages between 0-74 years old was 3.71%, and the cumulative risk was 3.64%. There were 18 572 male patients, with the CR, ASRC, and ASRW being 67.15/10 5, 43.82/10 5, and 43.87/10 5, respectively. The number of female patients was 8 424, and the CR, ASRC, and the ASRW were 29.62/10 5, 17.63/10 5, and 17.55/10 5, respectively. Temporal analysis indicated significant upward trends in the ASRCs for both genders combined, males, and females, with AAPC values of 2.21%, 1.76%, and 2.98% (all P<0.001), respectively. Age-specific incidence rates increased with age, peaking at 275.34/10 5 in the 75+ years age group, with an increasing trend in all age groups and the greatest increase in the 75+ years age group, with an AAPC value of 3.53% ( P<0.001). The results of the APC model showed that the net drift value of lung cancer incidence was 2.06% (95% CI: 1.72%-2.41%), and the highest value of local drift was 3.93% (95% CI: 3.20%-4.68%) in the 80+ years old group. The risk of cancer increases with age in the age effect. The period effect of the incidence rate ratio (RR) value increased from 1.12 during 1997-2001 to 2.09 during 2017-2021. The cohort effect of the RR value for risk of incidence increased from 0.17 during 1892-1896 to 2.54 during 1987-1991. Conclusions:From 1972 to 2021, the incidence rate of lung cancer in Qidong City showed an upward trend. Age, period, and cohort are all major factors influencing the incidence of lung cancer. It is necessary to develop precise and comprehensive prevention and control strategies to curb this increasing trend of lung cancer incidence.
10.Application of the theory of"yang transforming qi and yin shaping up body"in treating Raynaud syndrome
Ze YANG ; Yanzuo WU ; Qingmiao ZHU ; Yanhao CHEN ; Jie BAO ; Shuo HUANG ; Yongsheng FAN
Journal of Beijing University of Traditional Chinese Medicine 2025;48(8):1147-1151
Raynaud syndrome is a clinical syndrome characterized by paroxysmal vasospasms of the acral small arteries,and its pathogenesis is closely associated with the dynamic imbalance of yin and yang as elucidated by the theory of"yang transforming qi and yin shaping up body."The theory of"yang transforming qi and yin shaping up body"originated in Huangdi Neijing,which is aimed at that yang can be tangible essence,blood,fluid,and other substances belonging to the yin into an invisible qi,promote the internal and external zang-fu organs and qi of the body's operation;yin qi is transformed into tangible substances under the gasification effect of yang qi to nourish the organism,to consolidate the essence of internal zang-fu organs,and to maintain the balance of yin and yang in the body.This study innovatively employs this theory to systematically elucidate the dynamic pathomechanism evolution of Raynaud syndrome:at the beginning of the disease,the ischemic stage is dominated by the deficiency of yang qi and the inability of qi to transform yin;then the disease enters into the hypoxic stage and the dilatation stage,which are mostly caused by the lack of yang depression,the blockage of qi,and the over-excessive formation of yin;and finally,the yang transforms qi too much and yin is damaged and weak,and then reaches the stage of complication.In Raynaud syndrome,the key mechanism and pathology of"yang transforming qi"and"yin shaping up body"as well as the stage of the disease should be clarified,so that yang qi can be used as the basis to make up for yang deficiency,yang depression can be stretched out,yin evils such as cold condensation,blood stasis and water dampness can be transformed,heat and toxin can be eliminated,yin fluids can be restored,and the extremities can be warmed up.The disease will be convalesced gradually.

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