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Burdens of gastric and colorectal cancers and their attributable risk factors among 31 countries and territories in the Western Pacific region, 2000-2021
IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-02-01 DOI: 10.1016/j.lanwpc.2024.101415
Liangyu Kang , Wenxin Yan , Wenzhan Jing , Ning Zhang , Min Liu , Wannian Liang
<div><h3>Background</h3><div>Stomach cancer (SC) and colorectal cancer (CRC) are two leading gastrointestinal cancers worldwide, with particularly heavy burdens in the Western Pacific region (WPR). This study aimed to comprehensively describe the regional landscape, temporal trends, and risk factors for the burdens of SC and CRC in the WPR.</div></div><div><h3>Methods</h3><div>Estimates of incidence, disability-adjusted life years (DALYs), and deaths for SC and CRC were obtained from the Global Burden of Disease Study 2021. We calculated the percentage of relative changes in incident cases, DALYs, and deaths between 2000 to 2021. Estimated annual percentage changes (EAPCs) were used to reflect trends of age-standardized incidence rates (ASIR), age-standardized DALY rates (ASDR), and age-standardized mortality rates (ASMR). Risk factors for SC and CRC were also presented.</div></div><div><h3>Findings</h3><div>In 2021, the numbers of incident cases of SC and CRC were 756,303 and 933,200 in the WPR, constituting 61.77% and 43.07% of the global totals, respectively. From 2000 to 2021, the ASIR (EAPC=-2.30, 95% CI -2.44 to -2.16), ASDR (EAPC=-3.41, 95% CI -3.59 to -3.23), and ASMR (EAPC=-3.11, 95% CI -3.29 to -2.94) of SC decreased. Despite the increase in incident cases (24.00%) and deaths (8.33%) of SC, the DALYs declined by 6.20%. The ASIR of CRC increased by an average of 1.32% (95% CI 1.25% to 1.39%), while ASDR (EAPC=-0.48, 95% CI -0.59 to -0.38) and ASMR (EAPC=-0.45, 95% CI -0.53 to -0.37) declined. China exhibited the highest numbers of incident cases, DALYs, and deaths for both cancers among the 31 WPR countries or territories. Although the ASDRs of SC decreased in 27 countries, an increase was detected in Guam. Meanwhile, Viet Nam showed the fastest increase in ASIR of CRC, followed by China and Philippines. The incident cases, DALYs, and deaths of both SC and CRC peaked in individuals aged 65-74 years. The rates of incidence, DALY, and mortality increased non-linearly with age and were generally higher in males than in females. The slowest decline in incidence rates of SC (EAPC=-0.50, 95% CI -0.80 to -0.20) and the fastest increase in incidence rates of CRC (EAPC=2.57, 95% CI 2.19 to 2.95) were observed among individuals aged 25-29 years. The rates of DALY and mortality for both cancers decreased slowly or even increased among the elderly over 80 years. Smoking and diet high in sodium were attributable to 59.66 and 36.16 DALYs of SC per 100,000 population in 2021. Diet low in milk, diet low in whole grains, and diet high in red meat were three leading risk factors for DALYs and deaths of CRC. There were increasing trends in the ASDR and ASMR of CRC due to high body-mass index and alcohol use (EAPC range: 0.54-1.97).</div></div><div><h3>Interpretation</h3><div>SC and CRC remain noticeable public health issues in the WPR. There is a critical need to address the early onset of both cancers and improve management and prognosis for the elderly.
{"title":"Burdens of gastric and colorectal cancers and their attributable risk factors among 31 countries and territories in the Western Pacific region, 2000-2021","authors":"Liangyu Kang ,&nbsp;Wenxin Yan ,&nbsp;Wenzhan Jing ,&nbsp;Ning Zhang ,&nbsp;Min Liu ,&nbsp;Wannian Liang","doi":"10.1016/j.lanwpc.2024.101415","DOIUrl":"10.1016/j.lanwpc.2024.101415","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Stomach cancer (SC) and colorectal cancer (CRC) are two leading gastrointestinal cancers worldwide, with particularly heavy burdens in the Western Pacific region (WPR). This study aimed to comprehensively describe the regional landscape, temporal trends, and risk factors for the burdens of SC and CRC in the WPR.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Estimates of incidence, disability-adjusted life years (DALYs), and deaths for SC and CRC were obtained from the Global Burden of Disease Study 2021. We calculated the percentage of relative changes in incident cases, DALYs, and deaths between 2000 to 2021. Estimated annual percentage changes (EAPCs) were used to reflect trends of age-standardized incidence rates (ASIR), age-standardized DALY rates (ASDR), and age-standardized mortality rates (ASMR). Risk factors for SC and CRC were also presented.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;In 2021, the numbers of incident cases of SC and CRC were 756,303 and 933,200 in the WPR, constituting 61.77% and 43.07% of the global totals, respectively. From 2000 to 2021, the ASIR (EAPC=-2.30, 95% CI -2.44 to -2.16), ASDR (EAPC=-3.41, 95% CI -3.59 to -3.23), and ASMR (EAPC=-3.11, 95% CI -3.29 to -2.94) of SC decreased. Despite the increase in incident cases (24.00%) and deaths (8.33%) of SC, the DALYs declined by 6.20%. The ASIR of CRC increased by an average of 1.32% (95% CI 1.25% to 1.39%), while ASDR (EAPC=-0.48, 95% CI -0.59 to -0.38) and ASMR (EAPC=-0.45, 95% CI -0.53 to -0.37) declined. China exhibited the highest numbers of incident cases, DALYs, and deaths for both cancers among the 31 WPR countries or territories. Although the ASDRs of SC decreased in 27 countries, an increase was detected in Guam. Meanwhile, Viet Nam showed the fastest increase in ASIR of CRC, followed by China and Philippines. The incident cases, DALYs, and deaths of both SC and CRC peaked in individuals aged 65-74 years. The rates of incidence, DALY, and mortality increased non-linearly with age and were generally higher in males than in females. The slowest decline in incidence rates of SC (EAPC=-0.50, 95% CI -0.80 to -0.20) and the fastest increase in incidence rates of CRC (EAPC=2.57, 95% CI 2.19 to 2.95) were observed among individuals aged 25-29 years. The rates of DALY and mortality for both cancers decreased slowly or even increased among the elderly over 80 years. Smoking and diet high in sodium were attributable to 59.66 and 36.16 DALYs of SC per 100,000 population in 2021. Diet low in milk, diet low in whole grains, and diet high in red meat were three leading risk factors for DALYs and deaths of CRC. There were increasing trends in the ASDR and ASMR of CRC due to high body-mass index and alcohol use (EAPC range: 0.54-1.97).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;SC and CRC remain noticeable public health issues in the WPR. There is a critical need to address the early onset of both cancers and improve management and prognosis for the elderly. ","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101415"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of an artificial intelligence-based program for managing fatigue in Chinese young breast cancer survivors: a randomized controlled trial
IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-02-01 DOI: 10.1016/j.lanwpc.2024.101288
Yun Hu , Joshua Wiley , Lulu Jiang , Ran Yi , Eun-Ok Im

Background

Fatigue is a common problem among breast cancer survivors, particularly among young breast cancer survivors (YBCSs) who often juggle work and family responsibilities. This demographic frequently experiences high levels of fatigue, which adversely impacts their quality of life. The study aimed to examine the effectiveness of an artificial intelligence (AI) -based program in managing cancer-related fatigue among Chinese YBCSs.

Methods

A randomized clinical trial was conducted from Jan2021 to Dec 2022, involving 115 YBCSs. The intervention group received multimodal support combing artificial intelligence (AI) interaction and humanities skills, while the control group received online information support only for 12 weeks. The outcomes were measured using the BFI (Fatigue, primary), and the FACT-B (quality of life, secondary). An intention-to treat approach was used to analyze differences in fatigue and quality of life.

Findings

Both groups showed improvements in fatigue score(p<0.05) from baseline(T0) to 4 weeks(T1) and 12 weeks(T2). Notably, at the 12-week mark, the intervention group demonstrated a more substantial reduction in fatigue compared to the control group. Additionally, the intervention group experienced a greater increase in quality of life from T1 to T2 (β=15.384, 95% CI:13.028–17.740, P<.001).

Interpretation

This study demonstrates that an AI-based program could help effectively manage fatigue, subsequently enhancing the quality of life among YBCSs. The integration of AI and humanities skills offers a promising approach to improving health outcomes in this vulnerable population.
{"title":"Efficacy of an artificial intelligence-based program for managing fatigue in Chinese young breast cancer survivors: a randomized controlled trial","authors":"Yun Hu ,&nbsp;Joshua Wiley ,&nbsp;Lulu Jiang ,&nbsp;Ran Yi ,&nbsp;Eun-Ok Im","doi":"10.1016/j.lanwpc.2024.101288","DOIUrl":"10.1016/j.lanwpc.2024.101288","url":null,"abstract":"<div><h3>Background</h3><div>Fatigue is a common problem among breast cancer survivors, particularly among young breast cancer survivors (YBCSs) who often juggle work and family responsibilities. This demographic frequently experiences high levels of fatigue, which adversely impacts their quality of life. The study aimed to examine the effectiveness of an artificial intelligence (AI) -based program in managing cancer-related fatigue among Chinese YBCSs.</div></div><div><h3>Methods</h3><div>A randomized clinical trial was conducted from Jan2021 to Dec 2022, involving 115 YBCSs. The intervention group received multimodal support combing artificial intelligence (AI) interaction and humanities skills, while the control group received online information support only for 12 weeks. The outcomes were measured using the BFI (Fatigue, primary), and the FACT-B (quality of life, secondary). An intention-to treat approach was used to analyze differences in fatigue and quality of life.</div></div><div><h3>Findings</h3><div>Both groups showed improvements in fatigue score(p&lt;0.05) from baseline(T0) to 4 weeks(T1) and 12 weeks(T2). Notably, at the 12-week mark, the intervention group demonstrated a more substantial reduction in fatigue compared to the control group. Additionally, the intervention group experienced a greater increase in quality of life from T1 to T2 (<em>β</em>=15.384, 95% CI:13.028–17.740, <em>P</em>&lt;.001).</div></div><div><h3>Interpretation</h3><div>This study demonstrates that an AI-based program could help effectively manage fatigue, subsequently enhancing the quality of life among YBCSs. The integration of AI and humanities skills offers a promising approach to improving health outcomes in this vulnerable population.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101288"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The feasibility, acceptability and preliminary outcomes of a financial navigation program among breast cancer in China: a pilot randomized controlled trial
IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-02-01 DOI: 10.1016/j.lanwpc.2024.101369
Xiaoyi Yuan , Yanling Sun , Yi Kuang , Junyi Ruan , Lichen Tang , Jiajia Qiu , Linqin Chen , Weijie Xing

Background

Financial toxicity (FT) is a global challenge for breast cancer patients due to high costs of care. Financial navigation is a promising intervention to alleviate FT, but evidence remains limited, especially within the Chinese healthcare system. To assess the feasibility, acceptability, and preliminary effects of a financial navigation program among breast cancer patients in China.

Methods

In this single-center, single-blinded pilot randomized controlled trial, a financial navigation program comprising needs assessment, cost-related health education, resource/service referral, and personalized counseling was evaluated. Feasibility was assessed through recruitment, attrition, and adherence rates. Acceptability was measured via participant satisfaction surveys and semi-structured interviews. Preliminary effects were evaluated through cost-related health literacy and three domains of FT.

Results

Twenty-six breast cancer patients were recruited, with a consent rate of 55.9% and a 1-month attrition rate of 7.7%. All participants in the intervention group completed needs assessment and cost-related health education, with resource / service referral and personalized counseling provided as needed. The intervention significantly improved cost-related health literacy, although no statistically significant between-group difference in FT was observed. Most participants reported satisfaction and perceived the program as useful.

Conclusions

The financial navigation program was feasible, acceptable, and effective in improving cost-related health literacy among breast cancer patients in China.

Implications for Practice

This study generated insights to guide future implementation of full-scale RCTs with larger samples and longer durations to further explore the intervention’s effectiveness.
{"title":"The feasibility, acceptability and preliminary outcomes of a financial navigation program among breast cancer in China: a pilot randomized controlled trial","authors":"Xiaoyi Yuan ,&nbsp;Yanling Sun ,&nbsp;Yi Kuang ,&nbsp;Junyi Ruan ,&nbsp;Lichen Tang ,&nbsp;Jiajia Qiu ,&nbsp;Linqin Chen ,&nbsp;Weijie Xing","doi":"10.1016/j.lanwpc.2024.101369","DOIUrl":"10.1016/j.lanwpc.2024.101369","url":null,"abstract":"<div><h3>Background</h3><div>Financial toxicity (FT) is a global challenge for breast cancer patients due to high costs of care. Financial navigation is a promising intervention to alleviate FT, but evidence remains limited, especially within the Chinese healthcare system. To assess the feasibility, acceptability, and preliminary effects of a financial navigation program among breast cancer patients in China.</div></div><div><h3>Methods</h3><div>In this single-center, single-blinded pilot randomized controlled trial, a financial navigation program comprising needs assessment, cost-related health education, resource/service referral, and personalized counseling was evaluated. Feasibility was assessed through recruitment, attrition, and adherence rates. Acceptability was measured via participant satisfaction surveys and semi-structured interviews. Preliminary effects were evaluated through cost-related health literacy and three domains of FT.</div></div><div><h3>Results</h3><div>Twenty-six breast cancer patients were recruited, with a consent rate of 55.9% and a 1-month attrition rate of 7.7%. All participants in the intervention group completed needs assessment and cost-related health education, with resource / service referral and personalized counseling provided as needed. The intervention significantly improved cost-related health literacy, although no statistically significant between-group difference in FT was observed. Most participants reported satisfaction and perceived the program as useful.</div></div><div><h3>Conclusions</h3><div>The financial navigation program was feasible, acceptable, and effective in improving cost-related health literacy among breast cancer patients in China.</div></div><div><h3>Implications for Practice</h3><div>This study generated insights to guide future implementation of full-scale RCTs with larger samples and longer durations to further explore the intervention’s effectiveness.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101369"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The responsiveness of surgical research to Māori in Aotearoa, New Zealand—a scoping review
IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-02-01 DOI: 10.1016/j.lanwpc.2025.101487
Jamie-Lee Rahiri , Noah Appleby , Makayla Kahi , Annaliese Wheeler , Jason Tuhoe , Shanthi Ameratunga , Rachelle Love , Wiremu MacFater , Matire Harwood

Background

Māori, the Indigenous people of Aotearoa, New Zealand (NZ), experience significant inequities in access to surgery and postoperative outcomes. This scoping review aimed to present a synopsis of the extent and nature of research concerning Māori in surgery in NZ and evaluated the responsiveness of this evidence base to Māori using two Indigenous frameworks.

Methods

Utilising a Kaupapa Māori methodological stance, a scoping review of all studies related to Māori and surgical care in NZ (2000–2024) was performed. The studies underwent thorough evaluation using the CONSIDER and MĀORI frameworks to assess responsiveness to Indigenous Māori.

Findings

A total of 254 studies were included, most being quantitative (N = 230, 91%) and most categorised under General Surgery (N = 139, 55%). Māori responsiveness assessments of each study highlighted significant shortcomings, with 96% of studies (N = 243/254) rated as low quality as per the adapted CONSIDER framework and 68% (N = 172/254) rated as low quality in accordance with the MĀORI framework. More than half of all studies (55%) did not report Māori leadership, governance, and co-authorship. Studies that utilised Kaupapa Māori research were more likely to be considered high-quality.

Interpretation

This study shows that the current surgical evidence base is not responsive to Māori. It calls for a review of research practices and encourages monitoring of the surgical evidence base for all Indigenous peoples.

Funding

This study was supported by a Health Research Council of New Zealand Health Delivery Research Activation Grant (21/860) and Māori Health Knowledge Translation Grant (25/234). The funders had no role in the study design, conception, data collection, analysis, interpretation, or report writing. They also had no role in submitting our study for publication.
{"title":"The responsiveness of surgical research to Māori in Aotearoa, New Zealand—a scoping review","authors":"Jamie-Lee Rahiri ,&nbsp;Noah Appleby ,&nbsp;Makayla Kahi ,&nbsp;Annaliese Wheeler ,&nbsp;Jason Tuhoe ,&nbsp;Shanthi Ameratunga ,&nbsp;Rachelle Love ,&nbsp;Wiremu MacFater ,&nbsp;Matire Harwood","doi":"10.1016/j.lanwpc.2025.101487","DOIUrl":"10.1016/j.lanwpc.2025.101487","url":null,"abstract":"<div><h3>Background</h3><div>Māori, the Indigenous people of Aotearoa, New Zealand (NZ), experience significant inequities in access to surgery and postoperative outcomes. This scoping review aimed to present a synopsis of the extent and nature of research concerning Māori in surgery in NZ and evaluated the responsiveness of this evidence base to Māori using two Indigenous frameworks.</div></div><div><h3>Methods</h3><div>Utilising a Kaupapa Māori methodological stance, a scoping review of all studies related to Māori and surgical care in NZ (2000–2024) was performed. The studies underwent thorough evaluation using the CONSIDER and MĀORI frameworks to assess responsiveness to Indigenous Māori.</div></div><div><h3>Findings</h3><div>A total of 254 studies were included, most being quantitative (N = 230, 91%) and most categorised under General Surgery (N = 139, 55%). Māori responsiveness assessments of each study highlighted significant shortcomings, with 96% of studies (N = 243/254) rated as low quality as per the adapted CONSIDER framework and 68% (N = 172/254) rated as low quality in accordance with the MĀORI framework. More than half of all studies (55%) did not report Māori leadership, governance, and co-authorship. Studies that utilised Kaupapa Māori research were more likely to be considered high-quality.</div></div><div><h3>Interpretation</h3><div>This study shows that the current surgical evidence base is not responsive to Māori. It calls for a review of research practices and encourages monitoring of the surgical evidence base for all Indigenous peoples.</div></div><div><h3>Funding</h3><div>This study was supported by a <span>Health Research Council of New Zealand</span> Health Delivery Research Activation Grant (21/860) and Māori Health Knowledge Translation Grant (25/234). The funders had no role in the study design, conception, data collection, analysis, interpretation, or report writing. They also had no role in submitting our study for publication.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101487"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143376493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identification of breast cancer genes and establishment of a prediction model after menopausal hormone therapy
IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-02-01 DOI: 10.1016/j.lanwpc.2024.101350
Haiyan Li , Jingjie Li , Qiwen Liu , Meiqing Xie , Hongxia Wang , Linjuan Ma , Jie Wu , Kai Kang , Fan Wang , Xiaoyan Liang , Qi Yu
Menopausal hormone therapy (MHT) is a widely employed approach for managing menopausal syndrome, entailing the administration of exogenous estrogen to alleviate diverse symptoms and mitigate associated diseases in perimenopausal women. However, recent studies have reported an increased risk of breast cancer associated with estrogen and progestin therapy, although there are notable variations among these studies. Therefore, it is imperative to identify individuals at high risk for breast cancer following MHT. This study conducted a comparative analysis of genes between breast cancer patients who received MHT and those who did not, identifying SNP loci closely associated with the risk of developing breast cancer in postmenopausal women undergoing MHT. A predictive model for assessing the risk of breast cancer in postmenopausal women undergoing MHT was established to facilitate personalized treatment recommendations and alleviate menopausal symptoms. Based on the sequencing data of perimenopausal patients with breast cancer (treated MHT) and unaffected breast cancer (treated MHT), effective SNP sites were obtained in the whole genome, and differential SNP sites associated with breast cancer and hormone therapy were initially screened based on association analysis. Finally, a group of 128 SNP sites for risk prediction of breast cancer in perimenopausal women after hormone therapy was determined. The score of Breast cancer (treated MHT) Cohort was significantly different from the other two groups (Breast cancer (untreated MHT) Cohort, and Unaffected breast cancer (treated MHT) Cohort) (P=0.0032 and P=1.8E-06), which showed that patients with a high risk of breast cancer undergoing MHT could be distinguished based on the above 128 MHT-SNPs. In addition, the efficient of four algorithms was evaluated and the RF method had the highest AUC value 0.813, indicating its superior predictive capability in assessing MHT-related breast cancer risk. The 128 MHT-SNPs presented in this study can be utilized for precise determination of the suitability of MHT for women during perimenopause. And the validated model risk prediction tool effectively forecasts the risk of breast cancer following MHT, thereby offering personalized diagnostic and therapeutic recommendations to clinical practitioners.
{"title":"Identification of breast cancer genes and establishment of a prediction model after menopausal hormone therapy","authors":"Haiyan Li ,&nbsp;Jingjie Li ,&nbsp;Qiwen Liu ,&nbsp;Meiqing Xie ,&nbsp;Hongxia Wang ,&nbsp;Linjuan Ma ,&nbsp;Jie Wu ,&nbsp;Kai Kang ,&nbsp;Fan Wang ,&nbsp;Xiaoyan Liang ,&nbsp;Qi Yu","doi":"10.1016/j.lanwpc.2024.101350","DOIUrl":"10.1016/j.lanwpc.2024.101350","url":null,"abstract":"<div><div>Menopausal hormone therapy (MHT) is a widely employed approach for managing menopausal syndrome, entailing the administration of exogenous estrogen to alleviate diverse symptoms and mitigate associated diseases in perimenopausal women. However, recent studies have reported an increased risk of breast cancer associated with estrogen and progestin therapy, although there are notable variations among these studies. Therefore, it is imperative to identify individuals at high risk for breast cancer following MHT. This study conducted a comparative analysis of genes between breast cancer patients who received MHT and those who did not, identifying SNP loci closely associated with the risk of developing breast cancer in postmenopausal women undergoing MHT. A predictive model for assessing the risk of breast cancer in postmenopausal women undergoing MHT was established to facilitate personalized treatment recommendations and alleviate menopausal symptoms. Based on the sequencing data of perimenopausal patients with breast cancer (treated MHT) and unaffected breast cancer (treated MHT), effective SNP sites were obtained in the whole genome, and differential SNP sites associated with breast cancer and hormone therapy were initially screened based on association analysis. Finally, a group of 128 SNP sites for risk prediction of breast cancer in perimenopausal women after hormone therapy was determined. The score of Breast cancer (treated MHT) Cohort was significantly different from the other two groups (Breast cancer (untreated MHT) Cohort, and Unaffected breast cancer (treated MHT) Cohort) (P=0.0032 and P=1.8E-06), which showed that patients with a high risk of breast cancer undergoing MHT could be distinguished based on the above 128 MHT-SNPs. In addition, the efficient of four algorithms was evaluated and the RF method had the highest AUC value 0.813, indicating its superior predictive capability in assessing MHT-related breast cancer risk. The 128 MHT-SNPs presented in this study can be utilized for precise determination of the suitability of MHT for women during perimenopause. And the validated model risk prediction tool effectively forecasts the risk of breast cancer following MHT, thereby offering personalized diagnostic and therapeutic recommendations to clinical practitioners.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101350"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk factors of cancer among the working population in China: baseline findings of WECAN project
IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-02-01 DOI: 10.1016/j.lanwpc.2024.101345
Kaige Sun , Yuan Li , Rong Luo , Baohua Wang , Ning Wang , Changqiong Wang , Guangming Yi , Fengjun He , Jing Wu , Puhong Zhang
<div><h3>Background</h3><div>Global cancer burden is growing rapidly, and the risk of cancer significantly increases in aged 40 and above, primarily the working population. This study aims to assess the status quo of cancer risk factors among the working population to develop targeted intervention strategies for workplace cancer prevention.</div></div><div><h3>Methods</h3><div>We utilized the baseline data of a randomized controlled trial “Comprehensive Workplace Intervention for Cancer Prevention in China (WECAN)” to conduct the cross-sectional analysis. 937 employees from three cities in China were surveyed on demographics, lifestyle, exposures, disease history, cancer family history, women's reproductive history, and anthropometrics.</div></div><div><h3>Findings</h3><div>The mean age was 40.4±8.9 years and 61.1% were males. 57.2% were blue-collars (from production workshops), while 42.8% were white-collars (from offices). The proportions of participants with junior high school or below, high school, junior college, and bachelor's degree or higher were 13.1%, 20.9%, 31.0%, and 35.0%, respectively. Overall smoking rate is 37.7%, with significantly higher rates among aged 40 and above (42.8% versus 32.1%, p<0.0001), males (59.2% versus 3.9%, p<0.0001), blue-collars (45.9% versus 26.7%, p<0.0001). Smoking rates notably increased as educational levels decreased (p<0.0001). Overall alcohol consumption rate was 62.9%, with an average alcohol intake of 12.7±20.4 g/day. Males reported a higher rate (74.7% versus 44.2%, p<0.0001) and alcohol intake (15.9±22.1 g/day versus 4.4±11.6 g/day, p<0.0001). Employees aged 40 or older consumed more alcohol (15.2±22.9 g/day versus 10.1±17.0 g/day, p=0.0020). As educational levels rose, drinking rate significantly increased (p<0.0001), while alcohol intake substantially reduced (p=0.0012). The proportion of employees who achieved 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week was 51.9% and the average amount was 1740.2±2390.1 Mets·min. Overweight (BMI=24∼27.9 kg/m<sup>2</sup>) and obesity (BMI≥28 kg/m<sup>2</sup>) rates were 36.0% and 23.9%, with males significantly higher (40.1% versus 29.4%, 28.6% versus 16.5%, p<0.0001). Obesity increased with lower education (p=0.0007). Central obesity affected 56.0%, particularly males (66.8% versus 39.0%, p<0.0001), blue-collars (61.8% versus 48.4%, p<0.0001), aged 40 or older (61.7% versus 49.8%, p=0.0002), and lower education (p<0.0001). Daily average dietary intakes were: whole grains 48.0±80.2 g, tubers 37.8±47.3 g, vegetables 284.2±209.3 g, fruits 127.0±126.2 g, red meat 129.2±99.0 g, and processed meat 7.5±15.9 g. Males (98.4±104.2 g versus 172.0±143.6 g, p<0.0001), blue-collars (114.3±112.5 g versus 144.0±140.7 g, p=0.0005) consumed less fruits. Males (140.9±106.2 g vs 110.6±83.5 g, p<0.0001) and aged under 40 (141.2±113.7 g versus 118.2±82.2 g, p=0.0005) ate more
{"title":"Risk factors of cancer among the working population in China: baseline findings of WECAN project","authors":"Kaige Sun ,&nbsp;Yuan Li ,&nbsp;Rong Luo ,&nbsp;Baohua Wang ,&nbsp;Ning Wang ,&nbsp;Changqiong Wang ,&nbsp;Guangming Yi ,&nbsp;Fengjun He ,&nbsp;Jing Wu ,&nbsp;Puhong Zhang","doi":"10.1016/j.lanwpc.2024.101345","DOIUrl":"10.1016/j.lanwpc.2024.101345","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Global cancer burden is growing rapidly, and the risk of cancer significantly increases in aged 40 and above, primarily the working population. This study aims to assess the status quo of cancer risk factors among the working population to develop targeted intervention strategies for workplace cancer prevention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We utilized the baseline data of a randomized controlled trial “Comprehensive Workplace Intervention for Cancer Prevention in China (WECAN)” to conduct the cross-sectional analysis. 937 employees from three cities in China were surveyed on demographics, lifestyle, exposures, disease history, cancer family history, women's reproductive history, and anthropometrics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The mean age was 40.4±8.9 years and 61.1% were males. 57.2% were blue-collars (from production workshops), while 42.8% were white-collars (from offices). The proportions of participants with junior high school or below, high school, junior college, and bachelor's degree or higher were 13.1%, 20.9%, 31.0%, and 35.0%, respectively. Overall smoking rate is 37.7%, with significantly higher rates among aged 40 and above (42.8% versus 32.1%, p&lt;0.0001), males (59.2% versus 3.9%, p&lt;0.0001), blue-collars (45.9% versus 26.7%, p&lt;0.0001). Smoking rates notably increased as educational levels decreased (p&lt;0.0001). Overall alcohol consumption rate was 62.9%, with an average alcohol intake of 12.7±20.4 g/day. Males reported a higher rate (74.7% versus 44.2%, p&lt;0.0001) and alcohol intake (15.9±22.1 g/day versus 4.4±11.6 g/day, p&lt;0.0001). Employees aged 40 or older consumed more alcohol (15.2±22.9 g/day versus 10.1±17.0 g/day, p=0.0020). As educational levels rose, drinking rate significantly increased (p&lt;0.0001), while alcohol intake substantially reduced (p=0.0012). The proportion of employees who achieved 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week was 51.9% and the average amount was 1740.2±2390.1 Mets·min. Overweight (BMI=24∼27.9 kg/m&lt;sup&gt;2&lt;/sup&gt;) and obesity (BMI≥28 kg/m&lt;sup&gt;2&lt;/sup&gt;) rates were 36.0% and 23.9%, with males significantly higher (40.1% versus 29.4%, 28.6% versus 16.5%, p&lt;0.0001). Obesity increased with lower education (p=0.0007). Central obesity affected 56.0%, particularly males (66.8% versus 39.0%, p&lt;0.0001), blue-collars (61.8% versus 48.4%, p&lt;0.0001), aged 40 or older (61.7% versus 49.8%, p=0.0002), and lower education (p&lt;0.0001). Daily average dietary intakes were: whole grains 48.0±80.2 g, tubers 37.8±47.3 g, vegetables 284.2±209.3 g, fruits 127.0±126.2 g, red meat 129.2±99.0 g, and processed meat 7.5±15.9 g. Males (98.4±104.2 g versus 172.0±143.6 g, p&lt;0.0001), blue-collars (114.3±112.5 g versus 144.0±140.7 g, p=0.0005) consumed less fruits. Males (140.9±106.2 g vs 110.6±83.5 g, p&lt;0.0001) and aged under 40 (141.2±113.7 g versus 118.2±82.2 g, p=0.0005) ate more","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101345"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The spatiotemporal dynamics and disease burden of liver cancer among the elderly in Yunnan of China, 2012-2020
IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-02-01 DOI: 10.1016/j.lanwpc.2024.101328
Jianhua Yang , Teng Zhang , Yang Chen , Yuemei Feng , Shun Zha , Ying Qian , Jizhuo Yang , Junyi Liu , Hongmei Wen , Jianzhong Yin
<div><h3>Background</h3><div>The burgeoning incidence and mortality rates of tumors, exacerbated by an aging population, pose a significant public health challenge in China. While global and domestic trends from 2018 to 2022 indicate a stabilization or decline in liver cancer rates, the spatiotemporal dynamics and disease burden among the elderly in Yunnan, China, remain insufficiently characterized.</div></div><div><h3>Methods</h3><div>This study encompasses a retrospective analysis of 26,328 liver cancer patients aged 60 and above, drawn from the household population of Yunnan, China, between 2012 and 2020. The evaluation adheres to the China Cancer Registry Guidance Manual (2016) and aligns with data standards set by the International Agency for Research on Cancer (IARC) and the International Association of Cancer Registries (I-ACR). The Joinpoint software was utilized to ascertain the annual percentage change (APC) in liver cancer incidence and mortality from 2012 to 2020.</div></div><div><h3>Findings</h3><div>Between 2012 and 2020, the incidence rate of liver cancer among the elderly in Yunnan, China, stood at 71.76 per 100,000 (CSR of 70.87 per 100,000 and WSR of 69.55 per 100,000), with a male incidence rate of 99.39 per 100,000 (CSR 99.10 per 100,000 and WSR 97.78 per 100,000) and a female rate of 45.91 per 100,000 (CSR 43.95 per 100,000 and WSR 42.54 per 100,000). The mortality rate for liver cancer in this demographic was 70.12 per 100,000 (CSR 68.43 per 100,000 and WSR 66.73 per 100,000), with males at 96.65 per 100,000 (CSR 95.61 per 100,000 and WSR 93.69 per 100,000) and females at 45.31 per 100,000 (CSR 42.63 per 100,000 and WSR 41.05 per 100,000). Liver cancer incidence among elderly males in Yunnan Province ranked third among all malignant tumors in 2012 and maintained this ranking in 2020. For elderly females, liver cancer rose from the fourth to the third position, marking an increase of one rank. Mortality rankings placed liver cancer second among males and third among females, with no change observed. Over the 2012-2020 period, the incidence rate of liver cancer in Yunnan's elderly exhibited an overall upward trajectory (APC 95% CI: 0.37%-3.8%), with male and female trends remaining stable (males: APC 95% CI: -0.35%-5.83%; females: APC 95% CI: -3.67%-7.26%). The overall mortality trend for liver cancer in the elderly was upward (APC 95% CI: 1.35% to 4.12%), with males showing an increasing trend (APC 95% CI: 0.74% to 4.51%) and females maintaining a stable rate (APC 95% CI: -0.85% to 8.0%).</div></div><div><h3>Interpretation</h3><div>The incidence of malignant tumors correlates with the Human Development Index (HDI), with liver cancer prevalent in regions of lower HDI. While the incidence rate of liver cancer among the elderly in China has been on a downward trajectory in recent years, mirroring trends in Asia, Yunnan's elderly population defies this pattern with increasing incidence and mortality rates. This divergence from t
{"title":"The spatiotemporal dynamics and disease burden of liver cancer among the elderly in Yunnan of China, 2012-2020","authors":"Jianhua Yang ,&nbsp;Teng Zhang ,&nbsp;Yang Chen ,&nbsp;Yuemei Feng ,&nbsp;Shun Zha ,&nbsp;Ying Qian ,&nbsp;Jizhuo Yang ,&nbsp;Junyi Liu ,&nbsp;Hongmei Wen ,&nbsp;Jianzhong Yin","doi":"10.1016/j.lanwpc.2024.101328","DOIUrl":"10.1016/j.lanwpc.2024.101328","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The burgeoning incidence and mortality rates of tumors, exacerbated by an aging population, pose a significant public health challenge in China. While global and domestic trends from 2018 to 2022 indicate a stabilization or decline in liver cancer rates, the spatiotemporal dynamics and disease burden among the elderly in Yunnan, China, remain insufficiently characterized.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This study encompasses a retrospective analysis of 26,328 liver cancer patients aged 60 and above, drawn from the household population of Yunnan, China, between 2012 and 2020. The evaluation adheres to the China Cancer Registry Guidance Manual (2016) and aligns with data standards set by the International Agency for Research on Cancer (IARC) and the International Association of Cancer Registries (I-ACR). The Joinpoint software was utilized to ascertain the annual percentage change (APC) in liver cancer incidence and mortality from 2012 to 2020.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between 2012 and 2020, the incidence rate of liver cancer among the elderly in Yunnan, China, stood at 71.76 per 100,000 (CSR of 70.87 per 100,000 and WSR of 69.55 per 100,000), with a male incidence rate of 99.39 per 100,000 (CSR 99.10 per 100,000 and WSR 97.78 per 100,000) and a female rate of 45.91 per 100,000 (CSR 43.95 per 100,000 and WSR 42.54 per 100,000). The mortality rate for liver cancer in this demographic was 70.12 per 100,000 (CSR 68.43 per 100,000 and WSR 66.73 per 100,000), with males at 96.65 per 100,000 (CSR 95.61 per 100,000 and WSR 93.69 per 100,000) and females at 45.31 per 100,000 (CSR 42.63 per 100,000 and WSR 41.05 per 100,000). Liver cancer incidence among elderly males in Yunnan Province ranked third among all malignant tumors in 2012 and maintained this ranking in 2020. For elderly females, liver cancer rose from the fourth to the third position, marking an increase of one rank. Mortality rankings placed liver cancer second among males and third among females, with no change observed. Over the 2012-2020 period, the incidence rate of liver cancer in Yunnan's elderly exhibited an overall upward trajectory (APC 95% CI: 0.37%-3.8%), with male and female trends remaining stable (males: APC 95% CI: -0.35%-5.83%; females: APC 95% CI: -3.67%-7.26%). The overall mortality trend for liver cancer in the elderly was upward (APC 95% CI: 1.35% to 4.12%), with males showing an increasing trend (APC 95% CI: 0.74% to 4.51%) and females maintaining a stable rate (APC 95% CI: -0.85% to 8.0%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;The incidence of malignant tumors correlates with the Human Development Index (HDI), with liver cancer prevalent in regions of lower HDI. While the incidence rate of liver cancer among the elderly in China has been on a downward trajectory in recent years, mirroring trends in Asia, Yunnan's elderly population defies this pattern with increasing incidence and mortality rates. This divergence from t","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101328"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Individual and joint exposure to PM2.5 constituents and incidence of esophageal cancer: evidence from China cancer registry annual report 2019
IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-02-01 DOI: 10.1016/j.lanwpc.2024.101412
Junqi Wang , Yafeng Liang , Hangyu Li , Dan Lin , Shuangqing Zhai
<div><h3>Background</h3><div>In recent years, air pollution, particularly fine particulate matter (PM2.5), has been widely recognized as a significant risk factor for various health issues. PM2.5 consists of multiple components, including organic carbon, elemental carbon, and heavy metals, each of which may have varying potential toxic effects on human health. Esophageal cancer is a common malignant tumor worldwide, especially in China, where its incidence and mortality rates remain high. Although studies have suggested associations between air pollution and various cancers, limited research has focused on the specific components of PM2.5 and their associations with esophageal cancer, particularly the impact of joint exposure to different constituents on the incidence of this disease. This study, based on data from the China Cancer Registry Annual Report 2019, aims to explore the association between individual and joint exposure to PM2.5 constituents and the incidence of esophageal cancer, providing scientific evidence for environmental pollution control and strategies for esophageal cancer prevention.</div></div><div><h3>Methods</h3><div>This study analyzed data from the “China Cancer Registry Annual Report 2019” to examine the association between PM2.5 and its major constituents with the incidence of esophageal cancer. Air pollution exposure assessment data were obtained from the Tracking Air Pollution in China (TAP) database. Population density-weighted methods were used to calculate the average exposure levels over different time scales (1-year, 2-year, 5-year). Generalized linear models were employed to assess the relationship between single pollutants and esophageal cancer incidence, while weighted quantile sum regression (WQS) and Bayesian kernel machine regression models (BKMR) were used to analyze the effects of joint exposure to multiple pollutants.</div></div><div><h3>Findings</h3><div>The study found significant associations between exposure to PM2.5 and its components and the incidence of esophageal cancer, particularly within a 2-year exposure window, where the associations were strongest. Specifically, each 1 μg/m³ increase in the concentration of PM2.5 constituents significantly raised the incidence of esophageal cancer: PM2.5 (0.03, 95% CI: 0.02-0.04, P<0.001), nitrate (NO3) (0.14, 95% CI: 0.09-0.19, P<0.001), sulfate (SO4) (0.12, 95% CI: 0.09-0.19, P<0.001), ammonium (NH4+) (0.20, 95% CI: 0.09-0.19, P<0.001), organic matter (OM) (0.10, 95% CI: 0.09-0.19, P<0.001), and black carbon (BC) (0.18, 95% CI: 0.09-0.19, P<0.001). Subgroup analysis showed that female were slightly more affected than male. Analysis of joint exposure revealed that ammonium (NH4+) and nitrate (NO3−) contributed the most to the risk of esophageal cancer. The WQS and BKMR models further confirmed the significant effects of joint exposure to PM2.5 components, with a stronger linear positive correlation observed in the female population. Additi
{"title":"Individual and joint exposure to PM2.5 constituents and incidence of esophageal cancer: evidence from China cancer registry annual report 2019","authors":"Junqi Wang ,&nbsp;Yafeng Liang ,&nbsp;Hangyu Li ,&nbsp;Dan Lin ,&nbsp;Shuangqing Zhai","doi":"10.1016/j.lanwpc.2024.101412","DOIUrl":"10.1016/j.lanwpc.2024.101412","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;In recent years, air pollution, particularly fine particulate matter (PM2.5), has been widely recognized as a significant risk factor for various health issues. PM2.5 consists of multiple components, including organic carbon, elemental carbon, and heavy metals, each of which may have varying potential toxic effects on human health. Esophageal cancer is a common malignant tumor worldwide, especially in China, where its incidence and mortality rates remain high. Although studies have suggested associations between air pollution and various cancers, limited research has focused on the specific components of PM2.5 and their associations with esophageal cancer, particularly the impact of joint exposure to different constituents on the incidence of this disease. This study, based on data from the China Cancer Registry Annual Report 2019, aims to explore the association between individual and joint exposure to PM2.5 constituents and the incidence of esophageal cancer, providing scientific evidence for environmental pollution control and strategies for esophageal cancer prevention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This study analyzed data from the “China Cancer Registry Annual Report 2019” to examine the association between PM2.5 and its major constituents with the incidence of esophageal cancer. Air pollution exposure assessment data were obtained from the Tracking Air Pollution in China (TAP) database. Population density-weighted methods were used to calculate the average exposure levels over different time scales (1-year, 2-year, 5-year). Generalized linear models were employed to assess the relationship between single pollutants and esophageal cancer incidence, while weighted quantile sum regression (WQS) and Bayesian kernel machine regression models (BKMR) were used to analyze the effects of joint exposure to multiple pollutants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The study found significant associations between exposure to PM2.5 and its components and the incidence of esophageal cancer, particularly within a 2-year exposure window, where the associations were strongest. Specifically, each 1 μg/m³ increase in the concentration of PM2.5 constituents significantly raised the incidence of esophageal cancer: PM2.5 (0.03, 95% CI: 0.02-0.04, P&lt;0.001), nitrate (NO3) (0.14, 95% CI: 0.09-0.19, P&lt;0.001), sulfate (SO4) (0.12, 95% CI: 0.09-0.19, P&lt;0.001), ammonium (NH4+) (0.20, 95% CI: 0.09-0.19, P&lt;0.001), organic matter (OM) (0.10, 95% CI: 0.09-0.19, P&lt;0.001), and black carbon (BC) (0.18, 95% CI: 0.09-0.19, P&lt;0.001). Subgroup analysis showed that female were slightly more affected than male. Analysis of joint exposure revealed that ammonium (NH4+) and nitrate (NO3−) contributed the most to the risk of esophageal cancer. The WQS and BKMR models further confirmed the significant effects of joint exposure to PM2.5 components, with a stronger linear positive correlation observed in the female population. Additi","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101412"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long term lung infection surveillance after treatment of lung cancer
IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-02-01 DOI: 10.1016/j.lanwpc.2024.101320
Dewu Bi, Hailing Yu, Xiaocheng Luo, Huawei He, Chaoyou Chen

Background

Lung cancer patients who have undergone radiotherapy and chemotherapy show an increased risk of infection. The purpose of this study is to investigate the pathogen type, incidence, and associated risk factors of pulmonary infection in patients with lung cancer after treatment.

Methods

This cohort study included hospitalized patients who were diagnosed with lung cancer. Patients complain of coughing, dyspnea, fever, chest pain, or hemoptysis lasting more than two weeks (n=801). Data were collected retrospectively from January 2018 to December 2023, with follow-up data extending to July 2024.

Findings

Of 801 patients, the median age was 64 (IQR 56-71) years, and 632 (79%) were men. The main pathogens were Mycobacterium tuberculosis (44%), Klebsiella pneumoniae (15%), and Candida albicans (8%). The risk factors of pulmonary infection after treatment of lung cancer were human immunodeficiency virus (Odds Ratio, OR=1.5252 [95% CI 1.0562-2.2024], P=0.0243). Compared with other infectious disease, pulmonary tuberculosis has a higher incidence (Incidence rate ratio, IRR=1.9027 [95% CI 1.5880-2.2859], P<0.0001).

Interpretation

Approximately half of admitted patients with symptomatic infection are afflicted with Mycobacterium tuberculosis infection. Despite the diversity of infection, HIV is a risk factor, emphasizing the necessity of raising awareness of infectious diseases in order to improve decision-making about screening, diagnosing, and treating infections in patients with lung cancer.
{"title":"Long term lung infection surveillance after treatment of lung cancer","authors":"Dewu Bi,&nbsp;Hailing Yu,&nbsp;Xiaocheng Luo,&nbsp;Huawei He,&nbsp;Chaoyou Chen","doi":"10.1016/j.lanwpc.2024.101320","DOIUrl":"10.1016/j.lanwpc.2024.101320","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer patients who have undergone radiotherapy and chemotherapy show an increased risk of infection. The purpose of this study is to investigate the pathogen type, incidence, and associated risk factors of pulmonary infection in patients with lung cancer after treatment.</div></div><div><h3>Methods</h3><div>This cohort study included hospitalized patients who were diagnosed with lung cancer. Patients complain of coughing, dyspnea, fever, chest pain, or hemoptysis lasting more than two weeks (n=801). Data were collected retrospectively from January 2018 to December 2023, with follow-up data extending to July 2024.</div></div><div><h3>Findings</h3><div>Of 801 patients, the median age was 64 (IQR 56-71) years, and 632 (79%) were men. The main pathogens were <em>Mycobacterium tuberculosis</em> (44%), <em>Klebsiella pneumoniae</em> (15%), and <em>Candida albicans</em> (8%). The risk factors of pulmonary infection after treatment of lung cancer were human immunodeficiency virus (Odds Ratio, OR=1.5252 [95% CI 1.0562-2.2024], P=0.0243). Compared with other infectious disease, pulmonary tuberculosis has a higher incidence (Incidence rate ratio, IRR=1.9027 [95% CI 1.5880-2.2859], P&lt;0.0001).</div></div><div><h3>Interpretation</h3><div>Approximately half of admitted patients with symptomatic infection are afflicted with <em>Mycobacterium tuberculosis</em> infection. Despite the diversity of infection, HIV is a risk factor, emphasizing the necessity of raising awareness of infectious diseases in order to improve decision-making about screening, diagnosing, and treating infections in patients with lung cancer.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101320"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rural-urban disparities in breast cancer survival in the context of the national breast cancer screening program for rural women in China
IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-02-01 DOI: 10.1016/j.lanwpc.2024.101314
Xing Xing , Qing Wang , Xiaoyun Liu , Fuzhong Xue , Qingyue Meng , He Zhu
<div><h3>Background</h3><div>Breast cancer is the most diagnosed cancer and is the second leading cause of cancer death among women in China. To improve early detection and treatment intake, China initiated a national breast and cervical cancer screening program targeting rural women aged 35 to 64 years, with an investment exceeding $220 million by 2018. This study aims to compare the survival risks between urban and rural women with breast cancer following the implementation of the screening program for informing valuable evidence and insights to future policy efforts.</div></div><div><h3>Methods</h3><div>Data were extracted from the hospital and mortality records in Cheeloo Lifespan Electronic Health Research Data Library (Cheeloo LEAD), and it includes comprehensive medical information on patients across Shandong province. With an over 101 million population, Shandong accounts for about 7% of the national population, ranking as the second populous province in China. This study focused on eligible women aged≥18 years who have the breast cancer diagnosis in their hospitalization records between January 1, 2016, and June 30, 2020, and these records were linked to their mortality data. The final sample size included 99988 patients diagnosed with breast cancer. Urban-rural residency was determined based on patients ‘addresses, and age subgroup was categorized into 18∼34, 35∼64, ≥65 years aligned with the screening program. The Kaplan-Meier curves and Cox proportional hazards models were conducted to examine the associations between rural-urban residency and survival outcomes in the total sample and age subgroups. Age group, marital status, cancer stage, and surgical status were controlled as covariates.</div></div><div><h3>Findings</h3><div>In the total sample of breast cancer patients, 64.69% lived in urban areas, and 35.31% lived in rural areas. Compared to urban patients, rural patients had higher proportions of being aged 35 to 64 (77.0% vs. 75.6%, P<0.001), being single (3.9% vs. 1.5%, P<0.001), having regional stage cancers (10.30% vs. 6.70%, P<0.001), and receiving surgical treatment (90.90% vs. 88.70%, P<0.001). Cox proportional hazards model found that there was no significant difference in breast cancer-specific survival between urban and rural patients (adjusted hazard rate [aHR] = 1.02, 95% CI = 0.95, 1.10). In the subgroup of patients aged 35-64 years, there was no significant difference in breast cancer-specific survival between rural-urban residence (aHR = 0.98, 95% CI = 0.92, 1.04). However, among older patients aged≥65 years, rural patients were associated with an elevated risk of breast cancer-specific death than urban patients (aHR = 1.11, 95% CI = 1.04, 1.18); among younger patients aged 18-34 years, rural patients were associated with increased hazard for breast cancer-specific death before adjusting covariates (aHR = 1.34, 95% CI = 1.24, 1.56), but the increased hazard was no longer statistically significant after
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The Lancet Regional Health: Western Pacific
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