• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2785-2791
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• 2014

Aims: To analyze time-dependent changes in female breast cancer (BC) mortality in China, forecast the trend in the ensuing 5 years, and provide recommendations for prevention and management. Materials and Methods: Mortality data of breast cancer in China from 1991 to 2011 was used to describe characteristics and distribution, such as the changes of the standardized mortality rate, urban-rural differences and age differences. Trend-surface analysis was used to study the geographical distribution of mortality. In addition, curve estimation, time series modeling, Gray modeling (GM) and joinpoint regression were performed to estimate and predict future trends. Results: In China, the mortality rate of breast cancer has increased yearly since 1991. In addition, our data predicted that the trend will continue to increase in the ensuing 5 years. Rates in urban areas are higher than those in rural areas. Over the past decade, all peak ages for death by breast cancer have been delayed, with the first death peak occurring at 55 to 65 years of age in urban and rural areas. Geographical analysis indicated that mortality rates increased from Southwest to Northeast and from West to East. Conclusions: The standardized mortality rate of breast cancer in China is rising and the upward trend is predicted to continue for the next 5 years. Since this can cause an enormous health impact in China, much better prevention and management of breast cancer is needed. Consequently, disease control centers in China should place more focus on the northeastern, eastern and southeastern parts of China for breast cancer prevention and management, and the key population should be among women between ages 55 to 65, especially those in urban communities.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5829-5834
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• 2015

Objective: To describe and analyze the epidemiological characteristics of lung cancer mortality in China from 1991 to 2013, forecast the future five-year trend and provide scientific evidence for prevention and management of lung cancer. Materials and Methods: Mortality data for lung cancer in China from 1991 to 2013 were used to describe epidemiological characteristics. Trend surface analysis was applied to analyze the geographical distribution of lung cancer. Four models, curve estimation, time series modeling, gray modeling (GM) and joinpoint regression, were performed to forecast the trend for the future. Results: Since 1991 the mortality rate of lung cancer increased yearly. The rate for males was higher than that for females and rates in urban areas were higher than in rural areas. In addition, our results showed that the trend will continue to increase in the ensuing 5 years. The mortality rate increased from age 45-50 and peaked in the group of 85 years old. Geographical analysis indicated that people living in northeast China provinces and the coastal provinces in eastern China had a higher mortality rate for lung cancer than those living in the centre or western Chinese provinces. Conclusions: The standardized mortality rate of lung cancer has constantly increased from 1991 to 2013, and been predicted to continue in the ensuing 5 years. Further efforts should be concentrated on education of the general public to increase prevention and early detection. Much better prevention and management is needed in high mortality areas (northeastern and eastern parts of China) and high risk populations (45-50-year-olds).

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4723-4727
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• 2016

Background: There are substantial differences in the mortality rates of stomach cancer among the 47 prefectures in Japan, and Aomori prefecture is one of the most severely impacted. The aims of this study were to determine the incidence and mortality rates of stomach cancer in Aomori prefecture in comparison with Japan as a whole and cast light on reasons underlying variation. Methods: Data on stomach cancer cases were extracted from the Aomori Cancer Registry Database. Incidence rates for specific stages at the time of diagnosis were cited from Monitoring of Cancer Incidence in Japan, and mortality rates for stomach cancer in Aomori prefecture and the whole of Japan were obtained from Vital Statistics. Age-standardised incidence and mortality rates were calculated using the direct method. Results: The age-standardised incidence rate of stomach cancer in Aomori prefecture was higher than in the whole of Japan for males but lower for females. However, the age-standardised mortality rates were higher in Aomori prefecture in both sexes. The proportion of localised cancers was lower in Aomori prefecture than in the whole of Japan for most age groups. Conclusions: The lower rate for localised cancer suggests that higher age-standardised mortality rates are due to delays in diagnosis, despite an attendance rate for stomach cancer screening was higher in Aomori prefecture than in the whole of Japan. One plausible explanation for the failure of successful early detection might be poor quality control during screening implementation that impedes early detection.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3581-3585
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• 2013

Background: Accurate statistics on the cancer burden are essential, both for purposes of research and for setting priorities in healthcare management. So that in vast countries with partial registration coverage, such as Iran, local data are more useful. We here estimated the incidence, prevalence and mortality time trend of four major cancer site, lung, stomach, breast and prostate, over the period 2001-2010 and provided short-range projections to 2015 in Isfahan. Materials and Methods: Estimates were derived by applying the mortality-incidence analysis method, a back-calculation approach to estimate and project incidence, prevalence and mortality of chronic degenerative disease, starting from knowledge of mortality and relative survival information. Results: Age adjusted incidence, mortality and prevalence rates in Isfahan exhibited a clear upward trend for all four sites during the period 2001-2015, with marked increasees in prostate and breast predicted for the future. Difference in incidence trends between males and females might be attributable to the difference in risk factors specific to certain cancer sites, with smoking being the main risk factor. Conclusions: In this study, males and females displayed an increasing pattern for incidence and mortality rate over the entire study period until 2015. This information can be used as basis for planning healthcare management and allocating recourses in public health.

• Journal of Preventive Medicine and Public Health
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• 제46권2호
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• pp.74-81
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• 2013

Objectives: The objective of this study was to evaluate the performance of risk-adjusted mortality models for colorectal cancer surgery. Methods: We investigated patients (n=652) who had undergone colorectal cancer surgery (colectomy, colectomy of the rectum and sigmoid colon, total colectomy, total proctectomy) at five teaching hospitals during 2008. Mortality was defined as 30-day or in-hospital surgical mortality. Risk-adjusted mortality models were constructed using claims data (basic model) with the addition of TNM staging (TNM model), physiological data (physiological model), surgical data (surgical model), or all clinical data (composite model). Multiple logistic regression analysis was performed to develop the risk-adjustment models. To compare the performance of the models, both c-statistics using Hanley-McNeil pair-wise testing and the ratio of the observed to the expected mortality within quartiles of mortality risk were evaluated to assess the abilities of discrimination and calibration. Results: The physiological model (c=0.92), surgical model (c=0.92), and composite model (c=0.93) displayed a similar improvement in discrimination, whereas the TNM model (c=0.87) displayed little improvement over the basic model (c=0.86). The discriminatory power of the models did not differ by the Hanley-McNeil test (p>0.05). Within each quartile of mortality, the composite and surgical models displayed an expected mortality ratio close to 1. Conclusions: The addition of clinical data to claims data efficiently enhances the performance of the risk-adjusted postoperative mortality models in colorectal cancer surgery. We recommended that the performance of models should be evaluated through both discrimination and calibration.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2067-2070
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• 2013

Background/Aim: Stomach cancer is the second most common cause of death from all malignant tumors in the world (third in men, fifth in women), with a strong decreasing trend in most developed countries. The aim of this descriptive epidemiological study was to analyze mortality of stomach cancer in Serbia, excluding the Province of Kosovo, in the 1991-2009 period. Materials and Methods: In data analysis, we used mortality rates which were standardized directly using those of the world population as a standard. In order to analyze the mortality trend from stomach cancer, linear trend and regression analysis were used. Confidence intervals (CIs) for the average age-adjusted and age-specific mortality rates were assessed with 95% level of probability. Mortality data were derived from the data file of the Statistical Office of the Republic of Serbia. Results: During the 1991-2009 period, a significant downward trend in mortality of stomach cancer was recorded in Serbia (y=9.78 - 0.13x, p=0.000; average annual percent change was -6.3 (95%CI, -7.8 to - 4.8). During the same period, a significant decrease in mortality trend was found both in male (y=14.13 - 0.20x; p=0.000; % change was -7.7 (95%CI, -10.9 to -4.5) and female populations (y=6.27 - 0.08x; p=0.000; % change was - 4.4 (95%CI, -5.3 to -3.6). Conclusion: Decreasing trends in mortality from stomach cancer in Serbia are similar to those in most developed countries.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.253-256
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• 2016

Geographic disparity for colorectal cancer (CRC) incidence and mortality according to the human development index (HDI) might be expected. This study aimed at quantifying the effect measure of association HDI and its components on the CRC incidence and mortality. In this ecological study, CRC incidence and mortality was obtained from GLOBOCAN, the global cancer project for 172 countries. Data were extracted about HDI 2013 for 169 countries from the World Bank report. Linear regression was constructed to measure effects of HDI and its components on CRC incidence and mortality. A positive trend between increasing HDI of countries and age-standardized rates per 100,000 of CRC incidence and mortality was observed. Among HDI components education was the strongest effect measure of association on CRC incidence and mortality, regression coefficients (95% confidence intervals) being 2.8 (2.4, 3.2) and 0.9 (0.8, 1), respectively. HDI and its components were positively related with CRC incidence and mortality and can be considered as targets for prevention and treatment intervention or tracking geographic disparities.

• 보건의료산업학회지
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• 제8권4호
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• pp.81-94
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• 2014

The purpose of this study is to investigate factors affecting cancer mortality inequality in Busan according to demographic characteristics identified based on the region's mortality data including cancer incidence and mortality rates, ultimately helping the region improve its existing health policies and establish a more effective cancer prevention policy. To achieve this purpose, this researcher surveyed data about all persons who died in Busan from 2006 to 2009. Data were analyzed with an SPSS 18.0 program using descriptive statistics, Chi-Square(${\chi}^2$), and Logistic Regression analysis. Findings of the study can be summarized as follows. First, in Busan, men were about two times higher in cancer mortality rate than women. Second, persons who died of cancer in Busan were significantly different from one another in terms of demographic characteristics, especially, age, marital status, and job. Third, factors affecting cancer mortality inequality in Busan included such demographic characteristics as gender, age at the time of death, marital status, educational background, and job.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.10027-10031
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• 2014

Background: We investigated the risk of cancer mortality according to obesity status and metabolic health status using sampled cohort data from the National Health Insurance system. Materials and Methods: Data on body mass index and fasting blood glucose in the sampled cohort database (n=363,881) were used to estimate risk of cancer mortality. Data were analyzed using a Cox proportional hazard model (Model 1 was adjusted for age, sex, systolic blood pressure, diastolic blood pressure, total cholesterol level and urinary protein; Model 2 was adjusted for Model 1 plus smoking status, alcohol intake and physical activity). Results: According to the obesity status, the mean hazard ratios were 0.82 [95% confidence interval (CI), 0.75-0.89] and 0.79 (95% CI, 0.72-0.85) for the overweight and obese groups, respectively, compared with the normal weight group. According to the metabolic health status, the mean hazard ratio was 1.26 (95% CI, 1.14-1.40) for the metabolically unhealthy group compared with the metabolically healthy group. The interaction between obesity status and metabolic health status on the risk of cancer mortality was not statistically significant (p=0.31). Conclusions: We found that the risk of cancer mortality decreased according to the obesity status and increased according to the metabolic health status. Given the rise in the rate of metabolic dysfunction, the mortality from cancer is also likely to rise. Treatment strategies targeting metabolic dysfunction may lead to reductions in the risk of death from cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2727-2732
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• 2014

Objectives: The aim of this study was to describe and analyze the incidence and mortality of female breast cancer in Jiangsu Province of China. Methods: Incidence and mortality data for female breast cancer and corresponding population statistics from eligible cancer registries in Jiangsu from 2006 to 2010 were collected and analyzed. Crude rates, age-specific rates and age-standardized rates of incidence and mortality were calculated, and annual present changes (APCs) were estimated to describe the time trends. Results: From 2006 to 2010, 11,013 new cases and 3,068 deaths of female breast cancer were identified in selected cancer registry areas of Jiangsu. The annual average crude incidence and age-standardized incidence by world population (ASW) were 25.2/ and 17.9/100,000 respectively. The annual average crude and ASW for mortality rates were 7.03/ and 4.81/100,000. The incidence was higher in urban areas than that in rural areas, and this was consistent in all age groups. No significant difference was observed in mortality between urban and rural areas. Two peaks were observed when looking at age-specific rates, one at 50-59 years and another at over 85 years. During the 5 years, incidence and mortality increased with APCs of 4.47% and 6.89%, respectively. Compared to the national level, Jiangsu is an area with relatively low risk of female breast cancer. Conclusion: Breast cancer has become a main public health problem among Chinese females. More prevention and control activities should be conducted to reduce the burden of this disease, even in relatively low risk areas like Jiangsu.