Background:Statistical data on the burden and relevant risk factors of lung cancer are valuable for policy-making.This study aimed to compare the mortality of lung cancer attributable to smoking stratified by sex and ...Background:Statistical data on the burden and relevant risk factors of lung cancer are valuable for policy-making.This study aimed to compare the mortality of lung cancer attributable to smoking stratified by sex and age among adults in China and the United States(US).Methods:We extracted age-standardized mortality rates of lung cancer during 1990-2017 using the comparative risk assessment framework of the 2017 Global Burden of Disease study.We performed an age-period-cohort analysis to estimate time trend of lung cancer mortality attributable to smoking.Results:During 1990-2017,the age-standardized mortality rate of lung cancer was increasing in China but decreasing in the US for both sexes.The mortality attributable to smoking in China showed a generally increasing trend,while a continuous decrease was observed in the US.The age-period-cohort analysis showed a similar trend of age effect among adults between China and the US:the mortality substantially increased from the 30-34 to 80-84 age group and subsequently decreased in the 90-94 age group.However,the period effect rapidly increased in Chinese adults during 1990-2017,while it tended to be stable in the US although it was still slightly increasing in women.The cohort effect generally peaked in the earlier cohort born in 1902-1906 in the two countries.Conclusions:During 1990-2017,the lung cancer mortality attributable to smoking and the period effect are generally increasing in Chinese adults;the mortality attributable to smoking is decreasing in the US adults,but the period effect tends to be stable.The rapid aging and prevalence of smoking may intensify the increasing mortality of lung cancer in China.展开更多
Background:Tuberculosis(TB)poses a severe public health challenge in China and worldwide.This study evaluated the effects of age,period,and birth cohort on reported incidence trends of TB based on population and refin...Background:Tuberculosis(TB)poses a severe public health challenge in China and worldwide.This study evaluated the effects of age,period,and birth cohort on reported incidence trends of TB based on population and refined the characteristics of high-risk groups.Methods:Aggregate data that reported pulmonary tuberculosis(PTB)cases from China Tuberculosis Management Information System(TBIMS)from 2006 to 2020 were used to analyze effect coefficients through the age-period-cohort(APC)model based on intrinsic estimator(IE)method,and converted them into relative risk(RR)to estimate trends.Results:A total of 14.82 million cases of PTB were reported in China from 2006 to 2020,showing a continuous downward trend.The reporting rate increased with age by age group,with 70-74 years old being 2-3 times higher than that in 20-24 years old.APC analysis model showed that age effects were bimodal in 20-24 years old[RR=2.29,95%confidence interval(CI):1.73-3.03]and 70-74 years old(RR=1.95,95%CI:1.67-2.27),and lower than the overall average in the groups under 15 years old.Stratified results showed that the risk was higher for women under age 40 than men and higher for men over 40.The risk was higher in urban than in rural areas under 30 years old and slightly higher in rural than in urban between 30 and 64 years old.The risk for 15-34 years old was significantly higher in the east than in other regions.The period effects showed a decreasing trend,and the risk was higher in rural in recent years.Except for cohorts born in 1961-1965 and 2001-2005,where theRR increased,the later the cohort was born,the lower the risk.The cohort 1926-1930 in eastern had the highest risk(RR=3.49,95%CI:2.44-4.98).Conclusions:The reported incidence of PTB continued to decline in China from 2006 to 2020.The young(20-24 years old)and the elderly(70-74 years old)were equally at high risk.There were differences in the age,period and cohort effects on PTB incidence among gender,urban-rural and regions.Our findings better reflected the characteristics of high-ris展开更多
Background: The incidence and mortality of intrahepatic cholangiocarcinoma (ICC) are increasing worldwide. We used age-period-cohort (APC) modeling to evaluate the contribution of cohort effects to trends in ICC incid...Background: The incidence and mortality of intrahepatic cholangiocarcinoma (ICC) are increasing worldwide. We used age-period-cohort (APC) modeling to evaluate the contribution of cohort effects to trends in ICC incidence and mortality in the US. Methods: Incidence data were acquired from the Surveillance, Epidemiology and End-Results (SEER) program. Mortality data were obtained from the Centers for Disease Control and Prevention WONDER Database. APC models using restricted cubic splines were fitted to estimate change in incidence and mortality risk over age, and modification of incidence and mortality risks according to birth cohort and period of diagnosis or death. Likelihood ratio tests were used to summarize improvement in model fit with APC modeling. Results: There were 4,053 cases of ICC at SEER registry sites between 1973–2012. ICC incidence increased with older age and across all birth cohorts examined. Inclusion of cohort effects tended to improve model fit relative to an age-period model (likelihood ratio test P=0.082). The national crude ICC-related mortality rate increased from 2.9 to 5.0 per 100,000 among males and 2.7 to 4.6 per 100,000 among females. Among males, ICC mortality risk varied across birth cohorts, and inclusion of cohort effects in a model predicting ICC mortality risk improved model fit (likelihood ratio test P=0.001), but cohort effects did not alter model fit among females (P=0.223). Conclusions: ICC incidence and mortality have increased over time in the United States. Birth cohort effects influenced increased ICC incidence and ICC mortality among males, but were not evident in the trend of ICC mortality among females.展开更多
Background:As the result of dramatic political changes,civil wars,and a long-term refugee crisis from the end of the last to beginning of this century,the population of Serbia has experienced significant health proble...Background:As the result of dramatic political changes,civil wars,and a long-term refugee crisis from the end of the last to beginning of this century,the population of Serbia has experienced significant health problems.The aim of this study was to assess cancer mortality trends in Serbia.Methods:This nationwide study was carried out to analyze cancer mortality in Serbia during 1991-2015 using offi-cial data.The age-standardized mortality rates(per 100,000)were calculated by direct standardization,using the world standard population by Segi.The average annual percent change(AAPC)and corresponding 95%confidence interval(CI)were computed using joinpoint regression analysis.Age-period-cohort analysis was performed to address the possible underlying reasons for the observed temporal trends.Results:Over the 25-year study period,there were 466,075 cancer deaths(266,043 males and 200,032 females)in Serbia.Overall cancer mortality increased between 1991 and 2009 in both males(by+0.9%per year)and females(by+0.8%per year)and has been decreasing since then,by−0.9%annually in both sexes.For almost all major cancers except stomach cancer,cancer mortality in Serbia demonstrated upward trends during the study period.The largest increases were noted in lung cancer among females(AAPC=+3.7,95%CI 3.5-3.9)and prostate cancer in males(AAPC=+1.9,95%CI 1.4-2.3).Conclusions:After two decades of increase,cancer mortality rates are finally declining in Serbia.Despite this,these rates place Serbia among the countries with the highest cancer mortality in the world.展开更多
目的了解1990-2019年中国乙型肝炎病毒(HBV)相关肝癌的发病和死亡趋势,评估年龄、时期和出生队列对其影响,为制订科学、有效的防控措施提供理论依据.方法筛选2019年全球疾病负担(GBD 2019)数据库中1990-2019年中国相关数据,应用描述性...目的了解1990-2019年中国乙型肝炎病毒(HBV)相关肝癌的发病和死亡趋势,评估年龄、时期和出生队列对其影响,为制订科学、有效的防控措施提供理论依据.方法筛选2019年全球疾病负担(GBD 2019)数据库中1990-2019年中国相关数据,应用描述性流行病学方法对HBV相关肝癌的粗发病率和死亡率及标化发病率和死亡率的变化趋势进行分析,采用年龄-时期-队列(APC)模型评估年龄、时期和出生队列效应.所有统计分析均在R4.2.3以及APC Web Tool中完成.结果1990-2019年,男性HBV相关肝癌标化发病率和死亡率分别从1995年峰值30.6/10万和30.2/10万,逐年降低至2005年的11.8/10万和11.4/10万,之后基本平稳.女性标化发病率和死亡率在1995年之前均维持在6.0/10万左右,1995-2005年快速降至2.3/10万,之后逐年缓慢降至2019年的1.7/10万和1.6/10万.APC模型分析表明,1990-2019年,男性HBV相关肝癌发病率和死亡率年净变化值分别为-4.25%和-4.80%,女性分别为-5.68%和-6.14%.随着年龄增长,发病率和死亡率均呈倒"V"型变化,年龄效应在50~55岁达到顶点;时期效应在1997-2007年快速下降,之后男性发病率时期效应略有回升,女性发病率和死亡率时期效应缓慢下降并趋于稳定;男女性队列效应总体均呈下降趋势.结论1990年以来,中国HBV相关肝癌的发病率和死亡率均显著下降,但考虑到中国人口规模以及老龄化程度,HBV相关肝癌仍对中国公共卫生造成巨大压力,需加强相关研究,制定有效的防控措施.展开更多
Background:The incidence of hepatitis B virus(HBV)has decreased year by year in China after the expansion of vaccination,but there is still a high disease burden in Jiangsu Province of China.Methods:The year-by-year i...Background:The incidence of hepatitis B virus(HBV)has decreased year by year in China after the expansion of vaccination,but there is still a high disease burden in Jiangsu Province of China.Methods:The year-by-year incidence data of HBV in Jiangsu Province from 1990 to 2021 were collected.The incidence rates of males and females age groups were clustered by systematic clustering,and the incidence rates of each age group were analyzed and studied by using Joinpoint regression model and age-period-cohort effect model(APC).Results:Joinpoint regression model and APC model showed a general decrease in HBV prevalence in both males and females.In addition,the results of the APC model showed that the age,period,and cohort effects of patients all affected the incidence of HBV,and the incidence was higher in males than in females.The incidence is highest in the population between the ages of 15 and 30 years(mean:21.76/100,000),especially in males(mean:31.53/100,000)than in females(mean:11.67/100,000).Another high-risk group is those over 60 years of age(mean:21.40/100,000),especially males(mean:31.17/100,000)than females(mean:11.63/100,000).The period effect of the APC model suggests that HBV vaccination is effective in reducing the incidence of HBV in the population.Conclusions:The incidence of HBV in Jiangsu Province showed a gradual downward trend,but the disease burden in males was higher than that in females.The incidence is higher and increasing rapidly in the population between the ages of 15 and 30 years and people over 60 years of age.More targeted prevention and control measures should be imple-mented for males and the elderly.展开更多
AIM To investigate the incidence and mortality rates of upper gastrointestinal cancer(UGIC) in Hebei Province, China, and to identify high-risk populations to improve UGIC prevention and control.METHODS Data for UGIC ...AIM To investigate the incidence and mortality rates of upper gastrointestinal cancer(UGIC) in Hebei Province, China, and to identify high-risk populations to improve UGIC prevention and control.METHODS Data for UGIC patients were collected from 21 population-based cancer registries covering 15.25% of the population in Hebei Province. Mortality data were extracted from three national retrospective death surveys(1973-1975, 1990-1992 and 2004-2005). The data were stratified by 5-year age groups, gender and area(high-risk/non-high-risk areas) for analysis. The age-period-cohort and grey system model were used.RESULTS The crude incidence rate of UGIC was 55.47/100000, and the adjusted rate(Segi's population) was 44.90/100000. Males in rural areas had the highest incidence rate(world age-standardized rate = 87.89/100000). The crude mortality rate of UGIC displayed a decreasing trend in Hebei Province from the 1970 s to 2013, and the adjusted rate decreased by 43.81% from the 1970s(58.07/100000) to 2013(32.63/100000). The mortality rate declined more significantly in the high-risk areas(57.26%) than in the non-high-risk areas(55.02%) from the 1970 s to 2013. The median age at diagnosis of UGIC was 65.06 years in 2013. There was a notable delay in the median age at death from the 1970s(66.15 years) to 2013(70.39 years), especially in the high-risk areas. In Cixian, the total trend of the cohort effect declined, and people aged 65-69 years were a population at relatively high risk for UGIC. We predicted that the crude mortality rates of UGIC in Cixian and Shexian would decrease to 98.80 and 133.99 per 100000 in 2018, respectively.CONCLUSION UGIC was the major cause of cancer death in Hebei Province, and males in rural areas were a high-risk population. We should strengthen early detection and treatment of UGIC in this population.展开更多
Objective This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.Methods Data were obtained from the China national vital registration system.Significant changes in mort...Objective This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.Methods Data were obtained from the China national vital registration system.Significant changes in mortality were assessed by Joinpoint regression.Age-period-cohort analysis was used to explain the reasons for the changes.Future mortality and counts were predicted by the Bayesian age-period-cohort model.Results Between 2002 and 2019,a total of 6,253,951 stroke mortality in young and middle-aged adults were recorded.The age-adjusted mortality rates(AAMRs)of women showed a downward trend.The annual percent changes(APC)were-3.5%(-5.2%,-1.7%)for urban women and-2.8%(-3.7%,-1.9%)for rural women.By contrast,the AAMRs per 100,000 for rural men aged 25–44 years continued to rise from 9.40 to 15.46.The AAMRS for urban men aged 25–44 years and urban and rural men aged 45–64years did not change significantly.Between 2020 and 2030,the projected stroke deaths are 1,423,584 in men and 401,712 in women.Conclusion Significant sex and age disparities in the trends of stroke mortality among young and middle-aged adults were identified in China.Targeted health policy measures are needed to address the burden of stroke in the young generation,especially for rural men,with a focus on the prevention and management of high risk factors.展开更多
Objective To forecast the future burden and its attributable risk factors of infective endocarditis(IE).Methods We analyzed the disease burden of IE and its risk factors from 1990 to 2019 using the Global Burden of Di...Objective To forecast the future burden and its attributable risk factors of infective endocarditis(IE).Methods We analyzed the disease burden of IE and its risk factors from 1990 to 2019 using the Global Burden of Disease 2019 database and projected the disease burden from 2020 to 2030 using a Bayesian age-period-cohort model.Results By 2030,the incidence of IE will increase uncontrollably on a global scale,with developed countries having the largest number of cases and developing countries experiencing the fastest growth.The affected population will be predominantly males,but the gender gap will narrow.The elderly in high-income countries will bear the greatest burden,with a gradual shift to middle-income countries.The incidence of IE in countries with middle/high-middle social-demographic indicators(SDI) will surpass that of high SDI countries.In China,the incidence rate and the number of IE will reach 18.07 per 100,000 and 451,596 in 2030,respectively.IEassociated deaths and heart failure will continue to impose a significant burden on society,the burden on women will increase and surpass that on men,and the elderly in high-SDI countries will bear the heaviest burden.High systolic blood pressure has become the primary risk factor for IE-related death.Conclusions This study provides comprehensive analyses of the disease burden and risk factors of IE worldwide over the next decade.The IE-associated incidence will increase in the future and the death and heart failure burden will not be appropriately controlled.Gender,age,regional,and country heterogeneity should be taken seriously to facilitate in making effective strategies for lowering the IE disease burden.展开更多
基金This work was funded by the National Key Research and Development Program of China[grant numbers 2018YFC1315302,2017YFC1200502]the National Natural Science Foundation of China[grant number 81773552].
文摘Background:Statistical data on the burden and relevant risk factors of lung cancer are valuable for policy-making.This study aimed to compare the mortality of lung cancer attributable to smoking stratified by sex and age among adults in China and the United States(US).Methods:We extracted age-standardized mortality rates of lung cancer during 1990-2017 using the comparative risk assessment framework of the 2017 Global Burden of Disease study.We performed an age-period-cohort analysis to estimate time trend of lung cancer mortality attributable to smoking.Results:During 1990-2017,the age-standardized mortality rate of lung cancer was increasing in China but decreasing in the US for both sexes.The mortality attributable to smoking in China showed a generally increasing trend,while a continuous decrease was observed in the US.The age-period-cohort analysis showed a similar trend of age effect among adults between China and the US:the mortality substantially increased from the 30-34 to 80-84 age group and subsequently decreased in the 90-94 age group.However,the period effect rapidly increased in Chinese adults during 1990-2017,while it tended to be stable in the US although it was still slightly increasing in women.The cohort effect generally peaked in the earlier cohort born in 1902-1906 in the two countries.Conclusions:During 1990-2017,the lung cancer mortality attributable to smoking and the period effect are generally increasing in Chinese adults;the mortality attributable to smoking is decreasing in the US adults,but the period effect tends to be stable.The rapid aging and prevalence of smoking may intensify the increasing mortality of lung cancer in China.
文摘Background:Tuberculosis(TB)poses a severe public health challenge in China and worldwide.This study evaluated the effects of age,period,and birth cohort on reported incidence trends of TB based on population and refined the characteristics of high-risk groups.Methods:Aggregate data that reported pulmonary tuberculosis(PTB)cases from China Tuberculosis Management Information System(TBIMS)from 2006 to 2020 were used to analyze effect coefficients through the age-period-cohort(APC)model based on intrinsic estimator(IE)method,and converted them into relative risk(RR)to estimate trends.Results:A total of 14.82 million cases of PTB were reported in China from 2006 to 2020,showing a continuous downward trend.The reporting rate increased with age by age group,with 70-74 years old being 2-3 times higher than that in 20-24 years old.APC analysis model showed that age effects were bimodal in 20-24 years old[RR=2.29,95%confidence interval(CI):1.73-3.03]and 70-74 years old(RR=1.95,95%CI:1.67-2.27),and lower than the overall average in the groups under 15 years old.Stratified results showed that the risk was higher for women under age 40 than men and higher for men over 40.The risk was higher in urban than in rural areas under 30 years old and slightly higher in rural than in urban between 30 and 64 years old.The risk for 15-34 years old was significantly higher in the east than in other regions.The period effects showed a decreasing trend,and the risk was higher in rural in recent years.Except for cohorts born in 1961-1965 and 2001-2005,where theRR increased,the later the cohort was born,the lower the risk.The cohort 1926-1930 in eastern had the highest risk(RR=3.49,95%CI:2.44-4.98).Conclusions:The reported incidence of PTB continued to decline in China from 2006 to 2020.The young(20-24 years old)and the elderly(70-74 years old)were equally at high risk.There were differences in the age,period and cohort effects on PTB incidence among gender,urban-rural and regions.Our findings better reflected the characteristics of high-ris
文摘Background: The incidence and mortality of intrahepatic cholangiocarcinoma (ICC) are increasing worldwide. We used age-period-cohort (APC) modeling to evaluate the contribution of cohort effects to trends in ICC incidence and mortality in the US. Methods: Incidence data were acquired from the Surveillance, Epidemiology and End-Results (SEER) program. Mortality data were obtained from the Centers for Disease Control and Prevention WONDER Database. APC models using restricted cubic splines were fitted to estimate change in incidence and mortality risk over age, and modification of incidence and mortality risks according to birth cohort and period of diagnosis or death. Likelihood ratio tests were used to summarize improvement in model fit with APC modeling. Results: There were 4,053 cases of ICC at SEER registry sites between 1973–2012. ICC incidence increased with older age and across all birth cohorts examined. Inclusion of cohort effects tended to improve model fit relative to an age-period model (likelihood ratio test P=0.082). The national crude ICC-related mortality rate increased from 2.9 to 5.0 per 100,000 among males and 2.7 to 4.6 per 100,000 among females. Among males, ICC mortality risk varied across birth cohorts, and inclusion of cohort effects in a model predicting ICC mortality risk improved model fit (likelihood ratio test P=0.001), but cohort effects did not alter model fit among females (P=0.223). Conclusions: ICC incidence and mortality have increased over time in the United States. Birth cohort effects influenced increased ICC incidence and ICC mortality among males, but were not evident in the trend of ICC mortality among females.
基金supported by Ministry of Education,Science and Technological Development,Republic of Serbia,2011-2016(Contract No.175042).
文摘Background:As the result of dramatic political changes,civil wars,and a long-term refugee crisis from the end of the last to beginning of this century,the population of Serbia has experienced significant health problems.The aim of this study was to assess cancer mortality trends in Serbia.Methods:This nationwide study was carried out to analyze cancer mortality in Serbia during 1991-2015 using offi-cial data.The age-standardized mortality rates(per 100,000)were calculated by direct standardization,using the world standard population by Segi.The average annual percent change(AAPC)and corresponding 95%confidence interval(CI)were computed using joinpoint regression analysis.Age-period-cohort analysis was performed to address the possible underlying reasons for the observed temporal trends.Results:Over the 25-year study period,there were 466,075 cancer deaths(266,043 males and 200,032 females)in Serbia.Overall cancer mortality increased between 1991 and 2009 in both males(by+0.9%per year)and females(by+0.8%per year)and has been decreasing since then,by−0.9%annually in both sexes.For almost all major cancers except stomach cancer,cancer mortality in Serbia demonstrated upward trends during the study period.The largest increases were noted in lung cancer among females(AAPC=+3.7,95%CI 3.5-3.9)and prostate cancer in males(AAPC=+1.9,95%CI 1.4-2.3).Conclusions:After two decades of increase,cancer mortality rates are finally declining in Serbia.Despite this,these rates place Serbia among the countries with the highest cancer mortality in the world.
文摘目的了解1990-2019年中国乙型肝炎病毒(HBV)相关肝癌的发病和死亡趋势,评估年龄、时期和出生队列对其影响,为制订科学、有效的防控措施提供理论依据.方法筛选2019年全球疾病负担(GBD 2019)数据库中1990-2019年中国相关数据,应用描述性流行病学方法对HBV相关肝癌的粗发病率和死亡率及标化发病率和死亡率的变化趋势进行分析,采用年龄-时期-队列(APC)模型评估年龄、时期和出生队列效应.所有统计分析均在R4.2.3以及APC Web Tool中完成.结果1990-2019年,男性HBV相关肝癌标化发病率和死亡率分别从1995年峰值30.6/10万和30.2/10万,逐年降低至2005年的11.8/10万和11.4/10万,之后基本平稳.女性标化发病率和死亡率在1995年之前均维持在6.0/10万左右,1995-2005年快速降至2.3/10万,之后逐年缓慢降至2019年的1.7/10万和1.6/10万.APC模型分析表明,1990-2019年,男性HBV相关肝癌发病率和死亡率年净变化值分别为-4.25%和-4.80%,女性分别为-5.68%和-6.14%.随着年龄增长,发病率和死亡率均呈倒"V"型变化,年龄效应在50~55岁达到顶点;时期效应在1997-2007年快速下降,之后男性发病率时期效应略有回升,女性发病率和死亡率时期效应缓慢下降并趋于稳定;男女性队列效应总体均呈下降趋势.结论1990年以来,中国HBV相关肝癌的发病率和死亡率均显著下降,但考虑到中国人口规模以及老龄化程度,HBV相关肝癌仍对中国公共卫生造成巨大压力,需加强相关研究,制定有效的防控措施.
基金supported by the Fundamental Research Funds for the Central Universities,20720230001self-supporting Program of Guangzhou Laboratory,SRPG22-007research Project on Education and Teaching Reform of Undergraduate Universities of Fujian Province,FBJG20210260.
文摘Background:The incidence of hepatitis B virus(HBV)has decreased year by year in China after the expansion of vaccination,but there is still a high disease burden in Jiangsu Province of China.Methods:The year-by-year incidence data of HBV in Jiangsu Province from 1990 to 2021 were collected.The incidence rates of males and females age groups were clustered by systematic clustering,and the incidence rates of each age group were analyzed and studied by using Joinpoint regression model and age-period-cohort effect model(APC).Results:Joinpoint regression model and APC model showed a general decrease in HBV prevalence in both males and females.In addition,the results of the APC model showed that the age,period,and cohort effects of patients all affected the incidence of HBV,and the incidence was higher in males than in females.The incidence is highest in the population between the ages of 15 and 30 years(mean:21.76/100,000),especially in males(mean:31.53/100,000)than in females(mean:11.67/100,000).Another high-risk group is those over 60 years of age(mean:21.40/100,000),especially males(mean:31.17/100,000)than females(mean:11.63/100,000).The period effect of the APC model suggests that HBV vaccination is effective in reducing the incidence of HBV in the population.Conclusions:The incidence of HBV in Jiangsu Province showed a gradual downward trend,but the disease burden in males was higher than that in females.The incidence is higher and increasing rapidly in the population between the ages of 15 and 30 years and people over 60 years of age.More targeted prevention and control measures should be imple-mented for males and the elderly.
文摘AIM To investigate the incidence and mortality rates of upper gastrointestinal cancer(UGIC) in Hebei Province, China, and to identify high-risk populations to improve UGIC prevention and control.METHODS Data for UGIC patients were collected from 21 population-based cancer registries covering 15.25% of the population in Hebei Province. Mortality data were extracted from three national retrospective death surveys(1973-1975, 1990-1992 and 2004-2005). The data were stratified by 5-year age groups, gender and area(high-risk/non-high-risk areas) for analysis. The age-period-cohort and grey system model were used.RESULTS The crude incidence rate of UGIC was 55.47/100000, and the adjusted rate(Segi's population) was 44.90/100000. Males in rural areas had the highest incidence rate(world age-standardized rate = 87.89/100000). The crude mortality rate of UGIC displayed a decreasing trend in Hebei Province from the 1970 s to 2013, and the adjusted rate decreased by 43.81% from the 1970s(58.07/100000) to 2013(32.63/100000). The mortality rate declined more significantly in the high-risk areas(57.26%) than in the non-high-risk areas(55.02%) from the 1970 s to 2013. The median age at diagnosis of UGIC was 65.06 years in 2013. There was a notable delay in the median age at death from the 1970s(66.15 years) to 2013(70.39 years), especially in the high-risk areas. In Cixian, the total trend of the cohort effect declined, and people aged 65-69 years were a population at relatively high risk for UGIC. We predicted that the crude mortality rates of UGIC in Cixian and Shexian would decrease to 98.80 and 133.99 per 100000 in 2018, respectively.CONCLUSION UGIC was the major cause of cancer death in Hebei Province, and males in rural areas were a high-risk population. We should strengthen early detection and treatment of UGIC in this population.
文摘Objective This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.Methods Data were obtained from the China national vital registration system.Significant changes in mortality were assessed by Joinpoint regression.Age-period-cohort analysis was used to explain the reasons for the changes.Future mortality and counts were predicted by the Bayesian age-period-cohort model.Results Between 2002 and 2019,a total of 6,253,951 stroke mortality in young and middle-aged adults were recorded.The age-adjusted mortality rates(AAMRs)of women showed a downward trend.The annual percent changes(APC)were-3.5%(-5.2%,-1.7%)for urban women and-2.8%(-3.7%,-1.9%)for rural women.By contrast,the AAMRs per 100,000 for rural men aged 25–44 years continued to rise from 9.40 to 15.46.The AAMRS for urban men aged 25–44 years and urban and rural men aged 45–64years did not change significantly.Between 2020 and 2030,the projected stroke deaths are 1,423,584 in men and 401,712 in women.Conclusion Significant sex and age disparities in the trends of stroke mortality among young and middle-aged adults were identified in China.Targeted health policy measures are needed to address the burden of stroke in the young generation,especially for rural men,with a focus on the prevention and management of high risk factors.
文摘Objective To forecast the future burden and its attributable risk factors of infective endocarditis(IE).Methods We analyzed the disease burden of IE and its risk factors from 1990 to 2019 using the Global Burden of Disease 2019 database and projected the disease burden from 2020 to 2030 using a Bayesian age-period-cohort model.Results By 2030,the incidence of IE will increase uncontrollably on a global scale,with developed countries having the largest number of cases and developing countries experiencing the fastest growth.The affected population will be predominantly males,but the gender gap will narrow.The elderly in high-income countries will bear the greatest burden,with a gradual shift to middle-income countries.The incidence of IE in countries with middle/high-middle social-demographic indicators(SDI) will surpass that of high SDI countries.In China,the incidence rate and the number of IE will reach 18.07 per 100,000 and 451,596 in 2030,respectively.IEassociated deaths and heart failure will continue to impose a significant burden on society,the burden on women will increase and surpass that on men,and the elderly in high-SDI countries will bear the heaviest burden.High systolic blood pressure has become the primary risk factor for IE-related death.Conclusions This study provides comprehensive analyses of the disease burden and risk factors of IE worldwide over the next decade.The IE-associated incidence will increase in the future and the death and heart failure burden will not be appropriately controlled.Gender,age,regional,and country heterogeneity should be taken seriously to facilitate in making effective strategies for lowering the IE disease burden.
