Background:Gastrointestinal(GI)cancers were responsible for 26.3%of cancer cases and 35.4%of deaths worldwide in 2018.This study aimed to analyze the global incidence,mortality,prevalence,and contributing risk factors...Background:Gastrointestinal(GI)cancers were responsible for 26.3%of cancer cases and 35.4%of deaths worldwide in 2018.This study aimed to analyze the global incidence,mortality,prevalence,and contributing risk factors of the 6 major GI cancer entities[esophageal cancer(EC),gastric cancer(GC),liver cancer(LC),pancreatic cancer(PC),colon cancer,and rectal cancer].Methods:Using the Global Cancer Observatory and the Global Health Observatory databases,we reviewed the current GI cancer incidence,prevalence,and mortality,analyzed the association of GI cancer prevalence with national human development indices(HDIs),identified the contributing risk factors,and estimated developing age-and sex-specific trends in incidence and mortality.Results:In 2020,the trend in age-standardized rate of incidence of GI cancers closely mirrored that of mortality,with the highest rates of LC,EC,and GC in Asia and of colorectal cancer(CRC)and PC mainly in Europe.Incidence and mortality were positively,but the mortality-to-incidence ratio(MIR)was inversely correlated with the national HDI levels.High MIRs in developing countries likely reflected the lack of preventive strategies and effective treatments.GI cancer prevalence was highest in Europe and was also positively correlated with HDIs and lifestyle-associated risk factors,such as alcohol consumption,smoking,obesity,insufficient physical activity,and high blood cholesterol level,but negatively correlated with hypertension and diabetes.Incidences of EC were consistently and those of GC mostly decreasing,whereas incidences of CRC were increasing in most countries/regions,especially in the younger populations.Incidences of LC and PC were also increasing in all age-gender populations except for younger males.Mortalities were decreasing for EC,GC,and CRC in most countries/regions, and age-specific trends were observed in PC and LC with adecrease in the younger but an increase in the older population.Conclusions: On the global scale, higher GI cancer burden was accompanied,for the most part, 展开更多
AIM To evaluate annual incidence of low grade dysplasia(LGD) progression to high grade dysplasia(HGD) and/or esophageal adenocarcinoma(EAC) when diagnosis was made by two or more expert pathologists.METHODS Studies ev...AIM To evaluate annual incidence of low grade dysplasia(LGD) progression to high grade dysplasia(HGD) and/or esophageal adenocarcinoma(EAC) when diagnosis was made by two or more expert pathologists.METHODS Studies evaluating the progression of LGD to HGD or EAC were included. The diagnosis of LGD must be made by consensus of two or more expert gastrointestinal pathologists. Articles were searched in Medline, Pubmed, and Embase. Pooled proportions were calculated using fixed and random effects model. Heterogeneity among studies was assessed using the I2 statistic. RESULTS Initial search identified 721 reference articles, of which 53 were selected and reviewed. Twelve studies(n = 971) that met the inclusion criteria were included in this analysis. Among the total original LGD diagnoses in the included studies, only 37.49% reached the consensus LGD diagnosis after review by two or more expert pathologists. Total follow up period was 1532 patient-years. In the pooled consensus LGD patients, the annual incidence rate(AIR) of progression to HGD and or EAC was 10.35%(95%CI: 7.56-13.13) and progression to EAC was 5.18%(95%CI: 3.43-6.92). Among the patients down staged from original LGD diagnosis to No-dysplasia Barrett's esophagus, the AIR of progression to HGD and EAC was 0.65%(95%CI: 0.49-0.80). Among the patients down staged to Indefinite for dysplasia, the AIR of progression to HGD and EAC was 1.42%(95%CI: 1.19-1.65). In patients with consensus HGD diagnosis, the AIR of progression to EAC was 28.63%(95%CI: 13.98-43.27). CONCLUSION When LGD is diagnosed by consensus agreement of two or more expert pathologists, its progression towards malignancy seems to be at least three times the current estimates, however it could be up to 20 times the current estimates. Biopsies of all Barrett's esophagus patients with LGD should be reviewed by two expert gastroenterology pathologists. Follow-up strict surveillance programs should be in place for these patients.展开更多
目的:调查2011年～2016年四川省新增血液透析(HD)患者的年度发病率、原发病因及年龄等情况。方法:回顾性分析全国HD病例登记系统(Chinese national renal data system,CNRDS)中2011-01-01～2016-12-31四川省新增HD患者的人口统计学及原...目的:调查2011年～2016年四川省新增血液透析(HD)患者的年度发病率、原发病因及年龄等情况。方法:回顾性分析全国HD病例登记系统(Chinese national renal data system,CNRDS)中2011-01-01～2016-12-31四川省新增HD患者的人口统计学及原发病资料,按照年份、性别、年龄等因素进行分层分析。结果:(1)四川省2011年～2016年新增HD患者年度发病率分别为每百万人口61.84人、73.75人、78.04人、66.04人、72.61人和60.98人。(2)新增HD患者共计33 632例,男女比例为1.5∶1;各年度男性发病率明显高于女性(P<0.05);(3)新增HD患者≥40岁者占79.62%。我们将出生年月信息完整的32 952例按年龄分为8个组,发现新增病例主要集中在40～69岁年龄段,且≥60岁年龄段的新增HD患者比例呈逐年上升趋势;(4)新增HD患者原发病因慢性肾小球肾炎所占比例呈下降趋势,而糖尿病肾病呈上升趋势。结论:四川省2011年～2016年新增HD患者以中老年为主,且存在年龄增大趋势;原发病因慢性肾小球肾炎所占比例呈降低而糖尿病肾病呈增长趋势。展开更多
基金supported by the China Scholarship Council(grant number:201908080127).
文摘Background:Gastrointestinal(GI)cancers were responsible for 26.3%of cancer cases and 35.4%of deaths worldwide in 2018.This study aimed to analyze the global incidence,mortality,prevalence,and contributing risk factors of the 6 major GI cancer entities[esophageal cancer(EC),gastric cancer(GC),liver cancer(LC),pancreatic cancer(PC),colon cancer,and rectal cancer].Methods:Using the Global Cancer Observatory and the Global Health Observatory databases,we reviewed the current GI cancer incidence,prevalence,and mortality,analyzed the association of GI cancer prevalence with national human development indices(HDIs),identified the contributing risk factors,and estimated developing age-and sex-specific trends in incidence and mortality.Results:In 2020,the trend in age-standardized rate of incidence of GI cancers closely mirrored that of mortality,with the highest rates of LC,EC,and GC in Asia and of colorectal cancer(CRC)and PC mainly in Europe.Incidence and mortality were positively,but the mortality-to-incidence ratio(MIR)was inversely correlated with the national HDI levels.High MIRs in developing countries likely reflected the lack of preventive strategies and effective treatments.GI cancer prevalence was highest in Europe and was also positively correlated with HDIs and lifestyle-associated risk factors,such as alcohol consumption,smoking,obesity,insufficient physical activity,and high blood cholesterol level,but negatively correlated with hypertension and diabetes.Incidences of EC were consistently and those of GC mostly decreasing,whereas incidences of CRC were increasing in most countries/regions,especially in the younger populations.Incidences of LC and PC were also increasing in all age-gender populations except for younger males.Mortalities were decreasing for EC,GC,and CRC in most countries/regions, and age-specific trends were observed in PC and LC with adecrease in the younger but an increase in the older population.Conclusions: On the global scale, higher GI cancer burden was accompanied,for the most part,
文摘AIM To evaluate annual incidence of low grade dysplasia(LGD) progression to high grade dysplasia(HGD) and/or esophageal adenocarcinoma(EAC) when diagnosis was made by two or more expert pathologists.METHODS Studies evaluating the progression of LGD to HGD or EAC were included. The diagnosis of LGD must be made by consensus of two or more expert gastrointestinal pathologists. Articles were searched in Medline, Pubmed, and Embase. Pooled proportions were calculated using fixed and random effects model. Heterogeneity among studies was assessed using the I2 statistic. RESULTS Initial search identified 721 reference articles, of which 53 were selected and reviewed. Twelve studies(n = 971) that met the inclusion criteria were included in this analysis. Among the total original LGD diagnoses in the included studies, only 37.49% reached the consensus LGD diagnosis after review by two or more expert pathologists. Total follow up period was 1532 patient-years. In the pooled consensus LGD patients, the annual incidence rate(AIR) of progression to HGD and or EAC was 10.35%(95%CI: 7.56-13.13) and progression to EAC was 5.18%(95%CI: 3.43-6.92). Among the patients down staged from original LGD diagnosis to No-dysplasia Barrett's esophagus, the AIR of progression to HGD and EAC was 0.65%(95%CI: 0.49-0.80). Among the patients down staged to Indefinite for dysplasia, the AIR of progression to HGD and EAC was 1.42%(95%CI: 1.19-1.65). In patients with consensus HGD diagnosis, the AIR of progression to EAC was 28.63%(95%CI: 13.98-43.27). CONCLUSION When LGD is diagnosed by consensus agreement of two or more expert pathologists, its progression towards malignancy seems to be at least three times the current estimates, however it could be up to 20 times the current estimates. Biopsies of all Barrett's esophagus patients with LGD should be reviewed by two expert gastroenterology pathologists. Follow-up strict surveillance programs should be in place for these patients.
文摘目的:调查2011年～2016年四川省新增血液透析(HD)患者的年度发病率、原发病因及年龄等情况。方法:回顾性分析全国HD病例登记系统(Chinese national renal data system,CNRDS)中2011-01-01～2016-12-31四川省新增HD患者的人口统计学及原发病资料,按照年份、性别、年龄等因素进行分层分析。结果:(1)四川省2011年～2016年新增HD患者年度发病率分别为每百万人口61.84人、73.75人、78.04人、66.04人、72.61人和60.98人。(2)新增HD患者共计33 632例,男女比例为1.5∶1;各年度男性发病率明显高于女性(P<0.05);(3)新增HD患者≥40岁者占79.62%。我们将出生年月信息完整的32 952例按年龄分为8个组,发现新增病例主要集中在40～69岁年龄段,且≥60岁年龄段的新增HD患者比例呈逐年上升趋势;(4)新增HD患者原发病因慢性肾小球肾炎所占比例呈下降趋势,而糖尿病肾病呈上升趋势。结论:四川省2011年～2016年新增HD患者以中老年为主,且存在年龄增大趋势;原发病因慢性肾小球肾炎所占比例呈降低而糖尿病肾病呈增长趋势。
