Time trends of esophageal and gastric cancer mortality in China, 1991-2009: an age-period-cohort analysis.
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ABSTRACT:
SUBMITTER: Li M
PROVIDER: S-EPMC5533794 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background: Gastrointestinal (GI) cancers are the common cause of morbidity and mortality in China which seriously threaten people's health and lives. The aim of this study was to describe the temporal trend in the epidemiology of GI cancers from 1991 to 2015, with an emphasis on the effects of age, period and cohort in Yangzhong City, Jiangsu province, a high-risk area of GI cancers in China. Methods: Our study extracted cases of gastric cancer, esophageal cancer and colorectal cancer diagnosed from 1991 to 2015 from Yangzhong Cancer Registry. Age-standardized rates (ASRs) were calculated and joinpoint regression was used to compute the estimated annual percent changes. Age-period-cohort (APC) model was performed to investigate the independent effects of age, calendar period, and birth cohort. Results: Between 1991 and 2015, 18,006 new cases and 10,262 deaths were registered with GI cancers in Yangzhong. The age-standardized incidence rates (ASIRs) of gastric cancer decreased in both sexes during the study period. And the incidence rates of esophageal cancer stabilized at first then continued to decline, the turning point was in 2005 for men and 2001 for women. Changes in the mortality rates of gastric cancer and esophageal cancer showed significant declined trends around 2000-2010 in both genders. The incidence rates of colorectal cancer increased steadily during the entire study period, and the increase was more pronounced in the mortality rates of men. The results of APC analysis suggest that general decreases in incidence and mortality of esophageal cancer and gastric cancer might be caused by the downward trend of the period and cohort effects, while the increases in colorectal cancer might be caused by the uptrend of the period effects. Conclusions: The incidence and mortality rates of esophageal and gastric cancers showed a downward trend and colorectal cancer was on the rise as a whole in Yangzhong City. The different burden of gastrointestinal cancer indicating heterogeneous risk factors exist and may have contributed to these temporal variations.
| S-EPMC6306425 | biostudies-literature
Project description:BackgroundContributions of age-period-cohort effects to increases in BMI and overweight among Chinese adults must be resolved in order to design appropriate interventions. The objectives were to (i) describe the period effect on BMI and overweight among Chinese adults from 1991 to 2009 and assess modification of this effect by age (e.g. cohort effect) and gender, and (ii) quantify the influence of household income and community urbanicity on these effects.MethodsData are from the China Health and Nutrition Survey, a prospective sample across nine provinces in China; 53,298 observations from 18,059 participants were collected over a 19-year period. A series of mixed effects models was used to explicitly assess differences in BMI within individuals over time (age effect) and population-wide differences in BMI over time (period effect), and implicitly assess differences in the experienced period effect across individuals of varying ages (cohort effect).ResultsStronger period effects on BMI and overweight were observed among males compared with females; and younger cohorts had higher BMIs compared with older cohorts. Simulations predicted that increases in income and urbanicity in the order of magnitude of that observed from 1991 to 2009 would correspond to shifts in the BMIs of average individuals of 0.07 and 0.23 kg/m(2), respectively.ConclusionsAlthough period effects had a stronger influence on the BMI of males, interventions should not overlook younger female cohorts who are at increased risk compared with their older counterparts.
| S-EPMC3733700 | biostudies-literature
Project description:China is the largest producer of tobacco worldwide. We assessed secular trends in prevalence of smoking, average cigarettes per day, mean age of initiation, and mortality attributable to smoking among the Chinese population between 1991 and 2011.Data came from the China Health and Nutrition Survey, conducted eight times between 1991 and 2011. A total of 83,447 participants aged 15years or older were included in this study. Trends in smoking were stratified by sex, age, and region (urban vs. rural).In 2011, 311 millions individuals were current smokers in China, with 295 million men and 16 million women, respectively. Between 1991 and 2011, the prevalence of current smoking decreased from 60.6% to 51.6% in men, and from 4.0% to 2.9% in women. However, during this period, the average number of cigarettes smoked per day per smoker increased from 15.0 to 16.5 in males, and from 8.5 to 12.4 in females. Further, age of smoking initiation decreased from 21.9 to 21.4years in men and from 31.4 to 28.4years in women. In 2011, 16.5% of all deaths in men and 1.7% in women were due to smoking. Between 1991 and 2011, the total number of deaths caused by smoking increased from 800,000 to 900,000.During the past 20years, a slight decrease in smoking prevalence was observed in the Chinese population. However, cigarette smoking remains a major cause of death in China, especially in men.
| S-EPMC5124560 | biostudies-literature
Project description:BackgroundCancer is an important focus of public health worldwide. This study aims to provide a comprehensive overview of temporal trends in incidence and mortality of leading cancer in Guangzhou, China from 2004 to 2015.MethodsData were collected from the population-based registry in Guangzhou. Age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were calculated and Joinpoint regression was used for evaluating the average annual percent changes (AAPC) among the entire study period and the estimated annual percent changes (EAPC) in time segments. The effects of age, period, and birth cohort were assessed by the age-period-cohort model.ResultsThe age-standardized incidence and mortality by the world standard population decreased significantly among males with AAPC of -1.7% (95% CI: -3.0%, 0.2%) and -2.7% (95% CI: -4.3%, -1.1%) for all malignancies during 2004-2015, while among females, the age-standardized incidence had a non-significant reduction with AAPC of -1.3% (95% CI: -2.8%, 0.2%) and the age-standardized mortality demonstrated a remarkable decline (AAPC -2.0%, 95% CI: -3.6%, -0.3%). For males, the most commonly diagnosed cancers were trachea, bronchus, and lung (TBL), liver, colorectal, nasopharyngeal, stomach, and prostate cancer. For females, breast, TBL, colorectal, liver stomach, and thyroid cancer ranked the top. Unfavorable trends were observed in ASIR of colorectal, thyroid, and prostate cancer. APC models yielded different ages, periods, and birth cohort effect patterns by cancer sites.ConclusionsCancer burden remained a public health challenge in Guangzhou as the aging population and lifestyles changes, despite declines in incidence and mortality rates in some cancers. Surveillance of cancer trends contributed to valuable insights into cancer prevention and control.
| S-EPMC8026941 | biostudies-literature
Project description:OBJECTIVE:To analyse mortality trends of liver diseases in China over the past 30 years. DESIGN:Age-period-cohort analyses were applied to liver diseases data obtained from the Chinese Health Statistics Annual Report (1987-2001) and the Chinese Health Statistics Yearbook (2003-2017). SETTING:General population in mainland China. OUTCOMES:Mortality rates and age, period and cohort effects on three categories of liver diseases: primary liver cancer (PLC), chronic liver disease and cirrhosis (CLD), and viral hepatitis (VH). RESULTS:A total of 13.54 million deaths were attributable to liver diseases over the period between 1987 and 2016, resulting in an average of 36.15 deaths per 100 000 population per year. The risk of PLC mortality increased by 32.69% over the period after controlling for the effects of age and birth cohort. By contrast, the risk of CLD mortality decreased by 56.64% over the same period. The risk of VH mortality decreased first, followed by a resurgence after the period of 2002-2006. Similar mortality risk trends by age (increasing) and birth cohort (decreasing) were observed for PLC and CLD. The year 1952 represented a turning point for VH, with people born after 1950 experiencing a declining risk of VH mortality. CONCLUSIONS:China has achieved great success in reducing the mortality of VH and CLD. However, significant challenges lie ahead in the efforts to prevent and control PLC and the resurgence of VH.
| S-EPMC6858130 | biostudies-literature
Project description:Background: Unintentional falls seriously threaten the life and health of people in China. This study aimed to assess the long-term trends of mortality from unintentional falls in China and to examine the age-, period-, and cohort-specific effects behind them. Methods: This population-based multiyear cross-sectional study of Chinese people aged 0-84 years was a secondary analysis of the mortality data of fall injuries from 1990 to 2019, derived from the Global Burden of Disease Study 2019. Age-standardized mortality rates of unintentional falls by year, sex, and age group were used as the main outcomes and were analyzed within the age-period-cohort framework. Results: Although the crude mortality rates of unintentional falls for men and women showed a significant upward trend, the age-standardized mortality rates for both sexes only increased slightly. The net drift of unintentional fall mortality was 0.13% (95% CI, -0.04 to 0.3%) per year for men and -0.71% (95% CI, -0.96 to -0.46%) per year for women. The local drift values for both sexes increased with age group. Significant age, cohort, and period effects were found behind the mortality trends of the unintentional falls for both sexes in China. Conclusions: Unintentional falls are still a major public health problem that disproportionately threatens the lives of men and women in China. Efforts should be put in place urgently to prevent the growing number of fall-related mortality for men over 40 years old and women over 70 years old. Gains observed in the recent period, relative risks (RRs), and cohort RRs may be related to improved healthcare and better education.
| S-EPMC8744467 | biostudies-literature
Project description:Amyotrophic lateral sclerosis (ALS) is a disease of the motor neuron with poorly understood etiology. Recent studies have suggested that the incidence rate of ALS and the rate of death from ALS are increasing, but it is unclear whether this is due to changing exposures or improvements in diagnosis. We used age-period-cohort models to investigate trends in ALS incidence (hospitalization) from 1982 to 2009 and ALS mortality from 1970 to 2009 in Denmark. Among those 45 years of age or older, 4,265 deaths (incidence rate = 5.35 per 100,000 person-years) and 3,228 incident diagnoses (incidence rate = 5.55 per 100,000 person-years) were recorded. Age-adjusted mortality rates increased by an average of 3.0% annually between 1970 and 2009 and by an average of 2.1% annually after 1982. Age-period-cohort analyses suggested that the full age-period-cohort model provided the best fit to the mortality data (P < 0.001), although restriction to the post-1982 period suggested that the age-cohort model provided the best fit. Age-adjusted incidence rates increased by 1.6% annually after 1982 (P < 0.001), which was best explained by the age-period model, with borderline significant cohort effects (P = 0.08). A consistent finding regardless of parameterization or data subset appeared to be an increase in ALS incidence and mortality rate with later birth cohorts, up to a birth year of at least 1910.
| S-EPMC3792730 | biostudies-literature
Project description:BackgroundUntil 1990, there was an upward trend in mortality from breast, lung, prostate, and colon cancers in the United Kingdom. With improvements in cancer treatment there has, in general, been a fall in mortality over the last 20 years. We evaluate regional cancer mortality trends in the United Kingdom between 1991 and 2007.MethodsWe analysed mortality trends for breast, lung, prostate, and colon cancers using data obtained from the EUREG cancer database. We have described changes in age-standardised rates (using European standard population) per 100,000 for cancer mortality and generated trends in mortality for the 11 regions using Joinpoint regression.ResultsAcross all regions in the United Kingdom there was a downward trend in mortality for the four most common cancers in males and females. Overall, deaths from colon cancer decreased most rapidly and deaths from prostate cancer decreased at the slowest rate. Similar downward trends in mortality were observed across all regions of the United Kingdom with the data for lung cancer exhibiting the greatest variation.ConclusionsMortality from the four most common cancers decreased across all regions of the United Kingdom; however, the rate of decline varied between cancer type and in some instances by region.
| S-EPMC4742578 | biostudies-literature
Project description:IntroductionDespite tobacco control and health promotion efforts, the incidence rates of mouth cancer are increasing across most regions in India. Analysing the influence of age, time period and birth cohort on these secular trends can point towards underlying factors and help identify high-risk populations for improved cancer control programmes.MethodsWe evaluated secular changes in mouth cancer incidence among men and women aged 25-74 years in Mumbai between 1995 and 2009 by calculating age-specific and age-standardized incidence rates (ASR). We estimated the age-adjusted linear trend for annual percent change (EAPC) using the drift parameter, and conducted an age-period-cohort (APC) analysis to quantify recent time trends and to evaluate the significance of birth cohort and calendar period effects.ResultsOver the 15-year period, age-standardized incidence rates of mouth cancer in men in Mumbai increased by 2.7% annually (95% CI:1.9 to 3.4), p<0.0001) while rates among women decreased (EAPC=-0.01% (95% CI:-0.02 to -0.002), p=0.03). APC analysis revealed significant non-linear positive period and cohort effects in men, with higher effects among younger men (25-49 years). Non-significant increasing trends were observed in younger women (25-49 years).ConclusionsAPC analyses from the Mumbai cancer registry indicate a significant linear increase of mouth cancer incidence from 1995 to 2009 in men, which was driven by younger men aged 25-49 years, and a non-significant upward trend in similarly aged younger women. Health promotion efforts should more effectively target younger cohorts.
| S-EPMC4911594 | biostudies-literature
Project description:Tuberculosis (TB) remains a major public health problem in China and worldwide. In this article, we used a joinpoint regression model to calculate the average annual percent change (AAPC) of TB notification and mortality in China from 2004 to 2019. We also used an age-period-cohort (APC) model based on the intrinsic estimator (IE) method to simultaneously distinguish the age, period and cohort effects on TB notification and mortality in China. A statistically downward trend was observed in TB notification and mortality over the period, with AAPCs of -4.2% * (-4.9%, -3.4%) and -5.8% (-7.5%, -4.0%), respectively. A bimodal pattern of the age effect was observed, peaking in the young adult (aged 15-34) and elderly (aged 50-84) groups. More specifically, the TB notification risk populations were people aged 20-24 years and 70-74 years; the TB mortality risk population was adults over the age of 60. The period effect suggested that TB notification and mortality risks were nearly stable over the past 15 years. The cohort effect on both TB notification and mortality presented a continuously decreasing trend, and it was no longer a risk factor after 1978. All in all, the age effect should be paid more attention.
| S-EPMC8197385 | biostudies-literature