Background: China has the highest number of new cancer cases and deaths worldwide, posing huge health and economic burdens to society and affected families. This study comprehensively analyzed secular trends of national cancer mortality statistics to inform future prevention and intervention programs in China. Methods: The annual estimate of overall cancer mortality and its major subtypes were derived from the National Health Commission (NHC). Joinpoint analysis was used to detect changes in trends, and we used age-period-cohort modeling to estimate cohort and period effects in Cancers between 1987 and 2020. Net drift (overall annual percentage change), local drift (annual percentage change in each age group), longitudinal age curves (expected longitudinal age-specific rate), and period (cohort) relative risks were calculated. Results: The age-standardized cancer mortality in urban China has shown a steady downward trend but has not decreased significantly in rural areas. Almost all cancer deaths in urban areas have shown a downward trend, except for colorectal cancer in men. Decreasing mortality from cancers in rural of the stomach, esophagus, liver, leukemia, and nasopharynx was observed, while lung, colorectal cancer female breast, and cervical cancer mortality increased. Birth cohort risks peaked in the cohorts born around 1920–1930 and tended to decline in successive cohorts for most cancers except for leukemia, lung cancer in rural, and breast and cervical cancer in females, whose relative risks were rising in the very recent cohorts. In addition, mortality rates for almost all types of cancer in older Chinese show an upward trend. Conclusions: Although the age-standardized overall cancer mortality rate has declined, and the urban-rural gap narrowed, the absolute cancer cases kept increasing due to the growing elderly population in China. The rising mortality related to lung, colorectal, female breast, and cervical cancer should receive higher priority in managing cancer burden and calls for targeted public health actions to reverse the trend.
ObjectivesThis study aimed to examine the cross-sectional and longitudinal association between multimorbidity and memory-related diseases (MDs) among Chinese middle-aged and older adults.MethodsThis study included 8,338 subjects who participated in the China Health and Retirement Longitudinal Study (CHARLS). Logistic regression and Cox proportional hazards regression models were used to explore the association and effect of multimorbidity on MDs.ResultsThe overall prevalence of MDs was 2.52%, and the mean multimorbidity number was 1.87. In a cross-sectional analysis, compared with the no multimorbidity group, groups of multimorbidity with four or more non-communicable diseases (NCDs) were more likely to have MDs (OR: 6.49, 95%CI: 4.35–9.68). Within 2.7 years of follow-up, 82 cases of MDs (1.12%) were reported, and participants with multimorbidity were more likely to have new-onset MDs than participants without multimorbidity (HR: 2.93, 95%CI: 1.74–4.96).ConclusionMultimorbidity is associated with MDs among Chinese middle-aged and older adults. This relationship gradually strengthens with the severity of multimorbidity, which indicates that early prevention for people with multimorbidity may reduce the risk of MDs.
Diabetes mellitus (DM) is a public health challenge in China. Quantifying changes in DM mortality is of great significance, but related evidence of Chinese older adults is scarce. This study conducted a comprehensive analysis of China’s DM mortality changing trajectory. The data from 1987 to 2020 was derived from the National Health Commission of China. Joinpoint analysis and age-period-cohort (APC) model were used to calculate the annual change and the effects of age, period and cohort on DM mortality. The changing trajectory from 1987 to 2020 showed an upward trend, especially among rural groups, and the gap between rural-urban narrowed. Joinpoint analysis showed a consistent upward trend in rural areas (4.9%, 95%CI: 4.0%-5.7%). However, the urban showed an upward trend from 1987–1998 (5.7%) and a slow downward trend from 1998 to 2020 (-1.0%). The APC model showed that the reporting rate increased with age in urban and rural areas. For the effect of time period and cohort, as they proceeded, the rural showed a consistent and significant upward trend, but the trends in urban remained relatively stable. The DM mortality in China has shown an overall upward trend over the past three decades, especially in rural areas. Although the gap between urban-rural has been further reduced, the burden of the oldest-older has risen significantly regardless of areas. It is time to give priority attention to the high mortality of DM among females, the elderly and rural areas, and the government should take measures to curb this trend.
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