Association of Ethnicity, Sex, and Age With Cancer Diagnoses and Health Care Utilization Among Children in Inner Mongolia, China

Zhou, Hu-Zi-Wei; Qiao, Liying; Zhang, Yunjing; Kang, Weiwei; Xue, Yong; Jiang, Yuling; Ke, Yalei; Rao, Yingting; Liu, Guozhen; Wang, Mingyuan; Hui, Wang; Xi, Yunfeng; Wang, Shengfeng

doi:10.1001/jamanetworkopen.2022.31182

Cited by 3 publications

(1 citation statement)

References 55 publications

(74 reference statements)

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“…Several studies were conducted over a large time span, some more than 60 years ago; however, they were conducted at a national level ( 3 , 8 ). Furthermore, some published research estimates of mortality rates only focus on specific types of cancer in Inner Mongolia; moreover, other reported estimates of mortality only use data from a single year or even a shorter time ( 9 – 11 ).…”

Section: Introductionmentioning

confidence: 99%

Cancer mortality in 2020 and its trend analysis in Inner Mongolia during four time periods from 1973 to 2020

Hou

Kang

et al. 2023

Front. Oncol.

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Cancer is one of the leading causes of mortality in China and is responsible for placing a major burden on its economic system. Inner Mongolia is located close to the northern border of China and spans more than 2,400 km from east to west. It has a total area of 1,183,000 km2, which accounts for about one-third of the total area of the country. Its ethnic demographics are complex and unique. We were interested in understanding whether these situations lead to a higher mortality rate for certain types of cancer, which was the motivation behind our research. This study aims to estimate cancer mortality in Inner Mongolia, its burden, and its trend over a 60-year time span. We compiled data pertaining to cancer in Inner Mongolia, obtained from the three national causes of death sample surveys. In addition, we obtained data pertaining to cancer mortality rates from the cause of death surveillance system in Inner Mongolia in the year 2020. The proportion of deaths from various cancers, crude mortality rates, and standardized mortality rates were calculated. The Joinpoint Regression Program was used to calculate mortality trends and the periodic percentage change (PPC) in these rates. We found that the mortality rate of cancer was 142.15/105; the age-standardized mortality rate using the Chinese standard population in 2000 (ASMRC) and Segi’s world population (ASMRW) were 86.49/105 and 85.73/105 in 2020, respectively. From 1973 to 2020, during the four time periods, the leading five cancer types contributing to the mortality rate among Inner Mongolia residents in 2020 were stomach cancer, esophageal cancer, liver cancer, cervix/uterine cancer, and lung cancer. The four periods of time PYLL ‰ were 9.05‰, 10.79‰, 12.1‰, and 10.38‰ from 1973 to 2020. The overall trend of the crude mortality rate of cancer in Inner Mongolia from 1973 to 2020 increased (PPC =1.77%, P<0.05). Also, the crude mortality rate and ASMRC were higher in men than in women (P<0.05). The mortality rates of cancer in Inner Mongolia increased with age ie first time period and in 2020 for ages 10 to 84. The same trend was observed for ages 0 and 74 in the second and the third time periods. Overall, in 2020, the CMR and the ASMRW in Inner Mongolia were lower than the national level and significantly lower than those in other domestic Chinese provinces. Lung cancer was the most reported cancer. Cancers from the first to seventh place ranking were consistent with the national ranking in 2020. The overall crude mortality rate of cancer in Inner Mongolia during the four periods revealed an increasing trend, and liver cancer-related mortality also showed an upward trend during the four periods. The findings may provide baseline data for cancer research.

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Section: Introductionmentioning

confidence: 99%

Cancer mortality in 2020 and its trend analysis in Inner Mongolia during four time periods from 1973 to 2020

Hou

Kang

et al. 2023

Front. Oncol.

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Higher disease burden and lower utilization in Mongolian with breast cancer: a 9-year retrospective cohort study of 18.19 million adults in China

Chen,

Qiao,

et al. 2024

International Journal of Surgery

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Background: Whether health inequalities of disease burden and medical utilization exist by ethnicity in Asian breast cancer (BC) patients remains unclear. We aim to measure ethnic disparities in disease burden and utilization among Mongolian and Han female breast cancer patients in China. Materials and Methods: Based on data extracted from Inner Mongolia Regional Health Information Platform, a retrospective cohort study was established during 2012-2021. Disease burden including incidence, 5-year prevalence, mortality, survival rate, and medical cost were analyzed and compared between Han and Mongolian patients. Results: A total of 34,878 female patients (mean [SD] age, 52.34 [10.93] years) were included among 18.19 million Chinese, and 4,315 [12.03%] participants were Mongolian. Age-standardized rates of incidence are 32.68 (95% CI: 20.39-44.98) per 100,000. Higher age-specific incidence and 5-year prevalence were observed in Mongolian than in Han. The cost of breast cancer annually per capita was significantly lower for Mongolian than Han in FBC ($1,948.43 [590.11-4 776.42] vs. $2,227.35 [686.65-5,929.59], P<0.001). Mongolian females showed higher all-cause mortality (30.92, [95% CI: 28.15-33.89] vs. 27.78, [95% CI: 26.77-28.83] per 1,000, P=0.036) and breast cancer-specific mortality (18.78, [95% CI: 16.64-21.13] vs. 15.22, [95% CI: 14.47-16.00] per 1,000, P=0.002) than Han females. After adjusting covariates, Mongolian were associated with increased all-cause mortality (HR, 1.21, [95% CI, 1.09-1.34]; P<0.001) and breast cancer-specific mortality (HR, 1.31, [95% CI, 1.14-1.49]; P<0.001) Conclusion: The findings of this cohort study highlight a higher level of disease burden with unmet medical demand in Mongolian patients, suggesting that more practical efforts should be made for the minority. Further research is needed to explore the concrete mechanisms of the disparities as well as eliminate health disproportion.

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Do ethnic disparities exist in disease burden and healthcare utilization of male breast cancer: a 9-year cohort study of 18.19 million adults in China

Chen,

Qiao,

et al. 2024

Preprint

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Background As a rare disease, male breast cancer (MBC) is of increasing concern in China. Whether health inequalities of disease burden and healthcare utilization exist by ethnicity in male breast cancer remains unclear. We aim to measure disease burden and healthcare utilization by ethnicity among male breast cancer patients in China. Methods A retrospective cohort study was established during 2012–2021 based on Inner Mongolia Regional Health Information Platform. Disease burden including incidence, 5-year prevalence, mortality, survival rate, and medical cost were analyzed. Results Among 630 participants (mean [SD] age, 59.4 [13.1] years), age-standardized rates of incidence were 1.2 (95% CI: 0.4–2.1) per 100000. All-cause mortality was 50.8 per 1000 person-years (95% CI: 42.4–60.4) but breast cancer-specific mortality was 5.5 per 1000 person-years (95% CI: 3.0-9.3). Regarding ethnicity, Mongolian had a higher age-standardized 5-year prevalence rate than Han (3.2[95% CI: 2.5-4.0] vs 2.3[95% CI: 1.7-3.0], P = 0.016), but no significant differences existed in incidence rates, survival rates, and risk of all-cause and breast cancer-specific mortality. Patients residing in areas of lower GDP level were associated with increased breast-cancer specific mortality (HR, 22.5, [95% CI: 1.6–325.0]; P = 0.022). Conclusions This study revealed a moderate disease burden and relatively lower healthcare utilization for male breast cancer in Inner Mongolia, China. No significant ethnic disparities existed in disease burden and healthcare utilization. However, we still demanded for increasing attention to male breast cancer due to the crucial influence of economic factors on potential ethnic disparities.

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Association of Ethnicity, Sex, and Age With Cancer Diagnoses and Health Care Utilization Among Children in Inner Mongolia, China

Cited by 3 publications

References 55 publications

Cancer mortality in 2020 and its trend analysis in Inner Mongolia during four time periods from 1973 to 2020

Cancer mortality in 2020 and its trend analysis in Inner Mongolia during four time periods from 1973 to 2020

Higher disease burden and lower utilization in Mongolian with breast cancer: a 9-year retrospective cohort study of 18.19 million adults in China

Do ethnic disparities exist in disease burden and healthcare utilization of male breast cancer: a 9-year cohort study of 18.19 million adults in China

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