Colorectal cancer mortality in Inner Mongolia between 2008 and 2012

Bile Acids, Gut Microbes, and the Neighborhood Food Environment-a Potential Driver of Colorectal Cancer Health Disparities

Bile acids (BAs) facilitate nutrient digestion and absorption and act as signaling molecules in a number of metabolic and inflammatory pathways. Expansion of the BA pool and increased exposure to microbial BA metabolites has been associated with increased colorectal cancer (CRC) risk. It is well established that diet influences systemic BA concentrations and microbial BA metabolism. Therefore, consumption of nutrients that reduce colonic exposure to BAs and microbial BA metabolites may be an effective method for reducing CRC risk, particularly in populations disproportionately burdened by CRC. Individuals who identify as Black/African American (AA/B) have the highest CRC incidence and death in the United States and are more likely to live in a food environment with an inequitable access to BA mitigating nutrients. Thus, this review discusses the current evidence supporting diet as a contributor to CRC disparities through BA-mediated mechanisms and relationships between these mechanisms and barriers to maintaining a low-risk diet.

Association between PM2.5 and mortality of stomach and colorectal cancer in Xi'an: a time-series study

Globally, fine particulate matter has been associated with several health problems including cancer. However, most studies focused mainly on lung cancer. Stomach and colorectal cancers play significant roles in increasing public health's cancer globally. This study focused on investigating a possible significant association between exposure to fine particulate matter (PM_2.5) and mortality due to stomach and colorectal cancer in Xi'an from 2014 to 2016. Using time-series analysis, the study applied both single and multi-pollutant(s) approaches for investigations; PM_2.5 was the pollutant of interest. Generalized additive model (GAM) was the core statistical method used with the addition of distributed lag model (DLM) to observe delayed effects. As a single pollutant, PM_2.5 was significantly associated with stomach cancer mortality only RR (95%CI): 1.0003 (1.0001, 1.002). For the multi-pollutant analysis, PM_2.5 combinations with NO₂ were significantly associated with both stomach and colorectal cancer mortality RR (95%CI): 1.0103 (1.009, 1.021) and 1.054 (1.0324, 1.0667), respectively. Also, PM_2.5 combination with O₃ was significantly associated with colorectal cancer mortality, RR (95%CI): 1.0151 (1.0091, 1.0172), but no association was noted for combination with SO₂. Though this study has reported significant associations, it will be beneficial for the public's health if more studies further investigate the relationship between exposure to PM_2.5 and other cancer mortality.

The effect characteristics of temperature on stroke mortality in Inner Mongolia and globally

The current study investigated the correlation between stroke mortality and temperature. Monthly and seasonal variations in stroke mortality were plotted and daily stroke-related deaths were calculated. The lag times were calculated using the time series analysis. The correlation between stroke incidence and the diurnal temperature range (DTR) was analyzed using case-crossover analysis. Global stroke mortality was described in five latitudes. In the eastern region of Inner Mongolia, the stroke mortality was 174.18/105, about twice of that of the midwestern regions (87.07/105), and temperature was negatively correlated with stroke mortality. Mortality peaked in the winter and troughed in the summer (χ² = 13.634, P < 0.001). The days in which stroke-related deaths were greater than ten occurred between late October and early April. The effect of temperature on stroke incidence occurred during a lag time of 1 (P = 0.024) or 2 months (P = 0.039). A DTR over 13 °C was positively correlated (r = 0.95, P = 0.004) with stroke with a lag time of 1 day. The effect of temperature on stroke was shown to be the same for various populations. As the latitude increases, stroke mortality also increases with latitudes > 40°; the highest mortality was 188.05/105 at the highest latitude. Only in relatively cold regions as the temperature decreases does stroke mortality increase for various populations. Differences in the time lag as well as in the DTR lag and DTR critical point vary for both the temperature and region.

A systematic review of associations between non-communicable diseases and socioeconomic status within low- and lower-middle-income countries

Background

Non-communicable diseases (NCDs) are the leading cause of death globally. Eighty-two percent of premature NCD deaths occur within low- and lower middle-income countries (LLMICs). Research to date, largely drawn from high-income countries, suggests that disadvantaged and marginalized groups have a higher NCD burden, but there has been a dearth of research studying this relationship within LLMICs. The purpose of this systematic review is to map the literature on evidence from LLMICs on the socio-economic status (SES) gradient of four particular NCDs: cardiovascular disease, cancer, diabetes, and chronic respiratory diseases.

Methods

We conducted a comprehensive literature search for primary research published between 1 January 1990 and 27 April 2015 using six bibliographic databases and web resources. We included studies that reported SES and morbidity or mortality from cardiovascular disease, cancer, diabetes and chronic respiratory diseases within LLMICs.

Results

Fifty-seven studies from 17 LLMICs met our inclusion criteria. Fourteen of the 18 papers that reported significant associations between cancer and SES suggested that low SES groups had the highest cancer risk. Eleven of 15 papers reporting significant relationships between CVD and SES suggested that low SES groups have higher risk. In contrast, seven of 12 papers reporting significant findings related to diabetes found that higher SES groups had higher diabetes risk. We identified just three studies on the relationship between chronic respiratory diseases and SES; none of them reported significant findings.

Conclusions

Only 17 of the 84 LLMICs were represented, highlighting the need for more research on NCDs within these countries. The majority of studies were medium to high quality cross-sectional studies. When we restricted our analyses to high quality studies only, for both cancer and cardiovascular disease more than half of studies found a significantly higher risk for those of lower SES. The opposite was true for diabetes, whilst there was a paucity of high quality research on chronic respiratory disease. Development programmes must consider health alongside other aims and NCD prevention interventions must target all members of the population.

Systematic review registration number

Prospero: CRD42015020169.

Causes of Death in Children Aged < 15 Years in the Inner Mongolia Region of China, 2008-2012

The objective of our study was to identify the causes of death in children <15 years of age in Inner Mongolia and to examine the age-specific causes of death. Study data from 2008-2012 were obtained from the Death Registry System that is maintained by the Inner Mongolia Centers for Disease Control and Prevention. The mortality rate (per 100,000) for children <15 years of age was calculated and stratified by age in different years. We computed the proportion of age-specific causes of death for children <15 years that occurred between 2008 and 2012 across eight monitoring points in Inner Mongolia. We used a log-linear model to analyze the year and age effects on childhood mortality. From 2008-2012, the standardized mortality of children <15 years of age was 42.78/100,000. The mortality rate was not significantly different from 2008 to 2012 (p>0.05); the mortality rate was the highest in the <1-year age group (p<0.05); and the mortality rate of the <1-year age group was higher in 2012 compared to that in 2009 (p<0.05), 2010 (p<0.05), and 2011 (p<0.05). In children aged 1-14 years, the leading cause of death was injuries, among which transport accident injuries were the most prevalent. To reduce the childhood mortality rate in Inner Mongolia, China, we should focus on the prevention of perinatal deaths in infants <1 year of age and on the prevention of transport accident injuries among older children (1-14 years).

Leukemia-Related Mortality in Inner Mongolia, 2008-2012

In this study, we aimed to determine the leukemia-related mortality rates and associated sociodemographic characteristics in the Inner Mongolia region of China. We obtained data for the period 2008-2012 from the Death Registry System maintained by the Inner Mongolia Centers for Disease Control and Prevention. We computed the percentages of leukemia-related deaths and controls diagnosed by various methods and at different levels of hospitals. The χ(2) test was used to examine differences in leukemia-related mortality according to sex. We also calculated potential years of life lost (PYLL) and average years of life lost. Unconditional logistic regression models were used to analyze the effect of sociodemographic characteristics. The sex-adjusted leukemia-related mortality rate was 3.74/100 000. The mortality rate in men (4.27/100 000) was significantly higher than that in women (3.17/100 000), as was the respective PYLL (8040.5 vs. 6000.5 person-years). Mortality increased with increasing age in both men and women. The highest mortality rate was observed in those over 70 years of age for both men (18.36/100 000) and women (7.68/100 000). Men with a higher education level showed an increased risk of leukemia (odds ratio [OR] = 1.45, 95% confidence interval [CI] = 1.02-2.07, P = 0.04). In men, unemployment was associated with leukemia-related death (OR = 0.63, 95% CI = 0.42-0.95, P = 0.03). The leukemia-related mortality rate in Inner Mongolia was higher than that worldwide and that in China. A higher level of education and unemployment were associated with leukemia-related mortality in Inner Mongolia.

The gap in digestive organ cancers in Inner Mongolia, 2009-2012

Objective:

The aim of this study was to explore the characteristics of digestive organ cancer mortality and the potential years of life lost in Inner Mongolia, and to provide evidence for the prevention of digestive organ cancers.

Methods:

Using data from the Death Registry System from 2009 to 2012, we classified male and female cancer deaths according to the International Classification of Disease (10th revision). The mortality and potential years of life lost were calculated for digestive organ cancers in Inner Mongolia. The average years of life lost was calculated.

Results:

Digestive organ cancer mortality in Inner Mongolia was higher in men than in women. The potential years of life lost were also much higher in men than in women. Gallbladder cancer, pancreatic cancer, and colorectal, anus, and anal canal cancer were the most prominent contributors to mortality. Esophageal cancer was the most prominent contributor to potential years of life lost, and was the leading cause of average years of life lost in both sexes.

Conclusion:

Liver cancer and stomach cancer mortality and the potential years of life lost to liver and stomach cancer are demonstrably higher in Inner Mongolia. Although esophageal cancer mortality was not the highest of the digestive organ cancers, the average years of life lost to esophageal was the highest for both sexes, and it should therefore be targeted for prevention.