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Gu XF, Xu HF, Liu Y, Li L, Yu YQ, Zhang X, Wang XH, Wang WJ, Du LB, Duan SX, Cao HL, Zhao YQ, Liu YY, Huang JX, Cao J, Fan YP, Feng CY, Lian XM, Du JC, Rezhake R, Ma L, Qiao YL. Involvement in treatment decision-making and self-reported efficacy among patients with advanced colorectal cancer: a nationwide multi-center cross-sectional study. Front Oncol 2023; 13:1168078. [PMID: 37564928 PMCID: PMC10411882 DOI: 10.3389/fonc.2023.1168078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/22/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction This cross-sectional study evaluated the involvement of patients with advanced colorectal cancer (CRC) in treatment decision-making, assessed the treatment efficacy according to their self-reports, and investigated the influencing factors. Methods Patients with advanced CRC were recruited from 19 hospitals from March 2020 to March 2021 by a multi-stage multi-level sampling method. A self-designed questionnaire was used to collect demographic and clinical characteristics, involvement of CRC patients in treatment decision-making, treatment methods, and self-reported efficacy. Univariate and unordered multinomial logistic regression analyses were used to evaluate the factors affecting the involvement in treatment decision-making and self-reported efficacy. Results We enrolled 4533 patients with advanced CRC. The average age at diagnosis was 58.7 ± 11.8 years. For the treatment method, 32.4% of patients received surgery combined with chemotherapy, 13.1% of patients underwent surgery combined with chemotherapy and targeted therapy, and 9.7% of patients were treated with surgery alone. For treatment decision-making, 7.0% of patients were solely responsible for decision-making, 47.0% of patients shared treatment decision-making with family members, 19.0% of patients had family members solely responsible for treatment decision-making, and 27.0% of patients had their physicians solely responsible for treatment decision-making. Gender, age, education level, family income, marital status, treatment cost, hospital type, and treatment method were significantly associated with the involvement of patients in treatment decision-making. A total of 3824 patients submitted self-reported efficacy evaluations during treatment. The percentage of patients with good self-reported efficacy was 76.5% (for patients treated for the first time), 61.7% (for patients treated for the second time), and 43.2% (for patients treated after recurrence and metastasis), respectively. Occupation, education level, average annual family income, place of residence, time since cancer diagnosis, hospital type, clinical stage, targeted therapy, and involvement in treatment decision-making were the main influencing factors of self-reported efficacy of treatment. Discussion Conclusively, CRC patients are not highly dominant in treatment decision-making and more likely to make treatment decisions with their family and doctors. Timely and effective communication between doctors and patients can bolster patient involvement in treatment decision-making.
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Affiliation(s)
- Xiao-Fen Gu
- Department of Student Affairs, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
| | - Hui-Fang Xu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Yin Liu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Yan-Qin Yu
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Shuang-Xia Duan
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - He-Lu Cao
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Yu-Qian Zhao
- Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastrodiges, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Xue-Mei Lian
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Remila Rezhake
- Department of Student Affairs, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - You-Lin Qiao
- Department of Student Affairs, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Liu Y, Zhang X, Xu HF, Shi JH, Zhao YQ, Du LB, Liu YY, Wang WJ, Cao HL, Ma L, Huang JX, Cao J, Li L, Fan YP, Gu XF, Feng CY, Zhu Q, Wang XH, Du JC, Zhang JG, Zhang SK, Qiao YL. Real-World Utilization, Barriers, and Factors Associated With the Targeted Treatment of Metastatic Colorectal Cancer Patients in China: A Multi-Center, Hospital-Based Survey Study. Int J Public Health 2023; 68:1606091. [PMID: 37465051 PMCID: PMC10351535 DOI: 10.3389/ijph.2023.1606091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/23/2023] [Indexed: 07/20/2023] Open
Abstract
Objectives: To explore the utilization, barriers, and factors associated with the targeted treatment of Chinese metastatic colorectal cancer (mCRC) patients. Methods: A total of 1,688 mCRC patients from 19 hospitals in 14 cities were enrolled from March 2020 to March 2021 using stratified, multistage cluster sampling. The use of targeted therapy and any barriers patients experienced were collected. Logistic regression analyses were conducted to identify the factors associated with initiating targeted treatment. Results: About 51.6% of the patients initiated targeted therapy, of whom 44.5%, 20.2%, and 35.2% started first-, second-, and third-line treatment, respectively. The most reported barriers were high medical costs and a lack of belief in the efficacy of targeted therapy. Patients treated in the general hospital, diagnosed at an older age, less educated, and who had a lower family income, no medical insurance, poor health-related quality of life, metastasis outside the liver/lung or systemic metastasis, a shorter duration of mCRC were less likely to initiate targeted therapy. Conclusion: Reduced medical costs and interventional education to improve public awareness could facilitate the use of targeted treatment for mCRC.
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Affiliation(s)
- Yin Liu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital and Institute, Beijing, China
| | - Hui-Fang Xu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Ji-Hai Shi
- The Clinical Epidemiology of Research Center, Department of Dermatological, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Yu-Qian Zhao
- Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - He-Lu Cao
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Juan-Xiu Huang
- Department of Gastroenterology, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiao-Fen Gu
- Department of Student Affairs, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, Xinjiang, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Qian Zhu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Jian-Gong Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Shao-Kai Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Li YD, Li HZ, Chen SS, Jin CH, Chen M, Cheng M, Ma MJ, Zhang XP, Wang X, Zhou JB, Chen MT, Chen JN, Yu S, Wang TJ, Fang WP, Cao XW, Yu XJ, Du LB, Wang S. Correlation of the detection rate of upper GI cancer with artificial intelligence score: results from a multicenter trial (with video). Gastrointest Endosc 2022; 95:1138-1146.e2. [PMID: 34973966 DOI: 10.1016/j.gie.2021.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/17/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS The quality of EGD is a prerequisite for a high detection rate of upper GI lesions, especially early gastric cancer. Our previous study showed that an artificial intelligence system, named intelligent detection endoscopic assistant (IDEA), could help to monitor blind spots and provide an operation score during EGD. Here, we verified the effectiveness of IDEA to help evaluate the quality of EGD in a large-scale multicenter trial. METHODS Patients undergoing EGD in 12 hospitals were consecutively enrolled. All hospitals were equipped with IDEA developed using deep convolutional neural networks and long short-term memory. Patients were examined by EGD, and the results were recorded by IDEA. The primary outcome was the detection rate of upper GI cancer. Secondary outcomes were part scores, total scores, and endoscopic procedure time, which were analyzed by IDEA. RESULTS A total of 17,787 patients were recruited. The total detection rate of cancer-positive cases was 1.50%, ranging from .60% to 3.94% in each hospital. The total detection rate of early cancer-positive cases was .36%, ranging from .00% to 1.58% in each hospital. The average total score analyzed by IDEA ranged from 64.87 ± 16.87 to 83.50 ± 9.57 in each hospital. The cancer detection rate in each hospital was positively correlated with total score (r = .775, P = .003). Similarly, the early cancer detection rate was positively correlated with total score (r = .756, P = .004). CONCLUSIONS This multicenter trial confirmed that the quality of the EGD result is positively correlated with the detection rate of cancer, which can be monitored by IDEA. (Clinical trial registration number: ChiCTR2000029001.).
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Affiliation(s)
- Yan-Dong Li
- Department of Endoscopy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Hui-Zhang Li
- Zhejiang Provincial Office for Cancer Prevention and Control, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Sheng-Sen Chen
- Department of Endoscopy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Chao-Hui Jin
- Hithink Royal Flush Information Metwork Co, Ltd, Hangzhou, China
| | - Ming Chen
- Hithink Royal Flush Information Metwork Co, Ltd, Hangzhou, China
| | - Ming Cheng
- Department of Gastroenterology, ZheJiang Jinhua Guangfu Tumor Hospital, Jinhua, China
| | - Min-Jun Ma
- Department of Gastroenterology, The First People's Hospital of Fuyang, Hangzhou, China
| | - Xiao-Ping Zhang
- Department of Gastroenterology, Shaoxing People's Hospital (The First Affiliated Hospital of Shaoxing University), Shaoxing, China
| | - Xin Wang
- Department of Gastroenterology, Cangnan People's Hospital, Wenzhou, China
| | - Jian-Bo Zhou
- Department of Gastroenterology, Yuyao People's Hospital of Zhejiang Province, Ningbo, China
| | - Ming-Tong Chen
- Gastroenterology & Medicine, Yongkang Hospital of Traditional Chinese Medicine, Jinhua, China
| | - Jiang-Ning Chen
- Department of Gastroenterology, Xiangshan County Red Cross Taiwan Compatriots Hospital Medical and Health Group General Hospital, Ningbo, China
| | - Shan Yu
- Department of Gastroenterology, Shengzhou People's Hospital, Shaoxing, China
| | - Tie-Jun Wang
- Department of Internal Medicine, Hangzhou Yuhang District Second People's Hospital, Hangzhou, China
| | - Wei-Ping Fang
- Department of Gastroenterology, The First People's Hospital of Jiande, Hangzhou, China
| | - Xian-Wei Cao
- Department of Gastroenterology, Nanxun District People's Hospital, Huzhou, China
| | - Xiao-Jie Yu
- Department of Gastroenterology, Tonglu First People's Hospital, Huzhou, China
| | - Ling-Bin Du
- Zhejiang Provincial Office for Cancer Prevention and Control, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Shi Wang
- Department of Endoscopy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
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Zhang X, Lian XM, Gu XF, Liu Y, Feng CY, Li L, Xu HF, Du JC, Zhao YQ, Ma L, Liu YY, Huang JX, Cao J, Wang XH, Du LB, Duan SX, Wang WJ, Fan YP, Yu YQ, Zhang SK, Shi JH, Qiao YL. Utilization of genetic biomarkers testing and its associated factors in advanced colorectal cancer patients in China: a nationwide multicenter clinical epidemiological study. Ann Transl Med 2022; 10:324. [PMID: 35434030 PMCID: PMC9011275 DOI: 10.21037/atm-22-988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/16/2022] [Indexed: 11/22/2022]
Abstract
Background Biomarkers are a key tool in early detection, prognostication, survival, and predicting treatment response of colorectal cancer (CRC). However, little is known about biomarker testing for CRC patients in real-life clinical practice in China. This study aimed to address the usage of biomarker testing and analyze factors related to its acceptance among Chinese patients with advanced CRC. Methods A multicenter, cross-sectional, hospital-based clinical epidemiology study was conducted from March 2020 to March 2021. Nineteen hospitals were selected in seven geographical regions of China using stratified, multistage, nonrandomized cluster sampling. Data on demographics and clinical characteristics of each eligible CRC patient in stage III or IV diseases were recorded based on the patients’ self-reporting and/or medical records. In addition, information on whether biomarker testing [RAS, BRAF, and microsatellite instability (MSI)] was performed, the results and timing for performing biomarker testing, and the reasons for refusing biomarker testing were also recorded. Univariate and multivariate logistic regression were conducted to explore the potential factors of biomarker testing. Results A total of 4,526 patients were enrolled in the study, of whom 41.4%, 36.1%, and 28.2% underwent RAS, BRAF, and MSI testing, respectively. RAS, BRAF, and high-level MSI (MSI-high) mutation rates in Chinese patients with advanced CRC were 37.0%, 9.9%, and 8.1%, respectively. The logistic regression analysis revealed that the treating hospital, age at diagnosis, education, family income, tumor site, history of chemotherapy and radiotherapy, and metastases were dependent factors affecting the utilization of biomarker testing in advanced CRC in China (P<0.005). Conclusions The biomarker testing rate, especially MSI testing, is less prevalent in clinical practice for patients with advanced CRC in China. Our findings may guide the formulation of biomarker testing of CRC strategies in China and other low-income countries.
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Affiliation(s)
- Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xue-Mei Lian
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiao-Fen Gu
- Department of Student Affairs, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, China
| | - Yin Liu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Hui-Fang Xu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Yu-Qian Zhao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastroenterology, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Shuang-Xia Duan
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yan-Qin Yu
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Shao-Kai Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Ji-Hai Shi
- The Clinical Epidemiology of Research Center, Department of Dermatology, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zhang JG, Wang H, Gu XF, Wang XY, Wang WJ, Du LB, Cao HL, Zhang X, Shi JH, Zhao YQ, Ma L, Liu YY, Huang JX, Cao J, Fan YP, Li L, Feng CY, Zhu Q, Du JC, Wang XH, Han BB, Qiao YL. Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study. Ann Transl Med 2022; 10:342. [PMID: 35433943 PMCID: PMC9011287 DOI: 10.21037/atm-22-1003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/21/2022] [Indexed: 11/06/2022]
Abstract
Background The imbalanced allocation of medical resources leads to the occurrence of cross-regional healthcare-seeking in China. Due to the low cure rate, advanced colorectal cancer (CRC) patients may seek cross-regional healthcare for high-level medical facilities. Investigating status of cross-regional healthcare-seeking and its associated factors among advanced CRC patients is important for policymakers to understand access to health services and improve the quality of oncology services. Methods From March 2020 to March 2021, a cross‑sectional, nation-wide, hospital-based, multi-center survey was conducted. Nineteen hospitals in seven regions were selected by multi-stage stratified sampling. All eligible CRC patients in the selected hospitals were invited to participate in the current study. The outcome variable, cross-regional healthcare-seeking, was defined as seeking health facilities outside the local administration policy of medical insurance. The demographics, clinical information, and medical treatment history of each eligible CRC patient in stage III or IV, were collected through the patients' self-reporting or medical records by trained interviewers. Univariate and multivariate logistic analyses were used to explore the associated factors of cross-regional healthcare-seeking. All statistical analyses were conducted using SAS 9.4. Results A total of 4,589 individuals with advanced CRC were included. The average age of the patients was 60.1±11.6 years, and 59.5% were males. About 37.5% of the patients suffered from metastatic CRC at first diagnosis. Approximately 36.5% of the patients had sought cross-regional health care previously, and among them, 31.9% had encountered problems. The most common problems included complicated procedures (95.3%), unreimbursed expenses of outpatient service (71.0%), and reimbursement delay (59.4%). Logistic regression analysis showed that patients who completed undergraduate or above [odds ratio (OR) =1.40, 95% confidence interval (CI): 1.13-1.73], had an annual household income of more than 100,000 Chinse Yuan (CNY) (OR =1.46, 95% CI: 1.21-1.78), and had metastasis at diagnosis (OR =1.33, 95% CI: 1.18-1.51) were more likely to seek cross-regional health care. Conclusions About one third of advanced CRC patients seek cross-regional health care, and 31.9% had encountered problems. There is a need to simplify procedures of reimbursement, optimize direct settlement system and referral mechanisms in order to improve the equality of health services.
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Affiliation(s)
- Jian-Gong Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Hong Wang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Xiao-Fen Gu
- Department of Student Affairs, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, China
| | - Xiao-Yang Wang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - He-Lu Cao
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Ji-Hai Shi
- The Clinical Epidemiology of Research Center, Department of Dermatological, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Yu-Qian Zhao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastroenterology, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Qian Zhu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Bin-Bin Han
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China.,Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wang H, Ma L, Gu XF, Li L, Wang WJ, Du LB, Xu HF, Cao HL, Zhang X, Shi JH, Zhao YQ, Liu YY, Huang JX, Cao J, Fan YP, Feng CY, Zhu Q, Du JC, Wang XH, Zhang SK, Qiao YL. Out-of-pocket medical expenditure and associated factors of advanced colorectal cancer in China: a multi-center cross-sectional study. Ann Transl Med 2022; 10:356. [PMID: 35433986 PMCID: PMC9011322 DOI: 10.21037/atm-22-1001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022]
Abstract
Background Colorectal cancer (CRC) causes a substantial disease burden in China. Information on the medical expenditure of CRC patients is critical for decision-makers to allocate medical resources reasonably, however, relevant data is limited in China, especially advanced CRC. The aim of this survey was to quantify the out-of-pocket medical expenditure of advanced CRC and explore associated factors. Methods A nation-wide, multi-center, cross-sectional survey was conducted from March 2020 to March 2021. Nineteen hospitals in seven geographical regions were selected by multi-stage stratified sampling. For each eligible CRC patient with stage III or IV disease in the selected hospitals, the socio-demographics, clinical information, and range of out-of-pocket medical expenditure data were collected based on patients’ self-reporting or medical records. Multivariable logistic analysis was used to explore associated factors of medical expenditure. All statistical analyses were conducted using SAS 9.4. Results The mean age of the 4,428 advanced CRC patients included was 59.5±11.6 years, 59.6% were male, and 80.1% of patients were in stage III or IV at the time of diagnosis. Besides, 57.2% of patients had an annual household income of less than 50,000 Chinese Yuan (CNY), 40.9% of patients had an out-of-pocket medical expenditure of 50,000–99,999 CNY. As for the affordability of medical expenditure, 33.2% could afford 50,000–99,999 CNY. Multivariate analysis showed that patients who were in the southern [odds ratio (OR): 1.63, 95% confidence interval (CI): 1.31–2.03] and southwestern (OR: 1.55, 95% CI: 1.25–1.93), were in stage III at the time of diagnosis (OR: 1.33, 95% CI: 1.13–1.57), visited three or more hospitals (OR: 1.26, 95% CI: 1.04–1.52), had sought cross-regional health care (OR: 1.60, 95% CI: 1.40–1.83), used genetic testing (OR: 1.26, 95% CI: 1.10–1.45) and targeted drugs (OR: 2.12, 95% CI: 1.79–2.51) had higher out-of-pocket medical expenditure. Conclusions Patients with advanced CRC had a high out-of-pocket medical expenditure. It is necessary to strengthen the prevention and control of CRC to reduce the disease burden; also, it is critical to deepen the reform of the medical system, increase proportion of medical insurance reimbursement, and remove barriers to cross-regional health care.
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Affiliation(s)
- Hong Wang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Xiao-Fen Gu
- Department of Student Affairs, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Hui-Fang Xu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - He-Lu Cao
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Ji-Hai Shi
- The Clinical Epidemiology of Research Center, Department of Dermatological, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Yu-Qian Zhao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastroenterology, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Qian Zhu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Shao-Kai Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China.,Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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7
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Yu YQ, Ma L, Wang WJ, Zhao YQ, Xu HF, Cao J, Li L, Hao JQ, Gao JR, Gu XF, Liu YY, Huang JX, Fan YP, Du LB, Cao HL, Feng CY, Zhu Q, Wang XH, Du JC, Bangura MS, Zhang X, Zhang SK, Qiao YL. Health-related quality of life in advanced colorectal cancer patients in China: a nationwide hospital-based survey. Ann Transl Med 2022; 10:328. [PMID: 35433947 PMCID: PMC9011208 DOI: 10.21037/atm-22-991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/18/2022] [Indexed: 11/06/2022]
Abstract
Background Colorectal cancer (CRC) is one of the most common cancers in China, and most CRC patients have already reached an advanced stage by the time of initial diagnosis. Due to the loss of health as a result of cancer, it has consequence on the treatment which may affect the psychophysical and social impairment of CRC patients. These indicators (psychophysical, function and social impairment) affect the health-related quality of life (HRQOL). There are limited studies that focus on advanced CRC patients in China. This study aimed to assess the HRQOL and its associated factors of advanced CRC patients in China. Methods This was a cross-sectional, nationwide, hospital-based, and multi-center survey. According to the traditional administrative district definition, we selected 19 hospitals in 7 regions by multi-stage stratified sampling in China. For each eligible CRC patient with stage III or IV in the selected hospitals, socio-demographics, clinical information, and HRQOL were collected based on patients’ self-reporting and/or medical records between March 2020 and March 2021. Patients completed the Functional Assessment of Cancer Therapy Colorectal (FACT-C) plus-traditional Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-9. Results A total of 4,589 CRC patients (mean age 60.1 years, including 2,730 males and 1,859 females) were included. The total score of HRQOL in population was 128.2±24.70. There were significant differences in the overall score of HRQOL in gender, education level, occupation, region, disease type, and disease stage (P<0.05). The score of HRQOL was better in males, undergraduates and above, unemployed/laid-off, and southwestern and central China. Multivariate analysis showed that education level, occupation, location, number of hospitals visited and treatment methods, and gender were associated with utilities of CRC patients. Conclusions The HRQOL is an important outcome measure for CRC patients. The HRQOL scores differed according to socio-demographic and clinical characteristics, and findings of these factors were associated with education level, occupation, region, number of visited and treatment methods, and gender.
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Affiliation(s)
- Yan-Qin Yu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Yu-Qian Zhao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hui-Fang Xu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Jin-Qi Hao
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Jing-Ru Gao
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Xiao-Fen Gu
- Department of Student Affairs, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastroenterology, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - He-Lu Cao
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Qian Zhu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | | | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Shao-Kai Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China.,Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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8
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Wang XY, Wang WJ, Zhao YQ, Liu Y, Wang XH, Du LB, Duan SX, Zhang X, Yu YQ, Ma L, Liu YY, Huang JX, Cao J, Li L, Gu XF, Fan YP, Feng CY, Lian XM, Du JC, Zhang JG, Qiao YL. The choice of medical facility and associated factors among Chinese advanced colorectal cancer patients: a cross-sectional multi-center study. Ann Transl Med 2022; 10:326. [PMID: 35433962 PMCID: PMC9011249 DOI: 10.21037/atm-22-1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/18/2022] [Indexed: 11/06/2022]
Abstract
Background Colorectal cancer (CRC) poses a significant public health burden worldwide. The investigation of the choice of medical facility among CRC patients is helpful for understanding access to health services and improving quality of oncology services to optimize health outcomes. However, there are limited studies on the topic. The objective of this study was to investigate the choice of medical facility and its associated factors among advanced CRC patients. Methods This cross-sectional multi-center study included a total of 4,589 individuals with advanced CRC from 19 hospitals in 7 geographic regions in China. Participants were recruited by multi-stage stratified sampling. In the first stage, two cities in each geographic region were selected through simple random sampling. In the second stage, one tertiary cancer hospital and/or one general hospital were selected in each city. Data on medical experience and demographics were collected via a questionnaire during face-to-face interviews. Explanatory variables were selected based on the Andersen behavioral model. Multinomial logistic regression analyses were performed to explore the factors associated with the level of medical facility for the first treatment. Results Hospitals at the prefecture level were the most common medical facility sought by advanced CRC patients for initial medical care (44.9%), the first definite diagnosis (46.3%), the first treatment (39.5%), and regular follow-up (38.9%). However, the first priority was changed to hospitals at the national level for the second treatment (38.0%) and after recurrence and metastasis (45.9%). Female {odds ratios (ORs) ranged from 1.31 [95% confidence interval (CI): 1.01–1.71] to 1.41 (95% CI: 1.07–1.87)} and relatively well-educated individuals [ORs ranged from 1.74 (95% CI: 1.20–2.53) to 7.26 (95% CI: 4.18–12.60)] preferred to seek higher-level health facilities. Individuals with metastatic CRC at diagnosis were more likely to visit hospitals in provincial capitals versus hospitals at the county level (OR =1.68, 95% CI: 1.27–2.22). Individuals with “good” health-related quality of life (HRQOL) (OR =0.63, 95% CI: 0.49–0.81) were less likely to seek hospitals at the prefecture level compared with hospitals at the county level. Conclusions There is a need to improve the oncology services for CRC patients, including the optimization of referral reform policy and the promotion of quality of primary healthcare service. The results may provide evidence to fill the policy-implementation gap and potentially contribute to the improvement of the efficiency of the healthcare system.
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Affiliation(s)
- Xiao-Yang Wang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Yu-Qian Zhao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yin Liu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Shuang-Xia Duan
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yan-Qin Yu
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastroenterology, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Xiao-Fen Gu
- Department of Student Affairs, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Xue-Mei Lian
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Jian-Gong Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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9
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Xu HF, Gu XF, Wang XH, Wang WJ, Du LB, Duan SX, Liu Y, Zhang X, Zhao YQ, Ma L, Liu YY, Huang JX, Cao J, Fan YP, Li L, Feng CY, Lian XM, Du JC, Zhang JG, Yu YQ, Qiao YL. Knowledge and awareness of colorectal cancer risk factors, screening, and associated factors in advanced colorectal cancer patients: a multicenter cross-sectional study in China. Ann Transl Med 2022; 10:354. [PMID: 35433933 PMCID: PMC9011206 DOI: 10.21037/atm-22-1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/18/2022] [Indexed: 11/06/2022]
Abstract
Background Colorectal cancer (CRC) is the 3rd most common malignancy globally, and its disease burden is increasing rapidly in China. But CRC patients' knowledge and awareness of CRC have not yet been examined, which could facilitate the identification of targeted population from public for intervention. Methods A nationwide multicenter cross-sectional survey was conducted in 19 tertiary hospitals (10 cancer hospitals and 9 general hospitals) from March 2020 to March 2021 in China. During study period, all Stage III and IV CRC patients were invited to complete a semi-structured survey that had been designed to collect information about their socio-demographic characteristics, and knowledge and awareness of CRC risk factors and screening. A multivariate logistic regression model was used to identify factors associated with their knowledge and awareness. Results In total, 4,589 advanced CRC patients were enrolled in this study, of whom, 46.2% were from tertiary cancer hospitals, and 59.5% were male. Patients had a mean age of 60.1±11.6 years. Before diagnosis, 65.1% of the patients had no related knowledge of the CRC risk factors, and 84.9% were unaware of the CRC screening-related information. Only 30.4% of patients had actively sought to acquire CRC-related knowledge before diagnosis. The 3 most common knowledge sources were relatives or friends who had been diagnosed with CRC (13.2%), popular science television/broadcast shows (12.9%), and community publicity and education (9.6%). Generally, knowledge and awareness were positively associated with better education level [odds ratios (ORs) ranged from 1.49 to 2.54, P<0.001], annual household income ranged from 50,000 Chinese Yuan (CNY) to 100,000 CNY (OR =1.32, P<0.001), being manual laborer (OR =1.25, P<0.001) and being white-collar worker (OR =1.47, P<0.001). Conclusions Advanced CRC patients' knowledge and awareness of CRC were severely limited before diagnosis. Thus, those who had limited knowledge and awareness should has a priority for intervention.
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Affiliation(s)
- Hui-Fang Xu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Xiao-Fen Gu
- Department of Student Affairs, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Shuang-Xia Duan
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Yin Liu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yu-Qian Zhao
- Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastroenterology, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Xue-Mei Lian
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Jian-Gong Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Yan-Qin Yu
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China.,Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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10
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Zhang X, Shi JF, Liu GX, Ren JS, Guo LW, Huang WD, Shi LM, Ma Y, Huang HY, Bai YN, Liao XZ, Mao AY, Sun XJ, Zhu XY, Zhou Q, Gong JY, Zhou JY, Liu YQ, Mai L, Song BB, Zhu L, Xing XJ, Du LB, Qi X, Sun XH, Wu SL, Ren Y, Cao R, Lan L, Lou PA, Zhang K, He J, Dai M. Medical expenditure for lung cancer in China: a multicenter, hospital-based retrospective survey. Cost Eff Resour Alloc 2021; 19:53. [PMID: 34404418 PMCID: PMC8371812 DOI: 10.1186/s12962-021-00306-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 08/09/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Lung cancer is the most prevalent cancer, and the leading cause of cancer-related deaths in China. The aim of this study was to estimate the direct medical expenditure incurred for lung cancer care and analyze the trend therein for the period 2002-2011 using nationally representative data in China METHODS: This study was based on 10-year, multicenter retrospective expenditure data collected from hospital records, covering 15,437 lung cancer patients from 13 provinces diagnosed during the period 2002-2011. All expenditure data were adjusted to 2011 to eliminate the effects of inflation using China's annual consumer price index. RESULTS The direct medical expenditure for lung cancer care (in 2011) was 39,015 CNY (US$6,041) per case, with an annual growth rate of 7.55% from 2002 to 2011. Drug costs were the highest proportionally in the total medical expenditure (54.27%), followed by treatment expenditure (14.32%) and surgical expenditure (8.10%). Medical expenditures for the disease varied based on region, hospital level, type, and stage. CONCLUSION The medical expenditure for lung cancer care is substantial in China. Drug costs and laboratory test are the main factors increasing medical costs.
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Affiliation(s)
- Xin Zhang
- School of Health Management, Harbin Medical University, 194 Xuefu Road, Nangang District, Harbin, 150081, China
| | - Ju-Fang Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Guo-Xiang Liu
- School of Health Management, Harbin Medical University, 194 Xuefu Road, Nangang District, Harbin, 150081, China.
| | - Jian-Song Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China.
| | - Lan-Wei Guo
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Wei-Dong Huang
- School of Health Management, Harbin Medical University, 194 Xuefu Road, Nangang District, Harbin, 150081, China
| | - Lin-Mei Shi
- School of Health Management, Harbin Medical University, 194 Xuefu Road, Nangang District, Harbin, 150081, China
| | - Yi Ma
- School of Health Management, Harbin Medical University, 194 Xuefu Road, Nangang District, Harbin, 150081, China
| | - Hui-Yao Huang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Ya-Na Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, 730000, China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Provincial Cancer Hospital, Changsha, 410006, China
| | - A-Yan Mao
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, 100020, China
| | - Xiao-Jie Sun
- Center for Health Management and Policy, Key Lab of Health Economics and Policy, Shandong University, Jinan, 250012, China
| | - Xin-Yu Zhu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, 730000, China
| | - Qi Zhou
- Chongqing Office for Cancer Control and Research, Chongqing Cancer Hospital, Chongqing, 400030, China
| | - Ji-Yong Gong
- Science and Education Department of Public Health Division, Shandong Tumor Hospital, Jinan, 250117, China
| | - Jin-Yi Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Institute of Chronic Non-Communicable Diseases Prevention and Control, Nanjing, 210009, China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, 730050, China
| | - Ling Mai
- Department of Institute of Tumor Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Bing-Bing Song
- Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, 150081, China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Xiao-Jing Xing
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, 110042, China
| | - Ling-Bin Du
- Zhejiang Office for Cancer Control and Research, Zhejiang Cancer Hospital, Hangzhou, 310022, China
| | - Xiao Qi
- Department of Occupational Medicine, Tangshan People's Hospital, Tangshan, 063001, China
| | - Xiao-Hua Sun
- Ningbo Clinical Cancer Prevention Guidance Center, Ningbo NO.2 Hospital, Ningbo, 315010, China
| | - Shou-Ling Wu
- Health Department of Kailuan Group, Kailuan General Hospital, Tangshan, 063000, China
| | - Ying Ren
- Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, 112000, China
| | - Rong Cao
- Department of Health Policy and Economic Research, Guangdong Provincial Institute of Public Health, Guangzhou, 511430, China
| | - Li Lan
- Institute of Chronic Disease Prevention and Control, Harbin Center for Disease Control and Prevention, Harbin, 150056, China
| | - Pei-An Lou
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, 221006, China
| | - Kai Zhang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Jie He
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
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Wang YQ, Li HZ, Gong WW, Chen YY, Zhu C, Wang L, Zhong JM, Du LB. Cancer incidence and mortality in Zhejiang Province, Southeast China, 2016: a population-based study. Chin Med J (Engl) 2021; 134:1959-1966. [PMID: 34334631 PMCID: PMC8382332 DOI: 10.1097/cm9.0000000000001666] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUNDS Cancer is one of the main causes of death worldwide, seriously threatening human health and life expectancy. We aimed to analyze the cancer incidence and mortality rates during 2016 in Zhejiang Province, Southeast China. METHODS Data were collected from 14 population-based cancer registries across Zhejiang Province of China. Cancer incidence and mortality rates stratified by sex and region were analyzed. The crude rate, age-standardized rate, age-specific and region-specific rate, and cumulative rate were calculated. The proportions of 10 common cancers in different groups and the incidence and mortality rates of the top five cancers in different age groups were also calculated. The Chinese national census of 2000 and the world Segi population was used for calculating the age-standardized incidence and mortality rates. RESULTS The 14 cancer registries covered a population of 14,250,844 individuals, accounting for 29.13% of the population of Zhejiang Province. The total reported cancer cases and deaths were 55,835 and 27,013, respectively. The proportion of morphological verification (MV%) was 78.95% of the population, and percentage of incident cases identified through death certificates only (DCO%) was 1.23% with a mortality-to-incidence ratio (M/I ratio) of 0.48. The crude incidence rate in Zhejiang cancer registration areas was 391.80/105; the age-standardized incidence rate of the Chinese standard population (ASIRC) and the age-standardized incidence rate of the world standard population (ASIRW) were 229.76/105 and 220.96/105, respectively. The incidence rate in men was higher than that in women. The incidence rate increased rapidly after 45 years of age and peaked in individuals aged 80 to 84 years. The top 10 incidence rates of cancers were lung cancer, female breast cancer, thyroid cancer, colorectal cancer, stomach cancer, liver cancer, prostate cancer, cervical cancer, esophageal cancer, and pancreatic cancer (from highest to lowest). The crude mortality rate in Zhejiang cancer registration areas was 189.55/105; the age-standardized mortality rate of the Chinese standard population (ASMRC) and the age-standardized mortality rate of the world standard population (ASMRW) were 94.46/105 and 93.42/105, respectively. The mortality rate in men was higher than that in women, and the male population in rural areas was higher than that in urban areas. The cancer mortality rate increased rapidly after 50 years of age and peaked in individuals aged 85+ years. The top 10 mortality rates of cancers were lung cancer, liver cancer, stomach cancer, colorectal cancer, pancreatic cancer, esophageal cancer, female breast cancer, prostate cancer, lymphoma, and leukemia (from highest to lowest). CONCLUSIONS Lung cancer, female breast cancer, thyroid cancer, colorectal cancer, prostate cancer, liver cancer, and stomach cancer were the most common cancers in Zhejiang Province. Effective prevention and control measures should be established after considering the different characteristics of cancers in urban and rural areas.
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Affiliation(s)
- You-Qing Wang
- Zhejiang Provincial Office for Cancer Prevention and Control, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - Hui-Zhang Li
- Zhejiang Provincial Office for Cancer Prevention and Control, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - Wei-Wei Gong
- Department of Chronic Non-communicable Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
| | - Yao-Yao Chen
- Zhejiang Provincial Office for Cancer Prevention and Control, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - Chen Zhu
- Zhejiang Provincial Office for Cancer Prevention and Control, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - Le Wang
- Zhejiang Provincial Office for Cancer Prevention and Control, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - Jie-Ming Zhong
- Department of Chronic Non-communicable Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
| | - Ling-Bin Du
- Zhejiang Provincial Office for Cancer Prevention and Control, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
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Wang L, Li J, Zhu C, Wang YQ, Li HZ, Bi XF, Li N, Du LB, Chen WQ, He J. [Controversy on the age of initiation in colorectal cancer screening]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:1113-1117. [PMID: 34814517 DOI: 10.3760/cma.j.cn112338-20200807-01041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Colorectal cancer is a significant public health issue all over the world. Screening has been shown effective in improving the survival rate and decreasing the deaths of colorectal cancer. Several organizations have released guidelines for colorectal cancer screening. However, detailed recommendations like the age to begin remain controversial. This paper summarizes the recommended different age groups in initiating the colorectal cancer screening program from a few guidelines and analyzes the reasons for the inconsistency, thus facilitating the drafting of colorectal cancer screening guidelines in China.
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Affiliation(s)
- L Wang
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Hangzhou 310022, China
| | - J Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - C Zhu
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Hangzhou 310022, China
| | - Y Q Wang
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Hangzhou 310022, China
| | - H Z Li
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Hangzhou 310022, China
| | - X F Bi
- Department of Cancer Prevention, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L B Du
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Hangzhou 310022, China
| | - W Q Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Wen Y, Yu LZ, Du LB, Wei DH, Liu YY, Yang ZY, Zheng YD, Wu Z, Yu XY, Zhao L, Yu YW, Chen HD, Ren JS, Qin C, Xu YJ, Cao W, Wang F, Li J, Tan FW, Dai M, Chen WQ, Li N, He J. [Analysis of low-dose computed tomography compliance and related factors among high-risk population of lung cancer in three provinces participating in the cancer screening program in urban China]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:633-639. [PMID: 34034404 DOI: 10.3760/cma.j.cn112150-20201015-01286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the compliance and related factors of low-dose computed tomography (LDCT) screening among the high-risk population of lung cancer in three provinces participating in the cancer early diagnosis and early treatment program in urban areas of China. Methods: From October 2017 to October 2018, 17 983 people aged between 40 and 74 years old at high risk of lung cancer were recruited from Zhejiang, Anhui and Liaoning provinces. The basic demographic characteristics, living habits, history of the disease and family history of cancer were collected by using a cancer risk assessment questionnaire, and the data of participants examined by LDCT were obtained from the hospitals participating in the program. The screening compliance was quantified by the screening participation rate, and it was calculated as the proportion of participants completing LDCT scan among high-risk population. The related factors of LDCT screening compliance were analyzed by using a multivariate logistic regression model. Results: The age of 17 983 participants was (56.52±8.22) years old. Males accounted for 51.9% (N=9 332), and 69.5% (N=12 495) had ever smoked, including former smokers and current smokers. A total of 6 269 participants were screened by LDCT, and the screening participation rate was 34.86%. The results of multivariate logistic regression analysis showed that the age group of 50 to 69 years old, female, passive smokers, alcohol consumption, family history of lung cancer and history of chronic respiratory diseases were more likely to be screened by LDCT, while the compliance of LDCT screening in current smokers was low. Conclusions: The LDCT screening compliance of the high-risk population of lung cancer in urban areas of China still needs to be improved. Age, sex, smoking, drinking, family history of lung cancer and history of chronic respiratory disease are associated with screening compliance.
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Affiliation(s)
- Y Wen
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Z Yu
- Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
| | - L B Du
- Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou 310004, China
| | - D H Wei
- Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - Y Y Liu
- The Department of Cancer Prevention and Control, Liaoning Cancer Hospital/Institute, Shenyang 110042, China
| | - Z Y Yang
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y D Zheng
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Z Wu
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X Y Yu
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Zhao
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y W Yu
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H D Chen
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J S Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - C Qin
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y J Xu
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Cao
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - F Wang
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - F W Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- Office of Cancer Screening/National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - N Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - J He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Li HZ, Zheng RS, Du LB, Zhang SW, Zhu C, Wei WW, He J. [Bladder cancer incidence, mortality and temporal trends in China]. Zhonghua Zhong Liu Za Zhi 2021; 43:293-298. [PMID: 33752308 DOI: 10.3760/cma.j.cn112152-20200421-00362] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To describe the epidemiological characteristics of bladder cancer in 2015 and temporal trends in China. Methods: From 501 cancer registries in China, we collected data of cancer new cases, deaths and populations in 2015. After qualified, sex-specific, area-specific, age-specific and overall incidence/mortality rates (including age-standardized rates by Chinese standard population and by world standard population) and estimated cases of bladder cancer were calculated. Annual Percent Change (APC)/Average Annual Percent Change (AAPC) fitted from Log-line model was applied to evaluate the temporal trends of bladder cancer incidence/mortality rates from 1998 to 2015. Results: Bladder cancer is the 13(th) most common cancer in China. The crude, age-standardized by China standard population and by world standard population rates were 5.80/10(5), 3.60/10(5) and 3.57/10(5) for incidence, and 2.37/10(5), 1.31/10(5) and 1.32/10(5) for mortality, respectively. The incidence of bladder cancer ranked 7(th) in male. The incidence and mortality of male were 3.8 and 4.0 times as high as those of female. Bladder cancer incidence in urban area was 1.4 times as high as that in rural area. Incidence in western areas and middle areas of China were similar, which were lower than that in eastern areas. Geographical distribution characteristics of mortality was along with incidence.Both incidence and mortality remained low before 45 and 55 years old, then they increased rapidly and peaked at 80-84 and over 85 years old age group. Temporal trend analysis suggested that bladder cancer incidence in China increased in 1998-2007 (APC=2.58, P<0.001), while decreased from 2007 to 2015 (APC=-3.82, P<0.001). Bladder cancer mortality declined gradually, with APCs for 1998-2003 and 2003-2015 of 3.65% (P=0.002) and 1.42% (P<0.001). Conclusions: Bladder cancer is one of the main cancers in China. Its epidemiological distributions varies among different sex, area and age group. Both incidence and mortality of bladder cancer decline. More efforts on tobacco control should be made, and awareness of early diagnosis and early treatment could be enhanced for the middle-aged and elderly.
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Affiliation(s)
- H Z Li
- Department of Cancer Prevention (DCP), Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer Research and Basic Medical Sciences, Chinese Academy of Sciences, Hangzhou 310004, China
| | - R S Zheng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L B Du
- Department of Cancer Prevention (DCP), Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer Research and Basic Medical Sciences, Chinese Academy of Sciences, Hangzhou 310004, China
| | - S W Zhang
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - C Zhu
- Department of Cancer Prevention (DCP), Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer Research and Basic Medical Sciences, Chinese Academy of Sciences, Hangzhou 310004, China
| | - W W Wei
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Wang YQ, Li HZ, Wang L, Zhu C, Sun XH, Zhang MZ, Jin L, Du LB. [Analysis of liver cancer screening results and influencing factors of urban residents in Zhejiang Province from 2013 to 2018]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:346-352. [PMID: 33730826 DOI: 10.3760/cma.j.cn112150-20200818-01132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the results of liver cancer screening for urban residents in Zhejiang Province from 2013 to 2018 and explore the influencing factors of the detection rate. Methods: From September 2013 to August 2019, six urban communities in Hangzhou (Jianggan District and Gongshu District), Ningbo (Haishu District, Yinzhou District and Jiangbei District), and Quzhou (Kecheng District) were selected as study sites. All permanent residents aged 40-74 (with local household registration and living in the local area for more than 3 years) were selected as the research subjects by using cluster sampling method. Patients with confirmed cancers and other serious medical and surgical diseases were excluded. A total of 166 293 research subjects were included. Basic demographic characteristics and risk factors of subjects were obtained through questionnaire surveys. The cancer risk assessment system was used to evaluate the liver cancer risk of subjects. Clinical screening participation and screening results for subjects at high risk of liver cancer were obtained from participating hospitals. The high-risk rate of liver cancer, clinical screening rate, detection rate of positive lesions, and detection rate of suspected liver cancer were analyzed. Poisson regression was used to analyze the influencing factors of detection rate. Results: The age of 166 293 subjects was (56.01±8.40) years, of which 41.36% (68 777) were males. A total of 23 765 high-risk subjects for liver cancer were screened (the high-risk rate was 14.29%). Among them, a total of 12 375 subjects participated in clinical screening for liver cancer, with a screening rate of 52.07% (12 375/23 765). A total of 297 cases of positive lesions were detected and the detection rate was 2.40% (297/12 375). A total of 8 cases of suspected liver cancer were detected, with a detection rate of 0.06% (8/12 375). The results of multivariate Poisson regression model analysis showed that compared with men, people who never smoked, never ate pickled food, had low oil content, and had no history of hepatobiliary disease, female, people who were smoking or had smoked, sometimes ate pickled food, ate higher oil content, and had a history of hepatobiliary disease had a higher detection rate of positive lesions. The incidence rate ratio (IRR) (95%CI) values were 1.98 (1.45-2.70), 2.23 (1.61-3.09)/2.08 (1.31-3.28), 1.82 (1.22-2.70), 1.44 (1.08-1.91), and 1.45 (1.05-2.00), respectively. Compared with those aged from 40 to 49 years old and without HBsAg test, the IRR (95%CI) of suspected liver cancer in people aged 70 to 74 years old and HBsAg positive were 16.30 (1.32-200.74) and 6.43 (1.24-33.22), respectively. Conclusion: The urban cancer early diagnosis and early treatment project in Zhejiang Province has good compliance in clinical screening of liver cancer. Abdominal ultrasound examination and serum alpha-fetoprotein detection are helpful to detect liver cancer and its precancerous lesions in the high-risk population of liver cancer.
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Affiliation(s)
- Y Q Wang
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer (IBMC). Chinese Academy of Sciences, Hangzhou 310022, China
| | - H Z Li
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer (IBMC). Chinese Academy of Sciences, Hangzhou 310022, China
| | - L Wang
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer (IBMC). Chinese Academy of Sciences, Hangzhou 310022, China
| | - C Zhu
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer (IBMC). Chinese Academy of Sciences, Hangzhou 310022, China
| | - X H Sun
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, China
| | - M Z Zhang
- Kecheng District People's Hospital of Quzhou, Quzhou 324000, China
| | - L Jin
- Zhejiang Jinhua Guangfu Hospital, Jinhua 321000, China
| | - L B Du
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer (IBMC). Chinese Academy of Sciences, Hangzhou 310022, China
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Wang L, Li HZ, Zhu C, Wang YQ, Zhou HJ, Sun XH, Zhang MZ, Jin L, Du LB. [Results and cost-effectiveness of colorectal cancer screening program among urban residents in Zhejiang province, 2013-2018]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 41:2080-2086. [PMID: 33378820 DOI: 10.3760/cma.j.cn112338-20200324-00424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the results and cost-effectiveness of colorectal cancer (CRC) screening program among Zhejiang urban residents so as to provide evidence for further optimization of CRC screening strategies. Methods: Based on the Cancer Screening Program in Urban China which was conducted in Zhejiang province from 2013-2018, data related to the rates on compliance and detection through the CRC screening program among the 40-74 year-old residents were analyzed. Chi-square tests were used to compare the differences among groups, and multivariate logistic regression models were applied to explore the potential risk factors. Cost-effectiveness ratio (CER) was calculated by using the cost per lesion detected as the indicator. Results: Among all the 166 285 participants who completed the risk assessment questionnaire, 21 975 (13.2%) were recognized as under the high risk of CRC and 4 389 (20.0%) of them received the colonoscopy. The detection rates of CRC, advanced adenoma, and non-advance adenoma were 0.3% (11 cases), 2.7% (119 cases), and 5.2% (229 cases), respectively. Results from the multivariate logistic regression analyses showed that factors as age, gender, education level, smoking, drinking alcohol, previous fecal occult blood test (FOBT), polyp history, and family history of CRC were significantly associated with the compliance rate of colonoscopy while age, smoking and polyp history were significantly associated with the detection rate of advanced neoplasms (CRC and advanced adenoma). The costs were ¥22 355.74 Yuan for every CER advanced neoplasm detection and ¥264 204.18 Yuan per CRC detection, respectively. The CER decreased along with ageing. Sensitivity analysis showed that CERs were expected to decrease when the compliance rate of colonoscopy was increasing. Conclusions: The current screening program seems effective in detecting the precancerous colorectal lesions, but the relatively low compliance rate of colonoscopy restricting both the diagnostic yields and economic benefits. It is necessary to improve the awareness and acceptance of colonoscopy among the high-risk CRC population.
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Affiliation(s)
- L Wang
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou 310022, China
| | - H Z Li
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou 310022, China
| | - C Zhu
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou 310022, China
| | - Y Q Wang
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou 310022, China
| | - H J Zhou
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou 310022, China
| | - X H Sun
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, China
| | - M Z Zhang
- Kecheng District People's Hospital of Quzhou of Zhejiang Province, Quzhou 324000, China
| | - L Jin
- Zhejiang Jinhua Guangfu Hospital, Jinhua 321000, China
| | - L B Du
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou 310022, China
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Wang H, Liu CC, Bai FZ, Zhu J, Yan XX, Cao MD, Du LB, Wei DH, Wang DB, Liao XZ, Dong D, Gao Y, Dong P, Zhu C, Ma YL, Chai J, Xiao HF, Kong YX, Zhang Q, Zheng WF, Ying RB, Zhou H, Ren JS, Li N, Chen HD, Shi JF, Dai M. [Population's acceptance and attitude toward a novel fecal immunochemical test for colorectal cancer screening: a multi-center survey in China]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:760-767. [PMID: 32842299 DOI: 10.3760/cma.j.cn112150-20191218-00941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the acceptance and attitude toward a novel fecal immunochemical test (FIT) in colorectal cancer screening among populations in China. Methods: From May 2018 to May 2019, 2 474 people aged 50-74 years were recruited from five provinces of China (Zhejiang, Anhui, Jiangsu, Hunan and Yunnan). The general demographic characteristics, acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey. Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool, reading and uploading results. Results: The subjects were (60.0±6.4) years old, and female, high school of above educated, unemployed/retired/other, married and with medical insurance status of "new rural cooperative medical care (NRCMC)" accounted for 61.7% (1 526), 29.0%(718), 34.3% (849), 92.7% (2 293) and 31.3%(775), respectively. The population's acceptance of the FIT technology was 94.8%. In the process of FIT screening, the percentage of occurred difficulties in sampling stool, reading and uploading results were 33.1% (819), 46.4% (1 147) and 62.9% (1 557), respectively. The main difficulties were the uncertainty about whether the sampling operation was standard (28.0%), the inability to accurately judge the result displayed (32.5%) and the need for help without using a smartphone (44.2%). The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of "NRCMC" were more likely to encounter difficulties in sampling, and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling. Those aged 65-74 years old, farmers or migrant workers, and those with "NRCMC" were more likely to encounter difficulties in readingresults, and those with 3 or more family members were less likely to encounter difficulties in reading result. Those with "NRCMC" were more likely to encounter difficulties in uploading results, and those with education level of high school or above, living with more than 3 family members were less likely to encounter difficulties in uploading results. Conclusion: The acceptance of the new FIT technology is relatively high among the subjects. Age, education level, occupation, number of family members living together and medical insurance status might be related to difficulties encountered in sampling stool, reading and uploading results, and it can be further strengthened in terms of the technology and characteristics of sub-populations.
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Affiliation(s)
- H Wang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - C C Liu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - F Z Bai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Zhu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X X Yan
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M D Cao
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L B Du
- Institute of Cancer and Basic Medicine, Chinese Academy of Sciences/ Department of Cancer Prevention,Cancer Hospital of the University of Chinese Academy of Sciences/ Department of Cancer Prevention,Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - D H Wei
- Office for Cancer Prevention and Control, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - D B Wang
- School of Health Services Management, Anhui Medical University, Hefei 230032, China
| | - X Z Liao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - D Dong
- Office of Cancer Prevention and Treatment, Xuzhou Cancer Hospital, Xuzhou 221000, Jiangsu Province, China
| | - Y Gao
- Department of Colorectal Surgery, Department of Tumor Hospital of Yunnan Province/Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China
| | - P Dong
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - C Zhu
- Institute of Cancer and Basic Medicine, Chinese Academy of Sciences/ Department of Cancer Prevention,Cancer Hospital of the University of Chinese Academy of Sciences/ Department of Cancer Prevention,Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y L Ma
- Office for Cancer Prevention and Control, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - J Chai
- School of Health Services Management, Anhui Medical University, Hefei 230032, China
| | - H F Xiao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - Y X Kong
- Office of Cancer Prevention and Treatment, Xuzhou Cancer Hospital, Xuzhou 221000, Jiangsu Province, China
| | - Q Zhang
- Department of Cancer Prevention, Department of Tumor Hospital of Yunnan Province/ Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China
| | - W F Zheng
- Department of Proctology, Lanxi Red Cross Hospital, Lanxi 321100, Zhejiang Province, China
| | - R B Ying
- Department of Surgical Oncology, Taizhou Cancer Hospital, Taizhou 317502, Zhejiang Province, China
| | - H Zhou
- Administrative Management Office, Yunnan Cancer Hospital/ The Third Affiliated Hospital of Kunming Medical University/ Yunnan Cancer Center, Kunming 650118, China
| | - J S Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H D Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J F Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Li HZ, Du LB, Zhu C, Wang YQ, Dong P, Chen YY. [Analysis on the age of onset of malignant tumors in cancer registration areas in Zhejiang Province from 2000 to 2015]. Zhonghua Yu Fang Yi Xue Za Zhi 2019; 53:1253-1258. [PMID: 31795582 DOI: 10.3760/cma.j.issn.0253-9624.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the age of onset of malignant tumors in cancer registration areas in Zhejiang province from 2000 to 2015. Methods: Based on the incidence data of cancer from 14 national cancer registration areas in Zhejiang province between 2000 and 2015, the incidence rate, average/standardized average age of onset, and age-specific incidence proportion were calculated, and standardized by Segi's world population. The population was divided into 7 age groups (0-29, 30-39, 40-49, 50-59, 60-69, 70-79, ≥80 years old). The average age of onset and age-specific incidence proportion were analyzed by using a linear regression. The change trend of the proportion; the average annual percent change (AAPC) of the incidence rate was calculated by using the Joinpoint log-linear regression model. The birth cohort was constructed by using the standardized incidence rate and the year of onset of cancer, and the distribution characteristics of the age groups were described. Results: From calendar year 2000 to 2015, the average age of onset of malignant tumors in Zhejiang Province decreased from 59.7 to 57.6, with an average annual percent decrease of 0.09 year (P=0.033). After the merge of age groups, the standardized incidence proportion of 30-49 and ≥60 years old group standardization increased by an average annual change of 0.38% and decreased by an average annual change of 0.39%, respectively (both P values <0.001). The results of the log-linear regression model showed that the standardized incidence rate of the 30-39 and 40-49 years old age groups increased rapidly, with the AAPC (95%CI) about 5.2% (4.4%-6.0%) and 3.4% (2.5%-4.3%), respectively. The incidence rate of female increased rapidly, especially for 30-39 and 40-49 years old age groups with the AAPC about 6.2% (5.1%-7.2%) and 4.9% (4.0%-5.9%), respectively. The results of the birth cohort analysis showed that the population with different birth years in the same age groups saw an increasing trend with the increase of the birth year. Conclusion: The age of onset of malignant tumors in the cancer registration areas in Zhejiang Province is getting younger. The incidence rate and number of people with malignant tumors in 30-49 years old age group is evident. These characteristics are more obvious in female than that in male.
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Affiliation(s)
- H Z Li
- Department of Cancer Prevention, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences/Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310004, China
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Ren YJ, Liu QM, Ge MH, Li HZ, Liu B, Zhang Y, Du LB. [Incidence and mortality of thyroid cancer in cancer registries of Zhejiang Province, 2010-2014]. Zhonghua Yu Fang Yi Xue Za Zhi 2019; 53:1062-1065. [PMID: 31607057 DOI: 10.3760/cma.j.issn.0253-9624.2019.10.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
From 2010 to 2014, a total of 17 150 new cases of thyroid cancer (TC) reported in cancer registration areas of Zhejiang province, the crude incidence rate of TC was 29.28/100 000. Using the Chinese Census in 2000 and the World Segi's population as the standard population, the age-standardized incidence rate by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 24.11/100 000 and 20.65/100 000 respectively. 256 TC death cases reported in all, the crude mortality rate was 0.44/100 000, the age-standardized mortality rate by Chinese standard population (ASMRC) and by World standard population (ASMRW) were 0.23/100 000 and 0.23/100 000 respectively. The ASIRC had a upward trend [annual percent change (APC)=28.62%, 95%CI: 21.00%-36.72%, t=13.10, P=0.001], while the ASMRC trend seemed stable (APC=0.73%, 95%CI: -7.47%-9.66%, t=0.27, P=0.803).
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Affiliation(s)
- Y J Ren
- Institute of Chronic Noncommunicable Diseases Prevention and Control, Hangzhou Center for Disease Control and Prevention, Hangzhou 310021, China
| | - Q M Liu
- Institute of Chronic Noncommunicable Diseases Prevention and Control, Hangzhou Center for Disease Control and Prevention, Hangzhou 310021, China
| | - M H Ge
- Department of Cancer Prevention, Zhejiang Province People's Hospital, Hangzhou 310014, China
| | - H Z Li
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences/Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310004, China
| | - B Liu
- Institute of Chronic Noncommunicable Diseases Prevention and Control, Hangzhou Center for Disease Control and Prevention, Hangzhou 310021, China
| | - Y Zhang
- Institute of Chronic Noncommunicable Diseases Prevention and Control, Hangzhou Center for Disease Control and Prevention, Hangzhou 310021, China
| | - L B Du
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences/Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310004, China
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Zhu J, Wang L, Huang HY, Bai FZ, Li J, Fang Y, Wang Y, Mao AY, Liao XZ, Liu GX, Bai YN, Ren JS, Sun XJ, Guo LW, Wang DB, Dong HJ, Wang JL, Xing XJ, Zhou Q, Zhu L, Du LB, Song BB, Luo SX, Liu YQ, Ren Y, Zhou JY, Sun XH, Lan L, Wu SL, Qi X, Lou PA, Ma F, Li N, Zhang K, Chen WQ, He J, Dai M, Shi JF. Short-term impact of breast cancer screening intervention on health-related quality of life in China: A multicentre cross-sectional survey. Psychooncology 2019; 28:1836-1844. [PMID: 31240803 DOI: 10.1002/pon.5160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 05/21/2019] [Accepted: 05/27/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The impact of participating in breast cancer screening programmes on health-related quality of life (HRQoL)is poorly understood. METHODS Based on a national breast cancer screening programme in China, a multicentre cross-sectional survey was conducted covering 12 provinces from September 2013 to December 2014. HRQoL of participants in the screening population and general population was evaluated by the three-levelEuroQol-five-Dimensions (EQ-5D-3L) instrument, and utility scores were generated through the Chinese value set. Univariate and multivariate regression analyses were performed to explore determinants of utility scores and anxiety/depression problems. RESULTS For screening group and general population (n = 4756, mean age = 51.6 year old), the corresponding utility scores were 0.937 (95% CI, 0.933-0.941) and 0.953 (0.949-0.957) (P < .001). Pain/discomfort and anxiety/depression were the most common reported in both groups (51.4% and 34.3%, P < .001). Utility scores at prescreening, in-screening, and postscreening interview timings were 0.928 (0.921-0.935), 0.958 (0.948-0.969), and 0.938 (0.933-0.943), respectively (P < .001); the corresponding proportions of anxiety/depression reporting were 25.9%, 16.3%, and 21.1%, respectively (P = .004). Interview timing, geographical region, and insurance status were associated with HRQoL and anxiety/depression in women at high-risk of breast cancer. CONCLUSIONS Utility scores of screening participants were significantly lower than that of general population in China, but the difference may be clinically insignificant. Further cohort studies using HRQoL measurements are needed.
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Affiliation(s)
- Juan Zhu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS&PUMC), Beijing, China
| | - Le Wang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS&PUMC), Beijing, China
| | - Hui-Yao Huang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS&PUMC), Beijing, China
| | - Fang-Zhou Bai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS&PUMC), Beijing, China
| | - Jing Li
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - Yi Fang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - Yong Wang
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - A-Yan Mao
- Public Health Information Research Office, Institute of Medical Information, CAMS&PUMC, Beijing, China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, China
| | - Guo-Xiang Liu
- Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, China
| | - Ya-Na Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, China
| | - Jian-Song Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS&PUMC), Beijing, China
| | - Xiao-Jie Sun
- Center for Health Management and Policy, Key Lab of Health Economics and Policy, Shandong University, Jinan, China
| | - Lan-Wei Guo
- Department of Institute of Tumor Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - De-Bin Wang
- School of Health Service Management, Anhui Medical University, Hefei, China
| | - Heng-Jin Dong
- Center for Health Policy Studies, Zhejiang University School of Medicine, Hangzhou, China
| | - Jia-Lin Wang
- Science and Education Department of Public Health Division, Shandong Tumor Hospital, Jinan, China
| | - Xiao-Jing Xing
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Qi Zhou
- Chongqing Office for Cancer Control and Research, Chongqing Cancer Institute, Chongqing, China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
| | - Ling-Bin Du
- Cancer Prevention and Control Office, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences/Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou, China
| | - Bing-Bing Song
- Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, China
| | - Su-Xia Luo
- Department of Institute of Tumor Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Ying Ren
- Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, China
| | - Jin-Yi Zhou
- Institute of Chronic Non-communicable Diseases Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xiao-Hua Sun
- Ningbo Clinical Cancer Prevention Guidance Center, Ningbo No. 2 Hospital, Ningbo, China
| | - Li Lan
- Institute of Chronic Disease Prevention and Control, Harbin Center for Disease Control and Prevention, Harbin, China
| | - Shou-Ling Wu
- Health Department of Kailuan Group, Kailuan General Hospital, Tangshan, China
| | - Xiao Qi
- Department of Occupational Medicine, Tangshan People's Hospital, Tangshan, China
| | - Pei-An Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Fei Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - Ni Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS&PUMC), Beijing, China
| | - Kai Zhang
- Cancer Department of Physical Examination, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - Wan-Qing Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS&PUMC), Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS&PUMC), Beijing, China
| | - Ju-Fang Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS&PUMC), Beijing, China
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Song C, Lv J, Liu Y, Chen JG, Ge Z, Zhu J, Dai J, Du LB, Yu C, Guo Y, Bian Z, Yang L, Chen Y, Chen Z, Liu J, Jiang J, Zhu L, Zhai X, Jiang Y, Ma H, Jin G, Shen H, Li L, Hu Z. Associations Between Hepatitis B Virus Infection and Risk of All Cancer Types. JAMA Netw Open 2019; 2:e195718. [PMID: 31199446 PMCID: PMC6575146 DOI: 10.1001/jamanetworkopen.2019.5718] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE Hepatitis B virus (HBV) has been identified as a major risk factor for hepatocellular carcinoma. However, the associations between HBV infection and other cancer types are not well understood. OBJECTIVE To assess the associations between chronic HBV infection and risk of all cancer types. DESIGN, SETTING, AND PARTICIPANTS This population-based study involved 3 cohorts in China. The China Kadoorie Biobank (CKB) prospective cohort study, conducted between June 2004 and July 2008, used a dipstick assay for detection of serum hepatitis B surface antigen (HBsAg) among 496 732 participants to determine the association between HBV infection and risk of all cancer types. Two cohort studies were used to validate the associations by applying more precise serum HBsAg detection assays: the Qidong cohort (37 336 participants enrolled from November 2007 to April 2011) and the Changzhou nested case-control study (17 723 participants enrolled from June 2004 to September 2005). A total of 97 samples of stomach cancer tissues, 10 samples of pancreatic cancer tissues, and 9 samples of lung cancer tissues were included to assess the presence of HBV replication and expression. Statistical analysis was performed from December 2016 to October 2018. EXPOSURES Serum HBsAg status in the population-based stage and HBV DNA status, the expression of hepatitis B X protein, and hepatitis B core antibody (anti-HBc) in the tissue-based stage. MAIN OUTCOMES AND MEASURES Incidence of all cancer types during follow-up. RESULTS In the CKB cohort, the mean (SD) age of the 496 732 participants was 51.5 (10.7) years; 59.0% of the participants were women. After 4.4 million person-years of follow-up, participants who were HBsAg seropositive (n = 15 355) had a higher risk of hepatocellular carcinoma (hazard ratio [HR], 15.77; 95% CI, 14.15-17.57), stomach cancer (HR, 1.41; 95% CI, 1.11-1.80), colorectal cancer (HR, 1.42; 95% CI, 1.12-1.81), oral cancer (HR, 1.58; 95% CI, 1.01-2.49), pancreatic cancer (HR, 1.65; 95% CI, 1.03-2.65), and lymphoma (HR, 2.10; 95% CI, 1.34-3.31) when compared with participants who were HBsAg seronegative (n = 481 377). Because of the limitation of sample size, only associations of HBV infection with hepatocellular carcinoma and stomach cancer were validated in the Qidong cohort (hepatocellular carcinoma: HR, 17.51; 95% CI, 13.86-22.11; stomach cancer: HR, 2.02; 95% CI, 1.24-3.29); the Changzhou nested case-control study validated only an association between HBV infection and stomach cancer (odds ratio, 1.76; 95% CI, 1.04-2.98). Moreover, among 22 participants with stomach cancer from the Qidong cohort who were anti-HBc seropositive, 12 samples (54.5%) of cancer tissues were HBV DNA positive, while among 25 participants with stomach cancer who were anti-HBc seronegative, no HBV DNA was detected. The same negative and positive rate was observed in the validation set from Zhejiang Tumor Hospital (19 of 35 samples [54.3%] were HBV DNA positive). Moreover, among the 8 patients with stomach cancer from the Qidong cohort who were anti-HBc seropositive, anti-HBc and hepatitis B X protein were expressed in all of their stomach cancer tissue samples. The same phenomenon was observed in the patients with pancreatic cancer but not in the patients with lung cancer, which was consistent with the population-based results of the CKB cohort. CONCLUSIONS AND RELEVANCE This study found that HBV infection was also associated with the risk of nonliver cancer, especially digestive system cancers among adults in China.
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Affiliation(s)
- Ci Song
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yao Liu
- Pathology Center and Department of Pathology, Soochow University, Suzhou, China
| | - Jian Guo Chen
- Qidong Liver Cancer Institute, The First People’s Hospital of Qidong, Qidong, China
| | - Zijun Ge
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jian Zhu
- Qidong Liver Cancer Institute, The First People’s Hospital of Qidong, Qidong, China
| | - Juncheng Dai
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ling-Bin Du
- Zhejiang Cancer Center, Zhejiang Cancer Hospital, Hangzhou, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Yang
- Chinese Academy of Medical Sciences, Beijing, China
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Yiping Chen
- Chinese Academy of Medical Sciences, Beijing, China
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Zhengming Chen
- Chinese Academy of Medical Sciences, Beijing, China
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Jibin Liu
- Department of Hepatobiliary Surgery, Nantong Tumor Hospital, Nantong, China
| | - Jie Jiang
- Jiangsu Province Center for Disease Prevention and Control, Nanjing, China
| | - Liguo Zhu
- Jiangsu Province Center for Disease Prevention and Control, Nanjing, China
| | - Xiangjun Zhai
- Jiangsu Province Center for Disease Prevention and Control, Nanjing, China
| | - Yue Jiang
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hongxia Ma
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Guangfu Jin
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hongbing Shen
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zhibin Hu
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
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Xing PY, Zhu YX, Wang L, Hui ZG, Liu SM, Ren JS, Zhang Y, Song Y, Liu CC, Huang YC, Liao XZ, Xing XJ, Wang DB, Yang L, Du LB, Liu YQ, Zhang YZ, Liu YY, Wei DH, Zhang K, Shi JF, Qiao YL, Chen WQ, Li JL, Dai M. What are the clinical symptoms and physical signs for non-small cell lung cancer before diagnosis is made? A nation-wide multicenter 10-year retrospective study in China. Cancer Med 2019; 8:4055-4069. [PMID: 31150167 PMCID: PMC6639195 DOI: 10.1002/cam4.2256] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 04/27/2019] [Accepted: 05/03/2019] [Indexed: 12/24/2022] Open
Abstract
Background Most lung cancer patients are diagnosed after the onset of symptoms. However, whether the symptoms of lung cancer were independently associated with the diagnosis of lung cancer is unknown, especially in the Chinese population. Methods We conducted a 10 years (2005‐2014) nationwide multicenter retrospective clinical epidemiology study of lung cancer patients diagnosed in China. As such, this study focused on nonsmall cell lung cancer (NSCLC). We calculated the odds ratios (ORs) for variables associated with the symptoms and physical signs using multivariate unconditional logistic regressions. Results A total of 7184 lung cancer patients were surveyed; finally, 6398 NSCLC patients with available information about their symptoms and physical signs were included in this analysis. The most common initial symptom and physical sign was chronic cough (4156, 65.0%), followed by sputum with blood (2110, 33.0%), chest pain (1146, 17.9%), shortness of breath (1090, 17.0%), neck and supraclavicular lymphadenectasis (629, 9.8%), weight loss (529, 8.3%), metastases pain (378, 5.9%), fatigue (307, 4.8%), fever (272, 4.3%), and dyspnea (270, 4.2%). Patients with squamous carcinoma and stage III disease were more likely to present with chronic cough (P < 0.0001) and sputum with blood (P < 0.0001) than patients with other pathological types and clinical stages, respectively. Metastases pain (P < 0.0001) and neck and supraclavicular lymphadenectasis (P = 0.0006) were more likely to occur in patients with nonsquamous carcinoma than in patients with other carcinomas. Additionally, patients with stage IV disease had a higher percentage of chest pain, shortness of breath, dyspnea, weight loss, and fatigue than patients with other stages of disease. In multivariable logistic analyses, compared with patients with adenocarcinoma, patients with squamous carcinoma were more likely to experience symptoms (OR = 2.885, 95% confidence interval [CI] 2.477‐3.359) but were less likely to present physical signs (OR = 0.844, 95% CI 0.721‐0.989). The odds of having both symptoms and physical signs were higher in patients with late‐stage disease than in those with early‐stage disease (P < 0.0001). Conclusions The symptoms and physical signs of lung cancer were associated with the stage and pathological diagnosis of NSCLC. Patients with squamous carcinoma were more likely to develop symptoms, but not signs, than patients with adenocarcinoma. The more advanced the stage at diagnosis, the more likely that symptoms or physical signs are to develop. Further prospective cohort studies are needed to explore these results.
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Affiliation(s)
- Pu-Yuan Xing
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi-Xiang Zhu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Affiliated Hospital of Guizhou Medical University, Guizhou Province Tumor Hospital, Guiyang, P.R. China
| | - Le Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhou-Guang Hui
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shang-Mei Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian-Song Ren
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Song
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Cheng-Cheng Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | | - Xiao-Jing Xing
- Liaoning Cancer Hospital & Institute, Shenyang, P.R. China
| | | | - Li Yang
- Guangxi Medical University, Nanning, P.R. China
| | - Ling-Bin Du
- Zhejiang Cancer Hospital, Hangzhou, P.R. China
| | - Yu-Qin Liu
- Gansu Provincial Cancer Hospital, Lanzhou, Gansu, P.R. China
| | | | - Yun-Yong Liu
- Liaoning Cancer Hospital & Institute, Shenyang, P.R. China
| | - Dong-Hua Wei
- Anhui Provincial Cancer Hospital, Hefei, P.R. China
| | - Kai Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ju-Fang Shi
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - You-Lin Qiao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wan-Qing Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun-Ling Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Dai
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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23
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Hou DH, Zhao SJ, Shi JF, Wang L, Wang DB, Huang YC, Liao XZ, Xing XJ, Du LB, Yang L, Liu YQ, Zhang YZ, Wei DH, Liu YY, Zhang K, Li N, Chen WQ, Qiao YL, He J, Dai M, Wu N. Lung cancer imaging methods in China from 2005 to 2014: A national, multicenter study. Thorac Cancer 2019; 10:708-714. [PMID: 30737899 PMCID: PMC6449240 DOI: 10.1111/1759-7714.12988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 01/10/2023] Open
Abstract
Background The study was conducted to examine changes in diagnostic and staging imaging methods for lung cancer in China over a 10‐year period and to determine the relationships between such changes and socioeconomic development. Methods This was a hospital‐based, nationwide, multicenter retrospective study of primary lung cancer cases. The data were extracted from the 10‐year primary lung cancer databases at eight tertiary hospitals from various geographic areas in China. The chi‐squared test was used to assess the differences and the Cochran–Armitage trend test was used to estimate the trends of changes. Results A total of 7184 lung cancer cases were analyzed. Over the 10‐year period, the utilization ratio of diagnostic imaging methods, such as chest computed tomography (CT) and chest magnetic resonance imaging (MRI), increased from 65.79% to 81.42% and from 0.73% to 1.96%, respectively, while the utilization ratio of chest X‐ray declined from 50.15% to 30.93%. Staging imaging methods, such as positron emission tomography‐CT, neck ultrasound, brain MRI, bone scintigraphy, and bone MRI increased from 0.73% to 9.29%, 22.95% to 47.92%, 8.77% to 40.71%, 42.40% to 62.22%, and 0.88% to 4.65%, respectively; abdominal ultrasound declined from 83.33% to 59.9%. These trends were more notable in less developed areas than in areas with substantial economic development. Conclusion Overall, chest CT was the most common radiological diagnostic method for lung cancer in China. Imaging methods for lung cancer tend to be used in a diverse, rational, and regionally balanced manner.
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Affiliation(s)
- Dong-Hui Hou
- Department of Diagnostic Radiology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shi-Jun Zhao
- Department of Diagnostic Radiology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ju-Fang Shi
- Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Le Wang
- Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - De-Bin Wang
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Yun-Chao Huang
- Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunming, China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, China
| | - Xiao-Jing Xing
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Ling-Bin Du
- Zhejiang Office for Cancer Control and Research, Zhejiang Cancer Hospital, Hangzhou, China
| | - Li Yang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Yong-Zhen Zhang
- Department of Epidemiology, Shanxi Provincial Cancer Hospital, Taiyuan, China
| | - Dong-Hua Wei
- Medical Department, Anhui Provincial Cancer Hospital, Hefei, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Kai Zhang
- Department of Cancer Prevention, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ni Li
- Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wan-Qing Chen
- Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ning Wu
- Department of Diagnostic Radiology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,PET-CT Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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24
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Shi JF, Wang L, Wu N, Li JL, Hui ZG, Liu SM, Yang BY, Gao SG, Ren JS, Huang HY, Zhu J, Liu CC, Fan JH, Zhao SJ, Xing PY, Zhang Y, Li N, Lei WD, Wang DB, Huang YC, Liao XZ, Xing XJ, Du LB, Yang L, Liu YQ, Zhang YZ, Zhang K, Qiao YL, He J, Dai M. Clinical characteristics and medical service utilization of lung cancer in China, 2005–2014: Overall design and results from a multicenter retrospective epidemiologic survey. Lung Cancer 2019; 128:91-100. [PMID: 30642458 DOI: 10.1016/j.lungcan.2018.11.031] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/14/2018] [Accepted: 11/23/2018] [Indexed: 01/05/2023]
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25
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Sun ZX, Shi JF, Lan L, Mao AY, Huang HY, Lei HK, Qiu WQ, Dong P, Zhu J, Wang DB, Liu GX, Bai YN, Sun XJ, Liao XZ, Ren JS, Guo LW, Zhou Q, Yang L, Song BB, Du LB, Zhu L, Gong JY, Liu YQ, Ren Y, Mai L, Qin MF, Zhang YZ, Zhou JY, Sun XH, Wu SL, Qi X, Lou PA, Cai B, Zhang K, He J, Dai M. [Constituent and workload of service providers engaged in cancer screening: findings and suggestions from a multi-center survey in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:295-301. [PMID: 29609242 DOI: 10.3760/cma.j.issn.0254-6450.2018.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the constituent and workload of service providers engaged in cancer screening in China and provide evidence for the assessment of the sustainability of national cancer screening project. Methods: Using either questionnaire or online approach, the survey was conducted in 16 provinces, where Cancer Screening Program in Urban China (CanSPUC) was conducted, from 2014 to 2015. The medical institutes surveyed included hospitals [71.1% were class Ⅲ(A) hospitals], centers for disease control and prevention (CDCs) and community centers where cancer screening was undertaken during 2013-2015. The questionnaire survey was conducted among the staffs responsible for the overall coordination, management and implementation of the screening project to collect the information about the allocation, workload and compensation of the service providers from different specialties. Results: A total of 4 626 staffs were surveyed in this study, their average age was (37.7±9.5) years, and males accounted for 31.0%. Human resources allocated differed with province. The number of senior staff ranged from 6 (Chongqing) to 43 (Beijing) among the 8 comparable provinces. Among the staffs surveyed, 2 192 were from hospitals, 431 were from CDCs and 1 990 were from community centers, and the staffs who complained heavy workload accounted for 19.9%, 24.6% and 34.1% respectively (P<0.001). Among 227 staffs for overall coordination, 376 management staffs and 3 908 staffs for implementation, those who complained heavy workload accounted for 23.6%, 22.3% and 28.2% respectively (P<0.001). A total of 3 244 staffs (73.8%) got compensations for heavy workload. The compensation types were manly labor fee linked with workload (67.5%) and labor fee regardless workload (26.6%). Conclusion: The province specific differences in human resources allocation indicated the differences in screening project's organizing pattern and capability. It is suggested to conduct routine cancer screening (using specialized staffs), reduce the workload of the first line and community staffs and increase the compensation for the service providers for the sustainability of cancer screening project in China.
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Affiliation(s)
- Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - J F Shi
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - H Y Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H K Lei
- Chongqing Cancer Institute, Chongqing 400030, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J Zhu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - D B Wang
- Anhui Medical University, Hefei 230032, China
| | - G X Liu
- Harbin Medical University, Harbin 150056, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- Center for Health Management and Policy Research, Shandong University, Jinan 250012, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - J S Ren
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L W Guo
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - L Yang
- Guangxi Medical University, Nanning 530021, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - J Y Gong
- Shandong Tumor Hospital, Jinan 250117, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Ren
- Tieling Central Hospital, Tieling 112000, China
| | - L Mai
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - M F Qin
- Yunnan Cancer Hospital, Kunming 650018, China
| | - Y Z Zhang
- Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - K Zhang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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26
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Mao AY, Shi JF, Qiu WQ, Dong P, Sun ZX, Huang HY, Sun XJ, Liu GX, Wang DB, Bai YN, Liao XZ, Ren JS, Guo LW, Lan L, Zhou Q, Zhou JY, Yang L, Wang JL, Qin MF, Zhang YZ, Song BB, Xing XJ, Zhu L, Mai L, Du LB, Liu YQ, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, He J, Dai M. [Willingness of potential service suppliers to provide cancer screening in urban China]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:150-156. [PMID: 29495197 DOI: 10.3760/cma.j.issn.0254-6450.2018.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Based on the investment for potential suppliers of cancer screening services, we assessed the reasons that affecting their participation motivation related to the long-term sustainability of cancer screening in China. Methods: Hospitals that had never been involved in any national level cancer screening project were selected by using the convenient sampling method within the 16 project cities of Cancer Screening Program in Urban China (CanSPUC) with 1 or 2 hospitals for each city. All the managers from the institutional/department level and professional staff working and providing screening services in these hospitals, were interviewed by paper-based questionnaire. SAS 9.4 was used for logical verification and data analysis. Results: A total of 31 hospitals (18 hospitals at the third level and, 13 hospitals at the second level) and 2 201 staff (508 hospital and clinic unit managers, 1 693 professional staff) completed the interview. All the hospitals guaranteed their potential capacity in service providing. 92.5% hospital managers showed strong willingness in providing cancer screening services, while 68.3% of them declared that the project fund-raising function was the responsibility of the government. For professional staff, their prospect gains from providing screening service would include development on professional skills (72.4%) and material rewards (46.8%). Their main worries would include extra work for CanSPUC might interfere their routine work (42.1%) plus inadequate compensation (41.8%). Medians of the prospect compensation for extra work ran between 20 to 90 Chinese Yuan per screening item respectively. For all the screening items, workers from the third-level hospitals expected their compensation to be twice as much of those working at the second level hospitals. Conclusion: Professional capacity building and feasible material incentive seemed to be the two key factors that influenced the sustainability and development of the programs.
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Affiliation(s)
- A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J F Shi
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - H Y Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X J Sun
- School of Health Care Management, Shandong University, Jinan 250012, China
| | - G X Liu
- Harbin Medical University, Harbin 150081, China
| | - D B Wang
- Anhui Medical University, Hefei 230032, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - J S Ren
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L W Guo
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - L Yang
- Guangxi Medical University, Nanning 530021, China
| | - J L Wang
- Shandong Tumor Hospital, Jinan 250117, China
| | - M F Qin
- Yunnan Cancer Hospital, Kunming 650118, China
| | - Y Z Zhang
- Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - X J Xing
- Liaoning Cancer Hospital and Institute, Shenyang 110042, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L Mai
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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27
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Sun XJ, Shi JF, Guo LW, Huang HY, Yao NL, Gong JY, Sun YW, Liu GX, Mao AY, Liao XZ, Bai YN, Ren JS, Zhu XY, Zhou JY, Mai L, Song BB, Liu YQ, Zhu L, Du LB, Zhou Q, Xing XJ, Lou PA, Sun XH, Qi X, Wang Y, Cao R, Ren Y, Lan L, Zhang K, He J, Wang JL, Dai M. Medical expenses of urban Chinese patients with stomach cancer during 2002-2011: a hospital-based multicenter retrospective study. BMC Cancer 2018; 18:435. [PMID: 29665788 PMCID: PMC5905135 DOI: 10.1186/s12885-018-4357-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 04/10/2018] [Indexed: 12/29/2022] Open
Abstract
Background In China, stomach cancer is the third most common cancer and the third leading cause of cancer death. Few studies have examined Chinese stomach cancer patients’ medical expenses and their associated trends. The Cancer Screening Program in Urban China (CanSPUC) is a Major Public Health Project funded by the central government. Through this project, we have extracted patients’ medical expenses from hospital billing data to examine the costs of the first course treatments (which refers to 2 months before and 10 months after the date of cancer diagnosis) in Chinese patients with stomach cancer and the associated trends. Methods The expense data of 14,692 urban Chinese patients with stomach cancer were collected from 40 hospitals in 13 provinces. We estimated the inflation-adjusted medical expenses per patient during 2002–2011. We described the time trends of medical expenses at the country-level, and those trends by subgroup, and analyzed the compositions of medical expenses. We constructed the Generalized Linear Mixed (GLM) regression model with Poisson distribution to examine the factors that were associated with medical expenses per patient. Results The average medical expenses of the first course treatments were about 43,249 CNY (6851 USD) in 2011, more than twice of that in 2002. The expenses increased by an average annual rate of 7.4%. Longer stay during hospitalization and an increased number of episodes of care are the two main contributors to the expense increase. The upward trend of medical expenses was observed in almost all patient subgroups. Drug expenses accounted for over half of the medical expenses. Conclusions The average medical expenses of the first course (2 months before and 10 months after the date of cancer diagnosis) treatments per stomach cancer patient in urban China in 2011 were doubled during the previous 10 years, and about twice as high as the per capita disposable income of urban households in the same year. Such high expenses indicate that it makes economic sense to invest in cancer prevention and control in China. Electronic supplementary material The online version of this article (10.1186/s12885-018-4357-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiao-Jie Sun
- School of Health Care Management (key Lab of Health Economics and Policy, National Health Commission), Shandong University, Jinan, China
| | - Ju-Fang Shi
- Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Lan-Wei Guo
- Department of Cancer Epidemiology, Henan Office for Cancer Control and Research, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Hui-Yao Huang
- Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Neng-Liang Yao
- School of Health Care Management (key Lab of Health Economics and Policy, National Health Commission), Shandong University, Jinan, China.,Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22908, USA
| | - Ji-Yong Gong
- Shandong Academy of Medical Sciences, Shandong Provincial Cancer Hospital Affiliated to Shandong University, Jinan, 250117, China
| | - Ya-Wen Sun
- Shandong Academy of Medical Sciences, Shandong Provincial Cancer Hospital Affiliated to Shandong University, Jinan, 250117, China
| | - Guo-Xiang Liu
- Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, China
| | - A-Yan Mao
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Provincial Cancer Hospital, Changsha, China
| | - Ya-Na Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, China
| | - Jian-Song Ren
- Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xin-Yu Zhu
- Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.,Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, China
| | - Jin-Yi Zhou
- Institute of Chronic Non-communicable Diseases Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ling Mai
- Department of Institute of Tumor Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Bing-Bing Song
- Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
| | - Ling-Bin Du
- Zhejiang Office for Cancer Control and Research, Zhejiang Cancer Hospital, Hangzhou, China
| | - Qi Zhou
- Chongqing Office for Cancer Control and Research, Chongqing Cancer Hospital, Chongqing, China
| | - Xiao-Jing Xing
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Pei-An Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Xiao-Hua Sun
- Ningbo Clinical Cancer Prevention Guidance Center, Ningbo NO.2 Hospital, Ningbo, China
| | - Xiao Qi
- Department of Occupational Medicine, Tangshan People's Hospital, Tangshan, China
| | - Yuanzheng Wang
- Department of Economic Operation, Kailuan General Hospital, Tangshan, China
| | - Rong Cao
- Department of Health Policy and Economic Research, Guangdong Provincial Institute of Public Health, Guangzhou, China
| | - Ying Ren
- Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, China
| | - Li Lan
- Institute of Chronic disease prevention and control, Harbin Center for Disease Control and Prevention, Harbin, China
| | - Kai Zhang
- Department of Cancer Prevention, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jia-Lin Wang
- Shandong Academy of Medical Sciences, Shandong Provincial Cancer Hospital Affiliated to Shandong University, Jinan, 250117, China.
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
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Lei HK, Dong P, Zhou Q, Qiu WQ, Sun ZX, Huang HY, Ren JS, Liu GX, Bai YN, Wang DB, Sun XJ, Liao XZ, Guo LW, Lan L, Liu YQ, Gong JY, Yang L, Xing XJ, Song BB, Mai L, Zhu L, Du LB, Zhang YZ, Zhou JY, Qin MF, Wu SL, Qi X, Sun XH, Lou PA, Cai B, Zhang K, He J, Dai M, Mao AY, Shi JF. [Potential demand on cancer screening service in urban populations in China: a cross-sectional survey]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:289-294. [PMID: 29609241 DOI: 10.3760/cma.j.issn.0254-6450.2018.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the acceptance and personal demand for cancer screening service among the urban residents who had never been involved in any national level cancer screening programs in China and identify the key factors influencing the sustainability of cancer screening. Methods: A questionnaire survey was conducted among the local people aged 40-69 years selected through convenience sampling in 16 provinces of China to collect the general information about their demands for the screening service and others. Results: A total of 16 394 qualified questionnaires were completed. The average age of the people surveyed was (53.8±8.0) years, and men accounted for 44.6%. Without concerning the cost, 4 831 people (29.5%) had no demands for cancer screening services, the reasons are as follow: they would like to go to see doctors only when they were ill (61.8%); they had already received similar medical examinations (36.8%) and they would like to receive cancer screening directly without pre-health risk assessment (33.0%). Among the people surveyed, 10 795 (65.8%) had demands for cancer screening services, but they had choice on the screening settings, 43.7% wanted to receive the service in a general hospitals, while 36.5% would like to go to cancer-specialized hospitals. As for the level of medical institutes providing cancer screening service, 61.4% of the people surveyed would choose a higher level one, while 36.4% would choose an ordinary one. On screening procedures, 61.5% of the people surveyed would accept the mode of "clinical examination after questionnaire-assessment" . Conclusion: Most people surveyed had demands for cancer screening services and they would like to receive the screening services in higher level medical institutes. It is suggested to spread cancer screening know ledge, and strengthen the capability building of screening in grass root medical institutes to attract more people to receive cancer screening.
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Affiliation(s)
- H K Lei
- Chongqing Cancer Institute, Chongqing 400030, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - H Y Huang
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J S Ren
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - G X Liu
- Harbin Medical University, Harbin 150081, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - D B Wang
- Anhui Medical University, Hefei 230032, China
| | - X J Sun
- Center for Health Management and Policy of Shandong University, Jinan 250012, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - L W Guo
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - J Y Gong
- Shandong Tumor Hospital, Jinan 250117, China
| | - L Yang
- Guangxi Medical University 530021, China
| | - X J Xing
- Liaoning Cancer Hospital and Institute, Shenyang 110042, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - L Mai
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y Z Zhang
- Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - M F Qin
- Yunnan Cancer Hospital, Kunming 650118, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - K Zhang
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J F Shi
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Zhu J, Huang HY, Mao AY, Sun ZX, Qiu WQ, Lei HK, Dong P, Huang JW, Bai YN, Sun XJ, Liu GX, Wang DB, Liao XZ, Ren JS, Guo LW, Lan L, Zhou Q, Song BB, Liu YQ, Du LB, Zhu L, Cao R, Wang JL, Mai L, Ren Y, Zhou JY, Sun XH, Wu SL, Qi X, Lou PA, Cai B, Li N, Zhang K, He J, Dai M, Shi JF. [Preference on screening frequency and willingness-to-pay for multiple-cancer packaging screening programs in urban populations in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:157-164. [PMID: 29495198 DOI: 10.3760/cma.j.issn.0254-6450.2018.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: From an actual cancer screening service demanders' perspective, we tried to understand the preference on screening frequency and willingness-to-pay for the packaging screening program on common cancers and to evaluate its long-term sustainability in urban populations in China. Methods: From 2012 to 2014, a multi-center cross-sectional survey was conducted among the actual screening participants from 13 provinces covered by the Cancer Screening Program in Urban China (CanSPUC). By face-to-face interview, information regarding to preference to screening frequency, willingness-to-pay for packaging screening program, maximum amount on payment and related reasons for unwillingness were investigated. Results: A total of 31 029 participants were included in this survey, with an average age as (55.2±7.5) years and median annual income per family as 25 000 Chinese Yuan. People's preference to screening frequency varied under different assumptions ( " totally free" and "self-paid" ). When the packaging screening was assumed totally free, 93.9% of residents would prefer to take the screening program every 1 to 3 years. However, the corresponding proportion dropped to 67.3% when assuming a self-paid pattern. 76.7% of the participants had the willingness-to-pay for the packaging screening, but only 11.2% of them would like to pay more than 500 Chinese Yuan (the expenditure of the particular packaging screening were about 1 500 Chinese Yuan). The remaining 23.3% of residents showed no willingness-to-pay, and the main reasons were unaffordable expenditure (71.7%) and feeling'no need'(40.4%). Conclusions: People who participated in the CanSPUC program generally tended to choose high-frequency packaging screening program, indicating the high potential acceptance for scale-up packaging screening, while it needs cautious assessments and rational guidance to the public. Although about seven in ten of the residents were willing to pay, the payment amount was limited, revealing the necessity of strengthening individual's awareness of his or her key role in health self-management, and a reasonable payment proportion should be considered when establishing co-compensation mechanism.
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Affiliation(s)
- J Zhu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H Y Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - H K Lei
- Chongqing Cancer Institute, Chongqing 400030, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J W Huang
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- Center for Health Management and Policy of Shandong University, Jinan 250012, China
| | - G X Liu
- Harbin Medical University, Harbin 150081, China
| | - D B Wang
- School of Medical Administration, Anhui Medical University, Hefei 230032, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - J S Ren
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L W Guo
- Henan Cancer Hospital, Zhengzhou 450008, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - R Cao
- Guangdong Provincial Institute of Public Health, Guangzhou 511430, China
| | - J L Wang
- Shandong Tumor Hospital, Jinan 250117, China
| | - L Mai
- Henan Cancer Hospital, Zhengzhou 450008, China
| | - Y Ren
- Tieling Central Hospital, Tieling 112000, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - N Li
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - K Zhang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J F Shi
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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30
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Shi JF, Mao AY, Sun ZX, Lei HK, Qiu WQ, Huang HY, Dong P, Huang JW, Zhu J, Li J, Liu GX, Wang DB, Bai YN, Sun XJ, Liao XZ, Ren JS, Guo LW, Lan L, Zhou Q, Yang L, Song BB, Du LB, Zhu L, Wang JL, Liu YQ, Ren Y, Mai L, Qin MF, Zhang YZ, Zhou JY, Sun XH, Wu SL, Qi X, Lou PA, Cai B, Li N, Zhang K, He J, Dai M. [Willingness and preferences of actual service suppliers regarding cancer screening programs: a multi-center survey in urban China]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:142-149. [PMID: 29495196 DOI: 10.3760/cma.j.issn.0254-6450.2018.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: From the perspective of actual service suppliers regarding cancer screening, this study aimed to assess the long-term sustainability of cancer screening programs in China. Methods: Based on a Cancer Screening Program in Urban China (CanSPUC), our survey focused on all the hospitals, centers for disease control and prevention (CDC) and community service centers across 16 provinces in China which participated in the programs between 2013 and 2015. All the managers (institutional/department level) and professional staff involved in the program were interviewed using either paper-based questionnaire or online approach. Results: A total of 4 626 participants completed the interview. It showed that the main gains from providing screening service emphasized promotion in social value (63.6%), local reputation (35.9%), and professional skills (30.6%), whereas difficulties encountered included inadequate compensation (30.9%) and discordance among information systems (28.3%). When the service remuneration amounts to about 50 Chinese Yuan per screening item, those professional staff self-reported that they would like to work overtime. More than half (63.7%) of the staff expressed willingness to provide routine screening service, the main expectations were to promote their reputation to the local residents (48.7%) and to promote professional skills (43.1%). Those who were not willing to provide screening services were worried about the potential heavy workload (59.8%) or being interfered with their routine work (49.8%). Further detailed results regarding the different organization types and program roles were presented in the following detailed report. Conclusions: Findings of gains and difficulties showed that if cancer screening is expected to become a long-term running, incentive mechanism from the program, external promotion and advocacy as well as capacity building should be strengthened; furthermore, rewards to staff's screening services should be raised according to the local situations. Results regarding the "willingness to provide service" showed that management of the program should also be strengthened, including information system building and inter-agency and inter-department coordination at the government levels.
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Affiliation(s)
- J F Shi
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - H K Lei
- Chongqing Cancer Institute, Chongqing 400030, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - H Y Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J W Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Zhu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Li
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - G X Liu
- Harbin Medical University, Harbin 150081, China
| | - D B Wang
- School of Medical Administration, Anhui Medical University, Hefei 230032, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- Center for Health Management and Policy of Shandong University, Jinan 250012, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - J S Ren
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L W Guo
- Henan Cancer Hospital, Zhengzhou 450008, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - L Yang
- Guangxi Medical University, Nanning 530021, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - J L Wang
- Shandong Tumor Hospital, Jinan 250117, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Ren
- Tieling Central Hospital, Tieling 112000, China
| | - L Mai
- Henan Cancer Hospital, Zhengzhou 450008, China
| | - M F Qin
- Yunnan Cancer Hospital, Kunming 650118, China
| | - Y Z Zhang
- Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - N Li
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - K Zhang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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31
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Huang HY, Shi JF, Guo LW, Bai YN, Liao XZ, Liu GX, Mao AY, Ren JS, Sun XJ, Zhu XY, Wang L, Song BB, Du LB, Zhu L, Gong JY, Zhou Q, Liu YQ, Cao R, Mai L, Lan L, Sun XH, Ren Y, Zhou JY, Wang YZ, Qi X, Lou PA, Shi D, Li N, Zhang K, He J, Dai M. Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: a hospital-based, multicenter, cross-sectional survey. Chin J Cancer 2017; 36:41. [PMID: 28454595 PMCID: PMC5410077 DOI: 10.1186/s40880-017-0209-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 12/08/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND The increasing prevalence of colorectal cancer (CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China. METHODS We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan (CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup (hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure. RESULTS A total of 2356 patients with a mean age of 57.4 years were included, 57.1% of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY. The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage I, II, III, and IV disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3% of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups (P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spend more, whereas those with a lower household income and those who underwent surgery spent less (all P < 0.05). CONCLUSIONS For patients in China, direct expenditure for the diagnosis and treatment of CRC seemed catastrophic, and non-medical expenditure was non-ignorable. The financial burden varied among subgroups, especially among patients with different clinical stages of disease, which suggests that, in China, CRC screening might be cost-effective.
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Affiliation(s)
- Hui-Yao Huang
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Ju-Fang Shi
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Lan-Wei Guo
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
- Department of Cancer Epidemiology, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008 P. R. China
| | - Ya-Na Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, Gansu 730000 P. R. China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Provincial Cancer Hospital, Changsha, Hunan 410006 P. R. China
| | - Guo-Xiang Liu
- Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, Heilongjiang 150081 P. R. China
| | - A-Yan Mao
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, 100020 P. R. China
| | - Jian-Song Ren
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Xiao-Jie Sun
- Center for Health Management and Policy, Key Lab of Health Economics and Policy, Shandong University, Jinan, Shandong 250012 P. R. China
| | - Xin-Yu Zhu
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, Gansu 730000 P. R. China
| | - Le Wang
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Bing-Bing Song
- Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, Heilongjiang 150081 P. R. China
| | - Ling-Bin Du
- Zhejiang Office for Cancer Control and Research, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022 P. R. China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Ürümqi, Xinjiang 830011 P. R. China
| | - Ji-Yong Gong
- Science and Education Department of Public Health Division, Shandong Tumor Hospital, Jinan, Shandong 250117 P. R. China
| | - Qi Zhou
- Chongqing Office for Cancer Control and Research, Chongqing Cancer Hospital, Chongqing, 400030 P. R. China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, Gansu 730050 P. R. China
| | - Rong Cao
- Department of Health Policy and Economic Research, Guangdong Provincial Institute of Public Health, Guangzhou, Guangdong 511430 P. R. China
| | - Ling Mai
- Department of Institute of Tumor Research, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008 P. R. China
| | - Li Lan
- Institute of Chronic Disease Prevention and Control, Harbin Center for Disease Control and Prevention, Harbin, Heilongjiang 150081 P. R. China
| | - Xiao-Hua Sun
- Ningbo Clinical Cancer Prevention Guidance Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang 315010 P. R. China
| | - Ying Ren
- Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, Liaoning 112000 P. R. China
| | - Jin-Yi Zhou
- Institute of Chronic Non-communicable Diseases Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009 P. R. China
| | - Yuan-Zheng Wang
- Department of Economic Operation, Kailuan General Hospital, Tangshan, Hebei 063000 P. R. China
| | - Xiao Qi
- Department of Occupational Medicine, Tangshan People’s Hospital, Tangshan, Hebei 063000 P. R. China
| | - Pei-An Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, Jiangsu 221006 P. R. China
| | - Dian Shi
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, Gansu 730000 P. R. China
| | - Ni Li
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Kai Zhang
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Jie He
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Min Dai
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
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Zhu C, Wang L, Du LB, Li J, Zhang J, Dai M, Shi JF. [The accuracy of mammography screening for breast cancer: a Meta-analysis]. Zhonghua Liu Xing Bing Xue Za Zhi 2016; 37:1296-1305. [PMID: 27655581 DOI: 10.3760/cma.j.issn.0254-6450.2016.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To estimate the accuracy of mammography for population-based breast cancer screening. Methods: Studies of screening mammography performance were systematically reviewed in the Medline, Embase, Cochrane and China National Knowledge Infrastructure (CNKI) literature databases. The retrieval was performed by using related key words, including disease name, screening and intervention indicators and study type. A total of 1 167 records were retrieved by June 4, 2015 and those studies met the inclusion criteria were included for the current analysis. The numbers of true-positive, false-positive, false-negative and true-negative were originally extracted and calculated from each individual study. A QUADAS checklist was used to assess the quality of the studies. A curve of summary receiver operating characteristic (SROC) was applied as a comprehensive assessment of diagnosed accuracy. The pooled effect size of both sensitivity and specificity was quantitatively synthesized in both total population and subgroup with dense breast using the bivariate mixed-effects models. We conducted a sensitivity analysis in the studies with sample size over 100 000. Heterogeneity between studies was measured by the Q test and I2 statistic, and publication bias was evaluated by a funnel plot and the linear regression test. Results: A total of 48 publications with 8 551 873 individuals were identified for the final qualitative synthesis, most of them were from Europe area and American (38 studies), 8 were from Asia area, and 2 were from Oceania area. The studies were conducted during period of 1975-2013, and the age of study women ranged mostly from 40 to 75 years. The area under the SROC curve (AUC) was 0.95 (95%CI: 0.93-0.97). It was estimated that the pooled sensitivity and specificity were 0.81 (95%CI: 0.77-0.84) and 0.96 (95%CI: 0.94-0.96), respectively. The results were indicated stable and robust in sensitivity analysis. In the subgroup with dense breast, the sensitivity and specificity were 0.74 (95% CI: 0.61-0.83) and 0.93 (95% CI: 0.89-0.96), respectively. Funnel plot and test results showed there was no significant publication bias among the included studies. Conclusion: The accuracy of mammography is high for population-based breast cancer screening in women, although the sensitivity is lower in women with dense breast.
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Affiliation(s)
- C Zhu
- Zhejiang Provincial Office for Cancer Prevention, Zhejiang Cancer Center, Zhejiang Cancer Hospital, Hangzhou 310022, China; Program Office for Cancer Screening in Urban China
| | - L Wang
- Program Office for Cancer Screening in Urban China
| | - L B Du
- Zhejiang Provincial Office for Cancer Prevention, Zhejiang Cancer Center, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - J Li
- Program Office for Cancer Screening in Urban China; Diagnostic Imaging Department, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Zhang
- Radiology Department, Zhejiang Cancer Center, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - M Dai
- Program Office for Cancer Screening in Urban China
| | - J F Shi
- Program Office for Cancer Screening in Urban China
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Du LB, Li HZ, Wang XH, Zhu C, Liu QM, Li QL, Li XQ, Shen YZ, Zhang XP, Ying JW, Yu CD, Mao WM. Analysis of cancer incidence in Zhejiang cancer registry in China during 2000 to 2009. Asian Pac J Cancer Prev 2015; 15:5839-43. [PMID: 25081711 DOI: 10.7314/apjcp.2014.15.14.5839] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The Zhejiang Provincial Cancer Prevention and Control Office collected cancer registration data during 2000 to 2009 from 6 cancer registries in Zhejiang province of China in order to analyze the cancer incidence. METHODS Descriptive analysis included cancer incidence stratified by sex, age and cancer site group. The proportions and cumulative rates of 10 common cancers in different groups were also calculated. Chinese population census in 1982 and Segi's population were used for calculating age-standardized incidence rates. The log-linear model was used for fitting to calculate the incidence trends. RESULTS The 6 cancer registries in Zhejiang province in China covered a total of 60,087,888 person-years during 2000 to 2009 (males 30,445,904, females 29,641,984). The total number of new cancer cases were 163,104 (males 92,982, females 70,122). The morphology verified cases accounted for 69.7%, and the new cases verified only by information from death certification accounted for 1.23%. The crude incidence rate in Zhejiang cancer registration areas was 271.5/105 during 2000 to 2009 (male 305.41/105, female 236.58/105), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 147.1/105 and 188.2/105, the cumulative incidence rate (aged from 0 to 74) being 21.7%. The crude incidence rate was 209.6/105 in 2000, and it increased to 320.20/105 in 2009 (52.8%), with an annual percent change (APC) of 4.51% (95% confidence interval, 3.25%-5.79%). Age-specific incidence rate of 80-84 age group was achieved at the highest point of the incidence curve. Overall with different age groups, the cancer incidences differed, the incidence of liver cancer being highest in 15-44 age group in males; the incidence of breast cancer was the highest in 15-64 age group in females; the incidences of lung cancer were the highest in both males and females over the age of 65 years. CONCLUSIONS Lung cancer, digestive system malignancies and breast cancer are the most common cancers in Zhejiang province in China requiring an especial focus. The incidences of thyroid cancer, prostate cancer, cervical cancer and lymphoma have increased rapidly. Prevention and control measures should be implemented for these cancers.
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Affiliation(s)
- Ling-Bin Du
- Zhejiang Provincial Cancer Prevention and Control Office, Zhejiang Provincial Cancer Center, Zhejiang Cancer Hospital, Hangzhou, China E-mail :
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