Lung cancer (LC) has been the most common cancer worldwide for several decades. This study comprehensively examines recent geographic patterns and temporal trends in LC incidence from 1978 to 2012 in ...43 countries and evaluates the effects of birth cohort and period on temporal trends.
Data were retrieved from the Cancer Incidence in Five Continents database. Joinpoint regression and age-period-cohort models were applied.
The age-standardized rate was highest in Turkey (69.3 per 100,000 person-years) for men and in Denmark (36.7) for women in the period 2008 to 2012. Sex disparities were noted in most countries. From 1978 to 2012, a total of 19 countries had significantly declining trends among men, whereas 26 countries had significantly increasing trends among women (all p < 0.05). Quasi-reversed V-shaped and U-shaped incidence rate ratio trends indicating birth cohort effects were detected in 26 countries for men, with the highest risks mainly occurring in the 1930 to 1950 birth cohorts. However, the risks among recent generations have moderately increased in the People’s Republic of China and Japan for men and sharply increased in Lithuania, Belarus, and Republic of Korea for women. Incidence rate ratio increases were steep among earlier birth cohorts and gradual among the post-1930s cohorts in 15 countries for women. Period effects were more evident than birth cohort effects in five countries for both sexes.
Disparities in LC incidence and carcinogenic risk persist worldwide. Our findings identified high-risk target populations for primary prevention to reduce the LC incidence and highlighted the urgent need for etiologic studies to identify the reasons for pronounced cohort-specific risk increases in certain countries.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Ovarian cancer (OC) is the seventh most common malignancy worldwide and the most lethal gynaecological malignancy. We aimed to explore global geographical patterns and temporal trends from 1973 to ...2015 for 41 countries in OC incidence and especially to analyse the birth cohort effect to gain further insight into the underlying causal factors of OC and identify countries with increasing risk of OC.
OC data were drawn from the Cancer Incidence in Five Continents databases and online databases published by governments. The joinpoint regression model was applied to detect changes in OC trends. The age-period-cohort model was applied to explore age and birth cohort effects.
The age-standardized rate of OC incidence ranged from 3.0 to 11.4 per 100,000 women worldwide in 2012. The highest age-standardized rate was observed in Central and Eastern Europe, with 11.4 per 100,000 women in 2012. For the most recent 10-year period, the increasing trends were mainly observed in Central and South America, Asia and Central and Eastern Europe. The largest significant increase was observed in Brazil, with an average annual percentage change of 4.4%. For recent birth cohorts, cohort-specific increases in risk were pronounced in Estonia, Finland, Iceland, Lithuania, the United Kingdom, Germany, the Netherlands, Italy, Malta, Slovenia, Bulgaria, Russia, Australia, New Zealand, Brazil, Costa Rica, Ecuador, India, Japan, the Philippines and Thailand.
Disparities in the incidence and risk of OC persist worldwide. The increased risk of birth cohort in OC incidence was observed for most countries in Asia, Central and Eastern Europe, and Central and South America. The reason for the increasing OC risk for recent birth cohorts in these countries should be investigated with further epidemiology studies.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
With a large population of internal migrants from all over the world, China has the largest number of internal floating migrants, and most of them (up to 169 million in 2016) are rural-to-urban ...migrants. Those migrants have difficulty accessing essential health care services because of Hukou, leading to disparities in health needs and utilization between rural-to-urban migrants and residents. To compare the needs and utilization of health services between urban residents and rural-to-urban migrants in China from 2012 to 2016.
We used longitudinal data from the Chinese Labor Dynamic Survey (CLDS) with three waves in 2012, 2014 and 2016. Descriptive analysis was employed to show self-reported illnesses and health services utilization among locals and migrants in the most recent 2 weeks in China. Chi-square tests and log binomial regression models were constructed to explore factors influencing health care needs and utilization.
A total of 19.97% of respondents were rural-to-urban migrants, with an upward trend from 2012 to 2016. Rural-to-urban migrants (11.99%) had higher needs for health services than urban residents (10.47%) in general, while urban residents and migrants had no differences in needs in 2012. Besides, there was no difference in the utilization of health services between residents and migrants in 2012, 2014 or 2016. In addition, increased age, male sex, poor medical insurance coverage and dissatisfaction with income were found to have negative effects on health care needs.
This study has shown that the rural-to-urban migrants had higher health care needs but the same health care utilization compared with urban residents in China. Health policies focusing on equitable health outcomes should pay more attention to rural-to-urban migrants in China's health care system reform.
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CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Peer education has become a strategy for health promotion among high-risk groups for HIV infection worldwide. However, the extent to which peer education could have an impact on HIV prevention or the ...long-term effect of this impact is still unknown. This study thus quantifies the impact of peer education over time among high-risk HIV groups globally.
Following the PRISMA guidelines, a systematic review and meta-analysis was used to assess the effects and duration of peer education. A thorough literature search of PubMed, Web of Science, Embase and Cochrane Library was performed, and studies about peer education on high-risk HIV groups were reviewed. Pooled effects were calculated and the sources of heterogeneity were explored using meta-regression and subgroup analysis.
A total of 60 articles with 96,484 subjects were identified, and peer education was associated with 36% decreased rates of HIV infection among overall high risk groups (OR: 0.64; 95%CI: 0.47-0.87). Peer education can promote HIV testing (OR = 3.19; 95%CI:2.13,4.79) and condom use (OR = 2.66, 95% CI: 2.11-3.36) while reduce equipment sharing (OR = 0.50; 95%CI:0.33,0.75) and unprotected sex (OR = 0.82; 95%CI: 0.72-0.94). Time trend analysis revealed that peer education had a consistent effect on behavior change for over 24 months and the different follow-up times were a source of heterogeneity.
Our study shows that peer education is an effective tool with long-term impact for behavior change among high-risk HIV groups worldwide. Low and middle-income countries are encouraged to conduct large-scale peer education.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Hand, foot, and mouth disease (HFMD) has posed a great threat to the health of children and become a public health priority in China. This study aims to investigate the epidemiological ...characteristics, spatial-temporal patterns, and risk factors of HFMD in Guangdong Province, China, and to provide scientific information for public health responses and interventions.
HFMD surveillance data from May 2008 to December 2011were provided by the Chinese Center for Disease Control and Prevention. We firstly conducted a descriptive analysis to evaluate the epidemic characteristics of HFMD. Then, Kulldorff scan statistic based on a discrete Poisson model was used to detect spatial-temporal clusters. Finally, a spatial paneled model was applied to identify the risk factors.
A total of 641,318 HFMD cases were reported in Guangdong Province during the study period (total population incidence: 17.51 per 10,000). Male incidence was higher than female incidence for all age groups, and approximately 90% of the cases were children Formula: see text years old. Spatial-temporal cluster analysis detected four most likely clusters and several secondary clusters (P<0.001) with the maximum cluster size 50% and 20% respectively during 2008-2011. Monthly average temperature, relative humidity, the proportion of population Formula: see text years, male-to-female ratio, and total sunshine were demonstrated to be the risk factors for HFMD.
Children Formula: see text years old, especially boys, were more susceptible to HFMD and we should take care of their vulnerability. Provincial capital city Guangzhou and the Pearl River Delta regions had always been the spatial-temporal clusters and future public health planning and resource allocation should be focused on these areas. Furthermore, our findings showed a strong association between HFMD and meteorological factors, which may assist in predicting HFMD incidence.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Hand, foot, and mouth disease (HFMD) has caused a substantial burden of disease in China, especially in Guangdong Province. Based on notifiable cases, we use the time series ...Susceptible-Infected-Recovered model to estimate the basic reproduction rate (R0) and the herd immunity threshold, understanding the transmission and persistence of HFMD more completely for efficient intervention in this province. The standardized difference between the reported and fitted time series of HFMD was 0.009 (<0.2). The median basic reproduction rate of total, enterovirus 71, and coxsackievirus 16 cases in Guangdong were 4.621 (IQR: 3.907-5.823), 3.023 (IQR: 2.289-4.292) and 7.767 (IQR: 6.903-10.353), respectively. The heatmap of R0 showed semiannual peaks of activity, including a major peak in spring and early summer (about the 12th week) followed by a smaller peak in autumn (about the 36th week). The county-level model showed that Longchuan (R0 = 33), Gaozhou (R0 = 24), Huazhou (R0 = 23) and Qingxin (R0 = 19) counties have higher basic reproduction rate than other counties in the province. The epidemic of HFMD in Guangdong Province is still grim, and strategies like the World Health Organization's expanded program on immunization need to be implemented. An elimination of HFMD in Guangdong might need a Herd Immunity Threshold of 78%.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
People living with HIV (PLWH) have high rates of depressive symptoms. However, only a few effective mental health interventions exist for this vulnerable population.
The aim of this study was to ...assess the efficacy of a WeChat-based intervention, Run4Love, with a randomized controlled trial among 300 people living with HIV and depression (PLWHD) in China.
We recruited PLWH from the HIV outpatient clinic in South China. Participants were screened based on the Center for Epidemiologic Studies-Depression (CES-D) scale. Those who scored 16 or higher were eligible to participate. A total of 300 eligible patients were enrolled. After obtaining informed consent from the participants, completion of a baseline survey, and collection of participants' hair samples for measuring cortisol, the participants were randomly assigned to an intervention or a control group in a 1:1 ratio. The intervention group received the Run4Love program, delivered via the popular social media app WeChat. Cognitive behavioral stress management courses and weekly reminders of exercise were delivered in a multimedia format. Participants' progress was monitored with timely and tailored feedback. The control group received usual care and a brochure on nutrition for PLWH. Data were collected at 3, 6, and 9 months. The primary outcome was depression, which was measured by a validated instrument.
Participants in the intervention and control groups were comparable at baseline; about 91.3% (139/150), 88.3% (132/150), and 86.7% (130/150) participants completed the 3-, 6-, and 9-month follow-ups, respectively. At the 3-month follow-up, a significant reduction in CES-D score was observed in the intervention group (from 23.9 to 17.7 vs from 24.3 to 23.8; mean difference=-5.77, 95% CI -7.82 to -3.71; P<.001; standard effect size d=0.66). The mean changes in CES-D score from baseline to the 6- and 9-month follow-ups between the two groups remained statistically significant. No adverse events were reported.
The WeChat-based mobile health (mHealth) intervention Run4Love significantly reduced depressive symptoms among PLWHD, and the effect was sustained. An app-based mHealth intervention could provide a feasible therapeutic option for many PLWHD in resource-limited settings. Further research is needed to assess generalizability and cost-effectiveness of this intervention.
Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showproj.aspx?proj=21019 (Archived by WebCite at https://www.webcitation.org/78Bw2vouF).
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Anthocyanins have been shown to improve endothelial function in animal models. However, whether these compounds have similar beneficial effects in humans is largely unknown.
In a short-term crossover ...study, 12 hypercholesterolemic individuals were given oral anthocyanins (320 mg) isolated from berries or placebo. Brachial artery flow-mediated dilation (FMD) was assessed before and after the intervention. In a long-term intervention trial (12 weeks), 150 hypercholesterolemic individuals were given anthocyanins (320 mg/day, n = 75) or placebo (n = 75), after which we measured FMD, plasma cGMP, and other serum biomarkers. Another short-term intervention was conducted in the presence of NO-cGMP inhibitors in 6 people and in a rat aortic ring model (n = 8).
Significant increases of FMD from 8.3% (0.6%) at baseline to 11.0% (0.8%) at 1 h and 10.1% (0.9%) at 2 h were observed after short-term anthocyanin consumption, concomitantly with increases of plasma anthocyanin concentrations (P < 0.05). In the study participants who received long-term anthocyanin intervention, compared with the control group, we observed significant increases in the FMD (28.4% vs 2.2%), cGMP (12.6% vs -1.2%), and HDL-cholesterol concentrations, but decreases in the serum soluble vascular adhesion molecule-1 and LDL cholesterol concentrations (P < 0.05). The changes in the cGMP and HDL cholesterol concentrations positively correlated with FMD in the anthocyanin group (P < 0.05). In the presence of NO-cGMP inhibitors, the effects of anthocyanin on endothelial function were abolished in human participants and in a rat aortic ring model.
Anthocyanin supplementation improves endothelium-dependent vasodilation in hypercholesterolemic individuals. This effect involves activation of the NO-cGMP signaling pathway, improvements in the serum lipid profile, and decreased inflammation.
The global burden of lung cancer (LC) is increasing. Quantitative projections of the future LC burden in different world regions could help optimize the allocation of resources and provide a ...benchmark for evaluating LC prevention and control interventions.
We aimed to predict the future incidence of LC in 40 countries by 2035, with an emphasis on country- and sex-specific disparities.
Data on LC incidence from 1978 to 2012 were extracted from 126 cancer registries of 40 countries in Cancer Incidence in Five Continents Volumes V-XI and used for the projection. Age-standardized incidence rates (ASRs) per 100,000 person-years and the number of incident cases were predicted through 2035, using the NORDPRED age-period-cohort model.
Global ASRs of the 40 studied countries were predicted to decrease by 23% (8.2/35.8) among males, from 35.8 per 100,000 person-years in 2010 to 27.6 in 2035, and increase by 2% (0.3/16.8) among females, from 16.8 in 2010 to 17.1 in 2035. The ASRs of LC among females are projected to continue increasing dramatically in most countries by 2035, with peaks after the 2020s in most European, Eastern Asian, and Oceanian countries, whereas the ASRs among males will continue to decline in almost all countries. The ASRs among females are predicted to almost reach those among males in Ireland, Norway, the United Kingdom, the Netherlands, Canada, the United States, and New Zealand in 2025 and in Slovenia in 2035 and even surpass those among males in Denmark in 2020 and in Brazil and Colombia in 2025. In 2035, the highest ASRs are projected to occur among males in Belarus (49.3) and among females in Denmark (36.8). The number of new cases in 40 countries is predicted to increase by 65.32% (858,000/1,314,000), from 1.31 million in 2010 to 2.17 million in 2035. China will have the largest number of new cases.
LC incidence is expected to continue to increase through 2035 in most countries, making LC a major public health challenge worldwide. The ongoing transition in the epidemiology of LC highlights the need for resource redistribution and improved LC control measures to reduce future LC burden worldwide.
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