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Attributable Causes of Cancer in China:Fruit and Vegetable

Chinese Journal of Cancer Research 2011年第3期23卷 171-176页

作者： Hui-juan Xiao Hao Liang Jian-bing Wang Cheng-Yu Huang Wen-qiang Wei Mathieu Boniol You-lin Qiao paolo boffetta Department of Nutrition and Food Hygiene West China School of Public Health Sichuan University Chengdu 610041 China Departments of Cancer Epidemiolo gy Cancer Institute Chinese Academy of Medical Sciences Beijing 100021 China Department of Epidemiology and Statistics Institute of Basic Medical Sciences Chinese Academy of Medical Sciences ＆School of Basic Medicine Peking Union Medical College Beijing 100005 China International Prevention Research Institute Lyon 69008 France The Tisch Cancer Institute Mount Sinai School of Medicine New York NY 10029 USA Nutrition Department Tianjin Third Central Hospital Tianjin 300170 China

Objective：To provide an evidence-based and consistent assessment of the burden of cancer attributable to inadequate fruit and vegetable intake in China in 2005.Methods：The proportions of cancers attributable to low consumption of vegetable and fruit were calculated separately to estimate the burden of related cancers for the year 2005 in China.Data on the prevalence of exposure were derived from a Chinese nutrition and health survey.Data on relative risks were mainly derived from meta-analysis.Attributable fractions were calculated based on the counterfactual scenario which was a shift in the exposure distribution.Results：The total cancer burden attributable to inadequate consumption of fruit was up to 233,000 deaths （13.0% of all cancers） and 300,000 cases （11.6% of all cancers） in 2005.Increasing consumption of vegetable to the highest quintile could avoid total cancer deaths and cases by 3.6% （64,000 persons） and 3.4% （88,000 persons）.The contributions to cancer burden were higher in rural areas than in urban areas.They have greater influence on men than on women.The largest proportions of cancer burden attributable to low fruit and vegetable intake were for oral and pharyngeal cancers.Conclusion：This study showed that inadequate intake of fruit and vegetable makes a significant contribution to the cancer burden.Increasing consumption of fruit and vegetable could prevent many cancer deaths and save many lives.Promoting the consumption of fruit and vegetable is an important component in diet-based strategies for preventing cancer.

关键词： Fruit Vegetable Cancer Population attributable fraction China

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Age, socioeconomic features, and clinical factors predict receipt of endoscopic retrograde cholangiopancreatography in pancreatic cancer

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World Journal of Gastrointestinal Endoscopy 2019年第2期11卷 133-144页

作者： Sheila D Rustgi Sunil P Amin Michelle K Kim Satish Nagula Nikhil A Kumta Christopher J DiMaio paolo boffetta Aimee L Lucas Henry D. Janowitz Division of Gastroenterology Department of Medicine Icahn School of Medicine at Mount Sinai Division of Gastroenterology Virginia Mason Medical Center Tisch Cancer Institute Icahn School of Medicine at Mount Sinai

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP) is the recommended technique for biliary decompression in pancreatic cancer. Previous studies have suggested racial, socioeconomic and geographic differences in diagnosis,treatment and outcomes of pancreatic cancer patients.AIM To examine geographic, racial, socioeconomic and clinical factors associated with utilization of ERCP.METHODS Surveillance, Epidemiology and End Results and linked Medicare claims data were used to identify pancreatic cancer patients between 2000-2011. Claims data were used to identify patients who had ERCP and other treatments. The primary outcome was receipt of ERCP. Chi-squared analyses were used to compare demographic information. Trends in use of ERCP over time were assessed using Cochran Armitage test. Adjusted odds ratios(aORs) and 95% confidence intervals(CIs) for receipt ERCP were calculated using logistic regression,controlling for other characteristics.RESULTS Among 32510 pancreatic cancer patients, 14704(45.2%) underwent ERCP.Patients who had cancer located in the head of the pancreas(aOR 3.27, 95%CI:2.99-3.57), had jaundice(aOR 7.59, 95%CI: 7.06-8.17), cholangitis(aOR 4.22,95%CI: 3.71-4.81) or pruritus(aOR 1.42, 95%CI: 1.22-1.66) and lived in lower education zip codes(aOR 1.14, 95%CI: 1.04-1.24) were more likely to receive ERCP. In contrast, patients who were older(aOR 0.88, 95%CI: 0.83, 0.94), not married(aOR 0.92, 95%CI: 0.86, 0.98), and lived in a non-metropolitan area(aOR0.89, 95%CI: 0.82, 0.98) were less likely to receive ERCP. Compared to white patients, non-white/non-black patients(aOR 0.83, 95%CI: 0.70-0.97) were less likely to receive ERCP. Patients diagnosed later in the study period were less likely to receive ERCP(aOR 2004-2007 0.85, 95%CI: 0.78-0.92; aOR 2008-2011 0.76,95%CI: 0.70-0.83). After stratifying by indications for ERCP including jaundice,racial differences persisted(aOR black patients 0.80, 95%CI: 0.67-0.95,nonwhite/nonblack patients 0.73, 95%CI: 0.58-0.91). Among patients with jaundice, tho

关键词： Pancreatic cancer Endoscopic retrograde cholangiopancreatography Socioeconomic disparities Racial disparities Jaundice Outcomes research

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Attributable Causes of Lung Cancer Incidence and Mortality in China

Attributable Causes of Lung Cancer Incidence and Mortality i...

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第十三届中国科协年会第18分会场-癌症流行病趋势和防控...

作者： paolo boffetta The Tish Cancer Institute Mount Sinai School of MedicineNew YorkNYUSA and International Prevention Research Institute95 cours Lafayette69006 LyonFrance

Objective to estimate the contribution of known risk factors of lung cancer in China and to provide evidence to support the National Cancer Prevention and Control Program in China. Methods We calculated the proportion of lung cancer attributable to specific risk factors. Exposed data were from meta-analyses and large-scale national surveys of representative samples of Chinese population. Data on relative risks were from meta-analyses and large-scale prospective studies. Lung cancer mortality and incidence were originated from the 3rd national death cause survey and population-based cancer registries in China. Results We estimated that 285,304 lung cancer deaths (men: 229,990;women: 55,314) and 327,465 cases (men: 263,576, women: 63,889) were attributable to smoking, involuntary smoking (women only), occupational agents, indoor radon, low fruit intake in China in 2005. About 75.04% of lung cancer deaths among men and 18.35% among women were attributable to tobacco smoking. About 10.63% of lung cancer deaths in men and 7.04% in women were caused by occupational agents, and 0.15% for both genders caused by indoor radon. Low fruit intake was responsible for 12.24% lung cancer deaths among men and that of 12.60% among women. The fraction of lung cancer deaths attributable to involuntary smoking from the spouse or at the workplace among non-smoking women was 11.10%. Conclusions Smoking, occupational agents, indoor radon, and low fruit intake are responsible for 80% of lung cancer mortality and incidence among men and 41% among women (including involuntary smoking). However, more than half of lung cancer deaths and cases among women are caused by other risk factors. It is necessary to conduct large-scale, case series studies to demonstrate genetic factors and other important risk factors of lung cancer in women.

关键词： lung cancer population attributable fraction smoking passive smoking occupational agents indoor radon low fruit intake

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