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      Urban–rural disparity in colorectal cancer incidence and increasing trend in relation to socioeconomic development and urbanization in China

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          Abstract

          Objective

          To study urban–rural disparity in colorectal cancer incidence and the increasing trend in relation to rapid socioeconomic development and urbanization in China.

          Methods

          We compared the age-standardized incidence rates (ASRs) of colorectal cancer between rural and urban areas in China in 2012 and analyzed the trend in Shexian County for 2000–2015 using population-based tumor registration data collected in Shijiazhuang city (2012) and Shexian County (2000–2015).

          Results

          The ASRs of colorectal cancer in Shijiazhuang (urban) were considerably higher than in Shexian (rural) in both men (22.8 vs. 11.9/100,000) and women (15.0 vs. 9.3/100,000). The difference was similar to that between countries with high and medium human development indices according to GLOBOCAN 2012. In trend analysis, the biennial ASR in Shexian increased from 6.6 in 2000–2001 to 15.9/100,000 in 2014–2015 in men (averaged biennial percent change (ABPC) = +6.0%), and from 4.0 to 11.7/100,000 in women (ABPC=+5.5%).

          Conclusions

          The incidence of colorectal cancer in China is rising in parallel with socioeconomic development and urbanization. Integrated efforts should be made to reduce the incidences of overweight and obesity in society to help prevent this increase.

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          Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China.

          Y. WANG, J. Mi, X-Y Shan … (2007)
          Over the past two decades, China has enjoyed impressive economic development, and her citizens have experienced many remarked changes in their lifestyle. These changes are often associated with an increase in obesity and chronic disease. In this meta-analysis, based on nationally representative data, we studied the current prevalence of obesity and the trends in obesity, mortality and morbidity in China. Between 1992 and 2002, the prevalence of overweight and obesity increased in all gender and age groups and in all geographic areas. Using the World Health Organization body mass index cut points, the combined prevalence of overweight and obesity increased from 14.6 to 21.8%. The Chinese obesity standard shows an increase from 20.0 to 29.9%. The annual increase rate was highest in men aged 18-44 years and women aged 45-59 years (approximately 1.6 and 1.0% points, respectively). In general, male subjects, urban residents, and high-income groups had a greater increase. With the increase in overweight and obesity, obesity-, and diet-related chronic diseases (e.g., hypertension, cardiovascular disease (CVD), and type 2 diabetes) also increased over the past decade and became a more important preventable cause of death. Hypertension increased from 14.4% in 1991 to 18.8% in 2002 in adults; in older adults aged 35-74 years, it increased from 19.7 to 28.6%. Between 1993 and 2003, the prevalence of CVD increased from 31.4 to 50.0%; diabetes increased from 1.9 to 5.6%. During 1990-2003, although total mortality rate (per 100 000) decreased, overall the mortality rate and contribution (as percentages) to total death of obesity-related chronic disease increased, in particular, in rural areas. Mortality rate (per 100 000) of CVD increased from 128 to 145 and its contribution to total death, 27 to 32%, in rural areas; the figures decreased slightly in urban areas. The mortality rate of 'nutrition, endocrinology and metabolism-related disease' (NEMD) increased in both rural and urban areas between 1990 and 2000, 8.0 to 10.6 and 4.9 to 5.3, respectively. The current prevalence of hypertension, dyslipidaemia, metabolic syndrome, and diabetes among Chinese adults is approximately 20, 20, 15, and 3%, respectively. The prevalence of overweight and obesity and obesity-related chronic diseases have increased in China in the past decade. Our findings provide useful information for the projection of future trends and the formulation of national strategies and programmes that can address the challenges of the growing obesity and chronic disease epidemic.
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            Urbanization, Lifestyle Changes and the Nutrition Transition

            Barry M. Popkin (1999)
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              Overweight and obesity in China.

              Yangfeng Wu (2006)
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Int Med Res
                Journal ID (iso-abbrev): J. Int. Med. Res
                Journal ID (publisher-id): IMR
                Journal ID (hwp): spimr
                Title: The Journal of International Medical Research
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Print): 0300-0605
                ISSN (Electronic): 1473-2300
                Publication date (Electronic): 20 August 2018
                Publication date (Print): October 2018
                Volume: 46
                Issue: 10
                Pages: 4181-4196
                Affiliations
                [1 ]Cancer Center, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China
                [2 ]Medical Imaging, Hospital of Sinopec Shengli Oilfield, Dongying, China
                [3 ]Medical Imaging, the Fourth Hospital of Hebei Medical University Shijiazhuang, China
                Author notes
                [*]Guiying Wang, Cancer Center, 4th Hospital of Hebei Medical University, Jiankanglu 12, Shijiazhuang 050011, China. Email: guiyingwang136@ 123456163.com
                Article
                Publisher ID: 10.1177_0300060518791090
                DOI: 10.1177/0300060518791090
                PMC ID: 6166325
                PubMed ID: 30124349
                SO-VID: 477b658a-6910-449e-9d5a-9d60ae87d0c9
                Copyright © © The Author(s) 2018
                License:

                Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 28 March 2018
                Date accepted : 5 July 2018
                Funding
                Funded by: Key Medical Research Subjects in Hebei Province, FundRef ;
                Award ID: [2012] No 2056
                Categories
                Subject: Clinical Research Reports

                Keywords: colorectal cancer,socioeconomic development,urbanization,overweight,obesity,healthy food,food education
                Data availability:
                Keywords: colorectal cancer, socioeconomic development, urbanization, overweight, obesity, healthy food, food education

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