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      Epidemiological Characteristics of Cancer in Elderly Chinese

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          Abstract

          Background. Population of elder Chinese has been increasing, but the pattern and trend of cancer in that population was rarely reported. Methods. Mortality rates for cancer of all sites and of the site specific of the overall and elderly Chinese from 2004 to 2005 were estimated. The age structure of world population was used to observe the changes in the age-standardized mortality rates from 1975 to 2005 using the data from the national death surveys, Disease Surveillance Points, and cancer registries in China. Results. The mortalities among the elderly Chinese were 782.12 per 100,000, substantially higher than those of the people less than 60 years old. The mortalities for cancers of lung, stomach, liver, and esophagus in elderly population showed great increase compared to younger ages. Stomach cancer ranked as the second most common cancer following lung cancer in the elderly, and those two malignancies had similar mortality rates in male elderly, while in female, it ranked as first, surpassed lung cancer. Consistent decreased trends of M/I ratios of cancer were observed in all age groups. Conclusion. Strategies in cancer prevention and cost-effective preventive intervention should be highly considered and strongly implemented among the elderly Chinese.

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          Global patterns of cancer incidence and mortality rates and trends.

          While incidence and mortality rates for most cancers (including lung, colorectum, female breast, and prostate) are decreasing in the United States and many other western countries, they are increasing in several less developed and economically transitioning countries because of adoption of unhealthy western lifestyles such as smoking and physical inactivity and consumption of calorie-dense food. Indeed, the rates for lung and colon cancers in a few of these countries have already surpassed those in the United States and other western countries. Most developing countries also continue to be disproportionately affected by cancers related to infectious agents, such as cervix, liver, and stomach cancers. The proportion of new cancer cases diagnosed in less developed countries is projected to increase from about 56% of the world total in 2008 to more than 60% in 2030 because of the increasing trends in cancer rates and expected increases in life expectancy and growth of the population. In this review, we describe these changing global incidence and mortality patterns for select common cancers and the opportunities for cancer prevention in developing countries. (c)2010 AACR.
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            Validation of cause-of-death statistics in urban China.

            National vital registration systems are the principal source of cause specific mortality statistics, and require periodic validation to guide use of their outputs for health policy and programme purposes, and epidemiological research. We report results from a validation of cause of death statistics from health facilities in urban China. 2917 deaths from health facilities located in six cities in China constituted the study sample. A reference diagnosis of the underlying cause was derived for each death, based on expert review of available medical records, and compared with that filed at registration. Sensitivity, specificity and positive predictive value were computed for specific causes/cause categories according to the International Classification of Diseases (ICD), including analyses based on quality of evidence scores for each cause. Patterns of misclassification by the registration system were studied for individual causes of death. The registration system had good sensitivity in diagnosing cerebrovascular disease and several site specific cancers (lung, liver, stomach, colorectal, breast and pancreas). Sensitivity was average (50-75%) for some major causes of adult death in China, namely ischaemic heart disease (IHD), chronic obstructive lung disease (COPD), diabetes, and liver and kidney diseases, with compensatory misclassification patterns observed between several of them. Sensitivity was particularly low for hypertensive disease. Although diagnostic misclassification is not uncommon in urban death registration data, they appear to balance each other at the population level. Compensating misclassification errors suggest that caution is required when drawing conclusions about particular chronic causes of adult death in China. Investment is required to improve the quality of cause attribution for health facility deaths, and to assess the validity of cause attribution for home deaths. Periodic assessments of the quality of cause of death statistics will enhance their usability for health policy and epidemiological research.
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              Evaluating national cause-of-death statistics: principles and application to the case of China.

              Mortality statistics systems provide basic information on the levels and causes of mortality in populations. Only a third of the world's countries have complete civil registration systems that yield adequate cause-specific mortality data for health policy-making and monitoring. This paper describes the development of a set of criteria for evaluating the quality of national mortality statistics and applies them to China as an example. The criteria cover a range of structural, statistical and technical aspects of national mortality data. Little is known about cause-of-death data in China, which is home to roughly one-fifth of the world's population. These criteria were used to evaluate the utility of data from two mortality statistics systems in use in China, namely the Ministry of Health-Vital Registration (MOH-VR) system and the Disease Surveillance Point (DSP) system. We concluded that mortality registration was incomplete in both. No statistics were available for geographical subdivisions of the country to inform resource allocation or for the monitoring of health programmes. Compilation and publication of statistics is irregular in the case of the DSP, and they are not made publicly available at all by the MOH-VR. More research is required to measure the content validity of cause-of-death attribution in the two systems, especially due to the use of verbal autopsy methods in rural areas. This framework of criteria-based evaluation is recommended for the evaluation of national mortality data in developing countries to determine their utility and to guide efforts to improve their value for guiding policy.
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                Author and article information

                Journal
                ISRN Oncol
                ISRN Oncol
                ISRN.ONCOLOGY
                ISRN Oncology
                International Scholarly Research Network
                2090-5661
                2090-567X
                2012
                30 December 2012
                : 2012
                : 381849
                Affiliations
                1Office of Cancer Prevention and Control, National Cancer Center, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, 17 Panjiayuannanli, Chaoyang District, Beijing 100021, China
                2Department of Cancer Epidemiology, Peking Union Medical College, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, 17 Panjiayuannanli, Chaoyang District, Beijing 100021, China
                3Institute of Basic Medicine, Chinese Academy of Medical Sciences, 5 Dongdansantiao, Dongcheng District, Beijing 100005, China
                Author notes

                Academic Editors: S. Benavente and T. Komiya

                Article
                10.5402/2012/381849
                3544282
                23326683
                f66c1fac-0a14-4d63-801c-cae4d08656dd
                Copyright © 2012 Xiao Nong Zou et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 November 2012
                : 6 December 2012
                Categories
                Research Article

                Oncology & Radiotherapy
                Oncology & Radiotherapy

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