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Li M, Dal Maso L, Pizzato M, Vaccarella S. Evolving epidemiological patterns of thyroid cancer and estimates of overdiagnosis in 2013-17 in 63 countries worldwide: a population-based study. Lancet Diabetes Endocrinol 2024:S2213-8587(24)00223-7. [PMID: 39389067 DOI: 10.1016/s2213-8587(24)00223-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/17/2024] [Accepted: 07/17/2024] [Indexed: 10/12/2024]
Abstract
BACKGROUND The incidence of thyroid cancer has been increasing in many countries, mainly due to overdiagnosis. Given these rapid changes, we aim to assess the specific features of the thyroid cancer diagnosis epidemic and provide estimates of overdiagnosis across countries spanning five continents and identify areas in which coping strategies are needed. METHODS Two types of data were retrieved from the International Agency for Research on Cancer (IARC) Global Cancer Observatory database. The long-term annual incidence of thyroid cancer by sex and 5-year age group for all ages from 1980 to 2017 was obtained from continuous population-based registries available in the Cancer Incidence in Five Continents (CI5) plus, with 97 registries from 43 countries selected. Sex-age-specific thyroid cancer cases, overall and by subtype, along with corresponding population counts were retrieved from all registries included in the latest volume of CI5 (CI5-XII), with 385 registries in 63 countries. Annual mortality data from 1980 to 2022 were obtained from WHO, with population counts supplemented by UN population estimates. We estimated age-standardised rates (ASRs) of thyroid cancer incidence and mortality for all ages by sex using direct age standardisation, with the world population as a reference. Long-term annual trends of ASRs were compared between incidence and mortality since 1980. Subtype distribution was calculated for thyroid cancer incidence during 2013-17. We estimated the numbers of thyroid cancer cases and overdiagnosed cases and extrapolated to the whole country using a previously developed and validated method. FINDINGS Thyroid cancer incidence rates rose during 1980-2017 for most countries, with the highest rates seen in South Korea, Cyprus, Ecuador, China, and Türkiye for females and males. An upward trend was seen until the early 2010s, followed by a downward trend in South Korea, the USA, Canada, and Israel and some Western European countries, such as France, Italy, Austria, and Ireland. The difference between the highest and lowest incidence rates ranged from less than 10·0 per 100 000 females in the early 1980s to 101·4 per 100 000 females in 2012. For males, the difference between the highest and lowest incidence rates ranged from 2·7 per 100 000 to 23·5 per 100 000 over the study period. Mortality rates were substantially lower, with a difference between the highest and lowest rates across countries of around 1·0-2·0 per 100 000 for both sexes throughout the study period. During 2013-17, papillary thyroid cancer contributed to the large variation in ASRs of thyroid cancer incidence. The mortality rates of thyroid cancer increased with age for all countries, whereas the observed age-specific incidence rates showed an inverted U-shape in most countries. The magnitude of overdiagnosis varied across countries, ranging from no overdiagnosis (in Uganda, Zimbabwe, and Trinidad and Tobago) to more than 85·0% of thyroid cancer cases being overdiagnosed in females (in Cyprus, China, South Korea, and Türkiye). Overall, 1 736 133 (75·6%) of 2 297 057 cases were attributable to overdiagnosis, including 1 368 181 females and 367 952 males. INTERPRETATION Although the incidence of thyroid cancer has reached a plateau or decrease in some high-income countries, the magnitude of overdiagnosis is still very large and the expansion of overdiagnosis of thyroid cancer to the transitioning countries has been rapid, which makes it a global public health challenge that needs to be addressed. FUNDING National Natural Science Foundation of China, Guangdong Basic and Applied Basic Research Foundation, Young Talents Program of Sun Yat-sen University Cancer Center, Italian Association for Cancer Research, and the Italian Ministry of Health (Ricerca Corrente).
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Affiliation(s)
- Mengmeng Li
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China.
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano IRCCS, Aviano, Italy
| | - Margherita Pizzato
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Salvatore Vaccarella
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
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Wang S, Ji Y, Ren M, Li J, Yang Z. Estimating the Proportion of Overdiagnosis among Prostate, Breast, and Thyroid Cancers in China: Findings from the Global Burden of Disease 2019. Curr Oncol 2024; 31:5643-5651. [PMID: 39330046 PMCID: PMC11431510 DOI: 10.3390/curroncol31090418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 09/15/2024] [Accepted: 09/19/2024] [Indexed: 09/28/2024] Open
Abstract
The incidence of prostate, breast, and thyroid cancers has increased in China over the past few decades. Whether and how much these increases can be attributed to overdiagnosis are less understood. This study aimed to estimate the proportion of overdiagnosis among these three cancers in China during 2004-2019. The age-specific cancer incidence, cancer mortality, and all-cause mortality in China were extracted from the Global Burden of Diseases 2019. The lifetime risk of developing and that of dying from each cancer were calculated using the life table method. The proportion of overdiagnosis of a cancer was estimated as the difference between the lifetime risk of developing the cancer and that of suffering from the cancer (including death, metastasis, and symptoms caused by the cancer), further divided by the lifetime risk of developing the cancer. The highest possible values of these parameters were adopted in the estimation so as to obtain the lower bounds of the proportions of overdiagnosis. Sensitivity analyses assuming different lag periods between the diagnosis of a cancer and death from the cancer were performed. The results showed that the lifetime risk of developing prostate, breast, and thyroid cancer increased dramatically from 2004 to 2019 in China, while the increase in the lifetime risk of dying from these cancers was less pronounced. The proportions of overdiagnosis among prostate, breast, and thyroid cancers were estimated to be 7.88%, 18.99%, and 24.92%, respectively, in 2004, and increased to 18.20%, 26.25%, and 29.24%, respectively, in 2019. The increasing trends were statistically significant for all three cancers (all p < 0.001). In sensitivity analyses, the proportions of overdiagnosis decreased, but upward trends over time remained for all three cancers. In conclusion, the overdiagnosis of prostate, breast, and thyroid cancers in China increased from 2004 to 2019, with the highest proportion seen in thyroid cancer and the most rapid increase seen in prostate cancer. Multifaceted efforts by policy makers, guideline developers, and clinicians are needed to tackle this problem.
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Affiliation(s)
- Shuting Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Yanlai Ji
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Innovent Biologics, Shanghai 200050, China
| | - Mingxue Ren
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Immunoprophylaxis Department, Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, China
| | - Jun Li
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Department of Biostatistics and Programming, Sanofi, Chengdu 610000, China
| | - Zuyao Yang
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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Liang Q, Qi Z, Li Y. Machine learning to predict the occurrence of thyroid nodules: towards a quantitative approach for judicious utilization of thyroid ultrasonography. Front Endocrinol (Lausanne) 2024; 15:1385836. [PMID: 38774231 PMCID: PMC11106422 DOI: 10.3389/fendo.2024.1385836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/15/2024] [Indexed: 05/24/2024] Open
Abstract
Introduction Ultrasound is instrumental in the early detection of thyroid nodules, which is crucial for appropriate management and favorable outcomes. However, there is a lack of clinical guidelines for the judicious use of thyroid ultrasonography in routine screening. Machine learning (ML) has been increasingly used on big data to predict clinical outcomes. This study aims to leverage the ML approach in assessing the risk of thyroid nodules based on common clinical features. Methods Data were sourced from a Chinese cohort undergoing routine physical examinations including thyroid ultrasonography between 2013 and 2023. Models were established to predict the 3-year risk of thyroid nodules based on patients' baseline characteristics and laboratory tests. Four ML algorithms, including logistic regression, random forest, extreme gradient boosting, and light gradient boosting machine, were trained and tested using fivefold cross-validation. The importance of each feature was measured by the permutation score. A nomogram was established to facilitate risk assessment in the clinical settings. Results The final dataset comprised 4,386 eligible subjects. Thyroid nodules were detected in 54.8% (n=2,404) individuals within the 3-year observation period. All ML models significantly outperformed the baseline regression model, successfully predicting the occurrence of thyroid nodules in approximately two-thirds of individuals. Age, high-density lipoprotein, fasting blood glucose and creatinine levels exhibited the highest impact on the outcome in these models. The nomogram showed consistency and validity, providing greater net benefits for clinical decision-making than other strategies. Conclusion This study demonstrates the viability of an ML-based approach in predicting the occurrence of thyroid nodules. The findings highlight the potential of ML models in identifying high-risk individuals for personalized screening, thereby guiding the judicious use of ultrasound in this context.
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Affiliation(s)
- Qijun Liang
- Health Management Center, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China
| | - Zhenhong Qi
- Health Management Center, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China
| | - Yike Li
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, United States
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Zhou J, Liang B, Liu Y, Wang S, Xu H, Li K, Liang H, Sun Z, Wang Y, Zhang J, Hu X, Qin P. Exploring temporal trends and influencing factors for thyroid cancer in Guangzhou, China: 2004-2018. Endocrine 2024; 84:509-523. [PMID: 37936008 DOI: 10.1007/s12020-023-03578-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/14/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE Describe and analyze the trends of thyroid cancer incidence and mortality in Guangzhou, explore the potential influencing factors, and provide evidence for the government to formulate prevention and treatment measures. METHODS Incident and death cases of thyroid cancer were retrieved from the Guangzhou cancer registry. The joinpoint regression models were used to estimate the incidence and mortality trends. Age-period-cohort models were used to estimate the age, period, and cohort effects on the time trends. Grey correlation analysis was performed to explore possible connections between thyroid cancer and social factors. RESULTS A total of 15,955 new cases of thyroid cancer were registered in Guangzhou during 2004-2018, the age-standardized incidence rate (ASIR) of thyroid cancer increased from 4.29/105 in 2004 to 22.36/105 in 2018, with the average annual percentage change (AAPC) of 13.40%. The overall increase can be attributed to the increase in the incidence of papillary thyroid carcinoma (PTC), which was dominated by tumors <2 cm. The ASIR was higher in women (16.12/105) compared to men (5.46/105), and young and middle-aged individuals had higher incidence rates than older people. The number of thyroid cancer deaths registered between 2010 and 2018 was 356, and the age-standardized mortality rates (ASMRs) were stable (approximately 0.42/105). Men's ASMR (0.34/105) and women's (0.49/105) were similar, and those 60 and older had greater mortality. The period and cohort relative risks showed an overall increasing trend. Furthermore, there was a strong positive correlation between the ASIRs and social determinants. CONCLUSIONS During the study period, the incidence rate of thyroid cancer among young and middle-aged people in Guangzhou showed a rapidly increasing trend, and the mortality was relatively stable. In the future, more effective preventive measures should be taken for this age group to reduce the burden of disease and avoid overdiagnosis.
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Affiliation(s)
- Jingjing Zhou
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Boheng Liang
- Department of Chronic Noncommunicable Disease Prevention and Control, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Yanhong Liu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Suixiang Wang
- Department of Chronic Noncommunicable Disease Prevention and Control, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Huan Xu
- Department of Chronic Noncommunicable Disease Prevention and Control, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Ke Li
- Department of Chronic Noncommunicable Disease Prevention and Control, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Huiting Liang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Zeyu Sun
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yawen Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jiaqi Zhang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xiaoqin Hu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China.
| | - Pengzhe Qin
- Department of Chronic Noncommunicable Disease Prevention and Control, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
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Teng Y, Xia C, Li H, Cao M, Yang F, Yan X, He S, Cao M, Zhang S, Li Q, Chen W. Cancer statistics for young adults aged 20 to 49 years in China from 2000 to 2017: a population-based registry study. SCIENCE CHINA. LIFE SCIENCES 2024; 67:711-719. [PMID: 38155276 DOI: 10.1007/s11427-023-2445-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/01/2023] [Indexed: 12/30/2023]
Abstract
An increasing cancer incidence among adults younger than 50 years has been reported for several types of cancer in multiple countries. We aimed to report cancer profiles and trends among young adults in China. Data from the China Cancer Registry Annual Report were used to estimate incidence and mortality among young adults (ages 20-49 years) in China in 2017, and an age-period-cohort model was employed to estimate the average annual percent change (AAPC) in incidence and mortality from 2000 to 2017. All 25 cancer types were grouped into obesity- or overweight-associated cancers (12 cancer types) and additional cancers (13 cancer types). In 2017, there were 681,178 new cases and 214,591 cancer deaths among young adults in China. Among young adults, the most common cancers were thyroid, breast, cervical, liver, lung, and colorectal cancer, and the leading causes of cancer deaths were liver, lung, cervical, stomach, breast, and colorectal cancer. From 2000 to 2017, the cancer incidence increased for all cancers combined among young adults, with the highest AAPC (1.46%) for adults aged 20-24 years, while cancer mortality decreased, with the highest AAPC (-1.63%) for those aged 35-39 years. In conclusion, the cancer incidence in China has increased among young adults, while cancer mortality has decreased for nearly all ages. Cancer control measures, such as obesity control and appropriate screening, may contribute to reducing the increasing cancer burden among young adults.
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Affiliation(s)
- Yi Teng
- 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
| | - Changfa Xia
- 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
| | - He 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
| | - Maomao 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
| | - Fan 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
| | - Xinxin 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
| | - Siyi 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
| | - Mengdi 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
| | - Shaoli 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, Beijing, 100021, China
| | - Qianru 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
| | - Wanqing 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.
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Gao T, Luo S, Li H, Su Z, Wen Q. Prospective role of lusianthridin in attenuating cadmium-induced functional and cellular damage in rat thyroid. Heliyon 2024; 10:e27080. [PMID: 38449627 PMCID: PMC10915401 DOI: 10.1016/j.heliyon.2024.e27080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/30/2024] [Accepted: 02/23/2024] [Indexed: 03/08/2024] Open
Abstract
The thyroid represents the most prevalent form of head and neck and endocrine cancer. The present investigation demonstrates the anticancer effects of Lusianthridin against cadmium (Cd)-induced thyroid cancer in rats. Swiss Wistar rats were utilized in this experimental study. Cd was employed to induce thyroid cancer, and the rats were divided into different groups, receiving oral administration of Lusianthridin (20 mg/kg) for 14 days. Thyroid parameters, deiodinase levels, hepatic parameters, lipid parameters, and antioxidant parameters were respectively estimated. The mRNA expression was assessed using real-time reverse transcriptase polymerase chain reaction (RT-PCR). Lusianthridin significantly (P < 0.001) improved protein levels, T4, T3, free iodine in urine, and suppressed the level of TSH. Lusianthridin significantly (P < 0.001) enhanced the levels of FT3, FT4, and decreased the level of rT3. Lusianthridin significantly (P < 0.001) reduced the levels of D1, D2, D3, and enhanced the levels of hepatic parameters like AST, ALT. Lusianthridin remarkably (P < 0.001) altered the levels of lipid parameters such as LDL, total cholesterol, HDL, and triglycerides; antioxidant parameters viz., MDA, GSH, CAT, and SOD. Lusianthridin significantly altered the mRNA expression of Bcl-2, Bax, MEK1, ERK1, ERK2, p-eIf2α, GRP78, eIf2α, and GRP94. The results clearly state that Lusianthridin exhibits protective effects against thyroid cancer.
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Affiliation(s)
- Teng Gao
- Department of Thyroid Surgery, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, 450003, China
| | - Sijia Luo
- Department of General Surgery, General Hospital of Central Theater Command, Wuhan, Hubei, 430070, China
| | - Hongguang Li
- Department of Thyroid Surgery, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, 450003, China
| | - Zijie Su
- Department of Thyroid Surgery, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, 450003, China
| | - Qinghui Wen
- Department of Clinical Laboratory, Dongguan People's Hospital, Dongguan, Guangdong, 523059, China
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Tian R, Yu M, Liao L, Zhang C, Zhao J, Sang L, Qian W, Wang Z, Huang L, Ma H. An effective convolutional neural network for classification of benign and malignant breast and thyroid tumors from ultrasound images. Phys Eng Sci Med 2023; 46:995-1013. [PMID: 37195403 DOI: 10.1007/s13246-023-01262-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/16/2023] [Indexed: 05/18/2023]
Abstract
Breast and thyroid cancers are the two most common cancers among women worldwide. The early clinical diagnosis of breast and thyroid cancers often utilizes ultrasonography. Most of the ultrasound images of breast and thyroid cancer lack specificity, which reduces the accuracy of ultrasound clinical diagnosis. This study attempts to develop an effective convolutional neural network (E-CNN) for the classification of benign and malignant breast and thyroid tumors from ultrasound images. The 2-Dimension (2D) ultrasound images of 1052 breast tumors were collected, and 8245 2D tumor images were obtained from 76 thyroid cases. We performed tenfold cross-validation on breast and thyroid data, with a mean classification accuracy of 0.932 and 0.902, respectively. In addition, the proposed E-CNN was applied to classify and evaluate 9297 mixed images (breast and thyroid images). The mean classification accuracy was 0.875, and the mean area under the curve (AUC) was 0.955. Based on data in the same modality, we transferred the breast model to classify typical tumor images of 76 patients. The finetuning model achieved a mean classification accuracy of 0.945, and a mean AUC of 0.958. Meanwhile, the transfer thyroid model realized a mean classification accuracy of 0.932, and a mean AUC of 0.959, on 1052 breast tumor images. The experimental results demonstrate the ability of the E-CNN to learn the features and classify breast and thyroid tumors. Besides, it is promising to classify benign and malignant tumors from ultrasound images with the transfer model under the same modality.
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Affiliation(s)
- Ronghui Tian
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, Liaoning, China
| | - Miao Yu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, Liaoning, China
| | - Lingmin Liao
- Department of Ultrasound, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Nanchang, 330006, China
| | - Chunquan Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Jiali Zhao
- Department of Ultrasound, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Nanchang, 330006, China
| | - Liang Sang
- Department of Ultrasound, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China
| | - Wei Qian
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, Liaoning, China
| | - Zhiguo Wang
- Department of Nuclear Medicine, General Hospital of Northern Theatre Command, Shenyang, 110016, Liaoning, China
| | - Long Huang
- Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Nanchang, 330006, China.
| | - He Ma
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, Liaoning, China.
- National University of Singapore (Suzhou) Research Institute, Suzhou, 215123, China.
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Xiao ZH, Wang C, Wang Y, Yuan SK, Huang C, Chen RF, Li Y. Cancer Risk and its Association With Diabetes Mellitus in Patients With Acromegaly: A Two Center-based Study. Endocr Pract 2023; 29:699-704. [PMID: 37343764 DOI: 10.1016/j.eprac.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE To compare the incidence of cancer in patients with acromegaly with that of the local population in China and explore possible risk factors. METHODS Data from 117 patients diagnosed with acromegaly at 2 centers between 2011 and 2022 were analyzed, and their cancer diagnoses were recorded. The cancer standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated by comparison with those of the local population. The patients were divided into 2 groups, having cancer diagnosis or not. The relationships between cancer and sex, body mass index, age, growth hormone levels, diagnosis delay, tumor size, disease duration, treatment, disease status, and other comorbidities were analyzed. RESULTS Eight (6.8%) of 117 patients were diagnosed with cancer. The incidence of overall (SIR = 3.29, 95% CI = 1.42-6.94), colorectal (SIR = 16.67, 95% CI = 4.45-42.67), and thyroid cancers (SIR = 14.29, 95% CI = 1.73-51.60) was increased, but that of lung cancer (SIR = 4.17, 95% CI = 0.50-15.05) was not. Diagnostic delay (10.1[8.6-14.3] vs 3.8[1.3-9.0]; P = .005) and duration of acromegaly (12.8[8.9-16.4] vs 5.6[2.3-10.9]; P = .008) were prolonged in the cancer group. Diabetes mellitus (odds ratio = 7.01, 95% CI = 1.23-39.99) was an independent risk factor for acromegaly with cancer. CONCLUSION Acromegaly patients are at a higher risk of cancer and its association with diabetes mellitus. Considering the rarity of the disease, an Acromegaly Cancer Registry Center should be established in China as soon as possible.
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Affiliation(s)
- Zhe-Hao Xiao
- Department of medical oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Cheng Wang
- Emergency Department, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yong Wang
- Department of medical oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shang-Kun Yuan
- Department of medical oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Cheng Huang
- Department of medical oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ren-Fang Chen
- Department of medical oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yong Li
- Department of medical oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
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9
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Zhang MN, Liang XY, Li MT, Zhi XY, Yan QY, Zhu H, Xie J. Current status and temporal trend of disease burden of thyroid cancer in China from 1990 to 2019. Asia Pac J Clin Oncol 2023; 19:196-205. [PMID: 35692103 DOI: 10.1111/ajco.13800] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/22/2022] [Accepted: 05/07/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Thyroid cancer has been an increasingly high-profile public health issue. Comprehensive assessment for its disease burden seems particularly important for understanding health priorities and hinting high-risk populations. METHODS We estimated the age-sex-specific thyroid cancer burden and its temporal trend in China from 1990 to 2019 by following the general methods from the global burden of disease (GBDs) 2019 Study. And Joinpoint regression model, the Cox-Stuart trend test, and Cochran-Armitage test were applied for the analysis of temporal and age trend. The Mantel-Haenszel statistical method was used to compare the gender difference. RESULTS From 1990 to 2019, the age-standardized incidence rate of thyroid cancer in China has almost doubled to 2.05 per 100,000. Although the mortality rate and DALY rate kept leveling off, they presented a downtrend among females, while an upward trend in males. While the average annual percentage changes of those metrics all became deline since 2010 than the previous years. With age advancing, the rates of incidence, mortality, and DALYs for both sexes all presented linear fashion increases, which was particularly typical among males. CONCLUSION Given the serious trend and gender-age heterogeneity of Chinese thyroid cancer burden, male gender and advanced age may be related to poor prognosis of thyroid cancer, and strengthening primary prevention and exploring the underlying risk factors should be among the top priorities.
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Affiliation(s)
- Meng-Ni Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Xiao-Yu Liang
- Tianjin Medical University General Hospital, Tianjin, China
| | - Mao-Ting Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Xin-Yue Zhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Qiu-Yu Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Hong Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Juan Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
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10
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Wang Y, Li S, Zhou Q, Wang Y, Shi J. Vascular dementia has the highest hospitalisation rate in China: a nationwide hospital information system study. Stroke Vasc Neurol 2023; 8:59-68. [PMID: 36219569 PMCID: PMC9985804 DOI: 10.1136/svn-2022-001637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/16/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Although vascular dementia (VaD) is not uncommon in the hospital, most studies on VaD are community based. This study on VaD is the first to use a national hospital information system (HIS) in China. METHODS This study was a hospital population-based cohort study, and data were acquired from the Hospital Quality Monitoring System, a Chinese national database that covers 1531 tertiary hospitals in China. The medical records in the HIS included demographic information, diagnoses, procedures, expenses, etc. VaD was diagnosed by hospital attending physicians and identified by the International Classification of Diseases (ICD) 10 code (F01.0-F01.9). RESULTS 1259 (82.23%) tertiary hospitals were included in this study, and 274 230 hospitalisation records of 123 700 VaD patients from 2016 to 2018 were identified for analysis. VaD (51.27%) was the most common type of dementia in hospitalised patients. The age-adjusted and sex-adjusted hospital incidence of VaD was estimated to be 2.97 per 100 000 person-years (95% CI 2.92 to 3.02). The mean age of VaD patients admitted to hospitals was 74.13±10.88, with more male (61.0%) patients. The main comorbidities were hypertension (67.2%), heart disease (63.6%) and cerebral infarction (55.5%). The mortality rate of VaD in hospital was 28.91‰ (95% CI 28.0 to 29.9) between 2016 and 2018. The top 1 cause of death due to VaD was pneumonia and other respiratory disorders. CONCLUSIONS VaD is the most common form of dementia in hospitalised patients. It casts huge burdens on affected patients and their caregivers. Vascular risk factors are prevalent in VaD patients. Reducing these factors is essential to improve patient care. The leading causes of death by VaD are pneumonia and other respiratory disorders. Hospital care and the management of respiratory illness are critical for VaD care in the hospital.
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Affiliation(s)
- Yue Wang
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China.,National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Shiping Li
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China.,National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Qi Zhou
- National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China .,National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jiong Shi
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China .,National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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11
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Zhu J, Sun K, Wang J, He Y, Li D, Liu S, Huang Y, Zhang M, Song B, Liao X, Liang H, Zhang Q, Shi M, Guo L, Zhou Y, Lin Y, Lu Y, Tuo J, Xia Y, Sun H, Xiao H, Ji Y, Yan C, Qiao J, Zeng H, Zheng R, Zhang S, Liu S, Chang S, Wei W. Clinicopathological and surgical comparisons of differentiated thyroid cancer between China and the USA: A multicentered hospital-based study. Front Public Health 2022; 10:974359. [PMID: 36249201 PMCID: PMC9554273 DOI: 10.3389/fpubh.2022.974359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/02/2022] [Indexed: 01/21/2023] Open
Abstract
Background Thyroid cancer (TC), was the fastest-rising tumor of all malignancies in the world and China, predominantly differentiated thyroid cancer (DTC). However, evidence on TC stage distribution and influencing factors of late-stage were limited in China. Methods We carried out a retrospective study and enrolled TC patients who were first diagnosed and hospitalized in 8 hospitals in China in 2017. Logistic regression was used to evaluate associations between influencing factors and DTC stage. We extracted eligible primary DTC records newly diagnosed in 2017 from the USA's Surveillance, Epidemiology, and End Results (SEER) database. We compared clinicopathological features and surgical treatment between our DTC records and those from the SEER database. Results A total of 1970 eligible patients were included, with 1861 DTC patients with known stage. Among patients ≥45 years old, males (OR = 1.76, 95%CI 1.17-2.65) and those with new rural cooperative medical scheme insurance (NCMS) (OR = 1.99, 95%CI 1.38-2.88) had higher risks of late-stage DTC (stage III-IV). Compared with SEER database, over-diagnosis is more common in China [more DTC patients with onset age< 45 years old (50.3 vs. 40.7%, P < 0.001), with early-stage (81.2 vs. 76.0%, P < 0.001), and with tumors<2cm (74.9 vs. 63.7%, P < 0.001)]. Compared with the USA, TC treatment is more conservative in China. The proportion of lobectomy in our database was significantly higher than that in the SEER database (41.3 vs. 17.0%, P < 0.001). Conclusions Unique risk factors are found to be associated with late-stage DTC in China. The differences in the aspect of clinicopathological features and surgical approaches between China and the USA indicate that potential over-diagnosis and over-surgery exist, and disparities on surgery extent may need further consideration. The findings provided references for other countries with similar patterns.
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Affiliation(s)
- Juan Zhu
- Office of National Central Cancer Registry, 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 Prevention, Institute of Cancer and Basic Medicine (IBMC), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Chinese Academy of Sciences, Hangzhou, China
| | - Kexin Sun
- Office of National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Wang
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yutong He
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Daojuan Li
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shuzheng Liu
- Henan Cancer Prevention and Control Office, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yunchao Huang
- Office of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming, China
| | - Min Zhang
- Office of Cancer Prevention and Treatment, Hubei Cancer Hospital, Wuhan, China
| | - Bingbing Song
- Heilongjiang Cancer Center, Institute of Cancer Prevention and Treatment, Harbin Medical University, Harbin, China
| | - Xianzhen Liao
- Department of Cancer Prevention and Control, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - He Liang
- Scientific Research Education Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Qian Zhang
- Information Management and Big Data Center, The Tumor Hospital Affiliated to Xinjiang Medical University, Ürümqi, China
| | - Mumu Shi
- Science and Education Department, The Fifth People's Hospital of Qinghai, Xining, China
| | - Lanwei Guo
- Henan Cancer Prevention and Control Office, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yongchun Zhou
- Office of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming, China
| | - Yanping Lin
- Office of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming, China
| | - Yanni Lu
- Office of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming, China
| | - Jiyu Tuo
- Office of Cancer Prevention and Treatment, Hubei Cancer Hospital, Wuhan, China
| | - Yafen Xia
- Office of Cancer Prevention and Treatment, Hubei Cancer Hospital, Wuhan, China
| | - Huixin Sun
- Heilongjiang Cancer Center, Institute of Cancer Prevention and Treatment, Harbin Medical University, Harbin, China
| | - Haifan Xiao
- Department of Cancer Prevention and Control, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Yong Ji
- Medical Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Ci Yan
- Information Management and Big Data Center, The Tumor Hospital Affiliated to Xinjiang Medical University, Ürümqi, China
| | - Jinwan Qiao
- Science and Education Department, The Fifth People's Hospital of Qinghai, Xining, China
| | - Hongmei Zeng
- Office of National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rongshou Zheng
- Office of National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Siwei Zhang
- Office of National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shaoyan Liu
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sheng Chang
- Human Resources Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,*Correspondence: Sheng Chang
| | - Wenqiang Wei
- Office of National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Wenqiang Wei
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12
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Cai M, Ni WJ, Wang YH, Wang JJ, Zhou H. Targeting TMEM88 as an Attractive Therapeutic Strategy in Malignant Tumors. Front Oncol 2022; 12:906372. [PMID: 35734592 PMCID: PMC9207468 DOI: 10.3389/fonc.2022.906372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/09/2022] [Indexed: 12/24/2022] Open
Abstract
According to authoritative surveys, the overall morbidity and mortality of malignant tumors show an upward trend, and it is predicted that this trend will not be well contained in the upcoming new period. Since the influencing factors, pathogenesis, and progression characteristics of malignant tumors have not been fully elucidated, the existing treatment strategies, mainly including surgical resection, ablation therapy and chemotherapy, cannot achieve satisfactory results. Therefore, exploring potential therapeutic targets and clarifying their functions and mechanisms in continuous research and practice will provide new ideas and possibilities for the treatment of malignant tumors. Recently, a double-transmembrane protein named transmembrane protein 88 (TMEM88) was reported to regulate changes in downstream effectors by mediating different signaling pathways and was confirmed to be widely involved in cell proliferation, differentiation, apoptosis and tumor progression. At present, abnormal changes in TMEM88 have been found in breast cancer, ovarian cancer, lung cancer, thyroid cancer and other malignant tumors, which has also attracted the attention of tumor research and attempted to clarify its function and mechanism. However, due to the lack of systematic generalization, comprehensive and detailed research results have not been comprehensively summarized. In view of this, this article will describe in detail the changes in TMEM88 in the occurrence and development of malignant tumors, comprehensively summarize the corresponding molecular mechanisms, and explore the potential of targeting TMEM88 in the treatment of malignant tumors to provide valuable candidate targets and promising intervention strategies for the diagnosis and cure of malignant tumors.
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Affiliation(s)
- Ming Cai
- Department of Pharmacy, The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China.,Anhui Acupuncture and Moxibustion Clinical Medicine Research Center, The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Wei-Jian Ni
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, The Key Laboratory of Anti-inflammatory of Immune Medicines, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China.,Anhui Provincial Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Ying-Hong Wang
- Department of Pharmacy, Anhui Provincial Cancer Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jing-Ji Wang
- Anhui Acupuncture and Moxibustion Clinical Medicine Research Center, The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Hong Zhou
- Department of Pharmacy, Anhui Provincial Cancer Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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13
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Liu Y, Ning X, Zhang L, Long J, Liang R, Peng S, Wang H, Li Y, Chen W, Xiao H. Prevalence of long-term complications in inpatients with diabetes mellitus in China: a nationwide tertiary hospital-based study. BMJ Open Diabetes Res Care 2022; 10:10/3/e002720. [PMID: 35545316 PMCID: PMC9096476 DOI: 10.1136/bmjdrc-2021-002720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/12/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION There is absence of national data to estimate the prevalence of long-term diabetic complications among inpatients with diabetes in tertiary hospitals in China. RESEARCH DESIGN AND METHODS Using the national Hospital Quality Monitoring System database, inpatients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) were identified by the International Classification of Diseases-10 code, and the temporal trends of microvascular and macrovascular complications 2013-2017 were calculated, and then the risk factors were analysed by multivariate regression analysis. RESULTS A total of 92 413 inpatients with T1DM and 6 094 038 inpatients with T2DM were identified in 2013-2017. The proportions of inpatients with microvascular complications in inpatients with T1DM and T2DM increased from 29.9% and 19.0% in 2013 to 31.6% and 21.0% in 2017, respectively. The proportions of inpatients with macrovascular complications in inpatients with T1DM and T2DM increased from 7.3% and 14.5% in 2013 to 13.2% and 18.4% in 2017, respectively. Hypertension and hyperlipidemia were risk factors for both microvascular and macrovascular complications. Among inpatients with T1DM, the adjusted ORs of microvascular complications increased in 40-49 age group and Northeast region, while older age, male and North region were risks factor for macrovascular complications. Among inpatients with T2DM, the ORs of microvascular complications increased in 40-49 age group, female, urban and North region, while older age, male, urban and Southwest region were risks factor for macrovascular complications. CONCLUSIONS The proportions of long-term complications of inpatients with diabetes in China increased in 2013-2017. Efforts are needed to improve the management of patients with diabetes in China.
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Affiliation(s)
- Yihao Liu
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xin Ning
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University) and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China
| | - Luyao Zhang
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jianyan Long
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ruiming Liang
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Sui Peng
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haibo Wang
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanbing Li
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wei Chen
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University) and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China
| | - Haipeng Xiao
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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14
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Huo S, Liu Y, Sun A, Zhang B. Environmental and social determinants of thyroid cancer: A spatial analysis based on the Geographical Detector. Front Endocrinol (Lausanne) 2022; 13:1052606. [PMID: 36523594 PMCID: PMC9745063 DOI: 10.3389/fendo.2022.1052606] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/08/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Thyroid cancer has increased sharply in China in recent years. This change may be attributable to multiple factors. The current study aimed to explore the environmental and social determinants of thyroid cancer. METHODS Incidence data from 487 cancer registries in 2016 were collected. Eight factors were considered, namely, air pollution, green space, ambient temperature, ultraviolet radiation, altitude, economic status, healthcare, and education level. A geographical detector (measured by q statistic) was used to evaluate the independent and interactive impact of the eight factors on thyroid cancer. RESULTS Social factors, especially economic status and healthcare level (q > 0.2), were most influential on thyroid cancer.Ultraviolet radiation, air pollution, and temperature had more impact on women, while green space and altitude had more influence on men. Enhanced effects were observed when two factors interacted. Spatially, economic status, healthcare, and air pollution were positively associated with thyroid cancer, while education level, green space, and altitude were negatively related to thyroid cancer. CONCLUSION The socio-environmental determinants and spatial heterogeneity of thyroid cancer were observed in this study. These findings may improve our understanding of thyroid cancer epidemiology and help guide public health interventions.
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Affiliation(s)
- Shirui Huo
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Liu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Anyi Sun
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Bo Zhang
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing, China
- *Correspondence: Bo Zhang,
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15
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Liu W, Yan X, Cheng R. The active surveillance management approach for patients with low risk papillary thyroid microcarcinomas: is China ready? Cancer Biol Med 2021; 19:j.issn.2095-3941.2021.0058. [PMID: 34553851 PMCID: PMC9196058 DOI: 10.20892/j.issn.2095-3941.2021.0058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/30/2021] [Indexed: 11/17/2022] Open
Abstract
Due to exponential increases in incidences, low risk papillary thyroid microcarcinoma (PTMC) has become a clinical and social issue in recent years. An active surveillance (AS) management approach is an alternative to immediate surgery for patients with low risk PTMC. With decreased doubts about the safety and validity due to evidence from a large number of studies, the AS approach has become increasingly popular worldwide. However, Chinese thyroid surgeons still lag behind other countries in their knowledge of clinical practices and research related to AS. To promote the implementation of AS in China, thyroid surgeons should understand the implications, advantages, and disadvantages of management approaches for AS, and should also consider the willingness of Chinese patients, the impact on the medical billing system, and the enthusiasm of doctors. Thus, a management approach for AS based on the Chinese population should be developed to reduce the risk of disease progression and enhance patient adherence. Herein, we summarize the recent research achievements and deficiencies in AS approaches, and describe the initial experiences regarding AS in the Chinese population, in order to assist Chinese thyroid surgeons in preparing for AS management in the era of PTMC precision medicine.
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Affiliation(s)
- Wen Liu
- Department of Thyroid Surgery, Clinical Research Center for Thyroid Diseases of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Xuejing Yan
- Department of Management of Chronic Non-communicable Diseases, Yunnan Center for Disease Control and Prevention, Kunming 650034, China
| | - Ruochuan Cheng
- Department of Thyroid Surgery, Clinical Research Center for Thyroid Diseases of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
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16
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Liu Y, Lai F, Long J, Peng S, Wang H, Zhou Q, Li B, Su L, Gan L, Shi Y, Lv W, Li Y, Cheng K, Xiao H. Screening and the epidemic of thyroid cancer in China: An analysis of national representative inpatient and commercial insurance databases. Int J Cancer 2020; 148:1106-1114. [PMID: 32930403 PMCID: PMC7821127 DOI: 10.1002/ijc.33298] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/21/2020] [Accepted: 09/08/2020] [Indexed: 12/29/2022]
Abstract
Reasons behind the rapid increase of thyroid cancer (TC) in China are uncertain. We assessed the burden of TC and the role of access to screening and salt iodization. We analyzed two national databases in China: Hospital Quality Monitoring System (HQMS) and China Reinsurance Company (CRC) database. HQMS covered 1037 (44.3%) Class 3 hospitals and 76 263 617 Class 3 hospital inpatients in 2013 to 2017 and CRC covered 93 123 018 clients in 2000 to 2016. The proportion of TC inpatients among inpatients in HQMS and TC incidence in critical illness insurance buyers were used to evaluate the association with screening and iodine status. Between 2013 and 2017, the proportion of TC patients in HQMS with urban employee medical insurance and good access to screening increased sharply while there was little change among those with the other two forms of medical insurance. Across provinces, the proportion of TC inpatients in HQMS was positively correlated with per capita disposable income but not with median urinary iodine. Similar findings were observed in the CRC database. In 2017, approximately 1000 individuals were overdiagnosed with TC daily. We conservatively forecast that 5.1 million healthy individuals would become TC patients unnecessarily between 2019 and 2030. Our findings suggested the epidemic of TC in China was substantially underestimated. It was associated with screening but not with salt iodization. What's new? In recent decades, the incidence of thyroid cancer has increased rapidly worldwide. In China, the role of thyroid cancer screening as part of regular health checks and potential overdiagnosis remain unclear. Moreover, there are concerns among the general public that mandatory salt iodization may have contributed to the epidemic of thyroid cancer. Here, the authors found that the increase in thyroid cancer in China is associated with increased access to health care and screening, but not with salt iodization. Moreover, the results suggest that approximately 1000 individuals are overdiagnosed with thyroid cancer daily, calling for urgent measures to prevent overdiagnosis.
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Affiliation(s)
- Yihao Liu
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fenghua Lai
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jianyan Long
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Sui Peng
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haibo Wang
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qian Zhou
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bin Li
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei Su
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lanxia Gan
- China Standard Medical Information Research Center, Shenzhen, China
| | - Ying Shi
- China Standard Medical Information Research Center, Shenzhen, China
| | - Weiming Lv
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanbing Li
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Karkeung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Haipeng Xiao
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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