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Feng X, Hua ZL, Zhou Q, Shi AW, Song TQ, Qian DF, Chen R, Wang GQ, Wei WQ, Zhou JY, Wang JJ, Shao G, Wang X. Prevalence and coprevalence of modifiable risk factors for upper digestive tract cancer among residents aged 40-69 years in Yangzhong city, China: a cross-sectional study. BMJ Open 2021; 11:e042006. [PMID: 33827830 PMCID: PMC8031018 DOI: 10.1136/bmjopen-2020-042006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To describe the prevalence of modifiable risk factors for upper digestive tract cancer (UDTC) and its coprevalence, and investigate relevant influencing factors of modifiable UDTC risk factors coprevalence among residents aged 40-69 years in Yangzhong city, China. DESIGN Cross-sectional study. PARTICIPANTS A total of 21 175 participants aged 40-69 years were enrolled in the study. 1962 subjects were excluded due to missing age, marital status or some other selected information. Eventually, 19 213 participants were available for the present analysis. MAIN OUTCOMES MEASURES Prevalence and coprevalence of eight modifiable UDTC risk factors (overweight or obesity, current smoking, excessive alcohol consumption, insufficient vegetables intake, insufficient fruit intake and the consumption of pickled, fried and hot food) were analysed. RESULTS The prevalence of overweight/obesity, current smoking, excessive alcohol consumption, insufficient vegetables intake, insufficient fruit intake and the consumption of pickled, fried and hot food in this study was 45.3%, 24.1%, 16.2%, 66.1%, 94.5%, 68.1%, 36.0% and 88.4%, respectively. Nearly all (99.9%) participants showed one or more UDTC risk factors, 98.6% of the participants showed at least two risk factors, 92.2% of the participants had at least three risk factors and 69.7% of the participants had four or more risk factors. Multivariate logistic regression analysis revealed that men, younger age, single, higher education, higher annual family income and smaller household size were more likely to present modifiable UDTC risk factors coprevalence. CONCLUSIONS The prevalence and coprevalence of modifiable UDTC risk factors are high among participants in Yangzhong city. Extra attention must be paid to these groups who are susceptible to risk factors coprevalence during screening progress. Relative departments also need to make significant public health programmes that aim to decrease modifiable UDTC risk factors coprevalence among residents aged 40-69 years from high-risk areas of UDTC.
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Affiliation(s)
- Xiang Feng
- Institute of tumour prevention and control, People's Hospital of Yangzhong City, Yangzhong, China
| | - Zhao-Lai Hua
- Institute of tumour prevention and control, People's Hospital of Yangzhong City, Yangzhong, China
| | - Qin Zhou
- Institute of tumour prevention and control, People's Hospital of Yangzhong City, Yangzhong, China
| | - Ai-Wu Shi
- Institute of tumour prevention and control, People's Hospital of Yangzhong City, Yangzhong, China
| | - Tong-Qiu Song
- Institute of tumour prevention and control, People's Hospital of Yangzhong City, Yangzhong, China
| | - Dong-Fu Qian
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
| | - Ru Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Cancer Registry Office, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gui-Qi Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Cancer Registry Office, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wen-Qiang Wei
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Cancer Registry Office, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jin-Yi Zhou
- Depatment of Non-communicable Disease Prevention, Jiangsu Province Center for Disease Control and Prevention, Nanjing, China
| | - Jie-Jun Wang
- Changzheng Hospital, Department of Oncology, Second Military Medical University, Shanghai, China
| | - Gang Shao
- Department of Oncology, 923rd Hospital of PLA, Hangzhou, China
| | - Xi Wang
- Department of Oncology, 923rd Hospital of PLA, Hangzhou, China
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Taylor AW, Shi Z, Dal Grande E, Stockley C. The Relationship between Alcohol Consumption and other Risk Factors Assessed Using An Ongoing Population-based Surveillance System. AIMS Public Health 2016; 3:985-1002. [PMID: 29546207 PMCID: PMC5690417 DOI: 10.3934/publichealth.2016.4.985] [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: 08/26/2016] [Accepted: 11/29/2016] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to determine the relationship of alcohol consumption (reported in four different ways) with other specific disease-related risk factors (that is, smoking, high body mass index, low physical activity and insufficient fruit and vegetables). Data were collected from 2003 to 2015 in South Australia using an on-going monthly chronic disease and risk factor telephone survey of randomly selected persons (18+ years). The proportion of alcohol drinkers and, for those who drank alcohol, the proportion drinking more than one day per week, the proportion drinking on six or more days per week, and the mean alcohol drinks per day were assessed. Logistic regression and linear regression modelling were used on age and sex adjusted data. In total, over 71,000 respondents aged 18 years and older were interviewed (48.8% male). Overall prevalence of alcohol consumption was 81.3%. Trends in the direction promoted by current policies and preventative authorities were apparent with appropriate changes for all four measures for overall and for those underweight, undertaking sufficient activity, consuming <2 serves of fruit per day, consuming <5 serves of vegetables per day and with 3+ total risk factors. This research has provided evidence on the trends in alcohol consumption in relation to a range of other specific modifiable disease-related risk factors. The trends analysis has shown different patterns for each risk factor, and highlights the interplay between the respective modifiable or preventive risk factors.
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Affiliation(s)
- Anne W Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, South Australia, Australia
| | - Zumin Shi
- Population Research & Outcome Studies, The Univeristy of Adealide, South Australia, Australia
| | - Eleonora Dal Grande
- Population Research & Outcome Studies, The Univeristy of Adealide, South Australia, Australia
| | - Creina Stockley
- Health & Regulatory Information, The Australian Wine Research Institute, Urrbrae, Adelaide, South Australia, Australia
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deRuiter WK, Cairney J, Leatherdale S, Faulkner G. The period prevalence of risk behavior co-occurrence among Canadians. Prev Med 2016; 85:11-16. [PMID: 26658026 DOI: 10.1016/j.ypmed.2015.11.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/26/2015] [Accepted: 11/28/2015] [Indexed: 11/18/2022]
Abstract
INTRODUCTION While the benefits of complying with health recommendations is well documented, a considerable proportion of Canadians engage in multiple modifiable risk behaviors. The purpose of this multi-wave longitudinal study was to identify the individual period prevalence and co-occurrence of multiple modifiable risk behaviors, particularly excessive alcohol consumption, physical inactivity, and tobacco use, within a nationally representative sample of Canadians. METHODS Secondary data analysis was conducted on the first seven cycles of the National Population Health Survey. This longitudinal sample included 15,167 Canadians aged 12years of age or older. Gender-specific criteria were employed to define excessive alcohol consumption. Individuals expending <3.0kcal/kg/day during their leisure-time and smoking cigarettes (daily or occasionally) met the criteria for physical inactivity and tobacco use, respectively. RESULTS The period prevalence of the Canadian general population that participated in multiple risk behaviors was 21.5% in cycle 7. The most common pairwise combination of co-occurring risk behaviors was physical inactivity and smoking. The proportion of Canadians reporting the co-occurrence of all three risk behaviors in cycle 7 was 2.6%. CONCLUSIONS Understanding patterns of modifiable risk behaviors is an initial step in developing and implementing public health interventions. The co-occurrence of these three risk behaviors is a viable concern for one in five Canadians. For these individuals, the likelihood of encountering premature morbidity and mortality is escalated. As the majority of Canadians reported being physically inactive, allocating limited resources towards enhancing leisure-time physical activity levels could have significant population-level implications for improving the health of Canadians.
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Affiliation(s)
- Wayne K deRuiter
- Faculty of Kinesiology & Physical Education, University of Toronto, 55 Harbord Street, Toronto, ON M5S 2W6, Canada; Nicotine Dependence Service, Centre for Addiction and Mental Health, 175 College Street, Toronto, ON, M5T 1P7, Canada.
| | - John Cairney
- Department of Family Medicine, McMaster University, 100 Main Street West, 6th Floor, Hamilton, ON L8P 1H6, Canada; Psychiatry & Behavioural Neurosciences and Kinesiology, McMaster University, 100 West 5th Street, Hamilton, ON L8N 3K7, Canada
| | - Scott Leatherdale
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Guy Faulkner
- Faculty of Kinesiology & Physical Education, University of Toronto, 55 Harbord Street, Toronto, ON M5S 2W6, Canada; School of Kinesiology, University of British Columbia, 2146 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada
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Ryan CJ, Leatherdale ST, Cooke MJ. A cross-sectional examination of the correlates of current smoking among off-reserve First Nations and Métis adults: Evidence from the 2012 Aboriginal Peoples Survey. Addict Behav 2016; 54:75-81. [PMID: 26735185 DOI: 10.1016/j.addbeh.2015.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 12/03/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The purpose of this study was to examine the correlates of current smoking among off-reserve First Nations and Métis adults, two Aboriginal Canadian groups that are at higher risk to smoke and more likely to suffer from chronic health conditions relative to their non-Aboriginal counterparts. A particular focus was on culturally specific factors and their associations with current smoking. METHODS We used data from Statistics Canada's, 2012 Aboriginal Peoples Survey to investigate the correlates of smoking among 12,720 First Nations and Métis adults. Sequential binary logistic regression models were estimated to examine associations between smoking and culturally specific, demographic, geographic, socioeconomic and health-related variables. RESULTS Overall, 39.4% were current smokers. Multivariate results found that those who had hunted, fished or trapped within the last year were more likely to be smokers. In addition, respondents who were exposed to an Aboriginal language at home or outside the home were more likely to be smokers. Current smoking was significantly associated with being aged 35 to 49 years, living in a small population center, low income, low education, unemployment, being unmarried, low ratings of self-perceived health, heavy drinking and low body mass index. Respondents aged 65 years and older and those living in British Columbia were less likely to smoke. DISCUSSION The results of this study suggest that it may be useful to consider cultural characteristics, particularly language in efforts to reduce the prevalence of manufactured tobacco use among First Nations and Métis adults. Interventions should also consider demographic, geographic and socioeconomic variables, in addition to co-occurring health-risk behaviors.
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de Winter AF, Visser L, Verhulst FC, Vollebergh WAM, Reijneveld SA. Longitudinal patterns and predictors of multiple health risk behaviors among adolescents: The TRAILS study. Prev Med 2016; 84:76-82. [PMID: 26656404 DOI: 10.1016/j.ypmed.2015.11.028] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 11/25/2015] [Accepted: 11/28/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Most studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. PURPOSE To examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescents. METHODS Eight health risk behaviors (no regular consumption of fruit, vegetables or breakfast, overweight or obesity, physical inactivity, smoking, alcohol use and cannabis use) were assessed in a prospective population study (second and third wave). Participants were assessed in three waves between ages 10 and 17 (2001-2008; n=2230). Multiple linear regression was used to assess the influence of gender, self-control, parental health risk behaviors, parental monitoring and socioeconomic factors on the number of health risk behaviors adjusted for preceding multiple health risk behaviors (analysis: 2013-2014). RESULTS Rates of >5 health risk behaviors were high: 3.6% at age 13.5 and 10.2% at age 16. Smoking at age 13.5 was frequently associated with health risk behaviors at age 16. No regular consumption of fruit, vegetables and breakfast, overweight or obesity, physical inactivity and smoking predicted the co-occurrence of health risk behaviors at follow-up. Significant predictors of the development of multiple health risk behaviors were adolescents' levels of self-control, socioeconomic status and maternal smoking. CONCLUSIONS Multiple health risk behaviors are common among adolescents. Individual and social factors predict changes in multiple health risk behaviors, showing that prevention targeting multiple risk behaviors is needed. Special attention should be paid to adolescents with low self-control and families with low socioeconomic status or a mother who smokes.
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Affiliation(s)
- Andrea F de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, the Netherlands.
| | - Leenke Visser
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, the Netherlands; School for Marketing Management, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, the Netherlands
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Farazi P, Lander L, Pavlou P, Watkins K, Le L, Soliman A. Geographic trends of tobacco-related cancers in Cyprus. Tob Induc Dis 2015; 13:21. [PMID: 26229524 PMCID: PMC4520070 DOI: 10.1186/s12971-015-0048-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 07/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Causal relationships have been previously established between smoking and various cancers. In Cyprus, 39 % of men and 14 % of women reported daily smoking in 2008. The objective of this study was to compare the incidence of tobacco-related cancers to all other cancers by district and rural-urban classification to understand the impact of tobacco in Cyprus. METHODS Data on lung, urinary bladder, oral, pharyngeal, head/neck, and laryngeal cancers were obtained from the Cyprus Cancer Registry (1998-2008). There were 3,635 patients with tobacco-related cancers and 18,780 with non-tobacco cancers. Univariate analysis comparing tobacco-related cancers and all other cancers were conducted with regards to age at diagnosis, age groups, sex, smoking status, disease stage, and rural/urban status, with a p-value of 0.05 considered significant. Smoking prevalence, lung cancer, and bladder cancer rates of Cyprus were also compared to a number of other European countries. RESULTS Patients with tobacco-related cancers were older than those with non-tobacco cancers (mean age 67.2 ± 12.4 vs. 62.4 ± 17.1, p < 0.0001). Among those with tobacco-related cancers, 80.1 % were male compared to 45.4 % males with other cancer types. The proportion of ever smokers was higher among males compared to females in urban and rural districts. Sub-districts 41 (Age Adjusted Rate (AAR) 41.9, 95 % CI: 35.7-48.1), 60 (AAR 40.3, 95 % CI: 35.2-45.3), and 50 (AAR 36.3, 95 % CI: 33.8-38.7) had the highest rates of tobacco-related cancers. The overall tobacco-related cancer rate was the highest among males in urban districts (AAR 60.8, 95 % CI: 58.2-63.5). Among tobacco-related cancers, lung cancer had the highest overall AAR (17.9 per 100,000) while head and neck cancer had the lowest overall AAR (5.3 per 100,000). Additionally, even though Cypriot males aged 65-69 years old exhibited higher smoking prevalence than other European countries, the overall lung and bladder cancer rates were lower in Cyprus. CONCLUSION Despite the high proportion of smokers in Cyprus, cancer rates are low compared to other countries. Future in-depth measurements of relevant risk factors and smoking exposure can help understand this phenomenon and provide insights for cancer prevention.
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Affiliation(s)
- Paraskevi Farazi
- />Department of Life and Health Sciences, University of Nicosia, 46 Makedonitissas Ave, P.O. Box 24005, Nicosia, 1700 Cyprus
- />Mediterranean Center for Cancer Research, 46 Makedonitissas Ave, P.O. Box 24005, Nicosia, 1700 Cyprus
| | - Lina Lander
- />Department of Epidemiology, 984395 University of Nebraska Medical Center, Omaha, NE 68198-4395 USA
| | - Pavlos Pavlou
- />Cyprus Cancer Registry, Ministry of Health, Corner of Prodromou 1 and Chilonos 17, 1448 Nicosia, Cyprus
| | - Katherine Watkins
- />Department of Epidemiology, 984395 University of Nebraska Medical Center, Omaha, NE 68198-4395 USA
| | - Lynne Le
- />Department of Epidemiology, 984395 University of Nebraska Medical Center, Omaha, NE 68198-4395 USA
| | - Amr Soliman
- />Department of Epidemiology, 984395 University of Nebraska Medical Center, Omaha, NE 68198-4395 USA
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Ryan CJ, Cooke MJ, Leatherdale ST, Kirkpatrick SI, Wilk P. The correlates of current smoking among adult Métis: Evidence from the Aboriginal Peoples Survey and Métis Supplement. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2015; 106:e271-6. [PMID: 26451987 PMCID: PMC6972307 DOI: 10.17269/cjph.106.5053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 06/23/2015] [Accepted: 05/16/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the correlates of current smoking among Métis aged 18 years and older, with a particular focus on culturally-specific factors. Cultural factors included spirituality, knowledge of an Aboriginal language, membership in a Métis organization and attendance at Métis cultural events. Demographic, geographic, socio-economic and health-related variables were also considered. METHODS Data from 6,610 adult Métis aged 18 years and older who responded to the 2006 Aboriginal Peoples Survey and Métis supplement were used to examine the correlates of current smoking using sequential binary logistic regression modelling. RESULTS Overall, 39.9% of adult Métis respondents in the sample were current smokers. Adult Métis who reported a high level of spirituality were less likely to be current smokers. Those who spoke an Aboriginal language, or lived in a house where an Aboriginal language was spoken, were more likely to be current smokers. Being a member of a Métis organization and attending cultural events were not independently associated with current smoking. Métis with higher household income, greater education, higher self-perceived health, and greater physical activity participation were less likely to be current smokers, whereas those who reported heavy alcohol consumption were more likely to be current smokers. CONCLUSIONS The results of this study suggest that interventions aimed at reducing smoking among adult Métis might be more successful if they include some connection to spirituality. It is also evident that co-occurring risk behaviours, in addition to demographic and socio-economic factors, are important considerations when developing interventions to reduce smoking among this population.
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Leatherdale ST. An examination of the co-occurrence of modifiable risk factors associated with chronic disease among youth in the COMPASS study. Cancer Causes Control 2015; 26:519-28. [PMID: 25673505 DOI: 10.1007/s10552-015-0529-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 02/02/2015] [Indexed: 12/27/2022]
Abstract
PURPOSE To examine the prevalence of major modifiable risk factors for cancer, examine risk factor co-occurrence, and examine how demographic and social factors are associated with risk factor co-occurrence among youth in the COMPASS study. METHODS Data from 23,280 grade 9-12 students in Year 1 (2012-2013) of the COMPASS study were used to examine the prevalence of seven different modifiable risk factors and the co-occurrence of these risk factors by gender and by grade. The between-school variance in the number of risk factors was calculated, and a model was developed to examine how demographic and social factors were associated with the number of co-occurring risk factors. RESULTS Among youth in this sample, 5.5% were current smokers, 22.9% were current binge drinkers, 16.5% were current marijuana users, 20.0% were overweight/obese, 53.1% were physically inactive, 96.7% were highly sedentary, and 95.1% had inadequate fruit and vegetable consumption. The mean number of co-occurring risk factors among students was 3.2 (± 1.1) and only 0.2% (n = 42) reported having none of the risk factors and 0.4% (n = 67) reported having all seven risk factors. Significant between-school random variation in the number of co-occurring risk factors was not identified. The number of risk factors was associated with most of the correlates examined although the effect sizes were generally small. CONCLUSION This research identifies that risk factor co-occurrence is common, most of student characteristics examined are only modestly associated with the likelihood of co-occurrence and that the school environment is not associated with variability in the number of co-occurring risk factors.
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Affiliation(s)
- Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue, Waterloo, ON, N2L 3G1, Canada,
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Substance abuse and smoking among a Canadian cohort of first episode psychosis patients. Community Ment Health J 2013; 49:815-21. [PMID: 23775243 DOI: 10.1007/s10597-013-9634-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Accepted: 06/03/2013] [Indexed: 10/26/2022]
Abstract
Individuals experiencing their first psychotic episode report rates of substance and tobacco use that are higher than observed in the general population. In this sample of individuals diagnosed with first episode psychosis, rural/non-rural variations in substance use and smoking behaviour were evaluated. Analyses were performed utilizing data from a sample of individuals enrolled in early intervention programs located throughout the province of Ontario. Based upon population density, two geographical regions were developed: rural and non-rural. Illicit drug use, alcohol consumption, and smoking behaviour were assessed. The total sample consisted of 152 individuals experiencing their first episode of psychosis. Of these individuals, 82 and 70 resided in rural and non-rural areas, respectively. Rural vs non-rural residence was not significantly associated with substance or tobacco use. Regardless of geographical location, early intervention programs for individuals experiencing their first psychotic episode need to incorporate interventions that address substance use.
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Chiang YY, Chen KB, Tsai TH, Tsai WC. Lowered cancer risk with ACE inhibitors/ARBs: a population-based cohort study. J Clin Hypertens (Greenwich) 2013; 16:27-33. [PMID: 24304931 DOI: 10.1111/jch.12228] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 08/28/2013] [Accepted: 08/28/2013] [Indexed: 01/03/2023]
Abstract
There are conflicting reports on cancer risk associated with angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs). This retrospective cohort study was conducted to analyze the risk of cancer development in patients who received ACE inhibitors/ARBs as treatment for essential hypertension. Using the Taiwan National Health Insurance Research Database, 297,688 eligible study patients with essential hypertension were identified. According to their antihypertensive prescriptions, the study patients were stratified into an ACE inhibitor group, an ARB group, or a control group. After matching, participants were observed for the occurrence of cancer. In the ACE inhibitor group compared with the control group, the hazard ratio was 0.51 (95% confidence interval, 0.39-0.68). In the ARB group compared with the control group, the hazard ratio was 0.8 (95% confidence interval, 0.65-0.97). Regular use of ACE inhibitors/ARBs was not associated with an increased risk of cancer development and was actually found to decrease overall cancer risk in this study.
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Affiliation(s)
- Yi-Ying Chiang
- Department of Anesthesiology, China Medical University Hospital, Taichung, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan
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Carrière GM, Sanmartin C, Bryant H, Lockwood G. Rates of cancer incidence across terciles of the foreign-born population in Canada from 2001-2006. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2013; 104:e443-9. [PMID: 24495818 PMCID: PMC6973830 DOI: 10.17269/cjph.104.3884] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 10/25/2013] [Accepted: 10/29/2013] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To address the issue of comparative risk of cancer in Canada's immigrant population, an area-based methodology was applied to examine whether or not estimated cancer incidence rates among individuals living in given areas vary systematically according to the concentration of foreign-born individuals living in the same area. This method provides an alternative, accessible surveillance method in the absence of linked individual-level information to extend the work of others by providing both national and subnational standardized, hence comparable, results to address this issue. METHODS Canadian Cancer Registry data (2001 to 2006) and 2006 Census data provided dissemination area information regarding the concentration of the foreign-born population and population estimates for rate denominators. Cancer (all cause and cause-specific) incidence rate ratios (age-standardized and by age/sex) were calculated by foreign-born concentration areas at both national and regional levels. RESULTS An inverse gradient was identified between cancer incidence rates and area concentration of foreign-born, with the all-sites cancer rate ranging from a low of 388 per 100,000 among individuals living in areas with a high concentration of foreign-born to a high of 493 per 100,000 among individuals living in areas with a low concentration of foreign-born. This pattern occurred nationally for lung, colorectal, prostate and female breast cancers. However, for liver, nasopharynx, and thyroid cancers, higher cancer rates were observed in areas with a higher versus lower concentration of foreign-born populations. CONCLUSION The study findings provide suggestive evidence of decreased cancer risk among foreign-born populations for most cancers except nasopharynx, liver and thyroid for which risks were higher. The results of this study demonstrate the value of ecological-based methods for disease surveillance in the absence of individual-level information on immigrant status in the national cancer registry.
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McAloney K, Graham H, Law C, Platt L. A scoping review of statistical approaches to the analysis of multiple health-related behaviours. Prev Med 2013; 56:365-71. [PMID: 23518213 DOI: 10.1016/j.ypmed.2013.03.002] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 02/25/2013] [Accepted: 03/09/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Smoking, diet, exercise, and alcohol are leading causes of chronic disease and premature death, many engage in two or more of these behaviours concurrently. The paper identified statistical approaches used to investigate multiple behavioural risk factors. METHOD A scoping review of papers published in English from 2000 to 2011 was conducted; papers are related to concurrent participation in at least two of the behaviours. Statistical approaches were recorded and categorised. RESULTS Across 50 papers, two distinct approaches were identified. Co-occurrence analyses focused on concurrent but independent behaviours, represented by prevalence of behavioural combinations and/or by the summing behaviours into risk indexes. Clustering analyses investigated underlying associations between the concurrent behaviours, with clustering identified by divergences in observed and expected prevalence of combinations or through identification of latent or unobservable clusters. Co-occurrence was more frequently reported, but the use of clustering techniques and, in particular, cluster analytic and latent variable techniques increased across the study period. DISCUSSION The two approaches investigate concurrent participation in multiple health behaviours but differ in conceptualisation and analysis. Despite differences, inconsistency in the terminology describing the study of multiple health behaviours was apparent, with potential to influence understandings of concurrent health behaviours in policy and practice.
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Affiliation(s)
- Kareena McAloney
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK.
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Alamian A, Paradis G. Individual and social determinants of multiple chronic disease behavioral risk factors among youth. BMC Public Health 2012; 12:224. [PMID: 22439966 PMCID: PMC3331803 DOI: 10.1186/1471-2458-12-224] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 03/22/2012] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Behavioral risk factors are known to co-occur among youth, and to increase risks of chronic diseases morbidity and mortality later in life. However, little is known about determinants of multiple chronic disease behavioral risk factors, particularly among youth. Previous studies have been cross-sectional and carried out without a sound theoretical framework. METHODS Using longitudinal data (n = 1135) from Cycle 4 (2000-2001), Cycle 5 (2002-2003) and Cycle 6 (2004-2005) of the National Longitudinal Survey of Children and Youth, a nationally representative sample of Canadian children who are followed biennially, the present study examines the influence of a set of conceptually-related individual/social distal variables (variables situated at an intermediate distance from behaviors), and individual/social ultimate variables (variables situated at an utmost distance from behaviors) on the rate of occurrence of multiple behavioral risk factors (physical inactivity, sedentary behavior, tobacco smoking, alcohol drinking, and high body mass index) in a sample of children aged 10-11 years at baseline. Multiple behavioral risk factors were assessed using a multiple risk factor score. All statistical analyses were performed using SAS, version 9.1, and SUDAAN, version 9.01. RESULTS Multivariate longitudinal Poisson models showed that social distal variables including parental/peer smoking and peer drinking (Log-likelihood ratio (LLR) = 187.86, degrees of freedom (DF) = 8, p < .001), as well as individual distal variables including low self-esteem (LLR = 76.94, DF = 4, p < .001) increased the rate of occurrence of multiple behavioral risk factors. Individual ultimate variables including age, sex, and anxiety (LLR = 9.34, DF = 3, p < .05), as well as social ultimate variables including family socioeconomic status, and family structure (LLR = 10.93, DF = 5, p = .05) contributed minimally to the rate of co-occurrence of behavioral risk factors. CONCLUSIONS The results suggest targeting individual/social distal variables in prevention programs of multiple chronic disease behavioral risk factors among youth.
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Affiliation(s)
- Arsham Alamian
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA.
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Lv J, Liu Q, Ren Y, Gong T, Wang S, Li L. Socio-demographic association of multiple modifiable lifestyle risk factors and their clustering in a representative urban population of adults: a cross-sectional study in Hangzhou, China. Int J Behav Nutr Phys Act 2011; 8:40. [PMID: 21569614 PMCID: PMC3117756 DOI: 10.1186/1479-5868-8-40] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 05/15/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To plan long-term prevention strategies and develop tailored intervention activities, it is important to understand the socio-demographic characteristics of the subpopulations at high risk of developing chronic diseases. This study aimed to examine the socio-demographic characteristics associated with multiple lifestyle risk factors and their clustering. METHODS We conducted a simple random sampling survey to assess lifestyle risk factors in three districts of Hangzhou, China between 2008 and 2009. A two-step cluster analysis was used to identify different health-related lifestyle clusters based on tobacco use, physical activity, fruit and vegetable consumption, and out-of-home eating. Multinomial logistic regression was used to model the association between socio-demographic factors and lifestyle clusters. RESULTS A total of 2016 eligible people (977 men and 1039 women, ages 18-64 years) completed the survey. Three distinct clusters were identified from the cluster analysis: an unhealthy (UH) group (25.7%), moderately healthy (MH) group (31.1%), and healthy (H) group (43.1%). UH group was characterised by a high prevalence of current daily smoking, a moderate or low level of PA, low FV consumption with regard to the frequency or servings, and more occurrences of eating out. H group was characterised by no current daily smoking, a moderate level of PA, high FV consumption, and the fewest times of eating out. MH group was characterised by no current daily smoking, a low or high level of PA, and an intermediate level of FV consumption and frequency of eating out. Men were more likely than women to have unhealthy lifestyles. Adults aged 50-64 years were more likely to live healthy lifestyles. Adults aged 40-49 years were more likely to be in the UH group. Adults whose highest level of education was junior high school or below were more likely to be in the UH group. Adults with a high asset index were more likely to be in the MH group. CONCLUSIONS This study suggests that Chinese urban people who are middle-aged, men, and less educated are most likely to be part of the cluster with a high-risk profile. Those groups will contribute the most to the future burden of major chronic disease and should be targeted for early prevention programs.
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Affiliation(s)
- Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China
| | - Qingmin Liu
- Division for Chronic and Non-Communicable Disease Control and Prevention, Hangzhou Center for Disease Control and Prevention, Mingshi Road, Jianqiao Town, Hangzhou 310021, China
| | - Yanjun Ren
- Division for Chronic and Non-Communicable Disease Control and Prevention, Hangzhou Center for Disease Control and Prevention, Mingshi Road, Jianqiao Town, Hangzhou 310021, China
| | - Ting Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China
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Berto SJP, Carvalhaes MABL, Moura ECD. Tabagismo associado a outros fatores comportamentais de risco de doenças e agravos crônicos não transmissíveis. CAD SAUDE PUBLICA 2010; 26:1573-82. [DOI: 10.1590/s0102-311x2010000800011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Accepted: 06/10/2010] [Indexed: 11/22/2022] Open
Abstract
Foram entrevistados via ligação telefônica 1.410 indivíduos, amostra aleatória e representativa da população acima de 18 anos residente em domicílios conectados à rede de telefonia fixa. A prevalência de tabagismo foi de 21,8%, maior em homens (25%) e em indivíduos na faixa entre 18 e 29 anos. Tabagismo e sedentarismo juntos ocorrem em 13,9% dos homens e 14,2% das mulheres; tabagismo e baixo consumo de frutas em 12,9% dos homens e 12,3% das mulheres; e tabagismo e baixo consumo de legumes em 5,8% dos homens e 5,1% das mulheres. A associação de tabagismo e consumo excessivo de álcool foi observada apenas nos homens (em 3,5% deles) e, da mesma forma que verificada para tabagismo isoladamente, sua ocorrência concomitante a outros fatores comportamentais de risco de doenças e agravos crônicos não transmissíveis (DANT) associou-se inversamente à escolaridade. Os dados apontam indícios de efeito de aglomeração entre tabagismo e sedentarismo, tabagismo e álcool em excesso, tabagismo e dieta inadequada, justificando intervenções focadas na prevenção e redução concomitante dos principais fatores comportamentais de risco de DANT.
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Li FX, Robson PJ, Ashbury FD, Hatcher J, Bryant HE. Smoking frequency, prevalence and trends, and their socio-demographic associations in Alberta, Canada. Canadian Journal of Public Health 2010. [PMID: 20209740 DOI: 10.1007/bf03404343] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the numbers of smokers, smoking prevalence and trends, and to examine their socio-demographic associations in Alberta using data from three Canadian national health surveys undertaken between 2000 and 2005. METHODS The three surveys collected self-reported health data from Canadians aged 12 years and older. The weighted number of smokers and the smoking prevalence by health region and by urban/rural status were determined. The socio-demographic associations of smoking in Alberta were examined using logistic regression analysis. RESULTS The numbers of smokers and the smoking prevalence were both higher among men than women, in middle-aged groups (20-39 and 40-59 years) than in younger (12-19 years) and older (> or = 60 years) groups, and among Canadian-born people than immigrants to Canada. The smoking prevalence tended to 1) increase with the increasing rurality of residence, 2) decrease over the timeframe examined, 3) be inversely proportional to educational level and 4) be inversely proportional to household income. The number of smokers was largest in urban areas and among those who reported the highest education and household income. DISCUSSION The new tobacco legislation being introduced in Alberta in 2009 may decrease the smoking prevalence in the province, but additional interventions in the regions with the largest numbers of smokers may help further reduce the smoking population and overall smoking prevalence in Alberta.
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Affiliation(s)
- Feng Xiao Li
- Surveillance, Health Promotion, Disease and Injury Prevention - Cancer Bureau, Population and Public Health, Alberta Health Services, 14th Floor, Sun Life Building, 10123 99 St, Edmonton AB T5J 3H1.
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Li FX, Hatcher J. Update on prevalence, trend and socio-demographic association of five modifiable lifestyle risk factors for cancer in Alberta and Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2009; 100:478-479. [PMID: 20209746 PMCID: PMC6973689 DOI: 10.1007/bf03404349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Feng Xiao Li
- Surveillance, Health Promotion, Disease and Injury Prevention — Cancer Bureau, Population and Public Health, Alberta Health Services, Edmonton, AB Canada
| | - Juanita Hatcher
- Surveillance, Health Promotion, Disease and Injury Prevention — Cancer Bureau, Population and Public Health, Alberta Health Services, Edmonton, AB Canada
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