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Ma ZR, Lin KQ, Guo H, Yang KY, Cao M, Song X, Jia HM, Hu YH, Yan YZ. Fatal, non-fatal burden of cancer in the elderly in China, 2005-2016: a nationwide registry-based study. BMC Public Health 2023; 23:877. [PMID: 37173657 PMCID: PMC10176703 DOI: 10.1186/s12889-023-15686-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 04/16/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND As populations age, cancer burden becomes increasingly conspicuous. This study quantified the cancer burden of the elderly (≥ 60 years) in China, based on the China Cancer Registry Annual Report to provide epidemiological evidence for cancer prevention and control. METHODS Data on cancer cases and deaths among the elderly aged ≥ 60 years were collected from the China Cancer Registry Annual Report, 2008-2019. Potential years of life lost (PYLL) and disability-adjusted life years (DALY) were calculated to analyze fatalities and the non-fatal burden. The time trend was analyzed using the Joinpoint model. RESULTS From 2005 to 2016, the PYLL rate of cancer in the elderly was stable between 45.34‰ and 47.62‰, but the DALY rate for cancer decreased at an average annual rate of 1.18% (95% CI: 0.84-1.52%). The non-fatal cancer burden in the rural elderly was higher than that of the urban elderly. Lung, gastric, liver, esophageal, and colorectal cancers were the main cancers causing the cancer burden in the elderly, and accounted for 74.3% of DALYs. The DALY rate of lung cancer in females in the 60-64 age group increased (annual percentage change [APC] = 1.14%, 95% CI: 0.10-1.82%). Female breast cancer was one of the top five cancers in the 60-64 age group, with DALY rates that also increased (APC = 2.17%, 95% CI: 1.35-3.01%). With increasing age, the burden of liver cancer decreased, while that of colorectal cancer rose. CONCLUSIONS From 2005 to 2016, the cancer burden in the elderly in China decreased, mainly reflected in the non-fatal burden. Female breast and liver cancer were a more serious burden in the younger elderly, while colorectal cancer burden was mainly observed in the older elderly.
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Affiliation(s)
- Zhen-Rong Ma
- Department of Preventive Medicine, Medical College, Shihezi University, 129 Bei Er Road, Shihezi, 832002, China
| | - Kang-Qian Lin
- Department of Preventive Medicine, Medical College, Shihezi University, 129 Bei Er Road, Shihezi, 832002, China
| | - Hong Guo
- Department of Preventive Medicine, Medical College, Shihezi University, 129 Bei Er Road, Shihezi, 832002, China
| | - Kai-Yue Yang
- Department of Preventive Medicine, Medical College, Shihezi University, 129 Bei Er Road, Shihezi, 832002, China
| | - Miao Cao
- Department of Preventive Medicine, Medical College, Shihezi University, 129 Bei Er Road, Shihezi, 832002, China
| | - Xi Song
- Department of Preventive Medicine, Medical College, Shihezi University, 129 Bei Er Road, Shihezi, 832002, China
| | - Huai-Miao Jia
- Shihezi Municipal Center for Disease Control and Prevention, Shihezi, 832002, China
- Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public Health Security of The Xinjiang Production and Construction Corps, Xinjiang Production and Construction Corps, Shihezi, China
| | - Yun-Hua Hu
- Department of Preventive Medicine, Medical College, Shihezi University, 129 Bei Er Road, Shihezi, 832002, China
- Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public Health Security of The Xinjiang Production and Construction Corps, Xinjiang Production and Construction Corps, Shihezi, China
| | - Yi-Zhong Yan
- Department of Preventive Medicine, Medical College, Shihezi University, 129 Bei Er Road, Shihezi, 832002, China.
- Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public Health Security of The Xinjiang Production and Construction Corps, Xinjiang Production and Construction Corps, Shihezi, China.
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Tsang YP, Lau CW. Outcomes of Partial or Total Cystectomy in Advanced Colon Cancer with Suspected Bladder Invasion-Our 8-Year Experience and Literature Review. J Gastrointest Cancer 2021; 53:394-402. [PMID: 33689114 DOI: 10.1007/s12029-021-00623-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Advanced colon cancers with bladder invasion pose a heavy burden and challenge towards patients and surgeons. Herein, we report our series with regards to operative and oncological outcomes in our 8 years of experience. METHODS All patients with advanced colonic tumours and suspected bladder invasion being operated from 2012 to 2020 were included. The histological findings, clinical and oncological outcomes were evaluated. RESULTS Twenty-two patients were included. Partial cystectomy was performed in 17 of them (77%). No neoadjuvant treatment was prescribed. All preoperative computed tomography (CT) scan showed bladder invasion or colovesical fistula. True tumour invasion to bladder (T4b disease) was confirmed in 17 patients (77%) by histopathology. The 3-year overall survival and recurrence rates were 82% and 9%, respectively. CONCLUSION En bloc resection of colonic tumour with adherent bladder in advanced colon cancers can achieve a good operative and oncological outcome without neoadjuvant therapy. The relatively low concordance rate between preoperative CT scan and final histopathology may limit the benefit of routine administration of neoadjuvant therapy as it may overtreat and delay subsequent oncological treatment of our patients with possible added morbidity.
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Affiliation(s)
- Yi Po Tsang
- Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
| | - Chi Wai Lau
- Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
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Neoadjuvant chemotherapy in locally advanced colon cancer: a systematic review. Tech Coloproctol 2020; 24:1001-1015. [PMID: 32666362 DOI: 10.1007/s10151-020-02289-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 07/02/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Preoperative or neoadjuvant chemotherapy (NAC) has emerged as a novel alternative to treat locally advanced colon cancer (LACC), as in other gastrointestinal malignancies. However, evidence of its efficacy and safety has not yet been gathered in the literature. The aim of the present study was to perform an extensive review of the scientific evidence for NAC in patients with LACC. METHODS PubMed, EMBASE, MEDLINE and Cochrane Library were searched for a systematic review of the literature from 2010 to 2019. Six eligible studies were included, with a total of 27,937 patients, 1232 of them (4.4%) treated with NAC. There were only one randomized controlled trial, three phase II non-randomized single arm studies and two retrospective studies. RESULTS The baseline computed tomography scan showed that most of patients had a T3 tumor. The completion rate of the planned neoadjuvant treatment ranged from 52.5 to 93.8%. Between 97.2 and 100% of patients had the scheduled surgery. The median tumor volume reduction after NAC ranged from 62.5 to 63.7%. The anastomotic leak rate in the NAC group ranged from 0 to 7%, with no cases of postoperative mortality. There was major pathological tumor regression in 4-34.7% of cases. Between 84 and 100% of NAC patients had R0-surgery. Survival after NAC seems to be encouraging although significant improvement has only been proven in T4b tumours. CONCLUSIONS According to our systematic review, the NAC may be a safe and effective emerging therapeutic alternative for treating LACC. This approach, which is still being tested, increases the reliance on accurate radiological staging.
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