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Liu X, Meng JL, Wang MG, Mao DW, Dai M. [Experimental study on the inhibition of the NLRP3 signaling pathway with Shengsan Jiedu Huayu decoction to alleviate inflammatory injury in rats with acute-on-chronic liver failure]. Zhonghua Gan Zang Bing Za Zhi 2024; 32:354-362. [PMID: 38733191 DOI: 10.3760/cma.j.cn501113-20230816-00060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/13/2024]
Abstract
Objective: To observe the therapeutic effect of Shengsan Jiedu Huayu decoction in alleviating inflammatory liver injury in rats with acute-on-chronic liver failure (ACLF) and its effect on the activation intensity for the NLRP3 signaling pathway. Methods: 63 SD rats were randomly divided into a blank group, a model group, and low-, medium-, and high-dose groups of Shengsan Jiedu Huayu decoction (7.29 g/kg/d, 14.58 g/kg/d, and 29.16 g/kg/d). The ACLF rat model was replicated using carbon tetrachloride combined with d-galactosamine and lipopolysaccharide. Different dose gradients of the Shengsan Jiedu Huayu decoction were used for a five-day intervention treatment, and then rat serum and tissue samples were collected. A biochemical analyzer was used to detect the serum levels of ALT, AST, and TBIL in rats. ELISA was used to detect serum IL-18 and IL-1β content. HE staining was used to observe histomorphological changes in liver tissue. Immunohistochemistry was used to detect GSDMD expression in liver tissue. Western blot and PCR were used to detect NLRP3, Caspase1, ASC, TLR4, IL-1β, IL-18 protein, and mRNA expression levels.The groups were compared using analysis of variance and the rank-sum test. Results: Compared with the blank group, the model group's rat liver tissue was severely injured. Serum levels of ALT, AST, and TBIL, inflammatory factors IL-1β and IL-18, and the GSDMD protein expression level, NLRP3 expression level, TLR4, caspase 1, ASC, IL-1β, IL-18 protein, and mRNA (P<0.01) were all significantly increased in the model than the blank group (P<0.01). Additionally, compared with the model group, the low-, medium-, and high-dose groups of Shengsan Jiedu Huayu decoction had improved liver tissue injury in ACLF rats, while the serum levels of ALT, AST, TBIL, IL-1β, IL-18, liver tissue GSDMD protein, NLRP3, TLR4, caspase 1, and ASC expressions were all lower in the different dose gradients of the Shengsan Jiedu Huayu decoction than the model group, with the most evident reduction in the high-dose group (P<0.01). Conclusion: Shengsan Jiedu Huayu decoction can weaken the activation intensity of the NLRP3 signaling pathway, alleviate liver tissue pathological injury, reduce inflammatory factor release, and alleviate inflammatory liver injury in ACLF rats.
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Affiliation(s)
- X Liu
- Hunan University of Traditional Chinese Medicine, Changsha 410208, China
| | - J L Meng
- Guangxi University of Traditional Chinese Medicine, Nanning 530200, China
| | - M G Wang
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, China
| | - D W Mao
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, China
| | - M Dai
- Guangxi University of Traditional Chinese Medicine, Nanning 530200, China
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Chen HD, Lu B, Zheng Y, Du P, Qi X, Zhang K, Liu YY, Wei JL, Wei DH, Gong JY, Huang YC, Song ZY, Chu X, Dong D, Zheng WJ, Dai M. [Interpretation of specification for service of cancer screening for workers]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:486-489. [PMID: 38678342 DOI: 10.3760/cma.j.cn112338-20240311-00114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
As the backbone force of China's social and economic construction, the health status of workers is closely related to the nation's productivity and social development. Currently, cancers have become one of the major diseases threatening the health of workers. However, there are still many shortcomings in the cancer screening services for the workers. To standardize cancer screening services for workers, ensure the quality of screening services, and improve the overall screening effectiveness, 19 institutions, including Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences, have jointly formulated the Group Standard "Specification for service of cancer screening for workers (T/CHAA 023-2023)". This standard follows the principles of "legality, scientific rigor, advancement, and feasibility" and combines the frontier scientific advances in cancer screening. It clarifies the relevant requirements for service principles, service design, service delivery, service management, service evaluation, and improving worker cancer screening. Implementing this group standard will help connect the common screening needs of workers, employers, and cancer screening service providers, standardize the screening process, improve screening quality, and ultimately increase the early diagnosis rate and survival rate of cancer patients. Consequently, this group standard will help safeguard workers' health rights and interests, ensure the labor force resources, promote the comprehensive coordinated and sustainable development of society, and contribute to realizing the "Healthy China 2030" strategic policy.
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Affiliation(s)
- H D Chen
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - B Lu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Zheng
- Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - P Du
- Beijing Cancer Hospital, Beijing 100142, China
| | - X Qi
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - K Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Y Liu
- Cancer Prevention Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - J L Wei
- Henan Cancer Hospital, Zhengzhou 450003, China
| | - D H Wei
- Anhui Cancer Hospital, Hefei 230071, China
| | - J Y Gong
- Department of Preventive Management, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Y C Huang
- Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming 650106, China
| | - Z Y Song
- Department of Health Management Center and Department of General Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X Chu
- Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - D Dong
- Xuzhou Cancer Hospital, Xuzhou 221005, China
| | - W J Zheng
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - M Dai
- 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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Cai J, Lu B, Chen H, Lu M, Zhang Y, Luo C, You L, Dai M, Zhao Y. The impacts of exposure to risk factors during youth on the increasing global trend of early-onset pancreatic cancer. Public Health 2024; 229:65-72. [PMID: 38402665 DOI: 10.1016/j.puhe.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 10/18/2023] [Accepted: 11/05/2023] [Indexed: 02/27/2024]
Abstract
OBJECTIVES An increasing trend of pancreatic cancer in young adults has emerged in some countries. This study aimed to investigate global trends of pancreatic cancer in young adults and explore the impact of exposure to risk factors on pancreatic cancer incidence during youth. METHODS Global and national data on pancreatic cancer incidence, disability-adjusted life-years, attributive mortality, and summary exposure values of risk factors were retrieved from the Global Burden of Disease 2019. The average annual percent change (AAPC) of incidence and mortality was calculated. Additionally, generalized additive models were applied to explore the non-linear associations between the levels and changes in the Human Development Index and AAPC. RESULTS Global pancreatic cancer incidence increased during various periods from 1990 to 2019, particularly in adults aged <45 years from 2010 to 2019, at an average annual increase rate of 0.7% (95% confidence interval: 0.4-1.0%). The AAPC of early-onset pancreatic cancer incidence from 2010 to 2019 was negatively correlated with Human Development Index levels in both 2010 and 2019 but positively correlated with Human Development Index acceleration. Significant increases in early-onset pancreatic cancer incidence were observed over this period in 32 of 88 countries, primarily in South America, North America, Oceania, and Africa. Early-onset pancreatic cancer mortality attributed to high body mass index and fasting plasma glucose increased, while that attributed to tobacco use declined. CONCLUSIONS An increasing trend has emerged in the global incidence and burden of early-onset pancreatic cancer over the last few decades. This rise may partly be attributed to global epidemics of high body mass index and fasting plasma glucose.
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Affiliation(s)
- J Cai
- Department of Hospital Infection Control, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China; Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - B Lu
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China; Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - H Chen
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - M Lu
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Y Zhang
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China; Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - C Luo
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China; Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - L You
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - M Dai
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Y Zhao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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Wei P, Lamont B, He T, Xue W, Wang PC, Song W, Zhang R, Keyhani AB, Zhao S, Lu W, Dong F, Gao R, Yu J, Huang Y, Tang L, Lu K, Ma J, Xiong Z, Chen L, Wan N, Wang B, He W, Teng M, Dian Y, Wang Y, Zeng L, Lin C, Dai M, Zhou Z, Xiao W, Yan Z. Vegetation-fire feedbacks increase subtropical wildfire risk in scrubland and reduce it in forests. J Environ Manage 2024; 351:119726. [PMID: 38052142 DOI: 10.1016/j.jenvman.2023.119726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 12/07/2023]
Abstract
Climate dictates wildfire activity around the world. But East and Southeast Asia are an apparent exception as fire-activity variation there is unrelated to climatic variables. In subtropical China, fire activity decreased by 80% between 2003 and 2020 amid increased fire risks globally. Here, we assessed the fire regime, vegetation structure, fuel flammability and their interactions across subtropical Hubei, China. We show that tree basal area (TBA) and fuel flammability explained 60% of fire-frequency variance. Fire frequency and fuel flammability, in turn, explained 90% of TBA variance. These results reveal a novel system of scrubland-forest stabilized by vegetation-fire feedbacks. Frequent fires promote the persistence of derelict scrubland through positive vegetation-fire feedbacks; in forest, vegetation-fire feedbacks are negative and suppress fire. Thus, we attribute the decrease in wildfire activity to reforestation programs that concurrently increase forest coverage and foster negative vegetation-fire feedbacks that suppress wildfire.
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Affiliation(s)
- P Wei
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - B Lamont
- Ecology Section, School of Molecular and Life Sciences, Curtin University, Perth, WA 6845, Australia.
| | - T He
- College of Science Engineering & Education, Murdoch University, Murdoch, WA 6150, Australia.
| | - W Xue
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - P C Wang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W Song
- College of Agronomy, Northwest Agriculture & Forestry University, Xianyang, 712100, China.
| | - R Zhang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - A B Keyhani
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - S Zhao
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W Lu
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - F Dong
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - R Gao
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - J Yu
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - Y Huang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - L Tang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - K Lu
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - J Ma
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - Z Xiong
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - L Chen
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - N Wan
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - B Wang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W He
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - M Teng
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - Y Dian
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - Y Wang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - L Zeng
- Key Laboratory of Forest Ecology and Environment, Chinese Academy of Forestry, Beijing, 100091, China.
| | - C Lin
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - M Dai
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - Z Zhou
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W Xiao
- Key Laboratory of Forest Ecology and Environment, Chinese Academy of Forestry, Beijing, 100091, China.
| | - Z Yan
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
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Fu R, Lin R, Fan ZP, Huang F, Xu N, Xuan L, Huang YF, Liu H, Zhao K, Wang ZX, Jiang L, Dai M, Sun J, Liu QF. [Metagenomic next-generation sequencing for the diagnosis of Pneumocystis jirovecii pneumonia after allogeneic hematopoietic stem cell transplantation]. Zhonghua Xue Ye Xue Za Zhi 2024; 45:62-67. [PMID: 38527840 DOI: 10.3760/cma.j.cn121090-20230928-00147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Objectives: To investigate the value of metagenomic next-generation sequencing (mNGS) in the diagnosis of Pneumocystis jirovecii pneumonia (PJP) in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: The data of 98 patients with suspected pulmonary infection after allo-HSCT who underwent pathogen detection from bronchoalveolar lavage fluid between June 2016 and August 2023 at Nanfang Hospital were analyzed. The diagnostic performance of mNGS, conventional methods, and real-time quantitative polymerase chain reaction (qPCR) for PJP were compared. Results: A total of 12 patients were diagnosed with PJP, including 11 with a proven diagnosis and 1 with a probable diagnosis. Among the patients with a proven diagnosis, 1 was positive by both conventional methods and qPCR, and 10 were positive by qPCR only. Pneumocystis jirovecii was detected by mNGS in all 12 patients. The diagnostic sensitivity of mNGS for PJP was 100%, which was greater than that of conventional methods (8.3%, P=0.001) and similar to that of qPCR (91.6%, P=1.000) . A total of 75% of the patients developed mixed pulmonary infections, and cytomegalovirus and Epstein-Barr virus were the most common pathogens. Mixed infection was detected in eight patients by mNGS and in five patients by qPCR, but not by conventional methods (P=0.008) . Conclusions: mNGS had good sensitivity for diagnosing PJP after allo-HSCT and was advantageous for detecting mixed infectious pathogens; therefore, mNGS might be an effective supplement to regular detection methods and qPCR.
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Affiliation(s)
- R Fu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - R Lin
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - Z P Fan
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - F Huang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - N Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - L Xuan
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - Y F Huang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - H Liu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - K Zhao
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - Z X Wang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - L Jiang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - M Dai
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - J Sun
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
| | - Q F Liu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou 510515, China
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Dai M, Morgan ZJ, Russel K, Bortz BA, Peterson LE, Bazemore AW. Physician-Level Continuity of Care and Patient Outcomes in All-Payer Claims Database. J Am Board Fam Med 2024; 36:976-985. [PMID: 38171580 DOI: 10.3122/jabfm.2023.230119r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/05/2023] [Accepted: 07/18/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Being one of the few existing measures of primary care functions, physician-level continuity of care (Phy-CoC) is measured by the weighted average of patient continuity scores. Compared with the well-researched patient-level continuity, Phy-CoC is a new instrument with limited evidence from Medicare beneficiaries. This study aimed to expand the patient sample to include patients of all ages and all types of insurance and reassess the associations between full panel-based Phy-CoC scores and patient outcomes. METHODS Cross-sectional analysis at patient-level using Virginia All-Payer Claims Database (VA-APCD). Phy-CoC scores were calculated by averaging patient's Bice-Boxerman Index scores and weighted by the total number of visits. Patient outcomes included total cost and preventable hospitalization. RESULTS In a sample of 1.6 million Virginians, patients who lived in rural areas or had Medicare as primary insurance were more likely to be attributed to physicians with the highest Phy-CoC scores. Across all adult patient populations, we found that being attributed to physicians with higher Phy-CoC was associated with 7%-11.8% higher total costs, but was not associated with the odds of preventable hospitalization. Results from models with interactions revealed nuanced associations between Phy-CoC and total cost with patient's age and comorbidity, insurance payer, and the specialty of their physician. CONCLUSIONS In this comprehensive examination of Phy-CoC using all populations from the VA-APCD, we found an overall positive association of higher full panel-based Phy-CoC with total cost, but a non-significant association with the risk of preventable hospitalization. Achieving higher full panel-based Phy-CoC may have unintended cost implications.
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Affiliation(s)
- Mingliang Dai
- From the American Board of Family Medicine (MD, ZJM, LEP, AWB); Virginia Health Information (KR); Virginia Center for Health Innovation (BAB); Department of Family and Community Medicine at the University of Kentucky (LEP); Center for Professionalism and Value in Health Care (AWB).
| | - Zachary J Morgan
- From the American Board of Family Medicine (MD, ZJM, LEP, AWB); Virginia Health Information (KR); Virginia Center for Health Innovation (BAB); Department of Family and Community Medicine at the University of Kentucky (LEP); Center for Professionalism and Value in Health Care (AWB)
| | - Kyle Russel
- From the American Board of Family Medicine (MD, ZJM, LEP, AWB); Virginia Health Information (KR); Virginia Center for Health Innovation (BAB); Department of Family and Community Medicine at the University of Kentucky (LEP); Center for Professionalism and Value in Health Care (AWB)
| | - Beth A Bortz
- From the American Board of Family Medicine (MD, ZJM, LEP, AWB); Virginia Health Information (KR); Virginia Center for Health Innovation (BAB); Department of Family and Community Medicine at the University of Kentucky (LEP); Center for Professionalism and Value in Health Care (AWB)
| | - Lars E Peterson
- From the American Board of Family Medicine (MD, ZJM, LEP, AWB); Virginia Health Information (KR); Virginia Center for Health Innovation (BAB); Department of Family and Community Medicine at the University of Kentucky (LEP); Center for Professionalism and Value in Health Care (AWB)
| | - Andrew W Bazemore
- From the American Board of Family Medicine (MD, ZJM, LEP, AWB); Virginia Health Information (KR); Virginia Center for Health Innovation (BAB); Department of Family and Community Medicine at the University of Kentucky (LEP); Center for Professionalism and Value in Health Care (AWB)
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7
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Li N, Zhou YY, Lu M, Zhang YH, Lu B, Luo CY, Luo JH, Cai J, Chen HD, Dai M. [Participation rate and detection of colorectal neoplasms based on multi-round fecal immunochemical testing for colorectal cancer screening in the Chinese population]. Zhonghua Zhong Liu Za Zhi 2023; 45:1041-1050. [PMID: 38110312 DOI: 10.3760/cma.j.cn112152-20230221-00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Objective: To evaluate the participation rate and detection of colorectal neoplasms based on annual fecal immunochemical testing (FIT) for three consecutive years in a population-based colorectal cancer screening program in China. Methods: Based on a population-based colorectal cancer screening program conducted from May 2018 to May 2021 in 6 centers in China, 7 793 eligible participants aged 50-74 were included and offered free FIT and colonoscopy (for those who were FIT-positive on initial screening). At baseline, all participants were invited to receive FIT. In subsequent screening rounds, only FIT-positive participants who did not undergo colonoscopy or FIT-negative participants were invited to have repeated FIT screening. FIT-positive participants were recommended to undertake colonoscopy and pathological examination (if abnormalities were found during colonoscopy). An overall of three rounds of annual FIT screening were conducted. The primary outcomes of the study were the participation rate of FIT screening, the compliance rate of colonoscopy for FIT-positive participants, and the detection rate of colorectal neoplasms. Results: Among the 7 793 participants included in this study, 3 310 (42.5%) were male, with age of (60.50±6.49) years. The overall participation rates for the first, second and third round of FIT screening were 94.0%(7 327/7 793), 86.8% (6 048/6 968) and 91.3% (6 113/6 693), respectively. Overall, 7 742 out of 7 793 participants (99.3%) attended at least one round of screening, and 5 163 out of 7 793 participants (66.3%) attended all three rounds of screening. The positivity rate was significantly higher in the first (14.6%, 1 071/7 327) round compared with the second (5.6%, 3 41/6 048) and third (5.5%, 3 39/6 113) screening rounds (P<0.001). The overall compliance rates of colonoscopy examination among FIT-positive subjects were over 70% in three rounds, which were 76.3% (817/1 071), 75.7% (258/341) and 71.7% (243/339), respectively. In a multivariate logistic regression model considering factors including sex, education background, smoking, alcohol drinking, previous colonoscopy examination, colonic polyp history and family history of colorectal cancer among first-degree relatives, gender and smoking status were related factors affecting the participation rate of FIT screening, with higher rate in males and non-smokers. In addition, logistic regression analysis also found that age was negatively correlated with the compliance rate of colonoscopy in FIT positive patients. The detection rate of advanced tumors (colorectal cancer + advanced adenoma) declined from the first round to subsequent rounds [1st round: 1.15% (90/7 793); 2nd round: 0.57% (40/6 968); and 3rd round: 0.58% (39/6 693)], however, the positive predictive value for advanced neoplasms increased round by round, and was 11.02% in the first screening round, 15.50% in the second screening round, and 16.05 % in the third screening round. In each screening round, the detection rate for advanced neoplasms was higher in men than that in women, and increased with age. Conclusions: Annual repeated FIT screening has high acceptance and satisfying detection rates in the Chinese population. To optimize and improve the effectiveness of colorectal cancer screening, multi-round repeated FIT screening should be implemented while ensuring high participation rates.
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Affiliation(s)
- N Li
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Y Y Zhou
- Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - M Lu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Y H Zhang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - B Lu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - C Y Luo
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - J H Luo
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - J Cai
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - H D Chen
- Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - M Dai
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
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8
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Zhang H, Zhou M, Zhou QL, Luo X, Zheng R, Su J, Xiong GW, Cheng Y, Li YT, Zhang PP, Zhang K, Dai M, Huang XK, Zhang YN, Shi ZH, Tao J, Zhou YQ, Feng PY, Chen ZG, Yang QT. [Preliminary insights into the practice of hypoallergenic home visiting program]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1957-1963. [PMID: 38186142 DOI: 10.3760/cma.j.cn112150-20230903-00151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Allergic diseases affect about 40% of the world's population. Environmental factors are important in the occurrence and development of allergic diseases. Dust mites are one of the most important allergens in the indoor environment. The World Health Organization proposes the "four-in-one, combination of prevention and treatment" treatment principle for allergic diseases, in which environmental control to avoid or reduce allergens is the first choice for treatment. Modern people spend much more time at home (including sleeping) than outdoors, and the control of the home environment is particularly critical. This practice introduces the hypoallergenic home visit program, which including home environment assessment, environmental and behavioral intervention guidance, and common household hypoallergenic supplies and service guidance for the patient's home environment. The real-time semi-quantitative testing of dust mite allergens, qualitative assessments of other indoor allergens, record of patients' household items and lifestyle, and precise, individualized patient prevention and control education will be conducted. The hypoallergenic home visit program improves the doctors' diagnosis and treatment data dimension, and becomes a patient management tool for doctors outside the hospital. It also helps patients continue to scientifically avoid allergens and irritants in the environment, effectively build a hypoallergenic home environment, reduce exposure to allergens in the home environment, and achieve the goal of combining the prevention and treatment of allergic diseases.
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Affiliation(s)
- H Zhang
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - M Zhou
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Q L Zhou
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - X Luo
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - R Zheng
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - J Su
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - G W Xiong
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Y Cheng
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Y T Li
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - P P Zhang
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - K Zhang
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - M Dai
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - X K Huang
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Y N Zhang
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Z H Shi
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - J Tao
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Y Q Zhou
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Respiratory and Intensive Care, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - P Y Feng
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Dermatology and Cosmetic Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Z G Chen
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Q T Yang
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
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Zhou YY, Li N, Lu B, Luo CY, Zhang YH, Luo JH, Lu M, Cai J, Dai M, Chen HD. [Value of fecal immunochemical test in colorectal cancer screening]. Zhonghua Zhong Liu Za Zhi 2023; 45:911-918. [PMID: 37968075 DOI: 10.3760/cma.j.cn112152-20230418-00176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Screening and early diagnosis and treatment have been proven effective in reducing the incidence and mortality of colorectal cancer. Colonoscopy combined with pathological examination is the gold standard for colorectal cancer screening. However, due to the invasiveness, high cost and the need for professional endoscopists of colonoscopy, it is not feasible to directly use this method for mass population screening. Fecal immunochemical test (FIT) is one of the screening techniques recommended by authoritative international guidelines for colorectal cancer screening, and has been widely used in population-based colorectal cancer screening programs in countries around the world. This paper elaborates on the value of FIT in colorectal cancer screening from different aspects, such as the technical principles, the screening efficiency, the screening strategies, and the population effects and benefits. Additionally, it describes the current situation of colorectal cancer screening in China and summarizes the challenges faced in colorectal cancer screening in order to optimize the FIT-based colorectal cancer screening strategies in the population and provide theoretical reference for effective colorectal cancer screening.
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Affiliation(s)
- Y Y Zhou
- Institute of Clinical Medicine/Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - N Li
- Institute of Clinical Medicine/Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - B Lu
- Institute of Clinical Medicine/Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - C Y Luo
- Institute of Clinical Medicine/Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y H Zhang
- Institute of Clinical Medicine/Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J H Luo
- Institute of Clinical Medicine/Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Lu
- Institute of Clinical Medicine/Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - J Cai
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - M Dai
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H D Chen
- Institute of Clinical Medicine/Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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10
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Yang JW, Tang CH, Dai M, Duan J, Li YH, Yang J, Yang T, Gao Y, Ban D, Zhu JC, Yuan TY, Li Y, Fu HM. [Clinical characteristics of children with SARS-CoV-2 Omicron variant infection in Kunming]. Zhonghua Er Ke Za Zhi 2023; 61:922-927. [PMID: 37803860 DOI: 10.3760/cma.j.cn112140-20230712-00448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
Objective: To investigate the clinical characteristics of hospitalized children infected with the Omicron variant in Kunming after the withdrawal of non-pharmaceutical interventions (NPI) and analyze the risk factors of severe cases. Methods: Clinical data was retrospectively collected from 1 145 children with SARS-CoV-2 Omicron infection who were hospitalized in six tertiary grade A hospitals in Kunming from December 10th, 2022 to January 9th, 2023. According to clinical severity, these patients were divided into the general and severe SARS-CoV-2 groups, and their clinical and laboratory data were compared. Between-group comparison was performed using t-test, chi-square test and Mann-Whitney U test. Spearman correlation test and multivariate Logistic regression analysis were used to determine the risk factors of severe illness. Results: A total of 1 145 hospitalized patients were included, of whom 677 were male and 468 female. The age of these patients at visit was 1.7 (0.5, 4.1) years. Specifically, there were 758 patients (66.2%) aged ≤3 years at visit and 387 patients (33.8%) aged >3 years. Of these children, 89 cases (7.8%) had underline diseases and the remaining 1 056 cases (92.2%) had no combined diseases. Additionally, of all the patients, 319 cases (27.9%) were vaccinated with one or two doses of SARS-CoV-2 vaccine, 748 cases (65.3%) had acute upper respiratory tract infection (AURTI), and six cases died (0.5%). A total of 1 051 cases (91.8%) were grouped into general SARS-CoV-2 group and 94 cases (8.2%) were grouped into severe SARS-CoV-2 group. Compared with the general cases, the severe cases showed a lower rate of SARS-CoV-2 vaccination and younger median age, lower lymphocyte count, as well as proportions of CD8+T lymphocyte (36 cases (38.3%) vs. 283 cases (26.9%), 0.5 (2.6, 8.0) vs. 1.6 (0.5, 3.9) years, 1.3 (1.0, 2.7) ×109 vs. 2.7 (1.3,4.4)×109/L, 0.17 (0.12, 0.24) vs. 0.21 (0.15, 0.16), respectively, χ2=4.88, Z=-2.21,-5.03,-2.53, all P<0.05). On the other hand, the length of hospital stay, proportion of underline diseases, ALT, AST, creatine kinase isoenzyme, and troponin T were higher in the severe group compared to those in the general group ((11.6±5.9) vs. (5.3±1.8) d, 41 cases (43.6%) vs. 48 cases (4.6%), 67 (26,120) vs. 20 (15, 32) U/L, 51 (33, 123) vs. 44 (34, 58) U/L、56.9 (23.0, 219.3) vs. 3.6 (1.9, 17.9) U/L, 12.0 (4.9, 56.5) vs. 3.0 (3.0, 7.0) ×10-3 pg/L,respectively, t=-20.43, χ2=183.52, Z=-9.14,-3.12,-6.38,-3.81, all P<0.05). Multivariate regression analysis indicated that increased leukocyte count (OR=1.88, 95%CI 1.18-2.97, P<0.01), CRP (OR=1.18, 95%CI 1.06-1.31, P<0.01), ferritin (OR=1.01, 95%CI 1.00-1.00, P<0.01), interleukin (IL)-6 (OR=1.05, 95%CI 1.01-1.08, P=0.012), D-dimer (OR=2.56, 95%CI 1.44-4.56, P<0.01) and decreased CD4+T lymphocyte (OR=0.84, 95%CI 0.73-0.98, P=0.030) were independently associated with the risk of severe SARS-CoV-2 in hospitalized children with Omicron infection. Conclusions: After the withdrawal of NPI, the pediatric inpatients with Omicron infection in Kunming were predominantly children younger than 3 years of age, and mainly manifested as AURTI with relatively low rate of severe SARS-CoV-2 infection and mortality. Elevated leukocyte counts, CRP, ferritin, IL-6, D-dimer, and decreased CD4+T lymphocytes are significant risk factors for developing severe SARS-CoV-2 infection.
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Affiliation(s)
- J W Yang
- Department of Respiratory and Critical Care Medicine, Kunming Children's Hospital, Yunnan Provincial Key Laboratory of Children's Major Diseases Research, Kunming 650034, China
| | - C H Tang
- Department of Pediatrics, the First People's Hospital of Yunnan Province, Kunming 650032, China
| | - M Dai
- Department of Pediatrics, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - J Duan
- Department of Pediatrics, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Y H Li
- Department of Pediatrics, the Second Affiliated Hospital of Kunming Medical University, Kunming 650101, China
| | - J Yang
- Department of Respiratory and Critical Care Medicine, Kunming Children's Hospital, Yunnan Provincial Key Laboratory of Children's Major Diseases Research, Kunming 650034, China
| | - T Yang
- Department of Pediatrics, Yan'an Hospital of Kunming, Kunming 650051, China
| | - Y Gao
- Department of Pediatrics, the People's Hospital of Anning City, Kunming 650300, China
| | - D Ban
- Department of Respiratory and Critical Care Medicine, Kunming Children's Hospital, Yunnan Provincial Key Laboratory of Children's Major Diseases Research, Kunming 650034, China
| | - J C Zhu
- Department of Pediatrics, the First People's Hospital of Yunnan Province, Kunming 650032, China
| | - T Y Yuan
- Department of Respiratory and Critical Care Medicine, Kunming Children's Hospital, Yunnan Provincial Key Laboratory of Children's Major Diseases Research, Kunming 650034, China
| | - Y Li
- Department of Respiratory and Critical Care Medicine, Kunming Children's Hospital, Yunnan Provincial Key Laboratory of Children's Major Diseases Research, Kunming 650034, China
| | - H M Fu
- Department of Respiratory and Critical Care Medicine, Kunming Children's Hospital, Yunnan Provincial Key Laboratory of Children's Major Diseases Research, Kunming 650034, China
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11
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Wang RZ, Xi LJ, Yang XK, Ku CY, Wu BB, Dai M, Ping ZG. [Application of target trail emulation in real world: a case study of effect of statins on mortality in diabetes patients]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:1480-1485. [PMID: 37743285 DOI: 10.3760/cma.j.cn112338-20230301-00115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Target trail emulation is an observational research method, which can use real-world data (such as observational data and historical data) to carry out research design according to the design principles of randomized controlled trials (RCT) when RCT cannot be carried out. The intervention group and the control group were classified by simulating random grouping. Finally a high-reliable conclusion similar to RCT can be obtained. This paper summarizes the basic concepts and application process of target trail emulation based on the effect of statins on the prognosis of myocardial infarction in diabetic patients to provide reference for the application of this method in real world.
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Affiliation(s)
- R Z Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - L J Xi
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - X K Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - C Y Ku
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - B B Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - M Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Z G Ping
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
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12
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Zhou M, Luo X, Zhou QL, Zhou WH, Zheng R, Zhang YN, Wu XF, Wu S, Su J, Xiong GW, Cheng Y, Li YT, Zhang PP, Zhang K, Dai M, Huang XK, Shi ZH, Tao J, Zhou YQ, Feng PY, Chen ZG, Yang QT. [Diagnosis and treatment procedures and health management for patients with hereditary angioedema]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1280-1285. [PMID: 37574324 DOI: 10.3760/cma.j.cn112150-20230509-00359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
As a recognized rare and highly fatal disease, hereditary angioedema (HAE) is difficult to diagnose and characterized by recurrent edema involving the head, limbs, genitals and larynx, etc. Diagnosis of HAE is not difficult. However, low incidence and lack of clinical characteristics lead to difficulty of doctors on timely diagnosis and correct intervention for HAE patients. Therefore, it is crucial to improve the awareness of this disease and prevent its recurrence. for HAE patients. In view of absent cognition of doctors and the general public on HAE, patients often suffer from sudden death or become disabled due to laryngeal edema which cannot be treated in time. Thus, based on the Internet mobile terminal platform, the team set up an all-day rapid emergency response system which is provided for HAE patients by setting up "one-click help". The aim is to offer optimization on overall management of HAE and designed the intelligent follow-up management to provide timely assistance and specialized suggestion for patients with acute attacks.
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Affiliation(s)
- M Zhou
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - X Luo
- Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Q L Zhou
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - W H Zhou
- Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - R Zheng
- Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Y N Zhang
- Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - X F Wu
- Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - S Wu
- Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - J Su
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - G W Xiong
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Y Cheng
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Y T Li
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - P P Zhang
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - K Zhang
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - M Dai
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - X K Huang
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Z H Shi
- Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - J Tao
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Y Q Zhou
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Respiratory and Intensive Care, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - P Y Feng
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Dermatology and Cosmetic Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Z G Chen
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Q T Yang
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China Department of Otolaryngology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
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13
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Cai LJ, Wei XL, Wei YQ, Guo XT, Jiang XJ, Zhang Y, Yu GP, Dai M, Ye JY, Zhou HS, Xu D, Huang F, Fan ZP, Xu N, Shi PC, Xuan L, Feng R, Liu XL, Sun J, Liu QF. [A single-center study on the distribution and antibiotic resistance of pathogens causing bloodstream infection in patients with hematological malignancies]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:479-483. [PMID: 37550203 PMCID: PMC10450548 DOI: 10.3760/cma.j.issn.0253-2727.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Indexed: 08/09/2023]
Abstract
Objective: To study the incidence of bloodstream infections, pathogen distribution, and antibiotic resistance profile in patients with hematological malignancies. Methods: From January 2018 to December 2021, we retrospectively analyzed the clinical characteristics, pathogen distribution, and antibiotic resistance profiles of patients with malignant hematological diseases and bloodstream infections in the Department of Hematology, Nanfang Hospital, Southern Medical University. Results: A total of 582 incidences of bloodstream infections occurred in 22,717 inpatients. From 2018 to 2021, the incidence rates of bloodstream infections were 2.79%, 2.99%, 2.79%, and 2.02%, respectively. Five hundred ninety-nine types of bacteria were recovered from blood cultures, with 487 (81.3%) gram-negative bacteria, such as Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. Eighty-one (13.5%) were gram-positive bacteria, primarily Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecium, whereas the remaining 31 (5.2%) were fungi. Enterobacteriaceae resistance to carbapenems, piperacillin/tazobactam, cefoperazone sodium/sulbactam, and tigecycline were 11.0%, 15.3%, 15.4%, and 3.3%, with a descending trend year on year. Non-fermenters tolerated piperacillin/tazobactam, cefoperazone sodium/sulbactam, and quinolones at 29.6%, 13.3%, and 21.7%, respectively. However, only two gram-positive bacteria isolates were shown to be resistant to glycopeptide antibiotics. Conclusions: Bloodstream pathogens in hematological malignancies were broadly dispersed, most of which were gram-negative bacteria. Antibiotic resistance rates vary greatly between species. Our research serves as a valuable resource for the selection of empirical antibiotics.
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Affiliation(s)
- L J Cai
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - X L Wei
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - Y Q Wei
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - X T Guo
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - X J Jiang
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - Y Zhang
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - G P Yu
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - M Dai
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - J Y Ye
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - H S Zhou
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - D Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - F Huang
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - Z P Fan
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - N Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - P C Shi
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - L Xuan
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - R Feng
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - X L Liu
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - J Sun
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
| | - Q F Liu
- Department of Hematology, Nanfang Hospital, Southern Medical University, GuangZhou 510515, China
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Luo CY, Zhang YH, Lu M, Lu B, Cai J, Li N, Zhou YY, Luo JH, Zhang DD, Yang XZ, Chen HD, Dai M. [Research on applying genetic and environmental risk score in risk-adapted colorectal cancer screening]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:999-1005. [PMID: 37380425 DOI: 10.3760/cma.j.cn112338-20221102-00935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Objective: To evaluate the effectiveness of a risk-adapted colorectal cancer screening strategy constructed utilizing genetic and environmental risk score (ERS). Methods: A polygenic risk score (PRS) was constructed based on 20 previously published single nucleotide polymorphisms for colorectal cancer in East Asian populations, using 2 160 samples with MassARRAY test results from a multicenter randomized controlled trial of colorectal cancer screening in China. The ERS was calculated using the Asia-Pacific Colorectal Screening Score system. Logistic regression was used to analyze the association between PRS alone and PRS combined with ERS and colorectal neoplasms risk, respectively. We also designed a risk-adapted screening strategy based on PRS and ERS (high-risk participants undergo a single colonoscopy, low-risk participants undergo an annual fecal immunochemical test, and those with positive results undergo further diagnostic colonoscopy) and compared its effectiveness with the all-acceptance colonoscopy strategy. Results: The high PRS group had a 26% increased risk of colorectal neoplasms compared with the low PRS group (OR=1.26, 95%CI: 1.03-1.54, P=0.026). Participants with the highest PRS and ERS were 3.03 times more likely to develop advanced colorectal neoplasms than those with the lowest score (95%CI: 1.87-4.90, P<0.001). As the risk-adapted screening simulation reached the third round, the detection rate of the PRS combined with ERS strategy was not statistically different from the all-acceptance colonoscopy strategy (8.79% vs. 10.46%, P=0.075) and had a higher positive predictive value (14.11% vs. 10.46%, P<0.001) and lower number of colonoscopies per advanced neoplasms detected (7.1 vs. 9.6, P<0.001). Conclusion: The risk-adapted screening strategy combining PRS and ERS helps achieve population risk stratification and better effectiveness than the traditional colonoscopy-based screening strategy.
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Affiliation(s)
- C Y Luo
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y H Zhang
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Lu
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - B Lu
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Cai
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - N Li
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Y Zhou
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - J H Luo
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - D D Zhang
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - X Z Yang
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - H D Chen
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - M Dai
- Department of Cancer Epidemiology, 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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15
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Jo A, Dai M, Peterson L, Mainous III AG. Trends of Geriatric Certification and Practice Patterns of Family Physicians: 1988-2019. Fam Med 2023; 55:95-102. [PMID: 36787517 PMCID: PMC10614548 DOI: 10.22454/fammed.2023.917437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND AND OBJECTIVES Demand for geriatric care is increasing due to aging population. Trends in maintaining certification in geriatrics are unreported. Our objective was to describe the historic trend of family physicians who certified in geriatric medicine (FPs-GM) since 1988 and to assess differences in practice patterns between FPs-GM and family physicians (FPs). METHODS We performed a retrospective descriptive study using administrative data collected by the American Board of Family Medicine (ABFM). The study population was family physicians registering to continue their ABFM certification from 2017 to 2019. Medicare public use billing data was linked to ABFM administrative data on certification history. We used univariate analysis for descriptive analysis and logistic regression to identify contributors of recertification in geriatrics. RESULTS We identified a total of 3,207 FPs-GM between 1988 and 2019. More than half maintained GM certification since 2009 (57%), with male gender, White race, and urban practice associated with maintaining GM certification; 61% of their patients were older adults. FPs-GM were more likely to be in an academic practice setting with nearly half (53%) also practicing in hospitals or nursing homes. In the adjusted regression model, younger FPs or FPs who treat more older patients were significantly more likely to be recertified in geriatrics whereas other demographics and practice characteristics were not significant. CONCLUSIONS Most FPs who recently earned GM certification tended to retain certification since the required accredited fellowship started in 1995.
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Affiliation(s)
- Ara Jo
- Department of Health Services Research, Management and Policy, University of FloridaGainesville, FL
| | | | | | - Arch G. Mainous III
- Department of Health Services Research, Management and Policy, University of FloridaGainesville, FL
- Department of Community Health and Family Medicine, University of FloridaGainesville, FL
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16
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Dai M, Bazemore A, Fleischer S, Morgan Z. Exploring the Association Between Physician Continuity of Care and Diagnosing Hypertension. Ann Fam Med 2023; 21:3507. [PMID: 36972535 PMCID: PMC10549429 DOI: 10.1370/afm.21.s1.3507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Context. The American Board of Family Medicine was funded by the Gordon Betty Moore Foundation to study the association between physician continuity of care, a clinical quality measure, and its impact on accurate, timely, efficient, and cost-effective diagnosis of target conditions that contribute to cardiovascular disease. In this exploratory analysis, we used electronic health records data from the PRIME registry to examine the association of continuity with factors leading to a hypertension diagnosis. Objective. 1) to determine the rate and timeliness of hypertension diagnosis, 2) to investigate the number of hypertension-level blood pressure (BP) readings in the 12 months prior to the diagnosis, and 3) to explore the association between physician continuity of care and these variables. Study Design and Population Studied. In this cohort study, we created two patient cohorts. Our prospective cohort consisted of patients who had 2 or more BP readings greater than SBP of 130 or DBP of 80 mm Hg in 2017-2018 and who did not have a hypertension diagnosis prior to the date of the second reading. Our retrospective cohort consisted of patients who had a hypertension diagnosis in 2018-2019. Dataset. Electronic health records extracted from the PRIME registry Outcome Measures. The rate of diagnosis was calculated by dividing the number of patients with a hypertension diagnosis by the number of patients whose BP readings exceeded the thresholds for hypertension per clinical guidelines. We investigated the timeliness of diagnosis by counting the average days between the second reading and the diagnosis dates. We also identified the number of hypertension-level BP readings in the past 12 months for patients diagnosed with hypertension. Results. Of 7,615 eligible patients from 4 pilot practices, the rate of hypertension diagnosis varied from 39.6% (solo practice) to 11.5% (large practice). The average days until diagnosis ranged from 142 days (solo practice) to 247 days (medium practice). Among patients diagnosed with hypertension (n=104,727), 25.7% had 0, 39.8% had 1, 14.7% had 2 and 19.7 had 3 or more hypertension-level BP readings in the 12 months prior to the diagnosis. We found no significant association between physician continuity of care and the rate or timeliness of the hypertension diagnosis. Conclusions. Factors leading to a hypertension diagnosis may be influenced more by other unobserved variables than by physician continuity of care.
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Dai M, Aveni J, Abdulsattar J, Lairmore T. Endoscopic Ultrasound-Guided Fine Needle Aspiration of Solid Pseudopapillary Neoplasm of the Pancreas in a Male Patient: A Rare Report. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare pancreatic tumor with low malignant potential composed of poorly cohesive epithelial cells forming solid and pseudopapillary structures. It develops almost exclusively (90%) in young females (mean age: 28 years, range: 7-79 years), while it rarely develops in men (mean age: 35 years, range: 25-72 years).
Methods/Case Report
Herein we report an unusual presentation of SPN in a 59-year-old male who presented with severe nausea, vomiting, right upper quadrant pain, and weight loss. Computed tomography imaging revealed a large pancreatic head/uncinate process mass. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsies showed abundant monomorphic cuboidal tumor cells arranged in loosely cohesive groups and singly dispersed cells. A few tumor cells are arranged in multiple layers around vascular structures expanded by metachromatic hyaline material. The tumor cells have thin cytoplasm, indistinct cell borders, round to oval nuclei, finely dispersed chromatin, and indistinct nucleoli. No mitosis, tumor necrosis, or other high-grade features are identified. Immunohistochemical stains are performed on cell block material and the tumor cells are positive for beta-catenin (nuclear), cyclin D1, vimentin, CD10, synaptophysin, and CD56, and negative for DOG-1, tryptase, and AE1/AE3. Ki-67 proliferative index is less than 2% in tumor cells. The cytomorphologic features and immunoreactivity are diagnostic of solid pseudopapillary neoplasm. We diagnosed SPN preoperatively by EUS-FNA using cytopathologic and immunochemical characteristics, which are very helpful to differentiate SPN from acinar cell carcinoma, neuroendocrine tumor, pancreatoblastoma, or other pancreatic tumors.
Results (if a Case Study enter NA)
NA
Conclusion
EUS-FNA can be used as a gold standard method to characterize and diagnose SPN preoperatively and help to guide clinical management.
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Affiliation(s)
- M Dai
- Pathology, LSU Health Shreveport , Shreveport, Louisiana , United States
| | - J Aveni
- Pathology, LSU Health Shreveport , Shreveport, Louisiana , United States
| | - J Abdulsattar
- Pathology, LSU Health Shreveport , Shreveport, Louisiana , United States
| | - T Lairmore
- Surgery, LSU Health Shreveport , Shreveport, Louisiana , United States
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Dai M, Pavletic D, Shuemaker JC, Solid CA, Phillips RL. Measuring the Value Functions of Primary Care: Physician-Level Continuity of Care Quality Measure. Ann Fam Med 2022; 20:535-540. [PMID: 36443072 PMCID: PMC9705031 DOI: 10.1370/afm.2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 07/06/2022] [Accepted: 07/29/2022] [Indexed: 12/05/2022] Open
Abstract
PURPOSE Care continuity is foundational to the clinician/patient relationship; however, little has been done to operationalize continuity of care (CoC) as a clinical quality measure. The American Board of Family Medicine developed the Primary Care CoC clinical quality measure as part of the Measures That Matter to Primary Care initiative. METHODS Using 12-month Optum Clinformatics Data Mart claims data, we calculated the Bice-Boxerman Continuity of Care Index for each patient, which we rolled up to create an aggregate, physician-level CoC score. The physician quality score is the percent of patients with a Bice-Boxerman Index ≥0.7 (70%). We tested validity in 2 ways. First, we explored the validity of using 0.7 as a threshold for patient CoC within the Optum claims database to validate its use for reflecting patient-level continuity. Second, we explored the validity of the physician CoC measure by examining its association with patient outcomes. We assessed reliability using signal-to-noise methodology. RESULTS Mean performance on the measure was 27.6%; performance ranged from 0% to 100% (n = 555,213 primary care physicians). Higher levels of CoC were associated with lower levels of care utilization. The measure indicated acceptable levels of validity and reliability. CONCLUSIONS Continuity is associated with desirable health and cost outcomes as well as patient preference. The CoC clinical quality measure meets validity and reliability requirements for implementation in primary care payment and accountability. Care continuity is important and complementary to access to care, and prioritizing this measure could help shift physician and health system behavior to support continuity.
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Affiliation(s)
- Mingliang Dai
- American Board of Family Medicine, Lexington, Kentucky
| | - Denise Pavletic
- Center for Professionalism and Value in Health Care, American Board of Family Medicine Foundation, Washington, DC
| | - Jill C Shuemaker
- Center for Professionalism and Value in Health Care, American Board of Family Medicine Foundation, Washington, DC
| | | | - Robert L Phillips
- Center for Professionalism and Value in Health Care, American Board of Family Medicine Foundation, Washington, DC
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Kong YX, Dong D, Chen HD, Dai M, Zhuo L, Lou T, Cai ST, Chen JJ, Pan YH, Gao H, Lu ZM, Dong HY, Zhao XH, Luo GH, Chen G. [Comparison of application effects of colonoscopy, fecal immunochemical test and a novel risk-adapted screening approach in colorectal cancer screening in Xuzhou population]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:1074-1079. [PMID: 35922234 DOI: 10.3760/cma.j.cn112150-20211203-01113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To compare the application effect of the colonoscopy, fecal immunochemical test (FIT) and novel risk-adapted screening approach in colorectal cancer screening in Xuzhou population. Methods: From May 2018 to April 2019, 4 280 subjects aged 50-74 were recruited from Gulou district, Yunlong district and Quanshan district of Xuzhou. They were randomly assigned to the colonoscopy group (n=863), FIT group (n=1 723) and novel risk-adapted screening approach group (n=1 694) according to the ratio of 1∶2∶2. For the novel risk-adapted screening approach group, after the risk assessment, high-risk subjects were invited to undergo colonoscopy and low-risk subjects were invited to undergo FIT examination. All FIT positive subjects were invited to undergo colonoscopy. Colonoscopy participation rate [(the number of colonoscopies completed/the number of colonoscopies invited to participate)×100%], detection rate of colorectal lesions [(the number of diagnosed patients/the number of colonoscopies completed)×100%], colonoscopy resource load (the number of colonoscopies completed/the number of diagnosed advanced tumors) and FIT resource load in each group were calculated and compared. Results: The age of all subjects was (61±6) years old, including 1 816 males (42.43%). There was no statistically significant difference in the socio-demographic characteristics of the subjects in different screening groups. The colonoscopy participation rate was 22.60% (195/863) in the colonoscopy group, 57.04% (77/135) in the FIT group, and 33.94% (149/439) in the novel risk-adapted screening approach group, respectively. The colonoscopy participation rate was higher in the FIT group than in the colonoscopy group and the novel risk-adapted screening approach group (P<0.001). The colonoscopy participation rate of novel risk-adapted screening group was significantly higher than the colonoscopy group (P<0.001). The detection rates of advanced tumors were 6.67% (13/195), 9.09% (7/77) and 8.72% (13/149), respectively, and the difference was not statistically significant (P>0.05). The colonoscopy resource load (95%CI) was 15 (13-17) in the colonoscopy group, 11 (9-14) in the FIT group and 11 (10-13) in the novel risk-adapted screening approach group, respectively. Among them, the colonoscopy resource load of high-risk individuals in the novel risk-adapted screening approach group was 12 (9-15). FIT resource loads (95%CI) were 207 (196-218) and 88 (83-94) in the FIT group and the novel risk-adapted screening approach group. Conclusion: The combined application of risk-adapted screening approach and FIT may have a good application effect in colorectal cancer screening.
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Affiliation(s)
- Y X Kong
- Cancer Prevention and Control Office, Xuzhou Cancer Hospital, Xuzhou 221000, China
| | - D Dong
- Cancer Prevention and Control Office, Xuzhou Cancer Hospital, Xuzhou 221000, China
| | - H D Chen
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - M Dai
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - L Zhuo
- School of Public Health, Xuzhou Medical University, Xuzhou 221004, China
| | - T Lou
- Chronic Disease Prevention and Control Department, Xuzhou Center for Disease Control and Prevention, Xuzhou 221000, China
| | - S T Cai
- School of Management, Xuzhou Medical University, Xuzhou 221004, China
| | - J J Chen
- School of Management, Xuzhou Medical University, Xuzhou 221004, China
| | - Y H Pan
- School of Management, Xuzhou Medical University, Xuzhou 221004, China
| | - H Gao
- School of Public Health, Xuzhou Medical University, Xuzhou 221004, China
| | - Z M Lu
- School of Management, Xuzhou Medical University, Xuzhou 221004, China
| | - H Y Dong
- Chronic Disease Prevention and Control Department, Xuzhou Center for Disease Control and Prevention, Xuzhou 221000, China
| | - X H Zhao
- Cancer Prevention and Control Office, Xuzhou Cancer Hospital, Xuzhou 221000, China
| | - G H Luo
- Cancer Prevention and Control Office, Xuzhou Cancer Hospital, Xuzhou 221000, China
| | - Guohui Chen
- Cancer Prevention and Control Office, Xuzhou Cancer Hospital, Xuzhou 221000, China
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20
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Yang Z, Ganguli I, Davis C, Dai M, Shuemaker J, Peterson L, Bazemore A, Phillips R, Chung YK. Physician versus Practice-Level Primary Care Continuity and Association with Outcomes in Medicare Beneficiaries. Health Serv Res 2022; 57:914-929. [PMID: 35522231 PMCID: PMC9264477 DOI: 10.1111/1475-6773.13999] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To compare physician versus practice-level primary care continuity and their association with expenditure and acute care utilization among Medicare beneficiaries and evaluate if continuity of outpatient primary care at either/both physician or/and practice level could be useful quality measures. DATA SOURCE Medicare Fee-For-Service claims data for community dwelling beneficiaries without End-Stage Renal Disease who were attributed to a national random sample of primary care practices billing Medicare (2011-2017). STUDY DESIGN Retrospective secondary data analysis at per Medicare beneficiary per year level. We used multivariable linear regression with practice-level fixed effects to estimate continuity of care score at physician vs. practice level and their associations with outcomes. DATA COLLECTION/EXTRACTION METHOD We calculated clinician and practice level Bice-Boxerman continuity of care index scores, ranging from 0 to 1, using primary care outpatient claims. Medicare expenditures, hospital admissions, emergency department visits, and readmissions were obtained from the Medicare Beneficiary Summary File: Cost and Utilization Segment. Ambulatory care sensitive conditions (ACSC) were defined using diagnosis codes on inpatient claims. PRINCIPAL FINDINGS We studied 2,359,400 beneficiaries who sought care from 13,926 physicians. Every 0.1 increase in physician continuity score was associated with a $151 reduction in expenditures per beneficiary per year (P<0.01), and every 0.1 increase in practice continuity score was associated with $282 decrease (P<0.01) per beneficiary per year. Both physician- and practice-level continuity were associated with lower Medicare expenditures among small, medium, and large practices. Both physician- and practice-level continuity were associated with lower probabilities of hospitalization, emergency department visit, admissions for ACSC, and readmission. CONCLUSIONS Primary care continuity of care could serve as a potent value-based care quality metric. Physician-level continuity is a unique value center that cannot be supplanted by practice level continuity.
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Affiliation(s)
- Zhou Yang
- Omada Health, 500 Sansome St #200, San Francisco, CA
| | - Ishani Ganguli
- Brigham and Women's Hospital, Medicine, 1620 Tremont Street BC3-2M, Boston, MA
| | - Caitlin Davis
- Inova Fairfax Family Medicine, Residency Program, Fairfax, VA
| | - Mingliang Dai
- American Board of Family Medicine, 1648 McGrathiana Parkway Lexington, KY
| | - Jill Shuemaker
- The Center for Professionalism and Value in Health Care, 1016 16th Street NW Suite 700, Washington, DC
| | - Lars Peterson
- American Board of Family Medicine, 1648 McGrathiana Parkway Lexington, KY
| | - Andrew Bazemore
- The Center for Professionalism and Value in Health Care, 1016 16th Street NW Suite 700, Washington, DC
| | - Robert Phillips
- The Center for Professionalism and Value in Health Care, 1016 16th Street NW Suite 700, Washington, DC
| | - Yoon Kyung Chung
- The Robert Graham Center, 1133 Connecticut Avenue, NW Suite 1100, Washington, DC
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21
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Abstract
Context: Early evidence suggests that many patients chose to forgo or delay necessary medical care during the COVID-19 pandemic. Existing and well-documented racial and ethnic disparities in access to care were exacerbated by the pandemic for many reasons, potentially including the additional barriers involved in a rapid shift to telehealth for certain groups of patients. Objectives: 1) Examine changes in primary care visit volume and telehealth during the COVID-19 pandemic. 2) Test for racial and ethnic differences in primary care in-person and telehealth visits during the pandemic relative to pre-pandemic levels. Study design: Longitudinal. Datasets: EHR data including patient visits, procedures, and demographics captured in the American Board of Family Medicine's PRIME Registry. Population studied: 2,966,859 patients seeing 1,477 primary care clinicians enrolled in the PRIME Registry. Outcome measures: 7-day average of weekly visits per clinician, both in-person and telehealth, tracking trends in the volume of care provided before and during the pandemic by patient race/ethnicity. We defined telehealth conversion ratio (TCR) as the number of telehealth visits during the pandemic divided by the total number of pre-pandemic visits. We calculated TCR and visit volume changes from March 15 through the end of 2020 relative to the same period in 2019. Results: During the pandemic we observed decreases of 12% and 22% in the average number of total and in-person visits, respectively, as well as a 10% TCR. Total visits reached a nadir in April 2020 with a 29% decrease from the same point in 2019. Telehealth visits peaked the following week with 23% of that week's total visits, and 139 times more than 2019. Total visits decreased and telehealth visits increased for patients of all races/ethnicities. The magnitude of these changes differed, with Black (5% decline, 15% in-person decline, 10% TCR) and Hispanic (9%, 24%, 15%) patients seeing less of a decrease in total visits than White (12%, 21%, 9%) and Asian (16%, 30%, 14%) patients. Conclusion: Declines in primary care visits during the pandemic were partially offset by an increase in telehealth use. Utilization in our sample suggests less decline in Black and Hispanic patient primary care utilization during the pandemic than expected, in contrast to Asian patients, who demonstrated the largest declines. This metric and these results are novel and foundational for ongoing & further study using other data sources.
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Dai M, Chung Y, Peterson LE, Petterson S, Phillips RL. Family Practices in Transforming Clinical Practice Initiative Showed No Changes in Medicare Costs or Utilization. Med Care 2022; 60:50-55. [PMID: 34739412 DOI: 10.1097/mlr.0000000000001662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Centers for Medicare and Medicaid Services proposed that the Transforming Clinical Practice Initiative (TCPI) would improve health outcomes for patients, reduce utilization of institutional services, and generate significant savings for payers by the end of September 2019. OBJECTIVE The objective of this study was to investigate whether participation in TCPI's Practice Transformation Networks (PTNs) was associated with improved cost and utilization outcomes for Medicare patients of family medicine-based practices in the first 2 years, that is, 2016-2017, of the Initiative. STUDY DESIGN A quasi-experimental design with a longitudinal cohort of family medicine-based practices and a propensity-matched comparison sample. SUBJECTS A total of 761 PTN practices and 3451 non-PTN practices. MEASURES To measure practice-level patient outcomes, we attributed patients to practice based on the plurality of office visits. We obtained Medicare claims from 2011 to 2017 to assess PTN participation effects for Medicare Part A and B costs, hospital admission, and emergency department visit rates using a Difference-in-Differences design, adjusting for baseline characteristics. RESULTS The differences in Medicare Part A and B costs (-1.71%, P=0.25), annual rates of hospitalization (-0.59%, P=0.12) and emergency department visit (-0.29%, P=0.46) were not significantly lower among PTN practices (N=761) than among propensity score-matched non-PTN practices (N=3541). CONCLUSIONS TCPI's transforming efforts, such as the outcomes examined in the study, might need a longer time frame to manifest and require evaluation after the full 4-year participation period. The indistinguishable effect of PTN participation may also be attributed to the fact that non-PTN practices might have participated in other initiatives that changed their care and curbed health care utilization and costs consequently.
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Affiliation(s)
| | - Yoonkyung Chung
- Robert Graham Center of American Academy of Family Physicians, Washington, DC
| | - Lars E Peterson
- American Board of Family Medicine, Lexington, KY
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY
| | - Stephen Petterson
- Robert Graham Center of American Academy of Family Physicians, Washington, DC
| | - Robert L Phillips
- American Board of Family Medicine, Lexington, KY
- Center for Professionalism and Value in Health Care, Washington, DC
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23
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Wei N, Hou J, Chen J, Dai M, Du K, Wang S, Ni Q. Sentinel lymph node biopsy with carbon nanoparticle suspension after neoadjuvant chemotherapy for breast cancer patients. Ann R Coll Surg Engl 2021; 103:752-756. [PMID: 34448655 PMCID: PMC10750766 DOI: 10.1308/rcsann.2021.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The aim of the study was to explore the feasibility of performing sentinel lymph node biopsy (SLNB) using a carbon nanoparticle suspension (CNPS) after neoadjuvant chemotherapy in breast cancer patients. METHODS Some 152 patients diagnosed with primary breast cancer (cT1-3N0-2M0) were recruited. Patients were divided into two groups according to axillary lymph node (ALN) status after four to six cycles of neoadjuvant chemotherapy. All patients received a CNPS injection, after which SLNB and axillary lymph node dissection (ALND) were performed. RESULTS Sentinel lymph nodes (SLN) of 143 patients were identified; with an accuracy rate of 94.4% and a false-negative rate of 9.9%. Group A included 67 patients, and the detection, accuracy and false-negative rates within this group were 95.5%, 96.9% and 6.7%, respectively. The corresponding rates for group B (85 patients) were 92.9%, 92.4% and 11.8%, respectively. CONCLUSIONS CNPS is an ideal tracer for improving the detection rate of SLN and can be used to determine SLN status following neoadjuvant chemotherapy.
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Affiliation(s)
- N Wei
- Guizhou Provincial People's
Hospital, Guiyang, China
| | - J Hou
- Guizhou Provincial People's
Hospital, Guiyang, China
| | | | - M Dai
- Guizhou Provincial People's
Hospital, Guiyang, China
| | - K Du
- Guizhou Provincial People's
Hospital, Guiyang, China
| | - S Wang
- Guizhou Provincial People's
Hospital, Guiyang, China
| | - Q Ni
- Guizhou Provincial People's
Hospital, Guiyang, China
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Huang XW, Shi GM, Zhang T, Bao LQ, Wen TF, Zhang B, Peng T, Zhao H, Kuang M, Wang WL, Ran JH, Liu YB, Gong W, Mou HB, Luo Y, Wang Y, Sun H, Fan J, Liu LX, Dai M. 53P FGFR2 fusion and/or rearrangement profiling in Chinese patients with intrahepatic cholangiocarcinoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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25
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Li X, Feng XS, Zhang YH, Cui H, Li N, Dai M. [Progress in cohort study of lung cancer in high-risk population in communities]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:1174-1178. [PMID: 34814527 DOI: 10.3760/cma.j.cn112338-20210118-00041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The cohort study of lung cancer in high-risk population in communities in China was a part of Lung Cancer Cohort Study initiated in 2017 and funded by Precision Medicine Research of National Key Research and Development Program. Around 50 000 participants from the communities were enrolled from 7 cities in 7 regions in China. Information about the risk factors for lung cancer were collected and the populations at high risk for lung cancer were identified. Then, low-dose CT (LDCT) screening of lung cancer was conducted in the populations at high risk, and further information about the diagnosis of lung cancer cases and death cases were collected. Therefore, a community population-based cohort was established for lung cancer risk factor exposure survey, high risk population evaluation, LDCT screening and lung cancer case and death follow up. Meanwhile, biological samples were collected from all the participants in the cohort to support the future precision medicine research of lung cancer.
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Affiliation(s)
- X 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 Department of Medical Records, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou 450003, China
| | - X S Feng
- 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 Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Y H 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
| | - H Cui
- 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
| | - N 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
| | - M Dai
- 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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Dai M, Peterson LE, Phillips RL. Quality Changes Among Primary Care Clinicians Participating in the Transforming Clinical Practice Initiative. J Healthc Qual 2021; 43:e64-e69. [PMID: 33229941 DOI: 10.1097/jhq.0000000000000287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The Transforming Clinical Practice Initiative (TCPI) was designed to provide technical assistance to clinicians and prepare practices to participate in value-based payment arrangements. In this longitudinal cohort study, we assessed whether clinician's participation in TCPI practice transformation networks (PTNs) was associated with changes in quality of care from 2016 to 2018. We extracted quarterly measure performance data from 2016 to 2018 on two NQF-endorsed measures, one for outcome (Controlling High Blood Pressure) and one for process (Use of Imaging Studies for Low Back Pain), from 1,981 primary care clinicians enrolled in the PRIME Registry. Clinicians participating in PTNs were identified and compared with their counterparts who did not participate in PTNs. We found that the performance of PTN clinicians on controlling high blood pressure and use of imaging studies for low back pain was equivalent to that of non-PTN clinicians during the first 3 years of the TCPI. Although PTNs provided assistance to help practices achieve their clinical outcomes, these findings suggest that the changes in quality of care, for the measures studied, among PTN clinicians in the first 3 years of the TCPI were attributable to temporal trends rather than participation in PTNs.
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Wen Y, Yu LZ, Du LB, Wei DH, Liu YY, Yang ZY, Zheng YD, Wu Z, Yu XY, Zhao L, Yu YW, Chen HD, Ren JS, Qin C, Xu YJ, Cao W, Wang F, Li J, Tan FW, Dai M, Chen WQ, Li N, He J. [Analysis of low-dose computed tomography compliance and related factors among high-risk population of lung cancer in three provinces participating in the cancer screening program in urban China]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:633-639. [PMID: 34034404 DOI: 10.3760/cma.j.cn112150-20201015-01286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the compliance and related factors of low-dose computed tomography (LDCT) screening among the high-risk population of lung cancer in three provinces participating in the cancer early diagnosis and early treatment program in urban areas of China. Methods: From October 2017 to October 2018, 17 983 people aged between 40 and 74 years old at high risk of lung cancer were recruited from Zhejiang, Anhui and Liaoning provinces. The basic demographic characteristics, living habits, history of the disease and family history of cancer were collected by using a cancer risk assessment questionnaire, and the data of participants examined by LDCT were obtained from the hospitals participating in the program. The screening compliance was quantified by the screening participation rate, and it was calculated as the proportion of participants completing LDCT scan among high-risk population. The related factors of LDCT screening compliance were analyzed by using a multivariate logistic regression model. Results: The age of 17 983 participants was (56.52±8.22) years old. Males accounted for 51.9% (N=9 332), and 69.5% (N=12 495) had ever smoked, including former smokers and current smokers. A total of 6 269 participants were screened by LDCT, and the screening participation rate was 34.86%. The results of multivariate logistic regression analysis showed that the age group of 50 to 69 years old, female, passive smokers, alcohol consumption, family history of lung cancer and history of chronic respiratory diseases were more likely to be screened by LDCT, while the compliance of LDCT screening in current smokers was low. Conclusions: The LDCT screening compliance of the high-risk population of lung cancer in urban areas of China still needs to be improved. Age, sex, smoking, drinking, family history of lung cancer and history of chronic respiratory disease are associated with screening compliance.
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Affiliation(s)
- Y Wen
- 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
| | - L Z Yu
- Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
| | - L B Du
- Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou 310004, China
| | - D H Wei
- Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - Y Y Liu
- The Department of Cancer Prevention and Control, Liaoning Cancer Hospital/Institute, Shenyang 110042, China
| | - Z Y 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
| | - Y D Zheng
- 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
| | - Z Wu
- 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
| | - X Y Yu
- 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
| | - L Zhao
- 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
| | - Y W Yu
- 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
| | - H D 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
| | - J S Ren
- 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/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - C Qin
- 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
| | - Y J Xu
- 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
| | - W 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
| | - F Wang
- 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
| | - J 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/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - F W Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- 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
| | - W Q 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/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - N 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/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - J He
- Department of Thoracic Surgery, 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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Cai J, Chen HD, Lu M, Zhang YH, Lu B, You L, Dai M, Zhao YP. [Trend analysis on morbidity and mortality of pancreatic cancer in China, 2005-2015]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:794-800. [PMID: 34814469 DOI: 10.3760/cma.j.cn112338-20201115-01328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the trend of morbidity and mortality of pancreatic cancer in China from 2005 to 2015 and estimate the related age, period and cohort effect, respectively. Methods: Joinpoint regression analysis was used to analyze the trend of morbidity rate and mortality rate of pancreatic cancer during 2005-2015 and calculate the annual percentage change and average annual percentage change based on the data in the annual report of China Cancer Registry. Population aged 20-84 years was fitted by the Age-Period-Cohort model to estimate the effect parameters of age, period and cohort. Results: The trend variations of the crude morbidity rate and crude mortality rate of pancreatic cancer were consistent. The morbidity rate of pancreatic cancer firstly increased before 2008 and then decreased. The morbidity rate and mortality rate of pancreatic cancer were higher in men than women, and higher in urban areas than in rural areas. From 2005 to 2015, the overall age-standardized morbidity rate of pancreatic cancer increased by 2.78% annually and the overall age standardized mortality rate of pancreatic cancer increased by 2.24% annually. The age standardized morbidity of pancreatic cancer in rural men changed more rapidly, with an average annual increase of 3.74%, and the age standardized mortality rate of pancreatic cancer in urban men changed more rapidly, with an average annual increase of 3.57%. The age effect on the morbidity and mortality of pancreatic cancer increased with age, and the effect was most obvious in age group 70-80 years, the period effect increased over time and the cohort effect decreased with year, but rebound or fluctuation was observed after 1976. Conclusions: The morbidity rate and mortality rate of pancreatic cancer in China increased slightly in past decades. Strategies on effective prevention and control of pancreatic cancer should be developed in the future.
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Affiliation(s)
- J Cai
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - H D 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
| | - M Lu
- 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
| | - Y H 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
| | - B Lu
- 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
| | - L You
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - M Dai
- 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
| | - Y P Zhao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Stuart BC, Timmons V, Loh FHE, Dai M, Xu J. Can one or two simple questions predict poor medication adherence? J Eval Clin Pract 2021; 27:75-83. [PMID: 32212235 PMCID: PMC9829406 DOI: 10.1111/jep.13389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 01/12/2023]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Poor adherence to evidence-based medications is a major problem in conventional clinical practise. Better prognostic tools are needed to identify those with the highest likelihood of being non-adherent. The objective of this study is to determine if a 2-item patient activation status (PAS) measure identifies Medicare beneficiaries at risk of poor adherence to drugs typically recommended in treating type 2 diabetes. METHODS PAS and medication adherence were assessed for respondents to the 2009 Medicare Current Beneficiary Survey and then compared using bivariate and multivariate tests. Participants' PAS was classified as "active," "high effort," "complacent," or "passive" based on how confident they were in identifying needed medical care and whether they brought medication lists to their doctors' visits. Adherence with oral antidiabetic drugs, angiotensin-converting enzyme-inhibitors/angiotensin receptor blockers, and statins was assessed using proportion of days covered (PDC). RESULTS A total of 940 Medicare beneficiaries with diabetes enrolled in Part D plans in 2009. The overall effect of PAS on medication adherence was small (3% lower PDC for complacent/passive vs active/high effort beneficiaries, P < 0.10). However, interactions of complacent/passive PAS with other characteristics associated with poor adherence identified certain subgroups as especially prone to problematic adherence: age < 65 (PDC -11%, P < 0.05), non-Hispanic black (PDC -13%, P < 0.05), and morbidly obese (-9%, P < 0.10). CONCLUSION A single question relating to taking medication lists to doctor visits may help identify patient subgroups prone to poor adherence in conventional practise, but larger samples are necessary to validate and extend these findings.
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Affiliation(s)
- Bruce C Stuart
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Veronica Timmons
- Department of Pharmacy Practice and Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Feng-Hua E Loh
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Mingliang Dai
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jing Xu
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Cui Y, Chen J, Dai M, Cai X. Development of a steady state analysis code for molten salt reactor based on nodal expansion method. ANN NUCL ENERGY 2021. [DOI: 10.1016/j.anucene.2020.107950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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31
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Lu M, Chen HD, Liu CC, Zhang YH, Wei LP, Lyu ZY, Ren JS, Shi JF, Zou SM, Li N, Dai M. [Diagnostic performance of quantitative fecal immunochemical test in detection of advanced colorectal neoplasia]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 41:2104-2111. [PMID: 33378824 DOI: 10.3760/cma.j.cn112338-20191216-00888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the diagnostic performance of quantitative fecal immunochemical testing (FIT) and to provide reference for designing effective colorectal cancer (CRC) screening strategy in China. Methods: Based on an ongoing randomized controlled trial comparing the colorectal cancer screening strategies, this current study involved 3 407 participants aged 50-74 years who had undergone colonoscopies. All the feces samples were collected from the participants prior to receiving the colonoscopy. Fecal hemoglobin (Hb) was tested by FIT following a standardized operation process. Diagnosis-related indicators of FIT were calculated using the colonoscopy results as the gold standard. Results: Among the 3 407 participants, the mean age (SD) as 60.5 (6.3) years and 1 753 (51.5%) were males. The participants involved 28 (0.8%) CRCs, 255 (7.5%) advanced adenomas, 677 (19.9%) nonadvanced adenomas, and 2 447 (71.8%) benign or negative findings. With an overall positivity rate of 2.8% (96/3 407) at the recommended cutoff value of 20 μg Hb/g, the sensitivities of FIT for both CRC and advanced adenoma were 57.1% (95%CI: 37.2%-75.5%) and 11.0% (95%CI: 7.4%-15.5%), respectively, with the corresponding specificity as 98.4% (95%CI: 97.8%-98.8%). At a decreased cut-off value of 5 μg Hb/g, the sensitivities for detecting CRC and advanced adenoma increased to 64.3% (95%CI: 44.1%-81.4%) and 16.5% (95%CI: 12.1%-21.6%), respectively, but the specificity reduced to 95.2% (95%CI: 94.4%-95.9%). The areas under the ROC curve for CRC and advanced adenoma were 0.908 (95%CI: 0.842-0.973) and 0.657 (95%CI: 0.621-0.692), respectively. Of the diagnostic performance, there were no significant differences noticed by different sex and age groups. Conclusions: In our study, the quantitative FIT showed modest sensitivity in detecting CRC but limited sensitivity in detecting advanced adenoma. In population-based CRC screening programs, the quantitative FIT had the advantage of adjusting the positive threshold based on the targeted detection rate and available resource load of colonoscopy.
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Affiliation(s)
- M Lu
- 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
| | - H D 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
| | - C C Liu
- 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
| | - Y H 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
| | - L P Wei
- Department of Science and Development, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Z Y Lyu
- 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; Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Hospital, Tianjin 300060, China
| | - J S Ren
- 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
| | - J F Shi
- 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
| | - S M Zou
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N 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
| | - M Dai
- 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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Zhang YH, Chen HD, Lu M, Dai M. [Progress in research of biomarkers for colorectal cancer screening and early detection]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:142-148. [PMID: 33503711 DOI: 10.3760/cma.j.cn112338-20200411-00556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Disease burden caused by colorectal cancer is growing, which has become a major concern in public health. Population-based screening has been proved effective in reducing the morbidity and mortality of colorectal cancer. To date, more evidences regarding the changes in genetics, epigenetics and microbiome of colorectal cancer have been recognized. Emerging technologies for gene sequencing and molecular detection shed lights on the development of informative colorectal cancer related biomarkers. In this article, we summarize the latest findings in research of biomarkers for colorectal cancer screening and early detection to provide references for the development of novel effective and non-invasive colorectal cancer screening tests in the future.
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Affiliation(s)
- Y H 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
| | - H D 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
| | - M Lu
- 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
| | - M Dai
- 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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Chen HD, Lu M, Liu CC, Zhang YH, Zou SM, Shi JF, Ren JS, Li N, Dai M. [Rates on the acceptance of colonoscopy, fecal immunochemical test and a novel risk-adapted screening approach in the screening programs of colorectal cancer as well as related associated factors]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 41:1655-1661. [PMID: 33297622 DOI: 10.3760/cma.j.cn112338-20200227-00196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the rates of acceptance of colonoscopy, fecal immunochemical test (FIT), or a novel risk-adapted screening approach in the colorectal cancer (CRC) screening program. Related risk factors were also studied. Methods: The study has been based on an ongoing randomized controlled trial on colorectal cancer screening programs in six centers of research since May 2018. The involved participants were those who presented at the baseline screening phase. All the participants were randomly allocated into one of the following three intervention arms in a 1∶2∶2 ratio: colonoscopy group, FIT group, and a novel risk-adapted screening group. All the participants underwent risk assessment on CRC by an established risk score system. The subjects with high-risk were recommended to undertake the colonoscopy while the low-risk ones were receiving the FIT. Detailed epidemiological data was collected through questionnaires and clinical examinations. Rates of participation and compliance in all three groups were calculated. Multivariate logistic regression models were used to explore the potential associated factors related to the acceptance of screening. Results: There were 19 546 eligible participants involved in the study, including 3 916 in the colonoscopy group, 7 854 in the FIT group, and 7 776 in the novel risk-adapted screening group, respectively. Among the 19 546 participants, the mean age was 60.5 years (SD=6.5), and 8 154 (41.7%) were males. The rates of participation in the colonoscopy, FIT and the novel risk-adapted screening groups were 42.5%, 94.0% and 85.2%, respectively. In the novel risk-adapted screening group, the participation rate was 49.2% for the high-risk participants who need to undertake colonoscopy and was 94.0% for the low-risk ones who need to undertake FIT. Results from the multivariate logistic regression models demonstrated that there were several factors associated with the rates of participation in CRC screening, including age, background of education, history of smoking cigarettes, previous history of bowel examination, chronic inflammatory bowel disease and family history of CRC among the 1(st)-degree relatives. Conclusions: FIT and the novel risk-adapted screening approach showed superior participation rates to the colonoscopy. Further efforts including health promotion campaign for specific target population are needed to improve the engagement which ensures the effectiveness of CRC screening programs.
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Affiliation(s)
- H D 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
| | - M Lu
- 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
| | - C C Liu
- 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
| | - Y H 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
| | - S M Zou
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J F Shi
- 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
| | - J S Ren
- 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
| | - N 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
| | - M Dai
- 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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Chen HD, Dai M. [On prevention and control strategy of colorectal cancer in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 41:1627-1632. [PMID: 33297618 DOI: 10.3760/cma.j.cn112338-20200423-00629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Colorectal cancer is a major disease threatening the health of Chinese people, which has led to a heavy social burden. In this article, we briefly summarized the progress made on prevention and control of colorectal cancer, including risk factors identification and setting up intervention, screening, and early detection programs. Considerations regarding the directions on prevention and control of colorectal cancer in the future were also mentioned. Hopefully, the collective information could provide technical evidence to the ongoing practical and effective programs on prevention and control of colorectal cancer in this country.
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Affiliation(s)
- H D 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
| | - M Dai
- 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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Liu X, He Q, Liang Z, Wu H, Li Y, Zhang Z, Yu L, Dai M, Guo S, Jin G, Shen S, Su Z, Ma C, Xie Z, Liu R. 118MO Circulating tumour DNA methylation are markers for early detection of pancreatic ductal adenocarcinoma (PDAC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Wang H, Cao MD, Liu CC, Yan XX, Huang HY, Zhang Y, Chen HD, Ren JS, Li N, Chen WQ, Dai M, Shi JF. [Disease burden of colorectal cancer in China: any changes in recent years?]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:1633-1642. [PMID: 33297619 DOI: 10.3760/cma.j.cn112338-20200306-00273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To update the disease burden of colorectal cancer (CRC) in Chinese population by integrating the latest multi-source evidences. Methods: Groups of data from GLOBOCAN, series of Chinese Cancer Registry Annual Report (annual report), Cancer Incidence in Five Continents (CI5), Global Burden of Disease Project 2017 (GBD), China Death Cause Surveillance Datasets and China Health Statistical Yearbooks (yearbook) were used to extract the information. Data on incidence, mortality, disability-adjusted life year (DALY) and percentage distribution of sub-location of CRC were used to analyze the latest disease burden in China, and age-standardized rates by world standard population were mainly used. Joinpoint Trend Analysis Software 4.7.0.0 was applied for time trend analysis. Data related to the economic burden of CRC in China were gathered by literature review. Results: (1) Current status: according to the latest annual report, the incidence and mortality rates of CRC were 17.1 per 100 000 and 7.9 per 100 000, respectively among the covered registration sites in 2015. The incidence ratios of male to female and that of urban to rural were 1.5 and 1.4, with the mortality ratios were 1.6 and 1.4, respectively. Similar to data from the annual report, the mortality rate was reported as 6.9 per 100 000 in 2017 by the surveillance data sets. Data from the GBD project showed that, the DALYs caused by CRC in China in 2017 was 4.254 million person years (doubled compared with that of 1990), accounting for 22.4% of the global burden of CRC. (2) Time trends: according to the annual reports, from 2009 to 2015, the incidence rate and mortality rate of CRC in China decreased by 10.2% and 9.5%, respectively. The same trend was also observed in urban sites, but was opposite in rural areas (increased 20.0% in incidence and 15.2% in mortality). Results from the Joinpoint analysis showed that the averaged annual percentage change (AAPC) was estimated as -1.6% (P<0.05) in the national mortality rate. Similarly, in the incidence and mortality rates of urban sites appeared as AAPC=-1.5% and -1.4% (all P<0.05), but inversely in the incidence rate from the rural sites as AAPC=3.3% (P<0.05). The yearbook data showed a 9.8% increase in urban and 20.6% increase in rural on the mortality in 2017 when compared with 2004, but the Joinpoint analysis showed no statistical significance (P<0.05). (3) Distribution of sub-location of CRC: the annual report showed that among all the new CRC cases in China in 2015, colon, rectal and anal cancer accounted for 49.6%, 49.2% and 1.2%, respectively, while the proportions were 51.3%, 47.6% and 1.1%, respectively in 2009. The proportion of colon cancer was continuously higher in the urban (>52%) than that in the rural areas (<44%). The CI5 Ⅺ data showed that ascending and sigmoid colons were more commonly seen among all the colon cancers. (4) Economic burden: the average annual growth rate of the medical expenditure per CRC patient in China ranged from 6.9% to 9.2%, and the 1-year out-of-pocket expenditure of a newly diagnosed patient accounted for about 60% of their previous-year household income. Conclusions: In China, the overall disease burden of CRC might have been decreased slightly but generally remained stable in the last several years, however, the rising burden appeared in the rural areas should not be ignored. In consistent with findings from a previous review, men and people from the urban areas are considered the target populations for CRC. The finding of higher proportion of colon cancer in urban areas suggests the impact of development of socioeconomic and medical technologies on CRC development and detection. The economic burden of CRC continued to grow.
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Affiliation(s)
- H Wang
- 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
| | - M D 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
| | - C C Liu
- 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
| | - X X 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
| | - H Y Huang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Zhang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - H D 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
| | - J S Ren
- 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
| | - N 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
| | - W Q 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
| | - M Dai
- 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
| | - J F Shi
- 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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Zhou YC, Lin YP, Li Q, Ma LY, Liu X, Wang XX, Li HS, Liu JX, Shen ZH, Guo YJ, Du YX, Yang RJ, Huang YC, Dai M, Zhang Q. [Analysis of EGFR mutation and clinical features of lung cancer in Yunnan]. Zhonghua Zhong Liu Za Zhi 2020; 42:729-734. [PMID: 32988154 DOI: 10.3760/cma.j.cn112152-20200313-00201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the EGFR mutation profile of lung cancer patients in Yunnan, and to provide evidence for clinical personalized treatment. Methods: Demographic and clinical data of 2 967 lung cancer patients undergoing EGFR identification were collected and analyzed from January 2014 to August 2019 in Yunnan Cancer Hospital. Results: The proportion of EGFR mutation in 2 967 patients with lung cancer was 46.2%. Univariate analysis showed that the proportion of EGFR mutation in women was higher than that in men (P<0.001) and displayed a downward trend with age (P=0.03). The mutation rate of ethnic minorities was higher than Han (P=0.012). Mutation rate in patients without smoking history was higher than those with smoking history (P<0.001), and patients without drinking history was higher than patients with drinking history (P<0.001). Mutation rate in patients without family history of lung cancer was higher than those with family history (P=0.008). The mutation rate of adenocarcinoma was higher than other pathological types (P<0.001). The mutation rate was different among stages, and it was higher in early patients than that in advanced patients (P<0.001). The mutation rate of tissue specimens was higher than those of cytology and peripheral blood samples (P<0.001). The mutation rate of Xuanwei area was lower than that in non-Xuanwei area (P<0.001). Multivariate analysis showed that gender (P<0.001), age (P=0.036), smoking history (P<0.001), pathological type (P<0.001), specimen type (P<0.001), and whether or not Xuanwei area (P<0.001) were the independent factors of EGFR mutation.The EGFR mutation was more common in female, non-smokers, adenocarcinoma, non-Xuanwei area, tissue specimen and young lung cancer patients.The mutation types of EGFR in 1 370 cases mainly included 19-Del and L858R. The predominant mutation of EGFR in Xuanwei area was L858R, while in non-Xuanwei area was 19-Del.The mutation rates of G719X, G719X+ L861Q, G719X+ S768I, and S768I in Xuanwei were higher while the mutation rates of 19-Del, L858R, and 20-ins were lower than non-Xuanwei area (P<0.05). The 19-Del mutation rate of ethnic minorities is higher than that of Han (P<0.001). The combined mutation rate of G719X, L861Q in Han was higher than that of ethnic minorities (P=0.005). Conclusions: The EGFR mutation rate in lung cancer patients in Yunnan is similar to Asian and Chinese, and higher in female, non-smokers, adenocarcinomas, young and non-Xuanwei area patients. The most common types of EGFR mutation in Yunnan are 19-Del and L858R. The predominant mutation of EGFR in Xuanwei area is L858R, while in non-Xuanwei area is 19-Del. The mutation rates of G719X, G719X+ L861Q, G719X+ S768I and S768I are higher in Xuanwei patients than those in non-Xuanwei patients. The combined mutation rate of G719X and L861Q in Han nationality is higher than that of ethnic minorities.
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Affiliation(s)
- Y C Zhou
- Molecular Diagnostic Branch Center of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - Y P Lin
- Office of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - Q Li
- Molecular Diagnostic Branch Center of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - L Y Ma
- Molecular Diagnostic Branch Center of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - X Liu
- Molecular Diagnostic Branch Center of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - X X Wang
- Yunnan Provincial Key Laboratory of Lung Cancer, Kunming 650118, China
| | - H S Li
- Yunnan Provincial Key Laboratory of Lung Cancer, Kunming 650118, China
| | - J X Liu
- Yunnan Provincial Key Laboratory of Lung Cancer, Kunming 650118, China
| | - Z H Shen
- Office of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - Y J Guo
- Plateau Regional High-Rise Cancer International Cooperation Laboratory of Ministry of Education, Kunming 650118, China
| | - Y X Du
- Plateau Regional High-Rise Cancer International Cooperation Laboratory of Ministry of Education, Kunming 650118, China
| | - R J Yang
- Yunnan Provincial Key Laboratory of Lung Cancer, Kunming 650118, China
| | - Y C Huang
- Molecular Diagnostic Branch Center of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - M Dai
- 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
| | - Q Zhang
- Medical Center, Yunnan Cancer Hospital, Kunming 650118, China
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Zheng R, Niu J, Wu S, Wang T, Wang S, Xu M, Chen Y, Dai M, Zhang D, Yu X, Tang X, Hu R, Ye Z, Shi L, Su Q, Yan L, Qin G, Wan Q, Chen G, Gao Z, Wang G, Shen F, Luo Z, Qin Y, Chen L, Huo Y, Li Q, Zhang Y, Liu C, Wang Y, Wu S, Yang T, Deng H, Chen L, Zhao J, Mu Y, Xu Y, Li M, Lu J, Wang W, Zhao Z, Xu Y, Bi Y, Ning G. Gender and age differences in the association between sleep characteristics and fasting glucose levels in Chinese adults. Diabetes Metab 2020; 47:101174. [PMID: 32659495 DOI: 10.1016/j.diabet.2020.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/24/2020] [Accepted: 07/01/2020] [Indexed: 01/19/2023]
Abstract
AIM The present study examined the associations between night-time sleep duration, midday napping duration and bedtime, and fasting glucose levels, and whether or not such associations are dependent on gender and age. METHODS This study was a cross-sectional analysis of 172,901 adults aged≥40 years living in mainland China. Sleep duration was obtained by self-reports of bedtime at night, waking-up time the next morning and average napping duration at midday. Fasting plasma glucose (FPG)≥7.0mmol/L was defined as hyperglycaemia. Independent associations between night-time sleep duration, midday naptime duration and bedtime with hyperglycaemia were evaluated using regression models. RESULTS Compared with night-time sleep durations of 6-7.9h, both short (<6h) and long (≥8h) night-time sleep durations were significantly associated with an increased risk of hyperglycaemia in women [odds ratio (OR): 1.12, 95% confidence interval (CI): 1.01-1.29 and OR: 1.14, 95% CI: 1.08-1.21, respectively], and revealed a U-shaped distribution of risk in women and no significant association in men. Long midday nap durations (≥1h) were significantly but weakly associated with hyperglycaemia (OR: 1.04, 95% CI: 1.01-1.09) compared with no napping without interactions from gender or age, whereas the association between bedtime and fasting glucose levels did vary according to gender and age. CONCLUSION Night-time sleep duration, midday napping duration and bedtime were all independently associated with the risk of hyperglycaemia, and some of the associations between these sleep characteristics and hyperglycaemia were gender- and age-dependent.
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Affiliation(s)
- R Zheng
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - J Niu
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - S Wu
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - T Wang
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - S Wang
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - M Xu
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - Y Chen
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - M Dai
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - D Zhang
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - X Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - X Tang
- First Hospital of Lanzhou University, Lanzhou, China
| | - R Hu
- Zhejiang Provincial Centre for Disease Control and Prevention, Zhejiang, China
| | - Z Ye
- Zhejiang Provincial Centre for Disease Control and Prevention, Zhejiang, China
| | - L Shi
- Affiliated Hospital of Guiyang Medical College, Guiyang, China
| | - Q Su
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - L Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - G Qin
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Q Wan
- Affiliated Hospital of Luzhou Medical College, Luzhou, China
| | - G Chen
- Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Z Gao
- Dalian Municipal Central Hospital, Dalian Medical University, Dalian, China
| | - G Wang
- First Hospital of Jilin University, Changchun, China
| | - F Shen
- First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Z Luo
- First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Y Qin
- First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - L Chen
- Qilu Hospital of Shandong University, Jinan, China
| | - Y Huo
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Q Li
- Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Y Zhang
- Central Hospital of Shanghai Jiading District, Shanghai, China
| | - C Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
| | - Y Wang
- First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - S Wu
- Karamay Municipal People's Hospital, Xinjiang, China
| | - T Yang
- First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - H Deng
- First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - L Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J Zhao
- Shandong Provincial Hospital affiliated to Shandong University, Jinan, China
| | - Y Mu
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Y Xu
- Clinical Trials Centre, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - M Li
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - J Lu
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - W Wang
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - Z Zhao
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China.
| | - Y Xu
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China.
| | - Y Bi
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China.
| | - G Ning
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
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Wen Y, Wang G, Chen HD, Li X, Lyu ZY, Feng XS, Wei LP, Chen YH, Chen SH, Ren JS, Shi JF, Cui H, Wu SL, Dai M, Li N. [Total cholesterol and the risk of primary liver cancer in Chinese males: a prospective cohort study]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:753-759. [PMID: 32842298 DOI: 10.3760/cma.j.cn112150-20190809-00646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the association between total cholesterol (TC) and primary liver cancer in Chinese males. Methods: Since May 2006, all the male workers, including the employees and the retirees in Kailuan Group were recruited in the Kailuan male dynamic cohort study. Information about demographics, medical history and TC levels was collected at the baseline interview, as well as information on newly-diagnosed primary liver cancer cases during the follow-up period. A total of 110 612 males were recruited in the cohort by 31 December 2015. TC levels were divided into four categories by quartile (<4.27, 4.27-4.90, 4.90-5.56 and ≥5.56 mmol/L), with the first quartile group serving as the referent category. Cox proportional hazards regression model was used to evaluate the association between TC levels and primary liver cancer risk. Results: By December 31, 2015, a follow-up of 861 711.45 person-years was made with a median follow-up period of 8.83 years. During the follow-up, 355 primary liver cancer cases were identified. Compared with the first quartile, the HR of incident primary liver cancer among participants with the second, third and highest quartile TC levels were 0.76 (95%CI: 0.58-1.01), 0.59 (95%CI: 0.43-0.79), and 0.36 (95%CI: 0.25-0.52), respectively after adjusting for age, educational level, income level, smoking status, drinking status, body mass index, and HBsAg status (Pfor trend<0.001). Subgroup analyses found that the association between TC levels and primary liver cancer was robust (all Pfor trend<0.05). The results didn't change significantly after exclusion of newly-diagnosed cases within the first 2 years, males with history of cirrhosis or subjects who took antihyperlipidemic drugs, participants with higher TC levels had a lower risk of primary liver cancer (all Pfor trend<0.05) and HR(95%CI) of incident primary liver cancer among participants with the highest quartile TC levels were 0.41 (0.28-0.61), 0.36 (0.25-0.53) and 0.38 (0.26-0.54), respectively. Conslusion: In this large prospective study, we found that baseline TC levels were inversely associated with primary liver cancer risk, and low TC level might increase the risk of primary liver cancer.
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Affiliation(s)
- Y Wen
- 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
| | - G Wang
- Department of Oncology, Kailuan General Hospital, Tangshan 063000, China
| | - H D 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
| | - X 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
| | - Z Y Lyu
- 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
| | - X S Feng
- 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
| | - L P Wei
- 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
| | - Y H 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
| | - S H Chen
- Department of Health Care Center, Kailuan General Hospital, Tangshan 063000, China
| | - J S Ren
- 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
| | - J F Shi
- 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
| | - H Cui
- 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
| | - S L Wu
- Department of Health Care Center, Kailuan General Hospital, Tangshan 063000, China
| | - M Dai
- 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
| | - N 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
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Wang H, Liu CC, Bai FZ, Zhu J, Yan XX, Cao MD, Du LB, Wei DH, Wang DB, Liao XZ, Dong D, Gao Y, Dong P, Zhu C, Ma YL, Chai J, Xiao HF, Kong YX, Zhang Q, Zheng WF, Ying RB, Zhou H, Ren JS, Li N, Chen HD, Shi JF, Dai M. [Population's acceptance and attitude toward a novel fecal immunochemical test for colorectal cancer screening: a multi-center survey in China]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:760-767. [PMID: 32842299 DOI: 10.3760/cma.j.cn112150-20191218-00941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the acceptance and attitude toward a novel fecal immunochemical test (FIT) in colorectal cancer screening among populations in China. Methods: From May 2018 to May 2019, 2 474 people aged 50-74 years were recruited from five provinces of China (Zhejiang, Anhui, Jiangsu, Hunan and Yunnan). The general demographic characteristics, acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey. Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool, reading and uploading results. Results: The subjects were (60.0±6.4) years old, and female, high school of above educated, unemployed/retired/other, married and with medical insurance status of "new rural cooperative medical care (NRCMC)" accounted for 61.7% (1 526), 29.0%(718), 34.3% (849), 92.7% (2 293) and 31.3%(775), respectively. The population's acceptance of the FIT technology was 94.8%. In the process of FIT screening, the percentage of occurred difficulties in sampling stool, reading and uploading results were 33.1% (819), 46.4% (1 147) and 62.9% (1 557), respectively. The main difficulties were the uncertainty about whether the sampling operation was standard (28.0%), the inability to accurately judge the result displayed (32.5%) and the need for help without using a smartphone (44.2%). The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of "NRCMC" were more likely to encounter difficulties in sampling, and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling. Those aged 65-74 years old, farmers or migrant workers, and those with "NRCMC" were more likely to encounter difficulties in readingresults, and those with 3 or more family members were less likely to encounter difficulties in reading result. Those with "NRCMC" were more likely to encounter difficulties in uploading results, and those with education level of high school or above, living with more than 3 family members were less likely to encounter difficulties in uploading results. Conclusion: The acceptance of the new FIT technology is relatively high among the subjects. Age, education level, occupation, number of family members living together and medical insurance status might be related to difficulties encountered in sampling stool, reading and uploading results, and it can be further strengthened in terms of the technology and characteristics of sub-populations.
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Affiliation(s)
- H Wang
- 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
| | - C C Liu
- 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
| | - F Z Bai
- 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
| | - J Zhu
- 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
| | - X X 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
| | - M D 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
| | - L B Du
- Institute of Cancer and Basic Medicine, Chinese Academy of Sciences/ Department of Cancer Prevention,Cancer Hospital of the University of Chinese Academy of Sciences/ Department of Cancer Prevention,Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - D H Wei
- Office for Cancer Prevention and Control, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - D B Wang
- School of Health Services Management, Anhui Medical University, Hefei 230032, China
| | - X Z Liao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - D Dong
- Office of Cancer Prevention and Treatment, Xuzhou Cancer Hospital, Xuzhou 221000, Jiangsu Province, China
| | - Y Gao
- Department of Colorectal Surgery, Department of Tumor Hospital of Yunnan Province/Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China
| | - P Dong
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - C Zhu
- Institute of Cancer and Basic Medicine, Chinese Academy of Sciences/ Department of Cancer Prevention,Cancer Hospital of the University of Chinese Academy of Sciences/ Department of Cancer Prevention,Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y L Ma
- Office for Cancer Prevention and Control, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - J Chai
- School of Health Services Management, Anhui Medical University, Hefei 230032, China
| | - H F Xiao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - Y X Kong
- Office of Cancer Prevention and Treatment, Xuzhou Cancer Hospital, Xuzhou 221000, Jiangsu Province, China
| | - Q Zhang
- Department of Cancer Prevention, Department of Tumor Hospital of Yunnan Province/ Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China
| | - W F Zheng
- Department of Proctology, Lanxi Red Cross Hospital, Lanxi 321100, Zhejiang Province, China
| | - R B Ying
- Department of Surgical Oncology, Taizhou Cancer Hospital, Taizhou 317502, Zhejiang Province, China
| | - H Zhou
- Administrative Management Office, Yunnan Cancer Hospital/ The Third Affiliated Hospital of Kunming Medical University/ Yunnan Cancer Center, Kunming 650118, China
| | - J S Ren
- 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
| | - N 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
| | - H D 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
| | - J F Shi
- 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
| | - M Dai
- 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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Dai M, Peterson LE. Characteristics of Family Medicine Residency Graduates, 1994-2017: An Update. Ann Fam Med 2020; 18:370-373. [PMID: 32661040 PMCID: PMC7358018 DOI: 10.1370/afm.2535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 11/14/2019] [Accepted: 11/21/2019] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to characterize graduates of family medicine (FM) residencies from 1994 to 2017 and determine whether they continue to practice family medicine after residency. METHOD We sampled physicians who completed FM residency training from 1994-2017 using 2017 American Medical Association (AMA) Physician Masterfile linked with administrative files of the American Board of Family Medicine (ABFM). The main outcomes measured were characteristics of FM residency graduates, including medical degree type (Doctor of Medicine, MD vs Doctor of Osteopathic Medicine, DO), international medical school graduates (IMGs) vs US graduates, sex, ABFM certification status, and self-designated primary specialty. Family medicine residency graduates were grouped into 4-year cohorts by year of residency completion. RESULTS From 1994 to 2017, 66,778 residents completed training in an ACGME accredited FM residency, averaging 2,782 graduates per year. The number of FM residency graduates peaked in 1998-2001, averaging 3,053 each year. The composition of FM residents diversified with large increases in DOs, IMGs, and female graduates over the past 24 years. Of all the FM residency graduates, 91.9% claimed FM as their primary specialty and 81% were certified with ABFM in 2017. FM/sport medicine (2.1%), FM/geriatric medicine (0.9%), internal medicine/geriatrics (0.8%), and emergency medicine (0.7%) were the most common non-FM primary specialties reported. CONCLUSIONS DOs, IMGs, and female family medicine residency graduates increased from 1994 to 2017. With 9 in 10 graduates of family medicine residencies designating FM as their primary specialty, FM residency programs not only train but supply family physicians who are likely to remain in the primary care workforce.
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Affiliation(s)
- Mingliang Dai
- American Board of Family Medicine, Lexington, Kentucky
| | - Lars E Peterson
- American Board of Family Medicine, Lexington, Kentucky.,Department of Family and Community Medicine, University of Kentucky, Lexington, Kentucky
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Lu M, Chen H, Wang L, Liu C, Zhang Y, Ren J, Shi J, Li N, Dai M. PD-10 Improvement of Asia-Pacific colorectal screening score combined with fecal immunochemical testing at adjusted thresholds in colorectal cancer screening. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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43
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Wang H, Huang HY, Liu CC, Bai FZ, Zhu J, Wang L, Yan XX, Chen YS, Chen HD, Zhang YM, Ren JS, Zou SM, Li N, Zheng ZX, Feng H, Bai HJ, Zhang J, Chen WQ, Dai M, Shi JF. [Health economic evidence for colorectal cancer screening programs in China: an update from 2009-2018]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:429-435. [PMID: 32294848 DOI: 10.3760/cma.j.issn.0254-6450.2020.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: This study was to systematically update the economic evaluation evidence of colorectal cancer screening in mainland China. Methods: Based on a systematic review published in 2015, we expanded the scope of retrieval database (PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, CBM) and extended it to December 2018. Focusing on the evidence for nearly 10 years (2009-2018), basic characteristics and main results were extracted. Costs were discounted to 2017 using the consumer price index of medical and health care being provided to the residents, and the ratio of incremental cost-effectiveness ratio (ICER) to per capita GDP in corresponding years were calculated. Results: A total of 12 articles (8 new ones) were included, of which 9 were population-based (all cross-sectional studies) and 3 were model-based. Most of the initial screening age was 40 years (7 articles), and most of the frequency was once in a lifetime (11 articles). Technologies used for primary screening included: questionnaire assessment, immunological fecal occult blood test (iFOBT) and endoscopy. The most commonly used indicator was the cost per colorectal cancer detected, and the median (range) of the 20 screening schemes was 52 307 Chinese Yuan (12 967-3 769 801, n=20). The cost per adenoma detected was 9 220 Yuan (1 859-40 535, n=10). In 3 articles, the cost per life year saved (compared with noscreening) was mentioned and the ratio of ICER to GDP was 0.673 (-0.013-2.459, n=11), which was considered by WHO as "very cost-effective" ; The range of ratios overlapped greatly among different technologies and screening frequencies, but the initial age for screening seemed more cost-effective at the age of 50 years (0.002, -0.013-0.015, n=3), than at the 40 year-olds (0.781, 0.321-2.459, n=8). Conclusions: Results from the population-based studies showed that the cost per adenoma detected was only 1/6 of the cost per colorectal cancer detected, and limited ICER evidence suggested that screening for colorectal cancer was generally cost-effective in Chinese population. Despite the inconclusiveness of the optimal screening technology, the findings suggested that the initial screening might be more cost-effective at older age. No high-level evidence such as randomized controlled trial evaluation was found.
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Affiliation(s)
- H Wang
- 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
| | - H Y Huang
- 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
| | - C C Liu
- 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
| | - F Z Bai
- 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
| | - J Zhu
- 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
| | - L Wang
- 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
| | - X X 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
| | - Y S 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
| | - H D 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
| | - Y M Zhang
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J S Ren
- 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
| | - S M Zou
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N 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
| | - Z X Zheng
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H Feng
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - H J Bai
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - J Zhang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - W Q 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
| | - M Dai
- 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
| | - J F Shi
- 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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Lyu ZY, Tan FW, Lin CQ, Li J, Wang YL, Chen HD, Ren JS, Shi JF, Feng XS, Wei LP, Li X, Wen Y, Chen WQ, Dai M, Li N, He J. [The development and validation of risk prediction model for lung cancer: a systematic review]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:430-437. [PMID: 32268653 DOI: 10.3760/cma.j.cn112150-20190523-00415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To systematically understand the global research progress in the construction and validation of lung cancer risk prediction models. Methods: "lung neoplasms" , "lung cancer" , "lung carcinoma" , "lung tumor" , "risk" , "malignancy" , "carcinogenesis" , "prediction" , "assessment" , "model" , "tool" , "score" , "paradigm" , and "algorithm" were used as search keywords. Original articles were systematically searched from Chinese databases (CNKI, and Wanfang) and English databases (PubMed, Embase, Cochrane, and Web of Science) published prior to December 2018. The language of studies was restricted to Chinese and English. The inclusion criteria were human oriented studies with complete information for model development, validation and evaluation. The exclusion criteria were informal publications such as conference abstracts, Chinese dissertation papers, and research materials such as reviews, letters, and news reports. A total of 33 papers involving 27 models were included. The population characteristics of all included studies, study design, predicting factors and the performance of models were analyzed and compared. Results: Among 27 models, the number of American-based, European-based and Asian-based model studies was 12, 6 and 9, respectively. In addition, there were 6 Chinese-based model studies. According to the factors fitted into the models, these studies could be divided into traditional epidemiological models (11 studies), clinical index models (6 studies), and genetic index models (10 studies). 15 models were not validated after construction or were cross-validated only in the internal population, and the extrapolation effect of models was not effectively evaluated; 8 models were validated in single external population; only 4 models were verified in multiple external populations (3-7); the area under the curve (AUC) of models ranged from 0.57 to 0.90. Conclusion: Research on risk prediction models for lung cancer is in development stage. In addition to the lack of external validation of existing models, the exploration of potential clinical indicators was also limited.
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Affiliation(s)
- Z Y Lyu
- 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
| | - F W Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - C Q Lin
- 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
| | - J 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
| | - Y L Wang
- 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
| | - H D 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
| | - J S Ren
- 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
| | - J F Shi
- 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
| | - X S Feng
- 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
| | - L P Wei
- 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
| | - X 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
| | - Y Wen
- 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
| | - W Q 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
| | - M Dai
- 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
| | - N 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
| | - J He
- Department of Thoracic Surgery, 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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Jiang BS, Yao PT, Ge YB, Yang M, Sun X, Ren JS, Chen WQ, Dai M, Li J, Li N. [Systematic review of methodological quality and reporting quality in gastric cancer screening guidelines]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:314-319. [PMID: 32187938 DOI: 10.3760/cma.j.issn.0253-9624.2020.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To systematically evaluate the quality of gastric cancer screening guidelines/recommendations, and provide a reference for the update of gastric cancer screening guidelines/recommendations in China. Methods: "guidelines/consensus/specifications/standards" , "stomach/gastric tumors" , "screening/diagnosis" , "guideline/recommendation" , "gastric cancer/gastric tumor," "early detection of cancer/screening" were searched as keywords in PubMed, Embase, Web of knowledge, China Knowledge Network, Wanfang, China Biomedical Literature Database, and Cochrane Library, as well as the US Preventive Services Working Group, the American Cancer Society, the International Agency for Research on Cancer, the Australia Cancer Council and the International Guide Collaboration Network at the end of July 2018. The inclusion criteria were independent guidelines/recommendation documents for gastric cancer screening. The exclusion criteria were guideline abstracts, interpretation and evaluation literature, duplicate publications, updated original guidelines, and clinical treatment or practice guidelines for gastric cancer. The language was limited to Chinese and English. The European Guide to Research and Evaluation Tools (AGREE Ⅱ) and Practice Guideline Reporting Standard (RIGHT) for Gastric Cancer Screening Guidelines/Recommendations were used to compare and evaluate the quality and reporting standard of gastric cancer screening guidelines/recommendations. Results: A total of five guides/recommendations were included. The results of the AGREE Ⅱ quality evaluation showed that the overall quality of five guides/recommendations was different, including one recommended for "A", one for "B", and three for "C". Each guide/recommendation scored higher in the scope and purpose, clarity, and scores were more significant in the areas of rigor and independence. In the participants, the application field scores were generally low. The RIGHT evaluation results showed that the quality of five guides/recommendations should be improved. The six items with poor report quality were background, evidence, recommendations, review and quality assurance, funding and conflict of interest statement and management, and other aspects. Conclusion: The quality of the included gastric cancer screening guidelines/recommendations is generally low, and the standardization should be strengthened.
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Affiliation(s)
- B S Jiang
- School of Public Health, Capital Medical University/Program Office for Cancer Screening in Urban China, Beijing 100069, China
| | - P T Yao
- School of Public Health, Capital Medical University/Program Office for Cancer Screening in Urban China, Beijing 100069, China
| | - Y B Ge
- School of Medical Humanities, Capital Medical University/Program Office for Cancer Screening in Urban China, Beijing 100069, China
| | - M Yang
- National Cancer Center/National Clinical Research Center for Cancer/Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - X Sun
- National Cancer Center/National Clinical Research Center for Cancer/Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - J S Ren
- National Cancer Center/National Clinical Research Center for Cancer/Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Chen
- National Cancer Center/National Clinical Research Center for Cancer/Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/National Clinical Research Center for Cancer/Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Li
- National Cancer Center/National Clinical Research Center for Cancer/Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - N Li
- National Cancer Center/National Clinical Research Center for Cancer/Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
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Phillips WR, Dai M, Frey JJ, Peterson LE. General Practitioners in US Medical Practice Compared With Family Physicians. Ann Fam Med 2020; 18:127-130. [PMID: 32152016 PMCID: PMC7062491 DOI: 10.1370/afm.2503] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/28/2019] [Accepted: 08/16/2019] [Indexed: 11/09/2022] Open
Abstract
PURPOSE General practitioners (GPs) are part of the US physician workforce, but little is known about who they are, what they do, and how they differ from family physicians (FPs). We describe self-identified GPs and compare them with board-certified FPs. METHODS Analysis of data on 102,604 Doctor of Medicine and Doctor of Osteopathy physicians in direct patient care in the United States in 2016, who identify themselves as GPs or FPs. The study used linking databases (American Medical Association Masterfile, American Board of Family Medicine [ABFM], Area Health Resource File, Medicare Public Use File) to examine personal, professional, and practice characteristics. RESULTS Of the physicians identified, 6,661 self-designated as GPs and 95,943 self-designated as FPs. Of the self-designated GPs, 116 had been ABFM certified and were excluded from the study. Of the remaining 102,488 physicians, those who self-designated as GPs but were never ABFM certified constituted the GP group (n = 6,545, 6%). Self-designated FPs that were ABFM certified made up the FP group (n = 79,449, 78%). The remaining self-designated FPs not ABFM certified constituted the uncertified group (n = 16,494, 16%). GPs differed from FPs in every characteristic examined. Compared with FPs, GPs are more likely to be older, male, Doctors of Osteopathy, graduates of non-US medical schools, and have no family medicine residency training. GPs practice location is similar to FPs, but GPs are less likely to participate in Medicare or to work in hospitals. CONCLUSIONS GPs in the United States are a varied group that differ from FPs. Researchers, educators, and policy makers should not lump GPs together with FPs in data collection, analysis, and reporting.
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Affiliation(s)
- William R Phillips
- Department of Family Medicine, University of Washington, Seattle, Washington
| | - Mingliang Dai
- American Board of Family Medicine, Lexington, Kentucky
| | - John J Frey
- Department of Family Medicine, University of Wisconsin, Madison, Wisconsin
| | - Lars E Peterson
- American Board of Family Medicine, Lexington, Kentucky.,Department of Family and Community Medicine, University of Kentucky, Lexington, Kentucky
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Mao AY, Shi JF, Qiu WQ, Liu CC, Dong P, Huang HY, Wang K, Wang DB, Liu GX, Liao XZ, Bai YN, Sun XJ, Ren JS, Yang L, Wei DH, Song BB, Lei HK, Liu YQ, Zhang YZ, Ren SY, Zhou JY, Wang JL, Gong JY, Yu LZ, Liu YY, Zhu L, Guo LW, Wang YQ, He YT, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, Li N, Dai M, Chen WQ. [Analysis on the consciousness of the cancer early detection and its influencing factors among urban residents in China from 2015 to 2017]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:54-61. [PMID: 31914570 DOI: 10.3760/cma.j.issn.0253-9624.2020.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the consciousness of the cancer early detection among urban residents and identify the influencing factors from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. Self-designed questionnaires were used to collect population, socioeconomic indicators, self-cancer risk assessment, regular participation in physical examination and other information. The multivariate logistic regression model was used to identify the factors of people who had not regularly participated in the regular physical examination in the past five years. Results: The self-assessment results of 32 357 residents showed that there were 27.54% (8 882) of total study population with self-reported cancer risk, 45.48% (14 671) without cancer risk and 26.98% (8 704) with unclear judgement on their own cancer risk. Among population with cancer risk, 79.84% (7 091) considered physical examination accounted. In the past five years, there were 21 105 (65.43%) residents participated in regular physical examination and 11 148 (34.56%) participated in non-scheduled one, respectively. The multivariate logistic regression analysis showed that compared with unmarried and western region residents, divorced, middle and eastern region residents had a stronger consciousness to participate in the regular physical examination (P<0.05). Compare with residents with annual household income less than 20 000 CNY in 2014, cancer risk assessment/screening intervention population, and self-assessment with cancer risk, residents with annual household income between 20 000 CNY and 59 000 CNY in 2014, occupational population, community residents, cancer patients, self-reported cancer-free risk, and self-assessment with unclear judgement of cancer risk were less likely to participate in the regular physical examination (all P values <0.05). Conclusion: From 2015 to 2017, the Chinese urban residents had a acceptable consciousness of the cancer early detection. The marital status, annual household income, population group and self-assessment of cancer risk were related to the consciousness of the cancer early detection of people who had not participated in the regular physical examination in the past five years.
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Affiliation(s)
- A Y Mao
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - J F Shi
- 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
| | - W Q Qiu
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - C C Liu
- 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
| | - P Dong
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - H Y Huang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - K Wang
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - D B Wang
- Health Management College, Anhui Medical University, Hefei 230032, China
| | - G X Liu
- School of Public Health, Harbin Medical University, Harbin 150081, China
| | - X Z Liao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- School of Health Care Management, Shandong University, Jinan 250012, China
| | - J S Ren
- 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
| | - L Yang
- School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - D H Wei
- Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - B B Song
- The Department of Cancer Prevention and Control, Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - H K Lei
- Department of Cancer Research and Control, Chongqing University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital, Chongqing 400030, China
| | - Y Q Liu
- Department of Cancer Epidemiology, Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Z Zhang
- Department of Epidemiology, Shanxi Provincial Center Hospital, Taiyuan 030013, China
| | - S Y Ren
- Institute for Chronic and Non-communicable Disease Prevention and Control, Yunnan Center for Disease Prevention and Control,Kunming 650118, China
| | - J Y Zhou
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - J L Wang
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - J Y Gong
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - L Z Yu
- Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
| | - Y Y Liu
- The Department of Cancer Prevention and Control, Liaoning Cancer Hospital & Institute, Shenyang 110042, China
| | - L Zhu
- Cancer Research Institute, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L W Guo
- Office for Cancer Control and Research, Henan Cancer Hospital/The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Y Q Wang
- Department of Cancer Prevention, Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y T He
- The Department of Cancer Prevention and Control, Cancer Institute, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P A Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Department of Health Education and Chronic Disease Control, Nantong Center for Disease Control and Prevention, Nantong 226000, China
| | - X H Sun
- Endocrine Department, Ningbo NO.2 Hospital, Ningbo 315010,China
| | - S L Wu
- Department of Cardiovascular Diseases, Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Office of Cancer Screening, Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- Department of Medical Examination for Cancer Prevention, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N 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
| | - M Dai
- 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
| | - W Q 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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48
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Wang K, Liu CC, Mao AY, Shi JF, Dong P, Huang HY, Wang DB, Liu GX, Liao XZ, Bai YN, Sun XJ, Ren JS, Yang L, Wei DH, Song BB, Lei HK, Liu YQ, Zhang YZ, Ren SY, Zhou JY, Wang JL, Gong JY, Yu LZ, Liu YY, Zhu L, Guo LW, Wang YQ, He YT, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, Li N, Chen WQ, Qiu WQ, Dai M. [Analysis on the demand, access and related factors of cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:84-91. [PMID: 31914574 DOI: 10.3760/cma.j.issn.0253-9624.2020.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the demand and access to the cancer prevention and treatment knowledge and related factors among urban residents in China from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of general demographic characteristics, the demand and access to cancer prevention and treatment knowledge, and the influencing factors of the attitude. The Chi-square test was used to analyze the difference of the demand of the cancer prevention knowledge among different groups and the corresponding factors of the cancer prevention and treatment knowledge were analyzed by using the logistic regression model. Results: The proportion of residents who need the cancer prevention and treatment knowledge was 79.5%. The demand rate of the inducement, symptom and diagnosis methods of cancer in the occupational population was highest, about 66.8%, 71.0% and 20.8%, respectively. The demand rate of treatment methods and cost in current cancer patients was the highest, about the 45.9% and 21.9%, respectively. The top three sources to acquire the cancer prevention and treatment knowledge were "broadcast or television" (69.5%), "books, newspapers, posters or brochures" (44.7%) and "family and friends" (33.8%). The multivariate analysis showed that compared with public institution personnel/civil servants, unmarried/cohabiting/divorced/widowed and others, annual household income less than 20 000 CNY, from the eastern region, people without cancer diagnosis and people with self-assessment of cancer risk, the demand rate of cancer prevention and treatment knowledge was higher in enterprise personnel/workers, married, annual household income between 60 000 CNY and 150 000 CNY, from the central region, people with cancer and people with unclear cancer risk (all P values <0.05). Conclusion: There was a high demand for the cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017. The main access to the knowledge is from the radio or television. The occupation, marital status, annual household income, residential region, health status and risk of disease were the main factors of the demand of the cancer prevention and treatment knowledge.
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Affiliation(s)
- K Wang
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - C C Liu
- 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
| | - A Y Mao
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - J F Shi
- 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
| | - P Dong
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - H Y Huang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - D B Wang
- Health Management College, Anhui Medical University, Hefei 230032, China
| | - G X Liu
- School of Public Health, Harbin Medical University, Harbin 150081, China
| | - X Z Liao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- School of Health Care Management, Shandong University, Jinan 250012, China
| | - J S Ren
- 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
| | - L Yang
- School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - D H Wei
- Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - B B Song
- The Department of Cancer Prevention and Control, Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - H K Lei
- Department of Cancer Research and Control, Chongqing University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital, Chongqing 400030, China
| | - Y Q Liu
- Department of Cancer Epidemiology, Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Z Zhang
- Department of Epidemiology, Shanxi Provincial Center Hospital, Taiyuan 030013, China
| | - S Y Ren
- Institute for Chronic and Non-communicable Disease Prevention and Control, Yunnan Center for Disease Prevention and Control, Kunming 650118, China
| | - J Y Zhou
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - J L Wang
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - J Y Gong
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - L Z Yu
- Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
| | - Y Y Liu
- The Department of Cancer Prevention and Control, Liaoning Cancer Hospital & Institute, Shenyang 110042, China
| | - L Zhu
- Cancer Research Institute, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L W Guo
- Office for Cancer Control and Research, Henan Cancer Hospital/The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou 450008, China
| | - Y Q Wang
- Department of Cancer Prevention, Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y T He
- The Department of Cancer Prevention and Control, Cancer Institute, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P A Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou221006, China
| | - B Cai
- Department of Health Education and Chronic Disease Control, Nantong Center for Disease Control and Prevention, Nantong 226000, China
| | - X H Sun
- Endocrine Department, Ningbo NO.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Department of Cardiovascular Diseases, Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Office of Cancer Screening, Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- Department of Medical Examination for Cancer Prevention, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N 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
| | - W Q 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
| | - W Q Qiu
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - M Dai
- 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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49
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Liu CC, Shi CL, Shi JF, Mao AY, Huang HY, Dong P, Bai FZ, Chen YS, Wang DB, Liu GX, Liao XZ, Bai YN, Sun XJ, Ren JS, Yang L, Wei DH, Song BB, Lei HK, Liu YQ, Zhang YZ, Ren SY, Zhou JY, Wang JL, Gong JY, Yu LZ, Liu YY, Zhu L, Guo LW, Wang YQ, He YT, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, Li N, Xu WH, Qiu WQ, Dai M, Chen WQ. [Study on the health literacy and related factors of the cancer prevention consciousness among urban residents in China from 2015 to 2017]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:47-53. [PMID: 31914569 DOI: 10.3760/cma.j.issn.0253-9624.2020.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors. Results: The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05). Conclusion: The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.
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Affiliation(s)
- C C Liu
- 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
| | - C L Shi
- Department of Disease Control and Prevention, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - J F Shi
- 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
| | - A Y Mao
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - H Y Huang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - P Dong
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - F Z Bai
- 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
| | - Y S 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
| | - D B Wang
- Health Management College, Anhui Medical University, Hefei 230032, China
| | - G X Liu
- School of Public Health, Harbin Medical University, Harbin 150081, China
| | - X Z Liao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- Scholl of Health Care Management, Shandong University, Jinan 250012, China
| | - J S Ren
- 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
| | - L Yang
- School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - D H Wei
- Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - B B Song
- The department of Cancer Prevention and Control, Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - H K Lei
- Department of Cancer Research and Control, Chongqing University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital, Chongqing 400030, China
| | - Y Q Liu
- Department of Cancer Epidemiology, Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Z Zhang
- Department of Epidemiology, Shanxi Provincial Center Hospital, Taiyuan 030013, China
| | - S Y Ren
- Institute for Chronic and Non-communicable Disease Prevention and Control, Yunnan Center for Disease Prevention and Control, Kunming 650118, China
| | - J Y Zhou
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - J L Wang
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - J Y Gong
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - L Z Yu
- Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
| | - Y Y Liu
- The Department of Cancer Prevention and Control, Liaoning Cancer Hospital/Institute, Shenyang 110042, China
| | - L Zhu
- Cancer Research Institute, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L W Guo
- Office for Cancer Control and Research, Henan Cancer Hospital/The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Y Q Wang
- Department of Cancer Prevention, Cancer hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y T He
- The Department of Cancer Prevention and Control, Cancer Institute, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P A Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou221006, China
| | - B Cai
- Department of Health Education and Chronic Disease Control, Nantong Center for Disease Control and Prevention, Nantong 226000, China
| | - X H Sun
- Endocrine Department, Ningbo NO.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Department of Cardiovascular Diseases, Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Office of Cancer Screening, Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- Department of Medical Examination for Cancer Prevention, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N 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
| | - W H Xu
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - W Q Qiu
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - M Dai
- 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
| | - W Q 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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50
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Dong P, Shi JF, Qiu WQ, Liu CC, Wang K, Huang HY, Wang DB, Liu GX, Liao XZ, Bai YN, Sun XJ, Ren JS, Yang L, Wei DH, Song BB, Lei HK, Liu YQ, Zhang YZ, Ren SY, Zhou JY, Wang JL, Gong JY, Yu LZ, Liu YY, Zhu L, Guo LW, Wang YQ, He YT, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, Li N, Dai M, Chen WQ, Mao AY, He J. [Analysis on the health literacy of the cancer prevention and treatment and its related factors among urban residents in China from 2015 to 2017]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:76-83. [PMID: 31914573 DOI: 10.3760/cma.j.issn.0253-9624.2020.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the health literacy of the cancer prevention and treatment among urban residents of China, and explore the related factors. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The health literacy of the cancer prevention, early discovery, early diagnosis, early treatment and the demands of cancer prevention and treatment knowledge was analyzed. The level of health literacy among different groups were calculated and compared. The binary logistic regression model was used to analyze the influencing factors of the health literacy of the cancer prevention and treatment. Results: The level of health literacy of the cancer prevention and treatment was 56.97% among all study population; in each group it was 55.01% for community residents, 59.08% for cancer risk assessment/screening population, 61.99% for cancer patients and 57.31% for occupational population, respectively (P<0.001). The level of health literacy of the cancer prevention and treatment of residents aged 50 to 69 years old, other occupational groups, unmarried, the central and western region residents and the group with unclear self-assessment of cancer risk was significantly lower than that of residents younger than 40 years old, personnel of public institutions/civil servants, married, the eastern region residents and the group whose self-assessment without cancer risk (P<0.05) . The level of health literacy of cancer prevention and treatment of females, people who went to high school or over, cancer risk assessment/screening population, cancer patients and occupational population was significantly higher than that of males, people who had an education level of primary school or below and community residents (P<0.05) . Conclusion: The health literacy of the cancer prevention and treatment of urban residents in China was relatively high, but there was still room for improvement. Gender, age, educational level, occupation, region, marital status, self-assessment of cancer risk, and type of respondents were the key influencing factors of the health literacy of the cancer prevention and treatment. Male, 50-69 years old, lower educational level, central and western regions, unclear cancer risk self-assessment, and without specific environmental exposure to cancer prevention and treatment knowledge or related risk factors were the characteristics of the key intervention group of the health literacy of the cancer prevention and treatment.
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Affiliation(s)
- P Dong
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - J F Shi
- 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
| | - W Q Qiu
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - C C Liu
- 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
| | - K Wang
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - H Y Huang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - D B Wang
- Health Management College, Anhui Medical University, Hefei 230032, China
| | - G X Liu
- School of Public Health, Harbin Medical University, Harbin 150081, China
| | - X Z Liao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- School of Health Care Management, Shandong University, Jinan 250012, China
| | - J S Ren
- 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
| | - L Yang
- School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - D H Wei
- Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - B B Song
- The Department of Cancer Prevention and Control, Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - H K Lei
- Department of Cancer Research and Control, Chongqing University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital, Chongqing 400030, China
| | - Y Q Liu
- Department of Cancer Epidemiology, Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Z Zhang
- Department of Epidemiology, Shanxi Provincial Center Hospital, Taiyuan 030013, China
| | - S Y Ren
- Institute for Chronic and Non-communicable Disease Prevention and Control, Yunnan Center for Disease Prevention and Control, Kunming 650118, China
| | - J Y Zhou
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - J L Wang
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - J Y Gong
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - L Z Yu
- Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
| | - Y Y Liu
- The Department of Cancer Prevention and Control, Liaoning Cancer Hospital & Institute, Shenyang 110042, China
| | - L Zhu
- Cancer Research Institute, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L W Guo
- Office for Cancer Control and Research, Henan Cancer Hospital/The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Y Q Wang
- Department of Cancer Prevention, Cancer hospital of University of Chinese Academy of Sciences/Zhejiang cancer hospital, Hangzhou 310022, China
| | - Y T He
- The Department of Cancer Prevention and Control, Cancer Institute, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P A Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Department of Health Education and Chronic Disease Control, Nantong Center for Disease Control and Prevention, Nantong 226000, China
| | - X H Sun
- Endocrine Department, Ningbo NO.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Department of Cardiovascular Diseases, Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Office of Cancer Screening, Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- Department of Medical Examination for Cancer Prevention, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N 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
| | - M Dai
- 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
| | - W Q 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
| | - A Y Mao
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - J 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
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