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Wu W, Wang J, Liao XZ, Xu K, Zou Y, Shi Z, Hu Y, Xiao H, Li C, Cao S, Wang S, Guo J, Luo Z, Liu M, Xu M, Jin D, Chen M, Fu Z, Yan S. Projection of Premature Cancer Mortality in Hunan, China, Through 2030: Modeling Study. JMIR Public Health Surveill 2023; 9:e43967. [PMID: 36877566 PMCID: PMC10028508 DOI: 10.2196/43967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/01/2022] [Revised: 01/21/2023] [Accepted: 01/30/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The United Nations Sustainable Development Goals for 2030 include reducing premature mortality from noncommunicable diseases by one-third. Although previous modeling studies have predicted premature mortality from noncommunicable diseases, the predictions for cancer and its subcategories are less well understood in China. OBJECTIVE The aim of this study was to project premature cancer mortality of 10 leading cancers in Hunan Province, China, based on various scenarios of risk factor control so as to establish the priority for future interventions. METHODS We used data collected between 2009 and 2017 from the Hunan cancer registry annual report as empirical data for projections. The population-attributable fraction was used to disaggregate cancer deaths into parts attributable and unattributable to 10 risk factors: smoking, alcohol use, high BMI, diabetes, physical inactivity, low vegetable and fruit intake, high red meat intake, high salt intake, and high ambient fine particulate matter (PM2.5) levels. The unattributable deaths and the risk factors in the baseline scenario were projected using the proportional change model, assuming constant annual change rates through 2030. The comparative risk assessment theory was used in simulated scenarios to reflect how premature mortality would be affected if the targets for risk factor control were achieved by 2030. RESULTS The cancer burden in Hunan significantly increased during 2009-2017. If current trends for each risk factor continued to 2030, the total premature deaths from cancers in 2030 would increase to 97,787 in Hunan Province, and the premature mortality (9.74%) would be 44.47% higher than that in 2013 (6.74%). In the combined scenario where all risk factor control targets were achieved, 14.41% of premature cancer mortality among those aged 30-70 years would be avoided compared with the business-as-usual scenario in 2030. Reductions in the prevalence of diabetes, high BMI, ambient PM2.5 levels, and insufficient fruit intake played relatively important roles in decreasing cancer premature mortality. However, the one-third reduction goal would not be achieved for most cancers except gastric cancer. CONCLUSIONS Existing targets on cancer-related risk factors may have important roles in cancer prevention and control. However, they are not sufficient to achieve the one-third reduction goal in premature cancer mortality in Hunan Province. More aggressive risk control targets should be adopted based on local conditions.
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Affiliation(s)
- Wenqiong Wu
- Department of Radiotherapy, Hunan Cancer Hospital, Changsha, China
| | - Jing Wang
- Chengdu Center for Disease Control and Prevention, Chengdu, China
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xian-Zhen Liao
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Kekui Xu
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Yanhua Zou
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Zhaohui Shi
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Yingyun Hu
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Haifan Xiao
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Can Li
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Shiyu Cao
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Shiyu Wang
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Jia Guo
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Zhicheng Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Mengjiao Liu
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Mengyao Xu
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Mengshi Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhongxi Fu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Shipeng Yan
- Department of Cancer Prevention and Control, Hunan Cancer Hospital, Changsha, China
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2
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Zhang X, Shi JF, Liu GX, Ren JS, Guo LW, Huang WD, Shi LM, Ma Y, Huang HY, Bai YN, Liao XZ, Mao AY, Sun XJ, Zhu XY, Zhou Q, Gong JY, Zhou JY, Liu YQ, Mai L, Song BB, Zhu L, Xing XJ, Du LB, Qi X, Sun XH, Wu SL, Ren Y, Cao R, Lan L, Lou PA, Zhang K, He J, Dai M. Medical expenditure for lung cancer in China: a multicenter, hospital-based retrospective survey. Cost Eff Resour Alloc 2021; 19:53. [PMID: 34404418 PMCID: PMC8371812 DOI: 10.1186/s12962-021-00306-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 08/09/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Lung cancer is the most prevalent cancer, and the leading cause of cancer-related deaths in China. The aim of this study was to estimate the direct medical expenditure incurred for lung cancer care and analyze the trend therein for the period 2002-2011 using nationally representative data in China METHODS: This study was based on 10-year, multicenter retrospective expenditure data collected from hospital records, covering 15,437 lung cancer patients from 13 provinces diagnosed during the period 2002-2011. All expenditure data were adjusted to 2011 to eliminate the effects of inflation using China's annual consumer price index. RESULTS The direct medical expenditure for lung cancer care (in 2011) was 39,015 CNY (US$6,041) per case, with an annual growth rate of 7.55% from 2002 to 2011. Drug costs were the highest proportionally in the total medical expenditure (54.27%), followed by treatment expenditure (14.32%) and surgical expenditure (8.10%). Medical expenditures for the disease varied based on region, hospital level, type, and stage. CONCLUSION The medical expenditure for lung cancer care is substantial in China. Drug costs and laboratory test are the main factors increasing medical costs.
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Affiliation(s)
- Xin Zhang
- School of Health Management, Harbin Medical University, 194 Xuefu Road, Nangang District, Harbin, 150081, China
| | - Ju-Fang 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Guo-Xiang Liu
- School of Health Management, Harbin Medical University, 194 Xuefu Road, Nangang District, Harbin, 150081, China.
| | - Jian-Song 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China.
| | - Lan-Wei Guo
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Wei-Dong Huang
- School of Health Management, Harbin Medical University, 194 Xuefu Road, Nangang District, Harbin, 150081, China
| | - Lin-Mei Shi
- School of Health Management, Harbin Medical University, 194 Xuefu Road, Nangang District, Harbin, 150081, China
| | - Yi Ma
- School of Health Management, Harbin Medical University, 194 Xuefu Road, Nangang District, Harbin, 150081, China
| | - Hui-Yao 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Ya-Na Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, 730000, China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Provincial Cancer Hospital, Changsha, 410006, China
| | - A-Yan Mao
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, 100020, China
| | - Xiao-Jie Sun
- Center for Health Management and Policy, Key Lab of Health Economics and Policy, Shandong University, Jinan, 250012, China
| | - Xin-Yu 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, 730000, China
| | - Qi Zhou
- Chongqing Office for Cancer Control and Research, Chongqing Cancer Hospital, Chongqing, 400030, China
| | - Ji-Yong Gong
- Science and Education Department of Public Health Division, Shandong Tumor Hospital, Jinan, 250117, China
| | - Jin-Yi Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Institute of Chronic Non-Communicable Diseases Prevention and Control, Nanjing, 210009, China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, 730050, China
| | - Ling Mai
- Department of Institute of Tumor Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Bing-Bing Song
- Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, 150081, China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Xiao-Jing Xing
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, 110042, China
| | - Ling-Bin Du
- Zhejiang Office for Cancer Control and Research, Zhejiang Cancer Hospital, Hangzhou, 310022, China
| | - Xiao Qi
- Department of Occupational Medicine, Tangshan People's Hospital, Tangshan, 063001, China
| | - Xiao-Hua Sun
- Ningbo Clinical Cancer Prevention Guidance Center, Ningbo NO.2 Hospital, Ningbo, 315010, China
| | - Shou-Ling Wu
- Health Department of Kailuan Group, Kailuan General Hospital, Tangshan, 063000, China
| | - Ying Ren
- Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, 112000, China
| | - Rong Cao
- Department of Health Policy and Economic Research, Guangdong Provincial Institute of Public Health, Guangzhou, 511430, China
| | - Li Lan
- Institute of Chronic Disease Prevention and Control, Harbin Center for Disease Control and Prevention, Harbin, 150056, China
| | - Pei-An Lou
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, 221006, China
| | - Kai 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Jie 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Min 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
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3
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Huang HY, Wang H, Shi JF, Bai YN, Wang L, Liu CC, Yan XX, Liu GX, Liao XZ, Shi D, Mao AY, Ren JS, Sun XJ, Guan HJ, Huang WD, Lei HK, Gong JY, Liu YY, Zhu L, Song BB, Du LB, Guo LW, Liu YQ, Ren Y, Lan L, Zhou JY, Qi X, Sun XH, Lou PA, Wu SL, Tang Y, Li N, Zhang K, Li N, Chen WQ, Dai M, He J. Health-related quality of life of patients with colorectal neoplasms in China: A multicenter cross-sectional survey. J Gastroenterol Hepatol 2021; 36:1197-1207. [PMID: 32875595 DOI: 10.1111/jgh.15238] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/13/2020] [Revised: 08/06/2020] [Accepted: 08/25/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIM This study aimed to clarify health-related quality of life (HRQoL) of patients with colorectal precancer and colorectal cancer (CRC) in China and to better understand related utility scores. METHODS A hospital-based cross-sectional survey was conducted in precancer and CRC patients from 2012 to 2014, covering 12 provinces in China. HRQoL was assessed with EuroQol 5-Dimensions 3-Levels. Utility scores were derived using Chinese value set. A multivariate regression model was established to explore potential predictors of utility scores. RESULTS A total of 376 precancer (mean age 58.7 years, 61.2% men) and 2470 CRC patients (mean age 58.6 years, 57.6% men) were included. In five dimensions, there was a certain percentage of problem reported among precancer (range: 12.0% to 36.7%) and CRC (range: 32.4% to 50.3%) patients, with pain/discomfort being the most serious dimension. Utility scores of precancer and CRC patients were 0.870 (95% confidence interval [CI], 0.855-0.886) and 0.751 (95% CI, 0.742-0.759), both of which were lower than those of general Chinese population (0.960 [95% CI, 0.960-0.960]). Utilities for patients at stage I to stage IV were 0.742 (95% CI, 0.715-0.769), 0.722 (95% CI, 0.705-0.740), 0.756 (95% CI, 0.741-0.772), and 0.745 (95% CI, 0.742-0.767), respectively. Multivariate analysis showed that therapeutic regimen, time point of the interview, education, occupation, annual household income, and geographic region were associated with utilities of CRC patients. CONCLUSION Health-related quality of life of both precancer and CRC patients in China declined considerably. Utility scores differed by sociodemographic and clinical characteristics, and findings of these utilities may facilitate implementation of further cost-utility evaluations.
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Affiliation(s)
- Hui-Yao 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, China.,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, China
| | - Hong 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, China
| | - Ju-Fang 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, China
| | - Ya-Na Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, China
| | - Le Wang
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine(ICBM), Chinese Academy of Sciences, Hangzhou, China
| | - Cheng-Cheng 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, China
| | - Xin-Xin 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, China
| | - Guo-Xiang Liu
- Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Provincial Cancer Hospital, Changsha, China
| | - Dian 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, China.,Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, China
| | - A-Yan Mao
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, China
| | - Jian-Song 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, China
| | - Xiao-Jie Sun
- Center for Health Management and Policy, Key Lab of Health Economics and Policy, Shandong University, Jinan, China
| | - Hai-Jing Guan
- China Center for Health Economic Research, Peking University, Beijing, China
| | - Wei-Dong Huang
- Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, China
| | - Hai-Ke Lei
- Chongqing Office for Cancer Control and Research, Chongqing Cancer Hospital, Chongqing, China
| | - Ji-Yong Gong
- Science and Education Department of Public Health Division, Shandong Tumor Hospital, Jinan, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
| | - Bing-Bing Song
- Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, China
| | - Lin-Bing Du
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine(ICBM), Chinese Academy of Sciences, Hangzhou, China
| | - Lan-Wei Guo
- Department of Institute of Tumor Research, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Ying Ren
- Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, China
| | - Li Lan
- Institute of Chronic disease prevention and control, Harbin Center for Disease Control and Prevention, Harbin, China
| | - Jin-Yi Zhou
- Institute of Chronic Non-communicable Diseases Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xiao Qi
- Department of Occupational Medicine, Tangshan People's Hospital, Tangshan, China
| | - Xiao-Hua Sun
- Ningbo Clinical Cancer Prevention Guidance Center, Ningbo No. 2 Hospital, Ningbo, China
| | - Pei-An Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Shou-Ling Wu
- Health Department of Kailuan Group, Kailuan General Hospital, Tangshan, China
| | - Yu Tang
- 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, China
| | - Ni 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, China
| | - Kai Zhang
- Department of Physical Examination on Cancer, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ning Li
- 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, China
| | - Wan-Qing 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, China
| | - Min 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, China
| | - Jie 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, China
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4
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Zhu J, Yan XX, Liu CC, Wang H, Wang L, Cao SM, Liao XZ, Xi YF, Ji Y, Lei L, Xiao HF, Guan HJ, Wei WQ, Dai M, Chen W, Shi JF. Comparing EQ-5D-3L and EQ-5D-5L performance in common cancers: suggestions for instrument choosing. Qual Life Res 2020; 30:841-854. [PMID: 32930993 DOI: 10.1007/s11136-020-02636-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE To compare the performance of three-level EuroQol five-dimensions (EQ-5D-3L) and five-level EuroQol five-dimensions (EQ-5D-5L) among common cancer patients in urban China. METHODS A hospital-based cross-sectional survey was conducted in three provinces from 2016 to 2018 in urban China. Patients with breast cancer, colorectal cancer, or lung cancer were recruited to complete the EQ-5D-3L and EQ-5D-5L questionnaires. Response distribution, discriminatory power (indicator: Shannon index [H'] and Shannon evenness index [J']), ceiling effect (the proportion of full health state), convergent validity, and health-related quality of life (HRQoL) were compared between the two instruments. RESULTS A total of 1802 cancer patients (breast cancer: 601, colorectal cancer: 601, lung cancer: 600) were included, with the mean age of 55.6 years. The average inconsistency rate was 4.4%. Compared with EQ-5D-3L (average: H' = 1.100, J' = 0.696), an improved discriminatory power was observed in EQ-5D-5L (H' = 1.473, J' = 0.932), especially contributing to anxiety/depression dimensions. The ceiling effect was diminished in EQ-5D-5L (26.5%) in comparison with EQ-5D-3L (34.5%) (p < 0.001), mainly reflected in the pain/discomfort and anxiety/depression dimensions. The overall utility score was 0.790 (95% CI 0.778-0.801) for EQ-5D-3L and 0.803 (0.790-0.816) for EQ-5D-5L (p < 0.001). A similar pattern was also observed in the detailed cancer-specific analysis. CONCLUSIONS With greater discriminatory power, convergent validity and lower ceiling, EQ-5D-5L may be preferable to EQ-5D-3L for the assessment of HRQoL among cancer patients. However, higher utility scores derived form EQ-5D-5L may also lead to lower QALY gains than those of 3L potentially in cost-utility studies and underestimation in the burden of disease.
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Affiliation(s)
- Juan 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.,Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Xin-Xin 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Cheng-Cheng 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Hong 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Le 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Su-Mei Cao
- Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, People's Republic of China
| | - Yun-Feng Xi
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, People's Republic of China
| | - Yong Ji
- Cancer Hospital, Shenzhen Center, Chinese Academy of Medical Sciences, Shenzhen, People's Republic of China
| | - Lin Lei
- Shenzhen Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Hai-Fan Xiao
- Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, People's Republic of China
| | - Hai-Jing Guan
- China Center for Health Economic Research, Peking University, Beijing, People's Republic of China
| | - Wen-Qiang Wei
- Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Min 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.
| | - Wanqing Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.
| | - Ju-Fang 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, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.
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5
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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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6
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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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7
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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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8
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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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9
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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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Li HC, Wang K, Yuan YN, Mao AY, Liu CC, Liu S, Yang L, Huang HY, Dong P, 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, Wang N, Qiu WQ, Shi JF. [Analysis on the consciousness of the early cancer treatment and its influencing factors among urban residents in China from 2015 to 2017]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:69-75. [PMID: 31914572 DOI: 10.3760/cma.j.issn.0253-9624.2020.01.014] [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 treatment and its demographic and socioeconomic 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 questionnaire collected personal information, the consciousness of the cancer early treatment and relevant factors. The Chi square test was used to compare the difference between the consciousness of the cancer early treatment and relevant factors among the four groups. The logistic regression model was used to analyze the influencing factors related to the consciousness of the cancer early treatment. Results: With the assumption of being diagnosed as precancer or cancer, 89.97% of community residents, 91.84% of cancer risk assessment/screening population, 93.00% of cancer patients and 91.52% of occupational population would accept active treatments (P<0.001). If the immediate family members were diagnosed as precancer or cancer, people who would encourage their family members to receive early treatment in the four groups accounted for 91.96%, 91.94%, 92.44% and 91.55%, respectively (P<0.001). The company employees, annual household income with 40 000 yuan and more and other three groups had a relatively better consciousness of the cancer early treatment (P<0.05). Male, widowed, unemployed and from the central and western regions had a relatively worse consciousness of the cancer early treatment (P<0.05). Conclusion: Residents in urban China participants had a good consciousness of the cancer early treatment. The marital status, occupation, annual household income and residential regions were major factors related to the consciousness of the cancer early treatment.
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Affiliation(s)
- H C Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - K Wang
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - Y N Yuan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - A Y Mao
- 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
| | - S Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - L Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, 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
| | - P Dong
- 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
- Officeof 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
| | - N Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - W Q Qiu
- 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
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Xiao HF, Yan SP, Chen YF, Shi Z, Zou YH, Zhu SL, Xu KK, Song T, Liao XZ. Community-Based Upper Gastrointestinal Cancer Screening in a Randomized Controlled Trial: Baseline Results in a Non-high-incidence Area. Cancer Prev Res (Phila) 2019; 13:317-328. [PMID: 31871223 DOI: 10.1158/1940-6207.capr-19-0422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/14/2019] [Accepted: 12/17/2019] [Indexed: 12/24/2022]
Abstract
A cluster-randomized controlled trial (RCT) was conducted to evaluate to the effectiveness of reducing mortality of upper gastrointestinal cancer (UGC) and feasibility of screening through a questionnaire combined with endoscopy in non-high-incidence urban areas in China. The trial design, recruitment performance, and preliminary results from baseline endoscopy are reported. Seventy-five communities in two urban cities with a non-high-incidence of UGC were randomized to a screening endoscopy arm (n = 38) or a control arm (n = 37). In the screening arm, individuals at high risk of UGC underwent endoscopic screening. The primary outcome was the UGC mortality, and secondary outcomes included the UGC detection rate, incidence rate, survival rate, and clinical stage at the time of diagnosis. A total of 10,416 and 9,565 individuals were recruited into the screening and control arms, respectively. The participation rate was 74.3%. In the screening arm, 5,242 individuals (50.3%) were estimated to be high-risk. Among them, 2,388 (45.6%) underwent endoscopic screening. Age and household income were associated with undergoing endoscopy. Three early esophageal cancer (0.13%), one gastric cancer (0.04%), 29 precancerous esophageal lesions (1.21%), and 53 precancerous gastric lesions (2.22%) were detected. Age, sex, a family history of cancer, intake of meat-egg-milk frequently, superficial gastritis, and clinical symptoms of gastric cancer were associated with the presence of precancerous lesions. The detection rate was low using endoscopic screening in non-high-incidence area given the relatively low compliance rate. These findings provide a reference for designing effective community-based UGC screening strategies in non-high-incidence urban areas.
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Affiliation(s)
- Hai-Fan Xiao
- The Department of Cancer Prevention and Control, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Shi-Peng Yan
- The Department of Cancer Prevention and Control, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Yan-Fang Chen
- Yueyanglou District Center for Disease Control and Prevention, Yueyang City, Hunan Province, China
| | - Zhaohui Shi
- The Department of Cancer Prevention and Control, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Yan-Hua Zou
- The Department of Cancer Prevention and Control, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Song-Lin Zhu
- The Department of Cancer Prevention and Control, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ke-Kui Xu
- The Department of Cancer Prevention and Control, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ting Song
- Yueyanglou District Center for Disease Control and Prevention, Yueyang City, Hunan Province, China
| | - Xian-Zhen Liao
- The Department of Cancer Prevention and Control, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
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Zhu J, Wang L, Huang HY, Bai FZ, Li J, Fang Y, Wang Y, Mao AY, Liao XZ, Liu GX, Bai YN, Ren JS, Sun XJ, Guo LW, Wang DB, Dong HJ, Wang JL, Xing XJ, Zhou Q, Zhu L, Du LB, Song BB, Luo SX, Liu YQ, Ren Y, Zhou JY, Sun XH, Lan L, Wu SL, Qi X, Lou PA, Ma F, Li N, Zhang K, Chen WQ, He J, Dai M, Shi JF. Short-term impact of breast cancer screening intervention on health-related quality of life in China: A multicentre cross-sectional survey. Psychooncology 2019; 28:1836-1844. [PMID: 31240803 DOI: 10.1002/pon.5160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 05/21/2019] [Accepted: 05/27/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The impact of participating in breast cancer screening programmes on health-related quality of life (HRQoL)is poorly understood. METHODS Based on a national breast cancer screening programme in China, a multicentre cross-sectional survey was conducted covering 12 provinces from September 2013 to December 2014. HRQoL of participants in the screening population and general population was evaluated by the three-levelEuroQol-five-Dimensions (EQ-5D-3L) instrument, and utility scores were generated through the Chinese value set. Univariate and multivariate regression analyses were performed to explore determinants of utility scores and anxiety/depression problems. RESULTS For screening group and general population (n = 4756, mean age = 51.6 year old), the corresponding utility scores were 0.937 (95% CI, 0.933-0.941) and 0.953 (0.949-0.957) (P < .001). Pain/discomfort and anxiety/depression were the most common reported in both groups (51.4% and 34.3%, P < .001). Utility scores at prescreening, in-screening, and postscreening interview timings were 0.928 (0.921-0.935), 0.958 (0.948-0.969), and 0.938 (0.933-0.943), respectively (P < .001); the corresponding proportions of anxiety/depression reporting were 25.9%, 16.3%, and 21.1%, respectively (P = .004). Interview timing, geographical region, and insurance status were associated with HRQoL and anxiety/depression in women at high-risk of breast cancer. CONCLUSIONS Utility scores of screening participants were significantly lower than that of general population in China, but the difference may be clinically insignificant. Further cohort studies using HRQoL measurements are needed.
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Affiliation(s)
- Juan 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 (CAMS&PUMC), Beijing, China
| | - Le 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 (CAMS&PUMC), Beijing, China
| | - Hui-Yao 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 (CAMS&PUMC), Beijing, China
| | - Fang-Zhou 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 (CAMS&PUMC), Beijing, China
| | - Jing Li
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - Yi Fang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - Yong Wang
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - A-Yan Mao
- Public Health Information Research Office, Institute of Medical Information, CAMS&PUMC, Beijing, China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, China
| | - Guo-Xiang Liu
- Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, China
| | - Ya-Na Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, China
| | - Jian-Song 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 (CAMS&PUMC), Beijing, China
| | - Xiao-Jie Sun
- Center for Health Management and Policy, Key Lab of Health Economics and Policy, Shandong University, Jinan, China
| | - Lan-Wei Guo
- Department of Institute of Tumor Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - De-Bin Wang
- School of Health Service Management, Anhui Medical University, Hefei, China
| | - Heng-Jin Dong
- Center for Health Policy Studies, Zhejiang University School of Medicine, Hangzhou, China
| | - Jia-Lin Wang
- Science and Education Department of Public Health Division, Shandong Tumor Hospital, Jinan, China
| | - Xiao-Jing Xing
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Qi Zhou
- Chongqing Office for Cancer Control and Research, Chongqing Cancer Institute, Chongqing, China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
| | - Ling-Bin Du
- Cancer Prevention and Control Office, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences/Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou, China
| | - Bing-Bing Song
- Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, China
| | - Su-Xia Luo
- Department of Institute of Tumor Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Ying Ren
- Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, China
| | - Jin-Yi Zhou
- Institute of Chronic Non-communicable Diseases Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xiao-Hua Sun
- Ningbo Clinical Cancer Prevention Guidance Center, Ningbo No. 2 Hospital, Ningbo, China
| | - Li Lan
- Institute of Chronic Disease Prevention and Control, Harbin Center for Disease Control and Prevention, Harbin, China
| | - Shou-Ling Wu
- Health Department of Kailuan Group, Kailuan General Hospital, Tangshan, China
| | - Xiao Qi
- Department of Occupational Medicine, Tangshan People's Hospital, Tangshan, China
| | - Pei-An Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Fei Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - Ni 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 (CAMS&PUMC), Beijing, China
| | - Kai Zhang
- Cancer Department of Physical Examination, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - Wan-Qing 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 (CAMS&PUMC), Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS&PUMC, Beijing, China
| | - Min 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 (CAMS&PUMC), Beijing, China
| | - Ju-Fang 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 (CAMS&PUMC), Beijing, China
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Huang HY, Zhu SL, Zhou TH, Li ZF, Liu CC, Wang H, Yan SP, Song SM, Zou SM, Zhang YM, Li N, Zhu L, Liao XZ, Shi JF, Dai M. [Natural history of colorectal cancer: a Meta-analysis on global prospective cohort studies]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 40:821-831. [PMID: 31357806 DOI: 10.3760/cma.j.issn.0254-6450.2019.07.017] [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 acknowledge the availability and rates of annual transition of outcomes during the progression and regression stages of colorectal cancer (CRC) and related diseases, by pooling global follow-up studies on the natural history of CRC. Methods: Till March, 2017, data was collected through systematic literature review over multiple databases, including PubMed, Embase, Cochrane and Chinese Biology Medicine (CBM) disc. Information regarding the characteristics, classification system of health states, related outcomes and incidence rates on CRC or high-risk adenoma for the surveillance cohorts of the studies, were extracted and summarized. Both Meta and sensitivity analyses were performed on those outcomes if they appeared in more than 3 studies, using the random effects model. Annual transition rate with 95%CI was used to estimate each of the outcomes, Quality of the studies was assessed, using the Newcastle-Ottawa Scale. Results: A total of 29 cohort studies were included, with the mean follow-up period as 5.7 years. All studies except one, focused on adenoma-carcinoma pathway and reported the outcome parameters of adenomas by different risk, and some reported the findings on different sizes (n=6) of adenomas. These cohorts were divided into three groups (normal status, with low-risk or high-risk adenoma) according to the status of baseline endoscopic pathologic findings. Their available outcome parameters, corresponding number of involved articles, aggregated sample size and pooled annual transition rates were presented. Six parameters were obtained in the normal cohorts, including those from normal to low-risk adenoma (16 articles, 58 235, 0.030: 0.024-0.037), to high-risk adenoma (17 articles, 62 089, 0.003: 0.002-0.004), to diminutive adenoma (<5 mm, 4 articles, 1 277, 0.021: 0.013-0.029), to small adenoma (6-9 mm, 4 articles, 1 277, 0.006: 0.001-0.010), to large adenoma (≥10 mm, 7 articles, 3 531, 0.002: 0.000-0.003) and to CRC (19 articles, 104 836, 0.000 3: 0.000 2-0.000 5). Three parameters were obtained in low-risk adenoma in cohorts with polypectomy findings, including recurrence (9 articles, 4 788, 0.109: 0.062-0.157) from low-risk adenoma after polypectomy to high-risk adenoma (10 articles, 5 736, 0.009: 0.004-0.013) and to CRC (12 articles, 11 347, 0.000 6: 0.000 4-0.000 8). Three parameters were obtained on high-risk adenoma from cohorts with polypectomy findings, including recurrence (12 articles, 7 030, 0.038: 0.028-0.048) from high-risk adenoma after polypectomy to low-risk adenoma (8 articles, 2 489, 0.133: 0.081-0.185) and CRC (14 articles, 14 899, 0.002: 0.001-0.003). Except for normal to low-risk adenomas, results from the sensitivity analysis for the other parameters showed stable. Of the included studies, two presented incidence rates of CRC in different clinical stages and the another two were focusing on the parameters related to serrated pathway. Conclusions: Globally, follow-up studies reported data on natural history of colorectal cancer is of paucity. Compared to the "adenoma-carcinoma" pathway, transition parameters of the serrated lesion pathway are more limited. This Meta-analysis provided convincing evidence for optimizing the strategies regarding follow-up program on the disease, using the baseline endoscopic findings from global CRC Screening Program. These results also offered strong data-related support for Chinese population- specific interventional model on colorectal cancer.
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Affiliation(s)
- 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
| | - S L Zhu
- Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha 410006, China
| | - T H Zhou
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - Z F Li
- Medical Oncology, Health Center for Staff in Kailuan Hospital, Tangshan 063000, 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
| | - 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
| | - S P Yan
- Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha 410006, China
| | - S M Song
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, 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
| | - 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
| | - N Li
- 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
| | - L Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - X Z Liao
- Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha 410006, 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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14
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Xing PY, Zhu YX, Wang L, Hui ZG, Liu SM, Ren JS, Zhang Y, Song Y, Liu CC, Huang YC, Liao XZ, Xing XJ, Wang DB, Yang L, Du LB, Liu YQ, Zhang YZ, Liu YY, Wei DH, Zhang K, Shi JF, Qiao YL, Chen WQ, Li JL, Dai M. What are the clinical symptoms and physical signs for non-small cell lung cancer before diagnosis is made? A nation-wide multicenter 10-year retrospective study in China. Cancer Med 2019; 8:4055-4069. [PMID: 31150167 PMCID: PMC6639195 DOI: 10.1002/cam4.2256] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 04/27/2019] [Accepted: 05/03/2019] [Indexed: 12/24/2022] Open
Abstract
Background Most lung cancer patients are diagnosed after the onset of symptoms. However, whether the symptoms of lung cancer were independently associated with the diagnosis of lung cancer is unknown, especially in the Chinese population. Methods We conducted a 10 years (2005‐2014) nationwide multicenter retrospective clinical epidemiology study of lung cancer patients diagnosed in China. As such, this study focused on nonsmall cell lung cancer (NSCLC). We calculated the odds ratios (ORs) for variables associated with the symptoms and physical signs using multivariate unconditional logistic regressions. Results A total of 7184 lung cancer patients were surveyed; finally, 6398 NSCLC patients with available information about their symptoms and physical signs were included in this analysis. The most common initial symptom and physical sign was chronic cough (4156, 65.0%), followed by sputum with blood (2110, 33.0%), chest pain (1146, 17.9%), shortness of breath (1090, 17.0%), neck and supraclavicular lymphadenectasis (629, 9.8%), weight loss (529, 8.3%), metastases pain (378, 5.9%), fatigue (307, 4.8%), fever (272, 4.3%), and dyspnea (270, 4.2%). Patients with squamous carcinoma and stage III disease were more likely to present with chronic cough (P < 0.0001) and sputum with blood (P < 0.0001) than patients with other pathological types and clinical stages, respectively. Metastases pain (P < 0.0001) and neck and supraclavicular lymphadenectasis (P = 0.0006) were more likely to occur in patients with nonsquamous carcinoma than in patients with other carcinomas. Additionally, patients with stage IV disease had a higher percentage of chest pain, shortness of breath, dyspnea, weight loss, and fatigue than patients with other stages of disease. In multivariable logistic analyses, compared with patients with adenocarcinoma, patients with squamous carcinoma were more likely to experience symptoms (OR = 2.885, 95% confidence interval [CI] 2.477‐3.359) but were less likely to present physical signs (OR = 0.844, 95% CI 0.721‐0.989). The odds of having both symptoms and physical signs were higher in patients with late‐stage disease than in those with early‐stage disease (P < 0.0001). Conclusions The symptoms and physical signs of lung cancer were associated with the stage and pathological diagnosis of NSCLC. Patients with squamous carcinoma were more likely to develop symptoms, but not signs, than patients with adenocarcinoma. The more advanced the stage at diagnosis, the more likely that symptoms or physical signs are to develop. Further prospective cohort studies are needed to explore these results.
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Affiliation(s)
- Pu-Yuan Xing
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi-Xiang Zhu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Affiliated Hospital of Guizhou Medical University, Guizhou Province Tumor Hospital, Guiyang, P.R. China
| | - Le Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhou-Guang Hui
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shang-Mei Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian-Song Ren
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Song
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Cheng-Cheng Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | | - Xiao-Jing Xing
- Liaoning Cancer Hospital & Institute, Shenyang, P.R. China
| | | | - Li Yang
- Guangxi Medical University, Nanning, P.R. China
| | - Ling-Bin Du
- Zhejiang Cancer Hospital, Hangzhou, P.R. China
| | - Yu-Qin Liu
- Gansu Provincial Cancer Hospital, Lanzhou, Gansu, P.R. China
| | | | - Yun-Yong Liu
- Liaoning Cancer Hospital & Institute, Shenyang, P.R. China
| | - Dong-Hua Wei
- Anhui Provincial Cancer Hospital, Hefei, P.R. China
| | - Kai Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ju-Fang Shi
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - You-Lin Qiao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wan-Qing Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun-Ling Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Dai
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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15
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Hou DH, Zhao SJ, Shi JF, Wang L, Wang DB, Huang YC, Liao XZ, Xing XJ, Du LB, Yang L, Liu YQ, Zhang YZ, Wei DH, Liu YY, Zhang K, Li N, Chen WQ, Qiao YL, He J, Dai M, Wu N. Lung cancer imaging methods in China from 2005 to 2014: A national, multicenter study. Thorac Cancer 2019; 10:708-714. [PMID: 30737899 PMCID: PMC6449240 DOI: 10.1111/1759-7714.12988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 01/10/2023] Open
Abstract
Background The study was conducted to examine changes in diagnostic and staging imaging methods for lung cancer in China over a 10‐year period and to determine the relationships between such changes and socioeconomic development. Methods This was a hospital‐based, nationwide, multicenter retrospective study of primary lung cancer cases. The data were extracted from the 10‐year primary lung cancer databases at eight tertiary hospitals from various geographic areas in China. The chi‐squared test was used to assess the differences and the Cochran–Armitage trend test was used to estimate the trends of changes. Results A total of 7184 lung cancer cases were analyzed. Over the 10‐year period, the utilization ratio of diagnostic imaging methods, such as chest computed tomography (CT) and chest magnetic resonance imaging (MRI), increased from 65.79% to 81.42% and from 0.73% to 1.96%, respectively, while the utilization ratio of chest X‐ray declined from 50.15% to 30.93%. Staging imaging methods, such as positron emission tomography‐CT, neck ultrasound, brain MRI, bone scintigraphy, and bone MRI increased from 0.73% to 9.29%, 22.95% to 47.92%, 8.77% to 40.71%, 42.40% to 62.22%, and 0.88% to 4.65%, respectively; abdominal ultrasound declined from 83.33% to 59.9%. These trends were more notable in less developed areas than in areas with substantial economic development. Conclusion Overall, chest CT was the most common radiological diagnostic method for lung cancer in China. Imaging methods for lung cancer tend to be used in a diverse, rational, and regionally balanced manner.
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Affiliation(s)
- Dong-Hui Hou
- Department of Diagnostic Radiology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shi-Jun Zhao
- Department of Diagnostic Radiology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ju-Fang 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, China
| | - Le 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, China
| | - De-Bin Wang
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Yun-Chao Huang
- Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunming, China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, China
| | - Xiao-Jing Xing
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Ling-Bin Du
- Zhejiang Office for Cancer Control and Research, Zhejiang Cancer Hospital, Hangzhou, China
| | - Li Yang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Yong-Zhen Zhang
- Department of Epidemiology, Shanxi Provincial Cancer Hospital, Taiyuan, China
| | - Dong-Hua Wei
- Medical Department, Anhui Provincial Cancer Hospital, Hefei, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Kai Zhang
- Department of Cancer Prevention, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ni 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, China
| | - Wan-Qing 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, China
| | - You-Lin Qiao
- 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, China
| | - Jie 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, China
| | - Min 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, China
| | - Ning Wu
- Department of Diagnostic Radiology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,PET-CT Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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16
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Shi JF, Wang L, Wu N, Li JL, Hui ZG, Liu SM, Yang BY, Gao SG, Ren JS, Huang HY, Zhu J, Liu CC, Fan JH, Zhao SJ, Xing PY, Zhang Y, Li N, Lei WD, Wang DB, Huang YC, Liao XZ, Xing XJ, Du LB, Yang L, Liu YQ, Zhang YZ, Zhang K, Qiao YL, He J, Dai M. Clinical characteristics and medical service utilization of lung cancer in China, 2005–2014: Overall design and results from a multicenter retrospective epidemiologic survey. Lung Cancer 2019; 128:91-100. [PMID: 30642458 DOI: 10.1016/j.lungcan.2018.11.031] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/14/2018] [Accepted: 11/23/2018] [Indexed: 01/05/2023]
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17
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Qiu WQ, Shi JF, Guo LW, Mao AY, Huang HY, Hu GY, Dong P, Bai FZ, Yan XL, Liao XZ, Liu GX, Bai YN, Ren JS, Sun XJ, Zhu XY, Zhou JY, Gong JY, Zhu L, Mai L, Du LB, Zhou Q, Xing XJ, Song BB, Liu YQ, Lou PA, Sun XH, Wu SL, Cao R, Qi X, Lan L, Ren Y, Zhang K, He J, Qu C, Dai M. Medical expenditure for liver cancer in urban China: A 10-year multicenter retrospective survey (2002-2011). J Cancer Res Ther 2018. [PMID: 29516981 DOI: 10.4103/jcrt.jcrt_709_16] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 11/04/2022]
Abstract
Objective This study aims to understand the medical expenditure for liver cancer during 2002-2011 in urban areas of China. Materials and Methods This is a retrospective study. Based on a stratified cluster sampling method, a medical expenditure survey collected basic personal information from related medical records. Two-tailed independent sample t-test, variance analysis, and Student-Newman-Keuls Tests were used in cost analysis for the corresponding data types. Results A total of 12,342 liver cancer patients were included in the analysis. Overall average medical expenditure per case for liver cancer diagnosis and treatment in China has increased from ¥21, 950 to ¥40, 386 over the study period. For each liver cancer patient diagnosed between 2009 and 2011, the average expenditures were 29,332 CNY for stage I, 35,754 CNY for stage II, 34,288 CNY for stage III, and 30,275 CNY for stage IV diseases (P < 0.001). Pharmaceuticals accounted for the biggest part of the medical expenditure and it rose from 48.01% to 52.96% during these ten years, and the share of nursing fee expenses was the lowest (around 1%). Over the entire 10-year data period, the per capita expenditure of the east region (32,983 CNY) was higher than that of the west region (26,219 CNY) and slightly higher than the central region (31,018 CNY, P < 0.001). Discussion As a major cancer in China, liver cancer accounts for a large portion of health economic burden and its medical expenditure is heavy for families. Early diagnosis and treatment for liver cancer will save medical expenditure. Conclusion The economic burden of liver cancer is high in China and related medical expenditure has increased.
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Affiliation(s)
- Wu-Qi Qiu
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Ju-Fang Shi
- Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Cancer Center of China, No. 17 Panjiayuannanli, Chaoyang District, Beijing, P. R. China
| | - Lan-Wei Guo
- Department of Cancer Epidemiology, Henan Office for Cancer Control and Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, No. 127 Dongming Road, Zhengzhou, Henan, P. R. China
| | - A-Yan Mao
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Hui-Yao Huang
- Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Cancer Center of China, No. 17 Panjiayuannanli, Chaoyang District, Beijing, P. R. China
| | - Guang-Yu Hu
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Pei Dong
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Fang-Zhou Bai
- Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Cancer Center of China, No. 17 Panjiayuannanli, Chaoyang District, Beijing, P. R. China
| | - Xiao-Ling Yan
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Xian-Zhen Liao
- Department of Human Resources, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, P. R. China
| | - Guo-Xiang Liu
- Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, P. R. China
| | - Ya-Na Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, Gansu, P. R. China
| | - Jian-Song Ren
- Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Cancer Center of China, No. 17 Panjiayuannanli, Chaoyang District, Beijing, P. R. China
| | - Xiao-Jie Sun
- Center for Health Management and Policy, Key Lab of Health Economics and Policy, Shandong University, Jinan, Shandong, P. R. China
| | - Xin-Yu Zhu
- Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Cancer Center of China, No. 17 Panjiayuannanli, Chaoyang District, Beijing, P. R. China
| | - Jin-Yi Zhou
- Center for Health Management and Policy, Key Lab of Health Economics and Policy, Shandong University, Jinan, Shandong, P. R. China
| | - Ji-Yong Gong
- Science and Education Department of Public Health Division, Shandong Tumor Hospital, Jinan, Shandong, P. R. China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Ling Mai
- Department of Cancer Epidemiology, Henan Office for Cancer Control and Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, No. 127 Dongming Road, Zhengzhou, Henan, P. R. China
| | - Ling-Bing Du
- Zhejiang Office for Cancer Control and Research, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, P. R. China
| | - Qi Zhou
- Chongqing Office for Cancer Control and Research, Chongqing Cancer Hospital, Chongqing, P. R. China
| | - Xiao-Jing Xing
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, P. R. China
| | - Bing-Bing Song
- Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, Heilongjiang, P. R. China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, Gansu, P. R. China
| | - Pei-An Lou
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, Jiangsu, P. R. China
| | - Xiao-Hua Sun
- Ningbo Clinical Cancer Prevention Guidance Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang, P. R.C Shandong, P. R. China
| | - Shou-Ling Wu
- Health Department of Kailuan Group, Kailuan General Hospital, Tangshan, Hebei, P. R. China
| | - Rong Cao
- Department of Health Policy and Economic Research, Guangdong Provincial Institute of Public Health, Guangzhou, Guangdong, P. R. China
| | - Xiao Qi
- Department of Occupational Medicine, Tangshan People's Hospital, Tangshan, Hebei, P. R. China
| | - Li Lan
- Institute of Chronic Disease Prevention and Control, Harbin Center for Disease Control and Prevention, Harbin, Heilongjiang, P. R. China
| | - Ying Ren
- Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, Liaoning, P. R. China
| | - Kai Zhang
- Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Cancer Center of China, No. 17 Panjiayuannanli, Chaoyang District, Beijing, P. R. China
| | - Jie He
- Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Cancer Center of China, No. 17 Panjiayuannanli, Chaoyang District, Beijing, P. R. China
| | - Chunfeng Qu
- Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Cancer Center of China, No. 17 Panjiayuannanli, Chaoyang District, Beijing, P. R. China
| | - Min Dai
- Program Office for Cancer Screening in Urban China, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Cancer Center of China, No. 17 Panjiayuannanli, Chaoyang District, Beijing, P. R. China
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18
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Sun ZX, Shi JF, Lan L, Mao AY, Huang HY, Lei HK, Qiu WQ, Dong P, Zhu J, Wang DB, Liu GX, Bai YN, Sun XJ, Liao XZ, Ren JS, Guo LW, Zhou Q, Yang L, Song BB, Du LB, Zhu L, Gong JY, Liu YQ, Ren Y, Mai L, Qin MF, Zhang YZ, Zhou JY, Sun XH, Wu SL, Qi X, Lou PA, Cai B, Zhang K, He J, Dai M. [Constituent and workload of service providers engaged in cancer screening: findings and suggestions from a multi-center survey in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:295-301. [PMID: 29609242 DOI: 10.3760/cma.j.issn.0254-6450.2018.03.009] [Citation(s) in RCA: 2] [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 understand the constituent and workload of service providers engaged in cancer screening in China and provide evidence for the assessment of the sustainability of national cancer screening project. Methods: Using either questionnaire or online approach, the survey was conducted in 16 provinces, where Cancer Screening Program in Urban China (CanSPUC) was conducted, from 2014 to 2015. The medical institutes surveyed included hospitals [71.1% were class Ⅲ(A) hospitals], centers for disease control and prevention (CDCs) and community centers where cancer screening was undertaken during 2013-2015. The questionnaire survey was conducted among the staffs responsible for the overall coordination, management and implementation of the screening project to collect the information about the allocation, workload and compensation of the service providers from different specialties. Results: A total of 4 626 staffs were surveyed in this study, their average age was (37.7±9.5) years, and males accounted for 31.0%. Human resources allocated differed with province. The number of senior staff ranged from 6 (Chongqing) to 43 (Beijing) among the 8 comparable provinces. Among the staffs surveyed, 2 192 were from hospitals, 431 were from CDCs and 1 990 were from community centers, and the staffs who complained heavy workload accounted for 19.9%, 24.6% and 34.1% respectively (P<0.001). Among 227 staffs for overall coordination, 376 management staffs and 3 908 staffs for implementation, those who complained heavy workload accounted for 23.6%, 22.3% and 28.2% respectively (P<0.001). A total of 3 244 staffs (73.8%) got compensations for heavy workload. The compensation types were manly labor fee linked with workload (67.5%) and labor fee regardless workload (26.6%). Conclusion: The province specific differences in human resources allocation indicated the differences in screening project's organizing pattern and capability. It is suggested to conduct routine cancer screening (using specialized staffs), reduce the workload of the first line and community staffs and increase the compensation for the service providers for the sustainability of cancer screening project in China.
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Affiliation(s)
- Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - J F Shi
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - H Y Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H K Lei
- Chongqing Cancer Institute, Chongqing 400030, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J Zhu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - D B Wang
- Anhui Medical University, Hefei 230032, China
| | - G X Liu
- Harbin Medical University, Harbin 150056, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- Center for Health Management and Policy Research, Shandong University, Jinan 250012, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - J S Ren
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L W Guo
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - L Yang
- Guangxi Medical University, Nanning 530021, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - J Y Gong
- Shandong Tumor Hospital, Jinan 250117, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Ren
- Tieling Central Hospital, Tieling 112000, China
| | - L Mai
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - M F Qin
- Yunnan Cancer Hospital, Kunming 650018, China
| | - Y Z Zhang
- Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - K Zhang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Mao AY, Shi JF, Qiu WQ, Dong P, Sun ZX, Huang HY, Sun XJ, Liu GX, Wang DB, Bai YN, Liao XZ, Ren JS, Guo LW, Lan L, Zhou Q, Zhou JY, Yang L, Wang JL, Qin MF, Zhang YZ, Song BB, Xing XJ, Zhu L, Mai L, Du LB, Liu YQ, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, He J, Dai M. [Willingness of potential service suppliers to provide cancer screening in urban China]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:150-156. [PMID: 29495197 DOI: 10.3760/cma.j.issn.0254-6450.2018.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: Based on the investment for potential suppliers of cancer screening services, we assessed the reasons that affecting their participation motivation related to the long-term sustainability of cancer screening in China. Methods: Hospitals that had never been involved in any national level cancer screening project were selected by using the convenient sampling method within the 16 project cities of Cancer Screening Program in Urban China (CanSPUC) with 1 or 2 hospitals for each city. All the managers from the institutional/department level and professional staff working and providing screening services in these hospitals, were interviewed by paper-based questionnaire. SAS 9.4 was used for logical verification and data analysis. Results: A total of 31 hospitals (18 hospitals at the third level and, 13 hospitals at the second level) and 2 201 staff (508 hospital and clinic unit managers, 1 693 professional staff) completed the interview. All the hospitals guaranteed their potential capacity in service providing. 92.5% hospital managers showed strong willingness in providing cancer screening services, while 68.3% of them declared that the project fund-raising function was the responsibility of the government. For professional staff, their prospect gains from providing screening service would include development on professional skills (72.4%) and material rewards (46.8%). Their main worries would include extra work for CanSPUC might interfere their routine work (42.1%) plus inadequate compensation (41.8%). Medians of the prospect compensation for extra work ran between 20 to 90 Chinese Yuan per screening item respectively. For all the screening items, workers from the third-level hospitals expected their compensation to be twice as much of those working at the second level hospitals. Conclusion: Professional capacity building and feasible material incentive seemed to be the two key factors that influenced the sustainability and development of the programs.
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Affiliation(s)
- A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J F Shi
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - H Y Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X J Sun
- School of Health Care Management, Shandong University, Jinan 250012, China
| | - G X Liu
- Harbin Medical University, Harbin 150081, China
| | - D B Wang
- Anhui Medical University, Hefei 230032, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - J S Ren
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L W Guo
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - L Yang
- Guangxi Medical University, Nanning 530021, China
| | - J L Wang
- Shandong Tumor Hospital, Jinan 250117, China
| | - M F Qin
- Yunnan Cancer Hospital, Kunming 650118, China
| | - Y Z Zhang
- Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - X J Xing
- Liaoning Cancer Hospital and Institute, Shenyang 110042, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L Mai
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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20
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Sun XJ, Shi JF, Guo LW, Huang HY, Yao NL, Gong JY, Sun YW, Liu GX, Mao AY, Liao XZ, Bai YN, Ren JS, Zhu XY, Zhou JY, Mai L, Song BB, Liu YQ, Zhu L, Du LB, Zhou Q, Xing XJ, Lou PA, Sun XH, Qi X, Wang Y, Cao R, Ren Y, Lan L, Zhang K, He J, Wang JL, Dai M. Medical expenses of urban Chinese patients with stomach cancer during 2002-2011: a hospital-based multicenter retrospective study. BMC Cancer 2018; 18:435. [PMID: 29665788 PMCID: PMC5905135 DOI: 10.1186/s12885-018-4357-y] [Citation(s) in RCA: 11] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 04/10/2018] [Indexed: 12/29/2022] Open
Abstract
Background In China, stomach cancer is the third most common cancer and the third leading cause of cancer death. Few studies have examined Chinese stomach cancer patients’ medical expenses and their associated trends. The Cancer Screening Program in Urban China (CanSPUC) is a Major Public Health Project funded by the central government. Through this project, we have extracted patients’ medical expenses from hospital billing data to examine the costs of the first course treatments (which refers to 2 months before and 10 months after the date of cancer diagnosis) in Chinese patients with stomach cancer and the associated trends. Methods The expense data of 14,692 urban Chinese patients with stomach cancer were collected from 40 hospitals in 13 provinces. We estimated the inflation-adjusted medical expenses per patient during 2002–2011. We described the time trends of medical expenses at the country-level, and those trends by subgroup, and analyzed the compositions of medical expenses. We constructed the Generalized Linear Mixed (GLM) regression model with Poisson distribution to examine the factors that were associated with medical expenses per patient. Results The average medical expenses of the first course treatments were about 43,249 CNY (6851 USD) in 2011, more than twice of that in 2002. The expenses increased by an average annual rate of 7.4%. Longer stay during hospitalization and an increased number of episodes of care are the two main contributors to the expense increase. The upward trend of medical expenses was observed in almost all patient subgroups. Drug expenses accounted for over half of the medical expenses. Conclusions The average medical expenses of the first course (2 months before and 10 months after the date of cancer diagnosis) treatments per stomach cancer patient in urban China in 2011 were doubled during the previous 10 years, and about twice as high as the per capita disposable income of urban households in the same year. Such high expenses indicate that it makes economic sense to invest in cancer prevention and control in China. Electronic supplementary material The online version of this article (10.1186/s12885-018-4357-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiao-Jie Sun
- School of Health Care Management (key Lab of Health Economics and Policy, National Health Commission), Shandong University, Jinan, China
| | - Ju-Fang Shi
- Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Lan-Wei Guo
- Department of Cancer Epidemiology, Henan Office for Cancer Control and Research, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Hui-Yao Huang
- Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Neng-Liang Yao
- School of Health Care Management (key Lab of Health Economics and Policy, National Health Commission), Shandong University, Jinan, China.,Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22908, USA
| | - Ji-Yong Gong
- Shandong Academy of Medical Sciences, Shandong Provincial Cancer Hospital Affiliated to Shandong University, Jinan, 250117, China
| | - Ya-Wen Sun
- Shandong Academy of Medical Sciences, Shandong Provincial Cancer Hospital Affiliated to Shandong University, Jinan, 250117, China
| | - Guo-Xiang Liu
- Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, China
| | - A-Yan Mao
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Provincial Cancer Hospital, Changsha, China
| | - Ya-Na Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, China
| | - Jian-Song Ren
- Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xin-Yu Zhu
- Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.,Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, China
| | - Jin-Yi Zhou
- Institute of Chronic Non-communicable Diseases Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ling Mai
- Department of Institute of Tumor Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Bing-Bing Song
- Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
| | - Ling-Bin Du
- Zhejiang Office for Cancer Control and Research, Zhejiang Cancer Hospital, Hangzhou, China
| | - Qi Zhou
- Chongqing Office for Cancer Control and Research, Chongqing Cancer Hospital, Chongqing, China
| | - Xiao-Jing Xing
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Pei-An Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Xiao-Hua Sun
- Ningbo Clinical Cancer Prevention Guidance Center, Ningbo NO.2 Hospital, Ningbo, China
| | - Xiao Qi
- Department of Occupational Medicine, Tangshan People's Hospital, Tangshan, China
| | - Yuanzheng Wang
- Department of Economic Operation, Kailuan General Hospital, Tangshan, China
| | - Rong Cao
- Department of Health Policy and Economic Research, Guangdong Provincial Institute of Public Health, Guangzhou, China
| | - Ying Ren
- Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, China
| | - Li Lan
- Institute of Chronic disease prevention and control, Harbin Center for Disease Control and Prevention, Harbin, China
| | - Kai Zhang
- Department of Cancer Prevention, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jia-Lin Wang
- Shandong Academy of Medical Sciences, Shandong Provincial Cancer Hospital Affiliated to Shandong University, Jinan, 250117, China.
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
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21
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Lei HK, Dong P, Zhou Q, Qiu WQ, Sun ZX, Huang HY, Ren JS, Liu GX, Bai YN, Wang DB, Sun XJ, Liao XZ, Guo LW, Lan L, Liu YQ, Gong JY, Yang L, Xing XJ, Song BB, Mai L, Zhu L, Du LB, Zhang YZ, Zhou JY, Qin MF, Wu SL, Qi X, Sun XH, Lou PA, Cai B, Zhang K, He J, Dai M, Mao AY, Shi JF. [Potential demand on cancer screening service in urban populations in China: a cross-sectional survey]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:289-294. [PMID: 29609241 DOI: 10.3760/cma.j.issn.0254-6450.2018.03.008] [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 acceptance and personal demand for cancer screening service among the urban residents who had never been involved in any national level cancer screening programs in China and identify the key factors influencing the sustainability of cancer screening. Methods: A questionnaire survey was conducted among the local people aged 40-69 years selected through convenience sampling in 16 provinces of China to collect the general information about their demands for the screening service and others. Results: A total of 16 394 qualified questionnaires were completed. The average age of the people surveyed was (53.8±8.0) years, and men accounted for 44.6%. Without concerning the cost, 4 831 people (29.5%) had no demands for cancer screening services, the reasons are as follow: they would like to go to see doctors only when they were ill (61.8%); they had already received similar medical examinations (36.8%) and they would like to receive cancer screening directly without pre-health risk assessment (33.0%). Among the people surveyed, 10 795 (65.8%) had demands for cancer screening services, but they had choice on the screening settings, 43.7% wanted to receive the service in a general hospitals, while 36.5% would like to go to cancer-specialized hospitals. As for the level of medical institutes providing cancer screening service, 61.4% of the people surveyed would choose a higher level one, while 36.4% would choose an ordinary one. On screening procedures, 61.5% of the people surveyed would accept the mode of "clinical examination after questionnaire-assessment" . Conclusion: Most people surveyed had demands for cancer screening services and they would like to receive the screening services in higher level medical institutes. It is suggested to spread cancer screening know ledge, and strengthen the capability building of screening in grass root medical institutes to attract more people to receive cancer screening.
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Affiliation(s)
- H K Lei
- Chongqing Cancer Institute, Chongqing 400030, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - H Y Huang
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J S Ren
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - G X Liu
- Harbin Medical University, Harbin 150081, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - D B Wang
- Anhui Medical University, Hefei 230032, China
| | - X J Sun
- Center for Health Management and Policy of Shandong University, Jinan 250012, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - L W Guo
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - J Y Gong
- Shandong Tumor Hospital, Jinan 250117, China
| | - L Yang
- Guangxi Medical University 530021, China
| | - X J Xing
- Liaoning Cancer Hospital and Institute, Shenyang 110042, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - L Mai
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y Z Zhang
- Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - M F Qin
- Yunnan Cancer Hospital, Kunming 650118, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - K Zhang
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J F Shi
- National Cancer Center (NCC)/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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22
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Zhu J, Huang HY, Mao AY, Sun ZX, Qiu WQ, Lei HK, Dong P, Huang JW, Bai YN, Sun XJ, Liu GX, Wang DB, Liao XZ, Ren JS, Guo LW, Lan L, Zhou Q, Song BB, Liu YQ, Du LB, Zhu L, Cao R, Wang JL, Mai L, Ren Y, Zhou JY, Sun XH, Wu SL, Qi X, Lou PA, Cai B, Li N, Zhang K, He J, Dai M, Shi JF. [Preference on screening frequency and willingness-to-pay for multiple-cancer packaging screening programs in urban populations in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:157-164. [PMID: 29495198 DOI: 10.3760/cma.j.issn.0254-6450.2018.02.005] [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] [Indexed: 06/08/2023]
Abstract
Objective: From an actual cancer screening service demanders' perspective, we tried to understand the preference on screening frequency and willingness-to-pay for the packaging screening program on common cancers and to evaluate its long-term sustainability in urban populations in China. Methods: From 2012 to 2014, a multi-center cross-sectional survey was conducted among the actual screening participants from 13 provinces covered by the Cancer Screening Program in Urban China (CanSPUC). By face-to-face interview, information regarding to preference to screening frequency, willingness-to-pay for packaging screening program, maximum amount on payment and related reasons for unwillingness were investigated. Results: A total of 31 029 participants were included in this survey, with an average age as (55.2±7.5) years and median annual income per family as 25 000 Chinese Yuan. People's preference to screening frequency varied under different assumptions ( " totally free" and "self-paid" ). When the packaging screening was assumed totally free, 93.9% of residents would prefer to take the screening program every 1 to 3 years. However, the corresponding proportion dropped to 67.3% when assuming a self-paid pattern. 76.7% of the participants had the willingness-to-pay for the packaging screening, but only 11.2% of them would like to pay more than 500 Chinese Yuan (the expenditure of the particular packaging screening were about 1 500 Chinese Yuan). The remaining 23.3% of residents showed no willingness-to-pay, and the main reasons were unaffordable expenditure (71.7%) and feeling'no need'(40.4%). Conclusions: People who participated in the CanSPUC program generally tended to choose high-frequency packaging screening program, indicating the high potential acceptance for scale-up packaging screening, while it needs cautious assessments and rational guidance to the public. Although about seven in ten of the residents were willing to pay, the payment amount was limited, revealing the necessity of strengthening individual's awareness of his or her key role in health self-management, and a reasonable payment proportion should be considered when establishing co-compensation mechanism.
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Affiliation(s)
- J Zhu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H Y Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - H K Lei
- Chongqing Cancer Institute, Chongqing 400030, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J W Huang
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- Center for Health Management and Policy of Shandong University, Jinan 250012, China
| | - G X Liu
- Harbin Medical University, Harbin 150081, China
| | - D B Wang
- School of Medical Administration, Anhui Medical University, Hefei 230032, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - J S Ren
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L W Guo
- Henan Cancer Hospital, Zhengzhou 450008, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - R Cao
- Guangdong Provincial Institute of Public Health, Guangzhou 511430, China
| | - J L Wang
- Shandong Tumor Hospital, Jinan 250117, China
| | - L Mai
- Henan Cancer Hospital, Zhengzhou 450008, China
| | - Y Ren
- Tieling Central Hospital, Tieling 112000, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - N Li
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - K Zhang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J F Shi
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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23
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Shi JF, Mao AY, Sun ZX, Lei HK, Qiu WQ, Huang HY, Dong P, Huang JW, Zhu J, Li J, Liu GX, Wang DB, Bai YN, Sun XJ, Liao XZ, Ren JS, Guo LW, Lan L, Zhou Q, Yang L, Song BB, Du LB, Zhu L, Wang JL, Liu YQ, Ren Y, Mai L, Qin MF, Zhang YZ, Zhou JY, Sun XH, Wu SL, Qi X, Lou PA, Cai B, Li N, Zhang K, He J, Dai M. [Willingness and preferences of actual service suppliers regarding cancer screening programs: a multi-center survey in urban China]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:142-149. [PMID: 29495196 DOI: 10.3760/cma.j.issn.0254-6450.2018.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: From the perspective of actual service suppliers regarding cancer screening, this study aimed to assess the long-term sustainability of cancer screening programs in China. Methods: Based on a Cancer Screening Program in Urban China (CanSPUC), our survey focused on all the hospitals, centers for disease control and prevention (CDC) and community service centers across 16 provinces in China which participated in the programs between 2013 and 2015. All the managers (institutional/department level) and professional staff involved in the program were interviewed using either paper-based questionnaire or online approach. Results: A total of 4 626 participants completed the interview. It showed that the main gains from providing screening service emphasized promotion in social value (63.6%), local reputation (35.9%), and professional skills (30.6%), whereas difficulties encountered included inadequate compensation (30.9%) and discordance among information systems (28.3%). When the service remuneration amounts to about 50 Chinese Yuan per screening item, those professional staff self-reported that they would like to work overtime. More than half (63.7%) of the staff expressed willingness to provide routine screening service, the main expectations were to promote their reputation to the local residents (48.7%) and to promote professional skills (43.1%). Those who were not willing to provide screening services were worried about the potential heavy workload (59.8%) or being interfered with their routine work (49.8%). Further detailed results regarding the different organization types and program roles were presented in the following detailed report. Conclusions: Findings of gains and difficulties showed that if cancer screening is expected to become a long-term running, incentive mechanism from the program, external promotion and advocacy as well as capacity building should be strengthened; furthermore, rewards to staff's screening services should be raised according to the local situations. Results regarding the "willingness to provide service" showed that management of the program should also be strengthened, including information system building and inter-agency and inter-department coordination at the government levels.
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Affiliation(s)
- J F Shi
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - H K Lei
- Chongqing Cancer Institute, Chongqing 400030, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - H Y Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J W Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Zhu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Li
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - G X Liu
- Harbin Medical University, Harbin 150081, China
| | - D B Wang
- School of Medical Administration, Anhui Medical University, Hefei 230032, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- Center for Health Management and Policy of Shandong University, Jinan 250012, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - J S Ren
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L W Guo
- Henan Cancer Hospital, Zhengzhou 450008, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - L Yang
- Guangxi Medical University, Nanning 530021, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - J L Wang
- Shandong Tumor Hospital, Jinan 250117, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Ren
- Tieling Central Hospital, Tieling 112000, China
| | - L Mai
- Henan Cancer Hospital, Zhengzhou 450008, China
| | - M F Qin
- Yunnan Cancer Hospital, Kunming 650118, China
| | - Y Z Zhang
- Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - N Li
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - K Zhang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Xiao HF, Zhang BH, Liao XZ, Yan SP, Zhu SL, Zhou F, Zhou YK. Development and validation of two prognostic nomograms for predicting survival in patients with non-small cell and small cell lung cancer. Oncotarget 2017; 8:64303-64316. [PMID: 28969072 PMCID: PMC5610004 DOI: 10.18632/oncotarget.19791] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 06/18/2017] [Indexed: 12/29/2022] Open
Abstract
Purpose This study aimed to construct two prognostic nomograms to predict survival in patients with non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC) using a novel set of clinical parameters. Patients and Methods Two nomograms were developed, using a retrospective analysis of 5384 NSCLC and 647 SCLC patients seen during a 10-year period at Xiang Ya Affiliated Cancer Hospital (Changsha, China). The patients were randomly divided into training and validation cohorts. Univariate and multivariate analyses were used to identify the prognostic factors needed to establish nomograms for the training cohort. The model was internally validated via bootstrap resampling and externally certified using the validation cohort. Predictive accuracy and discriminatory capability were estimated using concordance index (C-index), calibration curves, and risk group stratification. Results The largest contributor to overall survival (OS) prognosis in the NSCLC nomogram was the therapeutic regimen and diagnostic method parameters, and in the SCLC nomogram was the therapeutic regimen and health insurance plan parameters. Calibration curves for the nomogram prediction and the actual observation were in optimal agreement for the 3-year OS and acceptable agreement for the 5-year OS in both training datasets. The C-index was higher for the NSCLC cohort nomogram than for the TNM staging system (0.67 vs. 0.64, P = 0.01) and higher for the SCLC nomogram than for the clinical staging system (limited vs. extensive) (0.60 vs. 0.53, P = 0.12). Conclusion Treatment regimen parameter made the largest contribution to OS prognosis in both nomograms, and these nomograms might provide clinicians and patients a simple tool that improves their ability to accurately estimate survival based on individual patient parameters rather than using an averaged predefined treatment regimen.
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Affiliation(s)
- Hai-Fan Xiao
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.,The Department of Cancer Prevention, Hunan Cancer Hospital, Changsha 410006, China
| | - Bai-Hua Zhang
- The Department of Thoracic Surgery, Hunan Cancer Hospital, Changsha 410006, China
| | - Xian-Zhen Liao
- The Department of Cancer Prevention, Hunan Cancer Hospital, Changsha 410006, China
| | - Shi-Peng Yan
- The Department of Cancer Prevention, Hunan Cancer Hospital, Changsha 410006, China
| | - Song-Lin Zhu
- The Department of Cancer Prevention, Hunan Cancer Hospital, Changsha 410006, China
| | - Feng Zhou
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Yi-Kai Zhou
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
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25
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Liao XZ, Shi JF, Liu JS, Huang HY, Guo LW, Zhu XY, Xiao HF, Wang L, Bai YN, Liu GX, Mao AY, Ren JS, Sun XJ, Mai L, Liu YQ, Song BB, Gong JY, Zhou JY, Du LB, Zhou Q, Cao R, Zhu L, Ren Y, Lou PA, Lan L, Sun XH, Qi X, Wang YZ, Zhang K, He J, Dai M. Medical and non-medical expenditure for breast cancer diagnosis and treatment in China: a multicenter cross-sectional study. Asia Pac J Clin Oncol 2017; 14:167-178. [PMID: 28670694 DOI: 10.1111/ajco.12703] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 04/11/2017] [Indexed: 12/01/2022]
Abstract
AIM We aimed to assess economic burden of breast cancer (BC) diagnosis and treatment in China through a multicenter cross-sectional study, and to obtain theoretical evidence for policy-making. METHODS This survey was conducted in 37 hospital centers across 13 provinces in China from September 2012 to December 2014. We collected information on the subject characteristics. We then assessed the medical and non-medical expenditure for BC diagnosis and treatment, factors influencing the average case expense, variations between medical and non-medical expenditure at different clinical stages, economic impact of overall expenditure in newly diagnosed course after reimbursement to the patient's family, composition of non-medical expenditure and time loss for the patient and family. RESULTS Among 2746 women with BC (72.6% were admitted to specialized hospitals), the overall average expenditure was US $8450 (medical expenditure: $7527; non-medical expenditure: $922). Significant differences were found among the overall expenditure in the four clinical stages (P < 0.0001); the expenditure was higher in stages III and IV than that in stages I and II, whereas the stage IV was the highest (P < 0.0001). Moreover, a higher self-reported predicted reimbursement ratio was associated with a less economic impact on the patient's family, and the average time lost was estimated as $1529. CONCLUSIONS Early detection and treatment of breast cancer might be effective for decreasing the economic burden, because costs escalate as the degree of malignancy increases.
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Affiliation(s)
| | - Ju-Fang Shi
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | - Hui-Yao Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lan-Wei Guo
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Xin-Yu Zhu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Lanzhou University, Lanzhou, China
| | | | - Le Wang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | | - A-Yan Mao
- Institute of Medical Information, CAMS, Beijing, China
| | - Jian-Song Ren
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | - Ling Mai
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yu-Qin Liu
- Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Bing-Bing Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin, China
| | | | - Jin-Yi Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | | | - Qi Zhou
- Chongqing Cancer Hospital, Chongqing, China
| | - Rong Cao
- Guangdong Provincial Institute of Public Health, Guangzhou, China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
| | - Ying Ren
- Tieling Central Hospital, Tieling, China
| | - Pei-An Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Li Lan
- Harbin Center for Disease Control and Prevention, Harbin, China
| | | | - Xiao Qi
- Tangshan People's Hospital, Tangshan, China
| | | | - Kai Zhang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Dai
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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- Hunan Cancer Hospital, Changsha, China
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26
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Huang HY, Shi JF, Guo LW, Bai YN, Liao XZ, Liu GX, Mao AY, Ren JS, Sun XJ, Zhu XY, Wang L, Song BB, Du LB, Zhu L, Gong JY, Zhou Q, Liu YQ, Cao R, Mai L, Lan L, Sun XH, Ren Y, Zhou JY, Wang YZ, Qi X, Lou PA, Shi D, Li N, Zhang K, He J, Dai M. Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: a hospital-based, multicenter, cross-sectional survey. Chin J Cancer 2017; 36:41. [PMID: 28454595 PMCID: PMC5410077 DOI: 10.1186/s40880-017-0209-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 12/08/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND The increasing prevalence of colorectal cancer (CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China. METHODS We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan (CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup (hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure. RESULTS A total of 2356 patients with a mean age of 57.4 years were included, 57.1% of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY. The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage I, II, III, and IV disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3% of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups (P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spend more, whereas those with a lower household income and those who underwent surgery spent less (all P < 0.05). CONCLUSIONS For patients in China, direct expenditure for the diagnosis and treatment of CRC seemed catastrophic, and non-medical expenditure was non-ignorable. The financial burden varied among subgroups, especially among patients with different clinical stages of disease, which suggests that, in China, CRC screening might be cost-effective.
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Affiliation(s)
- Hui-Yao Huang
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Ju-Fang Shi
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Lan-Wei Guo
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
- Department of Cancer Epidemiology, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008 P. R. China
| | - Ya-Na Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, Gansu 730000 P. R. China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Provincial Cancer Hospital, Changsha, Hunan 410006 P. R. China
| | - Guo-Xiang Liu
- Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, Heilongjiang 150081 P. R. China
| | - A-Yan Mao
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, 100020 P. R. China
| | - Jian-Song Ren
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Xiao-Jie Sun
- Center for Health Management and Policy, Key Lab of Health Economics and Policy, Shandong University, Jinan, Shandong 250012 P. R. China
| | - Xin-Yu Zhu
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, Gansu 730000 P. R. China
| | - Le Wang
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Bing-Bing Song
- Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, Heilongjiang 150081 P. R. China
| | - Ling-Bin Du
- Zhejiang Office for Cancer Control and Research, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022 P. R. China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Ürümqi, Xinjiang 830011 P. R. China
| | - Ji-Yong Gong
- Science and Education Department of Public Health Division, Shandong Tumor Hospital, Jinan, Shandong 250117 P. R. China
| | - Qi Zhou
- Chongqing Office for Cancer Control and Research, Chongqing Cancer Hospital, Chongqing, 400030 P. R. China
| | - Yu-Qin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, Gansu 730050 P. R. China
| | - Rong Cao
- Department of Health Policy and Economic Research, Guangdong Provincial Institute of Public Health, Guangzhou, Guangdong 511430 P. R. China
| | - Ling Mai
- Department of Institute of Tumor Research, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008 P. R. China
| | - Li Lan
- Institute of Chronic Disease Prevention and Control, Harbin Center for Disease Control and Prevention, Harbin, Heilongjiang 150081 P. R. China
| | - Xiao-Hua Sun
- Ningbo Clinical Cancer Prevention Guidance Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang 315010 P. R. China
| | - Ying Ren
- Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, Liaoning 112000 P. R. China
| | - Jin-Yi Zhou
- Institute of Chronic Non-communicable Diseases Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009 P. R. China
| | - Yuan-Zheng Wang
- Department of Economic Operation, Kailuan General Hospital, Tangshan, Hebei 063000 P. R. China
| | - Xiao Qi
- Department of Occupational Medicine, Tangshan People’s Hospital, Tangshan, Hebei 063000 P. R. China
| | - Pei-An Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, Jiangsu 221006 P. R. China
| | - Dian Shi
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, Gansu 730000 P. R. China
| | - Ni Li
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Kai Zhang
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Jie He
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
| | - Min Dai
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 South Panjiayuan Lane, Chaoyang District, Beijing, 100021 P. R. China
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Samudrala SK, Felfer PJ, Araullo-Peters VJ, Cao Y, Liao XZ, Cairney JM. New atom probe approaches to studying segregation in nanocrystalline materials. Ultramicroscopy 2013; 132:158-63. [PMID: 23485412 DOI: 10.1016/j.ultramic.2012.12.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 10/10/2012] [Accepted: 12/03/2012] [Indexed: 11/26/2022]
Abstract
Atom probe is a technique that is highly suited to the study of nanocrystalline materials. It can provide accurate atomic-scale information about the composition of grain boundaries in three dimensions. In this paper we have analysed the microstructure of a nanocrystalline super-duplex stainless steel prepared by high pressure torsion (HPT). Not all of the grain boundaries in this alloy display obvious segregation, making visualisation of the microstructure challenging. In addition, the grain boundaries present in the atom probe data acquired from this alloy have complex shapes that are curved at the scale of the dataset and the interfacial excess varies considerably over the boundaries, making the accurate characterisation of the distribution of solute challenging using existing analysis techniques. In this paper we present two new data treatment methods that allow the visualisation of boundaries with little or no segregation, the delineation of boundaries for further analysis and the quantitative analysis of Gibbsian interfacial excess at boundaries, including the capability of excess mapping.
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Affiliation(s)
- S K Samudrala
- School of Aerospace, Mechanical & Mechatronic Engineering, University of Sydney, NSW 2006, Australia; The Australian Centre for Microscopy and Microanalysis, The University of Sydney, NSW 2006, Australia
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Wu XL, Liao XZ, Srinivasan SG, Zhou F, Lavernia EJ, Valiev RZ, Zhu YT. New deformation twinning mechanism generates zero macroscopic strain in nanocrystalline metals. Phys Rev Lett 2008; 100:095701. [PMID: 18352724 DOI: 10.1103/physrevlett.100.095701] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Indexed: 05/26/2023]
Abstract
Macroscopic strain was hitherto considered a necessary corollary of deformation twinning in coarse-grained metals. Recently, twinning has been found to be a preeminent deformation mechanism in nanocrystalline face-centered-cubic (fcc) metals with medium-to-high stacking fault energies. Here we report a surprising discovery that the vast majority of deformation twins in nanocrystalline Al, Ni, and Cu, contrary to popular belief, yield zero net macroscopic strain. We propose a new twinning mechanism, random activation of partials, to explain this unusual phenomenon. The random activation of partials mechanism appears to be the most plausible mechanism and may be unique to nanocrystalline fcc metals with implications for their deformation behavior and mechanical properties.
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Affiliation(s)
- X L Wu
- State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100080, China
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Srinivasan SG, Liao XZ, Baskes MI, McCabe RJ, Zhao YH, Zhu YT. Compact and dissociated dislocations in aluminum: implications for deformation. Phys Rev Lett 2005; 94:125502. [PMID: 15903929 DOI: 10.1103/physrevlett.94.125502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2004] [Indexed: 05/02/2023]
Abstract
Atomistic simulations, confirmed by electron microscopy, show that dislocations in aluminum can have compact or dissociated cores. The calculated minimum stress (sigma(P)) required to move an edge dislocation is approximately 20 times smaller for dissociated than for equivalent compact dislocations. This contradicts the well accepted generalized stacking fault energy paradigm that predicts similar sigma(P) values for both configurations. Additionally, Frank's rule and the Schmid law are also violated because dislocation core energies become important. These results may help settle a 50-year-old puzzle regarding the magnitude of sigma(P) in face-centered-cubic metals, and provide new insights into the deformation of ultra-fine-grained metals.
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Affiliation(s)
- S G Srinivasan
- Materials Sciences Division, Los Alamos National Laboratory, Los Alamos, NM 87545, USA.
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Zheng LX, O'Connell MJ, Doorn SK, Liao XZ, Zhao YH, Akhadov EA, Hoffbauer MA, Roop BJ, Jia QX, Dye RC, Peterson DE, Huang SM, Liu J, Zhu YT. Ultralong single-wall carbon nanotubes. Nat Mater 2004; 3:673-6. [PMID: 15359345 DOI: 10.1038/nmat1216] [Citation(s) in RCA: 168] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2004] [Accepted: 07/30/2004] [Indexed: 05/08/2023]
Abstract
Since the discovery of carbon nanotubes in 1991 by Iijima, there has been great interest in creating long, continuous nanotubes for applications where their properties coupled with extended lengths will enable new technology developments. For example, ultralong nanotubes can be spun into fibres that are more than an order of magnitude stronger than any current structural material, allowing revolutionary advances in lightweight, high-strength applications. Long metallic nanotubes will enable new types of micro-electromechanical systems such as micro-electric motors, and can also act as a nanoconducting cable for wiring micro-electronic devices. Here we report the synthesis of 4-cm-long individual single-wall carbon nanotubes (SWNTs) at a high growth rate of 11 microm s(-1) by catalytic chemical vapour deposition. Our results suggest the possibility of growing SWNTs continuously without any apparent length limitation.
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Affiliation(s)
- L X Zheng
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
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Liao XZ, Zou J, Cockayne DJH, Matsumura S. [001] zone-axis bright-field diffraction contrast from coherent Ge(Si) islands on Si(001). Ultramicroscopy 2004; 98:239-47. [PMID: 15046804 DOI: 10.1016/j.ultramic.2003.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2003] [Revised: 07/08/2003] [Indexed: 10/27/2022]
Abstract
Coherent Ge(Si)/Si(001) quantum dot islands grown by solid source molecular beam epitaxy at a growth temperature of 700 degrees C were investigated using transmission electron microscopy working at 300kV. The [001] zone-axis bright-field diffraction contrast images of the islands show strong periodicity with the change of the TEM sample substrate thickness and the period is equal to the effective extinction distance of the transmitted beam. Simulated images based on finite element models of the displacement field and using multi-beam dynamical diffraction theory show a high degree of agreement. Studies for a range of electron energies show the power of the technique for investigating composition segregation in quantum dot islands.
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Affiliation(s)
- X Z Liao
- Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PH, UK
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Zhu YT, Egeland GW, Li Y, Jia QX, Gallegos J, Serquis A, Liao XZ, Peterson DE, Dye RC, Roop BJ, Hoffbauer MA. Formation of pile networks by long carbon nanotubes from decomposition of CO on Co-Mo film. J Nanosci Nanotechnol 2004; 4:189-191. [PMID: 15112565 DOI: 10.1166/jnn.2004.052] [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] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We report the formation of pile networks by long carbon nanotubes grown at 700 degrees C from a Co-Mo film on a quartz plate. Carbon monoxide (CO) was used as the carbon source. The networks were formed because the density of catalyst particles on the substrate was low, which resulted in low carbon nanotube density that did not support vertical growth. At the same time, the low carbon nanotube density makes it possible for CO to reach the catalysts on the substrate for continuous growth. No obvious amorphous carbon chunks were observed, suggesting that the pile networks consisted of fairly high-quality, long carbon nanotubes.
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Affiliation(s)
- Y T Zhu
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
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Ye MR, Li R, Liao HF, Liao XZ, Huang GY. [Pharmacological study on Asparagus officinalis Linn]. Zhongguo Zhong Yao Za Zhi 1994; 19:240-2, inside backcover. [PMID: 7945859] [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: 01/28/2023]
Abstract
Our experiment shows that Asparagus officinalis can increase the clearance rate of charcoal particles and the weight of immune organs in mice, and thus helps to facilitate their antifatigue, anoxia tolerance, analgesia and memory improvement, as well as decrease the contents of lipid peroxide (LPO) in plasma, liver and brain of the animal.
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