Potential Impact of Time Trend of Lifestyle Risk Factors on Burden of Major Gastrointestinal Cancers in China

BACKGROUND & AIMS

China has the largest number of incident liver, esophageal, gastric, and colorectal cancer cases in 2020. Examining the time trend of relevant lifestyle risk factors would help project the trend of these gastrointestinal (GI) cancer incidence in China.

METHODS

We estimated the time trend of the lifestyle factors based on the China Health and Nutrition Survey 1991 to 2011. We applied the comparative risk assessment method to estimate the population attributable fraction of GI cancers attributable to each risk factor. We also projected the prevalence of lifestyle factors and the associated burden of GI cancer from 2011 to 2031.

RESULTS

In 2011, 56.5% of colorectal, 59.8% of gastric, 48.5% of esophageal, and 35.2% of liver cancer in China were attributable to the lifestyle risk factors under study. Smoking, sodium intake, low vegetable intake, and low fruit intake have improved over time but remained far from optimal and are expected to be responsible for 170,000, 35,000, 22,000, and 50,000 GI cancer cases in 2031, respectively. High body mass index, red and processed meat consumption, and low physical activity are expected to contribute increasingly more GI cancer, accounting for 142,000, 185,000, 60,000, and 53,000 cases in 2031, respectively. The estimated population attributable fraction for all risk factors in 2031 is 52.1%.

CONCLUSIONS

Lifestyle risk factors have had an impact on the risk of GI cancer in China, and the impact is projected to increase. If everyone could adhere to the optimal lifestyle, half of all GI cancer events would be prevented by year 2031.

[Breast cancer, the risk attributable to type 2 diabetes]

BACKGROUND

Several studies have evaluated the association between a history of type 2 diabetes (T2D) and risk of breast cancer (BC), with controversial results. However, information regarding the population-attributable risk percent (PAR%) remains scarce. Objective: To estimate the association and the PAR% for BC and T2D, lifestyle and gynecologic factors in women in Mexico City.

METHODS

This case-control study was performed from May-December 2020. Women >40 years of age, from Mexico City, with a confirmed diagnosis for BC were included as cases. Controls were women with a BIRADS 1 or 2 mammography or an ultrasound clear of any BC suggestive findings.

RESULTS

A total of 134 cases and 134 controls were included. A higher risk for BC was identified among women who did not perform routine physical activity and those who had a history of hormonal contraceptive use > 5 years. The use of hormone replacement therapy (HRT) was associated with an odds ratio (OR) of 5.0 (p = 0.22) in the first model. After adjustment, HRT was associated with an OR of 2.92 (p=0.492) in the second and an OR of 3.6 (p = 0.753) in the third model. T2D was associated with an OR of 1.04 (p = 0.96) in the first model; an OR of 0.65 (p = 0.65) in the second model and an OR of RMa 0.75(p = 0.79) for the third model.

CONCLUSION

In this case-control study, there was no significant association identified between a T2D diagnosis and BC.

Poor Physical Function as a Risk Factor for Non-Communicable Diseases in Indonesia: A Retrospective Cohort Study

BACKGROUND

it cannot be ascertained whether an individual with poor physical function is at an increased risk of Non-Communicable Diseases (NCDs), thus the aim of this study is to examine this potential relationship.

METHODS

in this study, a fixed retrospective cohort design has been conducted by using data from the Indonesia Family Life Survey (IFLS) in 2007 and 2014. A total of 6,863 respondents who were not diagnosed with NCD by medical personnel in 2007 were successfully traced. After being controlled for covariates, the association between NCD type and poor physical function was measured by using the Adjusted Risk Ratio (ARR) and Population Attributable Risk (PAR).

RESULTS

respondents with poor physical function were at a significantly increased of being diagnosed with stroke (ARR: 6.9, 95%CI: 4.3-10.9), diabetes (ARR: 3.1, 95%CI: 2.4-4.1), or heart disease (ARR: 3.2, 95%CI: 2.4-4.5). The PAR score of respondents with diabetes was 0.006, meaning 0.6% of diabetes cases are attributed to poor physical function and can therefore be prevented if people maintain good physical function.

CONCLUSION

poor physical function can be assessed to identify risk of diabetes, heart disease, and stroke. Healthcare personnel should provide education programs that inform patients on the importance of maintaining a healthy physical ability.

Population attributable danger of hereditary heart breaks. Risk factors among newborns in Yazd, Iran

Background: hereditary heart problem are cardiac problems that develop prior to birth and influence the newborns' basic performance of heart. Different kinds of deficiency can range from mild (e.g. a small hole between the heart chambers) to severe (like a flaw or weakness into a heart part). Material & Method: This case-control research performed to evaluate PAR congenital heart defects danger parameters between newborns from 2012 to 2013 in Yazd hospitals. The defects were identified through echocardiography and recorded based on the 10th Revision of Diseases International Classification (DIC10). The total amount of cases were 96, of whom 14 were excluded regarding that the shortage of cooperation or insufficient data. One hundred and sixty five sex and region matched controls selected through random sampling involved in the research. Population Attributable Risk (PAR) utilized to evaluate and measure the priorities of the danger parameters. Finally, the Levin formula utilized to evaluate the regulate community ascribable portion. Result: Regulated odds rates evaluated for the danger parameters. The outcomes revealed that the greatest odds ratio belonged to the maternal history of stillbirth, lack of multivitamin use before pregnancy, maternal obesity, and overweight. The calculation of the adjusted Population Attributable Fraction in risk factors indicated that the highest fraction of the causes of natural heart malformations was associated with overweight and obesity. Conclusion: The current research showed that several factors that can impact the congenital heart defects. It concluded that although overweight and obesity had a weaker association than the other 2 parameters, they have a higher prevalence and a greater attributable risk.

The use of epidemiological measures to estimate the impact of primary prevention interventions on CHD, stroke and cancer outcomes: experiences from Herefordshire, UK

Background: CHD, stroke and cancers are the major causes of mortality in the UK and are responsible for significant amounts of morbidity and healthcare costs. This study examines the proportion of CHD, stroke and cancer owing to specific risk factors in Herefordshire, UK. It estimates the population impact of a number of interventions being implemented to reduce these risk factors, through the NHS Health Check program and the Herefordshire Health Improvement Plan. The present study also aims to demonstrate the value of epidemiological measures in providing evidence-based public health information in policy-making to aid decision makers when prioritizing investments and optimal use of resources.

Methods: The epidemiological measures–‘Population Attributable Risk’ and ‘Population Impact Measures’–were used to assess the impact of interventions to reduce the burden of CHD, stroke and cancer.

Results: Implementation of the NHS Health Check program will prevent 63 CHD events, 90 MI events and 125 stroke events, and one lung cancer over a period of 5 years. Reducing specific risk factors by 5% annually through the Health Improvement Plan will prevent 65 CHD events, 25 MI events, 140 stroke events, four lung cancer, one breast cancer and four colorectal cancer cases in Herefordshire if targets are met over a period of 5 years.

Conclusion: Physical inactivity and obesity are the major causes of CHD and stroke events (incidence and mortality) in Herefordshire. Their impact is greater than the combined effect of hypercholesterolemia and hypertension.

Epidemiological measures used in this study proved to be excellent tools in providing evidence-based public health information. Their use is strongly recommended to support prioritization of primary prevention interventions.