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Aim: To determine the associations between the Chinese visceral adiposity index (CVAI) and the risks of all‐cause and cause‐specific mortality. Materials and Methods: A total of 3 916 214 Chinese adults were enrolled in a nationwide population cohort covering all 31 provinces of mainland China. The CVAI was calculated based on age, body mass index, waist circumference, and triglyceride and high‐density lipoprotein cholesterol concentrations. We used a Cox proportional hazards regression model to determine the hazard ratios and 95% confidence intervals (CIs) for risk of mortality associated with different CVAI levels. Results: The median follow‐up duration was 3.8 years. A total of 86 158 deaths (34 867 cardiovascular disease [CVD] deaths, 29 884 cancer deaths, and 21 407 deaths due to other causes) were identified. In general, after adjusting for potential confounding factors, a U‐shaped relationship between CVAI and all‐cause mortality was observed by restricted cubic spline (RCS). Compared with participants in CVAI quartile 1, those in CVAI quartile 4 had a 23.0% (95% CI 20.0%–25.0%) lower risk of cancer death, but a 23.0% (95% CI 19.0–27.0) higher risk of CVD death. In subgroup analysis, a J‐shaped and inverted U‐shaped relationship for all‐cause mortality and cancer mortality was observed in the group aged < 60 years. Conclusions: The CVAI, an accessible indicator reflecting visceral obesity among Chinese adults, has predictive value for all‐cause, CVD, and cancer mortality risks. Moreover, the CVAI carries significance in the field of health economics and secondary prevention. In the future, it could be used for early screening purposes. [ABSTRACT FROM AUTHOR]

Simple Summary: We analyzed the long-term mortality trends and their Age-Period-cohort effects for overall cancer and its 10 sub-types in China. The results show that the overall cancer ASMR has declined, but the absolute cancer cases kept increasing due to the growing elderly population, with the death rates for almost all types of cancer among older Chinese continued to rise during the past three decades. The birth cohort RRs peaked in 1920–1930 and tended to decline in successive cohorts for most cancers except for leukemia, lung cancer in rural, and breast and cervical cancer in females, whose relative risks were rising in the very recent cohorts. The rising mortality related to lung, colorectal, breast and cervical cancer and the increasing burden of cancer death in rural areas should receive higher priority in managing cancer burden and calls for targeted public health actions to reverse the trend. Background: China has the highest number of new cancer cases and deaths worldwide, posing huge health and economic burdens to society and affected families. This study comprehensively analyzed secular trends of national cancer mortality statistics to inform future prevention and intervention programs in China. Methods: The annual estimate of overall cancer mortality and its major subtypes were derived from the National Health Commission (NHC). Joinpoint analysis was used to detect changes in trends, and we used age-period-cohort modeling to estimate cohort and period effects in Cancers between 1987 and 2020. Net drift (overall annual percentage change), local drift (annual percentage change in each age group), longitudinal age curves (expected longitudinal age-specific rate), and period (cohort) relative risks were calculated. Results: The age-standardized cancer mortality in urban China has shown a steady downward trend but has not decreased significantly in rural areas. Almost all cancer deaths in urban areas have shown a downward trend, except for colorectal cancer in men. Decreasing mortality from cancers in rural of the stomach, esophagus, liver, leukemia, and nasopharynx was observed, while lung, colorectal cancer female breast, and cervical cancer mortality increased. Birth cohort risks peaked in the cohorts born around 1920–1930 and tended to decline in successive cohorts for most cancers except for leukemia, lung cancer in rural, and breast and cervical cancer in females, whose relative risks were rising in the very recent cohorts. In addition, mortality rates for almost all types of cancer in older Chinese show an upward trend. Conclusions: Although the age-standardized overall cancer mortality rate has declined, and the urban-rural gap narrowed, the absolute cancer cases kept increasing due to the growing elderly population in China. The rising mortality related to lung, colorectal, female breast, and cervical cancer should receive higher priority in managing cancer burden and calls for targeted public health actions to reverse the trend. [ABSTRACT FROM AUTHOR]

Nationwide estimates of the impact of common modifiable risk factors on mortality remain crucial. We aim to assess the influence of social determinants, lifestyle, and metabolic factors on mortality in 174,004 adults aged ≥40 years from the China Cardiometabolic Disease and Cancer Cohort (4C) Study. We reveal that 17 modifiable factors are independently associated with mortality, accounting for 64.8% of all-cause mortality, 77.4% of cardiovascular mortality, and 44.8% of cancer mortality. Low education emerges as the leading factor for both all-cause and cancer mortality, while hypertension is predominant for cardiovascular mortality. Moreover, low gross domestic product per capita and high ambient particulate matter with a diameter of <2.5 μm (PM 2 ) air pollution account for 7.8% and 4.3% for all-cause mortality, respectively, using a different method. Gender-specific analyses reveal distinct patterns, with women's mortality primarily associated with social determinants and men exhibiting stronger associations with lifestyle factors. Targeted health interventions are essential to mitigate mortality risks effectively in China..5 ) air pollution account for 7.8% and 4.3% for all-cause mortality, respectively, using a different method. Gender-specific analyses reveal distinct patterns, with women's mortality primarily associated with social determinants and men exhibiting stronger associations with lifestyle factors. Targeted health interventions are essential to mitigate mortality risks effectively in China., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background The risk of cancer in adulthood can be influenced by exposure to environmental factors (e.g. food shortage and stress) in early life. Objectives This study compared the risk of cancer morbidity and mortality between Chinese adults who were or were not exposed to the Great Chinese Famine (1959–1961) in utero or during early childhood. Methods The Kailuan Study participants (n  = 101,095) were classified into 5 famine exposure groups by birth year collected at study baseline (2006–2007): after 1961 (unexposed), 1959–1961 (in utero exposed), 1956–1958 (infancy and early childhood exposed, aged 0.1–2.9 y), 1953–1955 (childhood exposed, aged 3.0–5.9 y), and before 1953 (exposed, aged 6+ y). They were further classified by the severity of famine exposure. Cancer and cancer mortality cases from 2006 to 2016 were confirmed by reviewing medical records. Cox proportional hazard models were computed, adjusting for sex, socioeconomic status, and other time-varying cancer-related covariates. Results During a median follow-up of 10.0 y, we identified 3560 incident cancer cases and 1749 cancer deaths. Famine exposure at all ages was positively associated with the risk of cancer morbidity and mortality (P  < 0.001 for all, compared with unexposed). Severe exposure to famine in early childhood, but not other ages, had a higher risk of composite cancer events [adjusted HR = 2.04 (95% CI: 1.47, 2.84) for 0.1–2.9 y; and 1.61 (95% CI: 1.15, 2.25) for 3.0–5.9 y], relative to the less severely exposed groups of the same age range. When cancer morbidity and mortality were studied separately, similar patterns were observed. Conclusions In utero and early childhood exposures to famine, especially severe famine, were associated with a higher risk of cancer morbidity and mortality in adulthood. Awareness should be raised regarding the long-term effect of early life nutritional status. Trial registration number: ChiCTR-TNRC-11001489 (http://www.chictr.org.cn/showprojen.aspx?proj=8050). [ABSTRACT FROM AUTHOR]

Background: Numerous studies have suggested that fasting plasma glucose (FPG) was associated with the risk of mortality. However, relationship on longitudinal changes of FPG with the risk of mortality remained inconsistent. Methods: We examined the association of FPG at baseline and its longitudinal changes with risk of mortality based on a cohort study in Yinzhou, China, during 2010–2018. Cox regression models and competing risk models were separately used to examine the association of FPG levels and long‐term fluctuation with risk of total and cause‐specific mortality. Results: Subjects who had an impaired fasting glucose or diabetes suffered a higher risk of total mortality than subjects who had a normal fasting glucose (HRs and 95% CIs: 1.17 [1.01–1.35], 1.30 [1.10–1.53], respectively). The HR for total mortality was 1.54 (95% CI: 1.29–1.84) and for cancer mortality was 1.41 (95% CI: 1.04–1.92) in the highest quartile of coefficient of variation of FPG. Trajectory analysis indicated that subjects with a significantly changed FPG suffered a higher risk of total mortality. Conclusion: According to this cohort study, we found that long‐term fluctuation of FPG was significantly associated with the risk of total and cancer mortality. Our findings suggest that long‐term fluctuation of FPG could be used as an efficient indicator for predicting the subsequent risk of mortality. [ABSTRACT FROM AUTHOR]

Abstract This study investigates the urban-rural and sex differences in the increased risks of the ten most common cancers in China related to high PM 2.5 concentration in the southeastern side of Hu line. Pearson correlation coefficient is estimated to reveal how the cancers closely associated with PM 2.5 long-term exposure. Then linear regression is conducted to evaluate sex- and area-specific increased risks of those cancers from high level PM 2.5 long-term exposure. The major finding is with the increase of every 10 μg/m3 of annual mean PM 2.5 concentration, the increase of relative risks for lung cancer incidence and mortality are 15% and 23% for males, and 22% and 24% for females in rural area. For urban area, the increase of relative risk for ovarian cancer incidence is 9% for females, while that for prostatic cancer increases 17% for males. For leukemia, the increase of relative risks for incidence and mortality are 22% and 19% for females in rural area, while in urban area the increase of relative risk for mortality is 9% for males and for incidence is 6% for females. It is also found that with increased PM 2.5 exposure, the risks for ovarian and prostatic cancer rise significantly in urban area, while risks for lung cancer and leukemia rise significantly in rural area. The results demonstrate the higher risks for lung cancer and leukemia with increased PM 2.5 exposure are more significant for female. This study also suggests that the carcinogenic effects of PM 2.5 have obvious sex and urban-rural differences. Highlights • Increased risks for lung, ovarian, prostate cancers and leukemia are closely associated with increased PM 2.5 exposure (Short version: Lung/ovarian/prostate cancer and leukemia are closely related with increased PM 2.5). • PM 2.5 significantly impacts the risks for lung cancer and leukemia in rural area. • PM 2.5 significantly impacts the risks for prostate and ovarian cancers in urban area. • Females are at higher risks for lung cancer and leukemia due to elevated PM 2.5 [ABSTRACT FROM AUTHOR]

Abstract Objectives China is undergoing a rapid aging transition. The trends in age-specific mortality rates from colorectal cancer remain unknown, and a number of studies have not distinguished the age, period, and cohort effects simultaneously. Study design A descriptive study was implemented with a joinpoint regression analysis and age–period–cohort (APC) model based on the intrinsic estimator (IE). Methods Age-specific mortality rates of colorectal cancer (1987–2016) were collected by gender (men/women) and region (urban/rural). The average annual percentage change (AAPC) and relative risks in the trend were identified using joinpoint Poisson regression and APC model (IE), respectively. Results Joinpoint regression analysis revealed that the rates decreased in the younger (men aged <45 years and women aged <75 years) but increased in the older (men aged >75 years and women aged >80 years) age groups. The APC model (IE) showed that the rates increased with age and time period but decreased with birth cohorts. But from 2000 to 2005, the period effects showed a substantial decline among urban residents. From the 1910–1914 to the 1915–1919 birth cohort, mortality increased among men, and from the 1925–1929 to the 1930–1934 birth cohort, mortality increased among rural residents. Conclusions The trends in colorectal cancer mortality are different between age groups. The younger age groups show a decreasing trend, whereas the older age groups an increasing trend. Cost-effective prevention and control should be implemented more in the elderly and for older cohorts at high risk. Highlights • Through the joinpoint Poisson regression, colorectal cancer mortality decreased in the younger (men aged <45 years and women aged <75 years) but increased in the older (men aged >75 years and women aged >80 years) over the last 30 years. • Through the age–period–cohort model (intrinsic estimator), the rates increased with age and time period but decreased with birth cohorts. • Analysis based on age-specific mortality rates reveals more information than that based on age-standardized rate. [ABSTRACT FROM AUTHOR]

Background: Over the past four decades, the Chinese government has conducted three surveys on the distribution of causes of death and built cancer registration. In order to shine a new light on better cancer prevention strategies in China, we evaluated the profile of cancer mortality over the forty years and analyzed the policies that have been implemented., Methods: We described spatial and temporal changes in both cancer mortality and the ranking of major cancer types in China based on the data collected from three national surveys during 1973-1975, 1990-1992, 2004-2005, and the latest cancer registration data published by National Central Cancer Registry of China. The mortality data were compared after conversion to age-standardized mortality rates based on the world standard population (Segi's population). The geographical distribution characteristics were explored by marking hot spots of different cancers on the map of China., Results: From 1973 to 2016, China witnessed an evident decrease in mortality rate of stomach, esophageal, and cervical cancer, while a gradual increase was recorded in lung, colorectal, and female breast cancer. A slight decrease of mortality rate has been observed in liver cancer since 2004. Lung and liver cancer, however, have become the top two leading causes of cancer death for the last twenty years. From the three national surveys, similar profiles of leading causes of cancer death were observed among both urban and rural areas. Lower mortality rates from esophageal and stomach cancer, however, have been demonstrated in urban than in rural areas. Rural areas had similar mortality rates of the five leading causes of cancer death with the small urban areas in 1973-1975. Additionally, rural areas in 2016 also had approximate mortality rates of the five leading causes with urban areas in 2004-2005. Moreover, stomach, esophageal, and liver cancer showed specific geographical distributions. Although mortality rates have decreased at most of the hotspots of these cancers, they were still higher than the national average levels during the same time periods., Conclusions: Building up a strong primary public health system especially among rural areas may be one critical step to reduce cancer burden in China., (© 2022 The Authors. Cancer Communications published by John Wiley & Sons Australia, Ltd. on behalf of Sun Yat-sen University Cancer Center.)

The study investigated the age-adjusted mortality rate and disease odds among deceased residents living in areas exposed to wastewater and cleanwater from 2007 to 2011, in Shijiazhuang, China. Mortality data for eight villages exposed to wastewater and 16 villages not exposed to wastewater were collected and crosschecked from multiple sources. Overall mean age-adjusted mortality rate for wastewater areas was 798/105 (95 % Confidence Interval (CI) = ± 68), insignificantly higher than the mean mortality rate for cleanwater area, 726/105 (95 % CI = ± 46),p > 0.05. Malignant neoplasms and respiratory mortality and disease odds were higher in wastewater areas than in cleanwater areas, OR = 1.7 (95 % CI = 1.3–2.2,p < 0.01) and OR = 1.9 (95 % CI = 1.1–3.4,p < 0.05), respectively. Wastewater area mortality and disease odds for Lung and Stomach cancers after adjustments were OR = 1.6 (95 % CI = 1.1–2.4,p < 0.05) and OR = 1.8 (95 % CI = 1.2–2.7,p < 0.01), respectively, significantly higher than those of cleanwater areas. There is a possibility that exposure to wastewater might be associated with cancer and respiratory disease mortality. The study recommends that the use of wastewater be limited, discouraged, or discontinued. [ABSTRACT FROM PUBLISHER]

According to the hypothesis of circadian disruption, external factors that disturb the function of the circadian system can raise the risk of malignant neoplasm and reduce life span. Recent work has shown that the functionality of the circadian system is dependent not only on latitude of residence but also on the region's position in the time zone. The purpose of the present research was to examine the influence of latitude and time zone on cancer incidence, cancer mortality, and life expectancy at birth. A stepwise multiple regression analysis was carried out on residents of 59 regions of the European part of the Russian Federation (EPRF) using age-standardized parameters (per 100,000) of cancer incidence (CI), cancer mortality (CM), and life expectancy at birth (LE, yrs) as dependent variables. The geographical coordinates (latitude and position in the time zone) of the regions were used as independent variables, controlling for the level of economic development in the regions. The same analysis was carried out for LE in 31 regions in China. Latitude was the strongest predictor of LE in the EPRF population; it explained 48% and 45% of the variability in LE of women and men, respectively. Position within the time zone accounted for an additional 4% and 3% variability of LE in women and men, respectively. The highest values for LE were observed in the southeast of the EPRF. In China, latitude was not a predictor of LE, whereas position in the time zone explained 15% and 18% of the LE variability in women and men, respectively. The highest values of LE were observed in the eastern regions of China. Both latitude and position within the time zone were predictors for CI and CM of the EPRF population. Latitude was the best predictor of stomach CI and CM; this predictor explained 46% and 50% of the variability, respectively. Position within the time zone was the best predictor of female breast CM; it explained 15% of the variability. In most cases, CI and CM increased with increasing latitude of residence, from the eastern to the western border of the time zone, and with increasing level of economic development within the region. The dependence of CI, CM, and LE on the geographical coordinates of residence is in agreement with the hypothesis of circadian disruption. (Author correspondence: ) [ABSTRACT FROM AUTHOR]

Keywords: cancer epidemiology; China; cancer incidence; cancer mortality; cancer survival; cohort Cancer epidemiology, China, cancer incidence, cancer mortality, cancer survival, cohort. [Extracted from the article]

This study compared the temporal and geographic trends of cancer in China with a specific focus on the long-term exposure to soil cadmium (Cd) pollution. The geographic information system (GIS; kriging interpolation method) was used to detect the Cd contained in the soil from the Dabaoshan area, Guangdong Province. The standard rate ratio (SRR) was calculated to describe the relationship between Cd exposure and cancer mortality risk using the low-exposure group as a reference. Eight hundred six cancer deaths (533 male and 273 female) in the total population of 972,970 were identified, and the age-standardized rate (world) was 145.64 per 100,000. Significant dose-response relationships were found using the low-exposure group as the reference group. The Cd soil levels were positively associated with the cancer mortality risk in the community population, particularly for all cancers (SRR = 3.27; 95% CI = 2.42-4.55), esophageal cancer (SRR = 5.42; 95% CI = 1.07-30.56), stomach cancer (SRR = 5.99; 95% CI = 2.00-18.66), liver cancer (SRR = 4.45; 95% CI = 2.16-10.34), and lung cancer (SRR = 2.86; 95% CI = 1.62-5.31) for the total population. Additionally, similar results were obtained when using the 2000 China standard population. Cd exposure significantly affected the standardized mortality rates (China) by age group for all cancers, esophageal cancer, stomach cancer, liver cancer, and lung cancer in the total population, particularly in the age groups of 35-54, 55-74, and ≥ 75 years, respectively. Cd soil level is likely positively associated with increased cancer mortality of all cancer types and esophageal, stomach, liver, and lung cancers but not for other specific categories of cancer., (© 2021. The Author(s).)

Background: Considering the serious health burden caused by adverse weather events, increasing researches focused on the relationship between temperature variability (TV) and cause-specific mortality, but its association with cancer was not well explored. We aimed to investigate the impacts of TV on cancer mortality and examine the modifying effects of weather type and geographical location as well as other characteristics., Materials and Methods: Daily city-specific data of cancer deaths, mean temperature (Tmean), maximum and minimum temperatures (Tmax and Tmin), relative humidity (RH), rainfall, and air pollutants were collected during 2016-2017 in 13 cities in Jiangsu Province, China. TV 0-t was defined as the standard deviation of the daily Tmax and Tmin on the exposure 0-t days. A two-stage analysis was applied. First, a time-stratified case-crossover design was used to examine the odds ratio (OR) and attributable fraction of cancer mortality per 1 °C increase in TV by adjusting for potential confounders. Random effect meta-analysis was used to summarize the pooled ORs. Second, stratified analysis was performed for weather type, geographical location, demographics, and other city-level characteristics. The weather was defined as four types according to days during warm or cold season combined with high or low RH., Results: A total of 303670 cases were included in our study. Meta-analysis showed that the ORs of cancer mortality per 1 °C increase in TV 0-t significantly increased and peaked in TV 0-2 (OR=1.0098, 95% CI: 1.0039-1.0157). The attributable fraction of TV 0-2 on cancer mortality was 4.74%, accounting for 14395 deaths in the study period. Significant ORs of TV-related cancer mortality were found during the warm season combined with high RH and in the northern region of Jiangsu. Susceptible groups of TV-related cancer mortality were identified as female patients, patients aged 45-65 years, and those living in cities with lower per capita green area., Conclusions: TV can significantly increase the risk of cancer mortality, especially during warm and humid days and in the northern region of Jiangsu. Findings are of great significance to formulate urban planning, resource allocation, and health intervention to prolong the life of cancer patients., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Cancer has become a global health problem, and assessments of cancer mortality are important for effective public health policy-making and adequate resource allocation. In this study, we aimed to predict the mortality rates and numbers of deaths related to four common cancers (lung, liver, stomach, and esophagus) in China from 2020 to 2030 and to estimate the corresponding cancer burden caused by population aging and tobacco smoking., Methods: Cancer mortality data (2004-2017) were extracted from China's death surveillance datasets, and China's population figures (2020-2030) were obtained from the United Nations population projections. Smoking prevalence data were retrieved from a World Health Organization global report, and relative risks of smoking and cancers were derived from large-scale Asian studies. We predicted the deaths related to the four major cancers and age-standardized mortality rates using joinpoint regression and linear regression models. The tobacco smoking-related burden of these four major cancers was estimated using the population attributable fraction., Results: Unlike lung cancer mortality which was predicted to continue to increase, the age-standardized mortality rates for digestive cancers (liver, stomach, and esophageal cancers) are predicted to decline over the next decade. The number of deaths caused by the four major cancers is predicted to increase from 1,490,304 in 2020 to 1,823,960 in 2030. The age-specific mortality rates of the four major cancers are predicted to increase with age after 40-45 years, peaking in the age groups of 80-84 and ≥85 years. In 2030, the combined number of deaths from the four examined cancers among adults aged ≥65 years is predicted to be 1,167,153, accounting for 64% of all deaths from these cancers. Tobacco smoking is predicted to contribute to nearly 29% of deaths from these cancers, corresponding to 527,577 deaths., Conclusions: The overall trend in the combined total mortality from four major cancers is predicted to decline over the next decade; however, the corresponding death toll is expected to surge, in the context of China's population aging and high smoking prevalence. These estimates provide data-driven evidence for China to implement effective cancer control measures in the future., (© 2021 The Authors. Cancer Communications published by John Wiley & Sons Australia, Ltd. on behalf of Sun Yat-sen University Cancer Center.)

Periostin (POSTN) regulates multiple biological behaviors of tumor cells. We studied the association of serum POSTN with mortality in home-dwelling men. POSTN was measured at baseline using immunoassay (USCN life science, China) in 815 home-dwelling men aged 60–87 followed-up for 8 years. In the entire cohort, higher serum POSTN was associated with higher all-cause mortality [Hazard Ratio (HR) = 1.30 per Standard Deviation (SD), 95% Confidence Interval (CI): 1.13–1.50, p <.001] after adjustment for potential confounders. In a similar model, cancer mortality (n = 69) increased with POSTN levels (HR = 1.44 per SD, 95%CI: 1.16–1.78, p <.001). Cardiovascular mortality (n = 55) and non-cardiovascular-non-cancer mortality (n = 44) was not associated with POSTN levels (p =.28 and p =.94 respectively). In 107 men with prevalent cancer, all-cause mortality (HR = 1.93 per SD, 95%CI: 1.30–2.87, p <.005) and cancer mortality (HR = 2.07 per SD, 95%CI: 1.23–3.47, p <.01) increased with the increasing POSTN concentrations. In 613 men with incident cancer, higher POSTN concentrations were associated with higher cancer mortality (HR = 1.40 per SD, 95%CI: 1.12–1.76, p <.005) but not with the risk of cancer (HR = 1.16 per SD, 95%CI: 0.89–1.46, p =.21). Higher serum POSTN is associated with higher cancer mortality, but not with the cancer risk in older home-dwelling men. [ABSTRACT FROM AUTHOR]

High-accuracy spatial distribution estimation is crucial for cancer prevention and control. Due to their complicated pathogenic factors, the distributions of many cancers' mortalities appear blocky, and spatial heterogeneity is common. However, most of the commonly used cancer mapping methods are based on spatial autocorrelation theory. Sandwich estimation is a new method based on spatial heterogeneity theory. A modified sandwich estimation method suitable for the estimation of cancer mortality distribution is proposed in this study. The variances of cancer mortality data are used to fuse sandwich estimation results from various auxiliary variables, the feasibility of which in estimating cancer mortality distributions is explained theoretically. The breast cancer (BC) mortality of the Chinese mainland in 2005 was taken as a case, and the accuracy of the modified sandwich estimation method was compared with that of the Hierarchical Bayesian (HB), the Co-Kriging (CK) and the Ordinary Kriging (OK) methods. The accuracy of the modified sandwich estimation method was better than the HB, the CK and the OK methods, and the estimation result from the modified sandwich estimation method was more likely to be acceptable. Therefore, this study represents an attempt to apply the sandwich estimation method to the estimation of cancer mortality distributions with strong spatial heterogeneity, which holds great potential for further application.

Background & Aims: Vitamin B6 has been postulated to play an important role in determining chronic diseases. However, few studies have evaluated associations between dietary vitamin B6 and cause-specific mortality comprehensively., Methods: We investigated the associations between vitamin B6 from diet and risk of all-cause, and cause-specific mortality in 134,480 participants from the Shanghai Men's Health Study (2002-2014) and Shanghai Women's Health Study (1997-2014). The median follow-up periods for men and women were 10.3 and 16.2 years, respectively. We estimated hazard ratio (HR) and 95% confidence interval (CI) using Cox proportional hazards models., Results: After adjustment for suspected confounders, the multivariable-adjusted HRs for the highest versus lowest quintiles for total, CVD, stroke and CHD mortality among men were 0.83 (95%CI = 0.76, 0.90), 0.73 (95%CI = 0.63, 0.85), 0.71 (95%CI = 0.58, 0.88), 0.66 (95%CI = 0.47, 0.91), accordingly. Women with the highest intake had significantly 17% (HR = 0.83; 95% CI = 0.77, 0.90), 20% (HR = 0.80; 95% CI = 0.70, 0.92), and 28% (HR = 0.72; 95% CI = 0.59, 0.86) lower risks of total, CVD and stroke mortality compared with those of women with lowest vitamin B6 intake. No significant association was observed between dietary vitamin B6 and cancer mortality both among men and women., Conclusions: In the current study with two prospective Chinese cohorts, high dietary vitamin B6 consumption was inversely associated with risk of all-cause and CVD mortality., (Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Objectives: This paper examines rural-urban inequities in mortality and cancer mortality amid rapid economic growth and environmental degradation in China., Methods: SPSS and Joinpoint Regression were used to analyze the 2002-2015 datasets from all death registries in China and associated economic and environmental data., Results: Death and cancer mortality rates among rural residents were higher and increased faster than urban residents. In particular, rural men 30-34 years old were 44% more likely to die from cancer and over 67% more likely to die from all causes, compared to their urban counterparts. Among rural women 15-19 years old, the death rate was 47% higher and the cancer mortality rate was 44% higher than among urban women. Death and cancer mortality rates tended to be positively associated with economic growth and air pollution variables., Conclusions: Rural-urban health inequities have widened in China, with rural youth at the greatest disadvantage. The anticipated health benefits from income growth may have been offset by the impact of air pollution, which calls for further investigation into the causes of rural-urban health inequities.

The aim was to study the variation trends of all-cause and cancer mortality during 1984⁻2013 in Macheng City, China. The mortality data were collected from Macheng City disease surveillance points system and Hubei Center for Disease Control and Prevention. The model life table system was used to adjust mortality rates due to an under-reporting problem. An age-period-cohort model and intrinsic estimator algorithm were used to estimate the age effect, period effect, and cohort effect of all-cause mortality and cancer mortality for males and females. Age effect of all-cause mortality for both sexes increased with age, while the age effect of cancer mortality for both sexes reached a peak at the age group of 55⁻59 years old and then decreased. The relative risks (RRs) of all-cause mortality for males and females declined with the period and decreased by 51.13% and 63.27% during the whole study period, respectively. Furthermore, the period effect of cancer mortality in both sexes decreased at first and then increased. The cohort effect of all-cause and cancer mortality for both sexes born after 1904 presented the pattern of "rise first and then fall," and decreased by 82.18% and 90.77% from cohort 1904⁻1908 to 1989⁻1993, respectively; especially, the risk of all-cause and cancer mortality for both sexes born before 1949 was much higher than that for those born after 1949.

Several large prospective studies show an association between serum uric acid (SUA) and cancer, however there is a lack of evidence in China. We aimed to investigate the effects of SUA levels on cancer incidence and mortality in China. This study included 20,577 adult hypertensive patients with valid SUA measurements who participated in the China Stroke Primary Prevention Trial where subjects were randomly assigned to receive a double-blind treatment of either 10 mg enalapril (n = 10,286) or 10.8 mg enalapril-folic acid (n = 10,291). Subjects were prospectively followed for a median of 4.5 years. Cox proportional hazards models were used to calculate hazards ratios (HR) of cancer risk associated with SUA. A total of 232 participants developed cancer. SUA was independently associated with increased cancer risk in the enalapril group [HR: 1.12, (95% CI: 1.03-1.22)]. Compared to the lowest tertile, combined subjects with SUA levels from the upper two tertiles had a higher risk of cancer in the enalapril group [T2 + T3: HR: 1.58, (95% CI: 1.02-2.47)]. In cancer site-specific analyses, a positive association of SUA levels with digestive cancer and all fatal cancer was also observed [HR: 1.18, (95% CI: 1.09-1.27); HR: 1.15, (95% CI: 1.03-1.28), respectively] in the enalapril group. Interestingly, SUA levels were not associated with the risk of cancer or related mortality in the enalapril folic acid group. Our results suggest that elevated SUA is independently and positively associated with the risk of total cancer incidence, digestive cancer incidence and cancer mortality among hypertensive Chinese., (© 2017 UICC.)