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Background: Only few epidemiological data on primary central nervous system (CNS) tumors in Shanghai have been reported. Methods: All cases of primary CNS tumors that were registered at Center for Disease Control and Prevention (CDC) were collected (1973-2007: urban Shanghai; 2003-2007: whole Shanghai city). Trends were analyzed using joinpoint analysis and rates were stratified by age, gender and region. Histological data were collected from both CDC and Huashan Hospital. Results: From 1973 to 2007, the five-year average incidence rate in urban Shanghai increased in both genders, especially in the elderly population. Joinpoint analysis showed the age-adjusted incidence rate for males increased first but then plateaued, whilst rates for females continued increasing over the 35 years. For the five-year status quo (2003-2007), rural had a higher age- adjusted incidence rate than urban populations, and females higher than males, especially those with advanced age. According to CDC (2003-2007) and Huashan Hospital (1951-2011), the two most common histological subtypes were neuroepithelial tumors (with male predominance) and meningiomas (with female predominance). Conclusions: In Shanghai, a steadily increased incidence rate of primary CNS tumors was observed in general, and in the elderly and female population in particular.

Background The seventh edition of the tumor, node, metastasis Classification of Malignant Tumors is due to be published in 2009. The recommendations of International Association for the Study of Lung Cancer for changes to the T descriptors have been published. We combined this new parameter with other well-established prognostic factors and performed multivariate survival analyses to validate its value in Chinese stage I non-small cell lung cancer (NSCLC). Methods We try to validate the new staging project in 325 patients who underwent complete surgical resection for stage I NSCLC in Single Institution of Shanghai Chest Hospital from 1998 to 2003. Variables in the analysis included age, gender, performance status, history of smoking, pathologic type, type of resection (pneumonectomy, lobectomy, and bilobectomy), tumor size (greatest dimension of tumor), T-status (T1 or T2), type of lymph node resection (systematic mediastinal lymphadenectomy or mediastinal lymph node sampling), lymphovascular vessel invasion, and adjuvant chemotherapy. Results The 5-year overall survival (OS) of patients whose tumor measured no larger than 2 cm in largest diameter or larger than 2 cm but no larger than 3 cm were 75.49 and 74.58%, respectively. For those with tumors measured larger than 3 cm but smaller than 5 cm or larger than 5 cm but smaller than 7 cm were 60.87 and 55.63%. The 5-year OS of patients whose tumor measured larger than 7 cm was 46.15% (p = 0.025). The 5-year disease-free survival rates of patients whose tumor measured no larger than 2 cm in largest diameter or larger than 2 cm but no larger than 3 cm were 67.65 and 66.67%, respectively. For those with tumors measured larger than 3 cm but smaller than 5 cm or larger than 5 cm but smaller than 7 cm were 53.14 and 52.63%. The 5-year disease-free survival rate of patients whose tumor measured larger than 7 cm was 30.77% (p = 0.009). Multivariate analyses revealed that age, gender, type of resection (pneumonectomy, lobectomy, and bilobectomy), tumor size (greatest dimension of tumor), type of lymph node resection (systematic mediastinal lymphadenectomy or mediastinal lymph node sampling), and lymphovascular vessel invasion were significant predictive factors for OS. Conclusions The tumor size is a significant independent prognostic factors in stage I NSCLC.

To examine the recent incidences and trends of childhood malignant solid tumors in Shanghai.Data from the population-based Shanghai Cancer Registry and related retrospective survey were used to analyze the patterns of incidence and trends of malignant solid tumors diagnosed between 2002 and 2010 in children aged 0-14 years. The distributions of incidences were described according to gender, age and cancer types which were classified according to International Classification of Childhood Cancer (ICCC). Annual age-standardized rates (ASRs) were adjusted by the world standard population. Approximate confidence intervals for standardized rate ratios (SRR) based Poisson distribution test-based methods were used to assess changes in incidence over the period 2002 - 2006 and 2007 - 2010.(1)A total of 868 cases of childhood malignant solid tumors were diagnosed in Shanghai during 2002 - 2010, accounting for 65.8% of all childhood cancers. The ASR of 2002 - 2010 was 80.2 per million for all solid tumors. (2) The ASR was higher in boys (86.3 per million) than in girls (73.8 per million) with SRR 1.2 (95%CI 1.0 - 1.3). Incidence rate was the highest in the first five years of life with 93.4 per million. The age-specific incidence rates in 5 - 9 and 10 - 14 age groups were 65.2 and 79.3 per million, respectively. (3) CNS tumors, lymphomas, germ cell tumors, neuroblastoma, and soft tissue sarcomas were the top 5 most common solid tumors in children, with the incidence rate of 23.8, 11.0, 7.8, 7.7 and 6.8 per million, respectively. The patterns of subgroups varied in different age groups. Blastomas, such as neuroblastoma, retinoblastoma, were more common in the children aged 0 - 4 years, whereas epithelial carcinomas and bone tumors developed more frequently in elder children aged 10 - 14 years. (4) Compared with the ASR in 2002 - 2006, the ASR for both genders in 2007 - 2010 had no substantial changes (78.7 per million in 2002 - 2006 and 82.9 per million in 2007 - 2010). However, among boys, the incidence rate in 2007 - 2010 was significantly higher than that in 2002 - 2006 with SRR 1.2 (95%CI: 1.0 - 1.4). For specific subgroups of cancer, there were no substantial changes. Some cautions should be taken when interpreting results involving a small number of cases per year and those with wide 95% confidence intervals.The incidence rate of pediatric malignant solid tumors among males was higher than females during 2002 - 2010, and it differed among different age groups with the highest in the first five years of life. CNS tumor was the most common type of solid tumors in children. This was a unique characteristics comparing with adult reflected in disease spectrum and age of onset. The patterns of incidence and its trends for childhood malignant solid tumors in Shanghai could provide a basis for etiologic research and preventive interventions. The findings also suggest an urgent need for longer population-based surveillance to verify the pattern and changing trends.

There have been no population-based studies on cancer survival among children aged 0-14 years in China. In this study, we aimed to characterize the cancer survival among children in Shanghai.Childhood cancer cases registered by the Shanghai Cancer Registry between 2002 and 2005 and enrolled in the Shanghai Childhood Survival Study were included in this study. We used Kaplan-Meier product-limit method for survival analysis and Cox proportional hazards models for investigating the effects of various prognostic factors.The median follow-up time was 5.4 years (range 0-8.9 years). The 5-year observed survival for all childhood cancers combined was 55.7% (95% CI: 51.7-59.6%). For leukemia, lymphoma, and central nervous system tumors, the three most common types of childhood cancer, 5-year survival rates were 52.2%, 58.8%, and 41.2%, respectively. Higher 5-year survival rates were observed for epithelial cancer (88.9%), malignant renal tumors (86.7%), germ cell and other gonadal tumors (78.4%), and retinoblastoma (75.0%). Cancers with poor prognosis included sympathetic nervous system tumors (57.9%), soft tissue sarcoma (54.1%), bone tumors (52.6%), and liver cancer (33.3%). There were no significant differences between survival rates by gender and age groups. Compared with those reported in the USA and Europe, the survival rates for all cancers combined and the three most common types in Shanghai were lower.The survival rate for children aged 0-14 diagnosed with cancer in Shanghai during 2002-2005 was at the medium level. There was a substantial survival difference from childhood cancers between Shanghai and specific developed countries.

To describe the current status of mortality breast cancer in Chinese females between 2004 and 2005, as well as its developing trend from 1973 to 2005.The data of female breast cancer deaths and number of female under exposure were collected through the Third National Mortality Retrospective Sampling Survey, which covered a total of 69 690 241 person years of females. The data was descriptively analyzed, and compared with the data of time-trend of breast cancer mortality in the previous two surveys in 1973 - 1975 and 1990 - 1992 respectively.The crude mortality of female breast cancer in China in 2004 - 2005 was 5.90 per 100 000 (4112/69 690 241), ranking the sixth most common cancer death in Chinese females, and accounted for 5.90% (4112/69 667) of all female deaths from cancer. The crude mortality of female breast cancer was 6.86/100 000 (1777/25 900 856) in the eastern China, 5.91/100 000 (1431/24 225 738) in the central China and 4.62/100 000 (904/19 563 647) in the western China. The age-standardized mortality among Chinese standard population of female breast cancer in urban area (4.91/100 000, 1899 death cases) was 1.44 times higher than that in rural area (3.42/100 000, 2213 death cases). The crude mortality increased 99.99% from 1973 - 1975 (2.95/100 000) to 2004 - 2005 (5.90/100 000), the absolute figure increased by 2.95/100 000. The age-standardized mortality among Chinese standard population increased 37.85% from 1973 - 2005 (2.88/100 000) to 2004 - 2005 (3.97/100 000), the absolute figure increased 1.09/100 000.The mortality of female breast cancer in urban area was higher than that in rural area, and it decreased from the eastern China, to the central China and to the western China in turn. The mortality of female breast cancer has constantly increased in China since 1973.

To describe trends in cancer incidence and mortality among children less than 15 years of age in urban Shanghai between 1973 and 2005.Annual rates of cancer incidence were calculated per 1,000,000 children for 3-year intervals between 1973 and 2005. Linear regression models were used to analyze the annual percent change (APC) in incidence and mortality across these distinct intervals.For all cancers combined, the incidence rate during the observed time period did not substantially change in urban Shanghai. Rates for the incidence of individual cancer did exhibit variations. Leukemia incidence remained relatively stable but the incidence of myeloid leukemia decreased sharply in both males (APC -8.6%) and females (APC -9.5%). The rate of NHL varied little among males with APC 2.1% and modestly increased among females with APC 9.3%. Anatomic sites that only occasionally demonstrate malignancy, bone and joints in males and endocrines in females, showed upward trends in incidence. A significant reduction in liver cancer incidence in males was observed. Examining mortality rates, all cancer mortality decreased by -6.0% annually in males and by -3.9% in females. This trend was mainly due to the reduction in mortality for leukemia, particularly the myeloid subtype, which decreased in males (APC -7.2%) and females (APC -7.3%).Childhood cancer incidence rates showed no substantial changes but mortality demonstrated a dramatic reduction during the observed time period, suggesting an improvement in both childhood cancer diagnosis and treatment.

To investigate the incidence, survival, and influential factors of lung cancer in the Shanghai populations.Data of individual cases of lung cancer 2000 - 2004 were obtained from the Shanghai Cancer registry System. The annual prevent change (APC) of incidence of lung cancer from 1972 to 2004 was calculate by crude and standardized rates so as to analyze the time trends. Cox proportional risk model was used to analyze the factors influencing the survival.23,196 new cases of lung cancer were diagnosed 2002 - 2004. The crude incidence rate of lung cancer in the females was 33.73/100,000, and the age-adjusted rate was 30.90/100,000. The crude incidence rate of lung cancer and the age-adjusted rate for the males were 81.65/100,000 and 33.73/100,000 respectively, both higher than those of females. The APC values of crude incidence 2004 for both the males and females increased by 1.723% and 2.036% respectively in comparison with the values 1972 (both P0.01). The age-adjusted APC of standardized incidence rate for the males in the city center was -0.605% (P0.01), showing a tendency to reduce; while the age-adjusted APC of standardized incidence rate for the females in the city center was -0.136 (P0.05). The proportion of stage IV cases in the females was 47.5%, significantly higher than that in the males (40.0%, P0.05). The proportion of adenocarcinoma in the females was 86.1%, significantly higher than that in the males (47.8%, P0.05). The 3-year survival rate and median survival time of adenocarcinoma in the females were 30.38% and 1.48 years respectively, both significantly higher than those in the males (22.66% and 0.98 years, both P0.01). Female gender, being younger, living in urban area, squamous cancer, early stage, visit to higher-grade hospital were the factors beneficial to the prognosis of lung cancer.The age adjusted incidence rate of lung cancer in Shanghai is much closer to that of Western Europe and North America. The beneficial factors for higher survival rate are female, younger age, urban residency, squamous cell lung cancer, earlier stage of diagnosis, and higher grade hospital for treatment. Women have statistically better outcomes than men in different stages of disease.

To determine the prevalence of depression among cancer patients and its influencing factors.We investigated 7967 cancer patients who lived in communities with cluster sampling based on 'Shanghai Cancer Patient Database'. They were investigated through questionnaires and completed the Zung Self-rating Scale. 6694 questionnaires were identified as 'qualified'. We calculated the prevalence of depression and determined the factors with logistic regression model.The prevalence rate of depression among cancer patients in communities was 24.74% (95% CI: 23.71% - 25.79%). Results from multi-factor analysis showed that duration since diagnosis, stages at diagnosis, metastasis, therapeutics, KPS scores, and pain VAS scores were the important factors.Early detection, improving the curative effect and providing community health services could reduce the prevalence of depression.

Now the quality of life of cancer patients has become one of the end-points in cancer researches. It reflects the survival status and prognosis of cancer patients. This study was to determine the quality of life and its influential factors of cancer patients who live in communities in Shanghai, and to design suitable intervention and evaluate the effectiveness of community-based health care service.A total of 7,967 cancer patients who lived in communities in Shanghai were selected through searching Shanghai Cancer Patient Database by cluster sampling. Questionnaire with FACT-G Self-rating Scale was applied; 6,694 valid questionnaires were obtained. The scores of quality of life were calculated and analyzed with multiple linear regression model to determine the influential factors.The average score of quality of life of the 6 694 cancer patients was 107.62+/-18.77 (95% CI=107.17-108.07). Duration since diagnosis, stage at diagnosis, metastasis status, treatment effect, KPS score, and pain VAS score were main influential factors of quality of life of the cancer patients.Early diagnosis of cancer, improvement of the treatment effect, and providing community health care and analgesic services might improve the quality of life of cancer patients who live in communities.