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Background The disease burden of ischemic heart disease is becoming heavier, and the influence of metabolic factors is gradually increasing, and there is still insufficient research in exploring the disease burden caused by metabolic factors and its change trend. Objective To analyzes the long-term impact and trend of the disease burden of ischemic heart disease caused by metabolic factors in China from 1990 to 2019, so as to provide solid and powerful scientific support and basis for the prevention and control of ischemic heart disease. Methods Based on the data of the Global Burden of Disease Study in 2019, the mortality rate, disability adjusted life year (DALY) and corresponding normalized indicators attributed to metabolic factors in ischemic heart disease of different ages and sexes in China from 1990 to 2019 were obtained. The Joinpoint model was used to systematically evaluate the temporal trend of disease changes. Results The mortality rate and DALY rate of ischemic heart disease attributed to metabolic factors in the whole population of China increased from 38.01/100 000 and 944.68/100 000 in 1990 to 103.34/100 000 and 1 972.50/100 000 in 2019, respectively. Compared with 1990, in 2019, the mortality rate of ischemic heart disease, DALY rate and corresponding standardized indicators attributed to metabolic factors were significantly higher in males than in females, and higher in the older age group than in the lower age group. In terms of gender, during the period of 1990—2019, the standardized mortality rate of men with IHD attributed to metabolic factors in China was gradually higher than the global level, while the standardized mortality rate of the whole population and women was always lower than the global level. The standardized DALY rates of all three are significantly lower than the global level. In terms of age, the DALY rate attributed to high body mass index in 1990—2019 showed an upward trend and dominated the population, and renal insufficiency gradually became prominent in the elderly population. Conclusion Since 1990, the overall burden of ischemic heart disease in China has shown an upward trend. The burden of ischemic heart disease caused by metabolic factors is increasing, and it is necessary to continue to increase the publicity of ischemic heart disease prevention and control, especially for key groups such as men and the elderly, carry out targeted health management, better guide the formulation of health policies, improve the utilization efficiency of health resources, and optimize the layout and structure of medical services, so as to better meet the public health needs, reduce the burden of ischemic heart disease in China to a greater extent, and help achieve the goal of healthy China.

Abstract Background Cervical and breast cancers are among the top 4 leading causes of cancer-related mortality in women. This study aimed to examine age-specific temporal trends in mortality for cervical and breast cancers in urban and rural areas of China from 2009 to 2021. Methods Age-specific mortality data for cervical and breast cancers among Chinese women aged 20–84 years were obtained from China’s National Disease Surveillance Points system spanning the years 2009 to 2021. Negative binomial regression models were utilized to assess urban–rural differences in mortality rate ratios, while Joinpoint models with estimated average annual percent changes (AAPC) and slopes were employed to compare temporal trends and the acceleration of mortality rates within different age groups. Results From 2009 to 2021, there was a relative increase in age-specific mortality associated with the two cancers observed in rural areas compared with urban areas. A rising trend in the screening age of 35–64 [AAPC: 4.0%, 95% confidence interval (CI) 0.5–7.6%, P = 0.026] for cervical cancer was noted in rural areas, while a stable trend (AAPC: − 0.7%, 95% CI − 5.8 to 4.6%, P = 0.78) was observed in urban areas. As for breast cancer, a stable trend (AAPC: 0.3%, 95% CI − 0.3 to 0.9%, P = 0.28) was observed in rural areas compared to a decreasing trend (AAPC: − 2.7%, 95% CI − 4.6 to − 0.7%, P = 0.007) in urban areas. Urban–rural differences in mortality rates increased over time for cervical cancer but decreased for breast cancer. Mortality trends for both cervical and breast cancers showed an increase with age across 4 segments, with the most significant surge in mortality observed among the 35–54 age group across urban and rural areas, periods, and regions in China. Conclusions Special attention should be given to women aged 35–54 years due to mortality trends and rural–urban disparities. Focusing on vulnerable age groups and addressing rural–urban differences in the delivery of cancer control programs can enhance resource efficiency and promote health equity.

Abstract Background Viral hepatitis imposes a heavy disease burden worldwide and is also one of the most serious public health problems in China. We aimed to describe the epidemiological characteristics of hepatitis in China and to investigate the influencing factors. Methods We first used the JoinPoint model to analyze the percentage change (APC) and average annual percentage change (AAPC) of hepatitis in Chinese provinces from 2002 to 2021. We then explored the influencing factors by using the time-series global principal component analysis (GPCA) and the panel fixed-effects model. Results The disease burden varied across different provinces from 2002 to 2021. The AAPC of the total HAV incidence decreased by 10.39% (95% CI: [-12.70%, -8.02%]) from 2002 to 2021. Yet the AAPC of HBV, HCV, and HEV increased by 1.50% (95% CI: [0.23%, 2.79%]), 13.99% (95% CI: [11.28%, 16.77%]), and 7.10% (95% CI: [0.90%, 13.69%]), respectively. The hotspots of HAV, HBV, HCV, and HEV moved from the west to the center, from the northwest to the southeast, from the northeast to the whole country, and from the northeast to the southeast, respectively. Different types of viral hepatitis infections were associated with hygiene, pollutant, and meteorological factors. Their roles in spatial-temporal incidence were expressed by panel regression functions. Conclusions Viral hepatitis infection in China showed spatiotemporal heterogeneity. Interventions should be tailored to its epidemiological characteristics and determinants of viral hepatitis.

Background: Cervical and breast cancers are among the top 4 leading causes of cancer-related mortality in women. This study aimed to examine age-specific temporal trends in mortality for cervical and breast cancers in urban and rural areas of China from 2009 to 2021. Methods: Age-specific mortality data for cervical and breast cancers among Chinese women aged 20–84 years were obtained from China's National Disease Surveillance Points system spanning the years 2009 to 2021. Negative binomial regression models were utilized to assess urban–rural differences in mortality rate ratios, while Joinpoint models with estimated average annual percent changes (AAPC) and slopes were employed to compare temporal trends and the acceleration of mortality rates within different age groups. Results: From 2009 to 2021, there was a relative increase in age-specific mortality associated with the two cancers observed in rural areas compared with urban areas. A rising trend in the screening age of 35–64 [AAPC: 4.0%, 95% confidence interval (CI) 0.5–7.6%, P = 0.026] for cervical cancer was noted in rural areas, while a stable trend (AAPC: − 0.7%, 95% CI − 5.8 to 4.6%, P = 0.78) was observed in urban areas. As for breast cancer, a stable trend (AAPC: 0.3%, 95% CI − 0.3 to 0.9%, P = 0.28) was observed in rural areas compared to a decreasing trend (AAPC: − 2.7%, 95% CI − 4.6 to − 0.7%, P = 0.007) in urban areas. Urban–rural differences in mortality rates increased over time for cervical cancer but decreased for breast cancer. Mortality trends for both cervical and breast cancers showed an increase with age across 4 segments, with the most significant surge in mortality observed among the 35–54 age group across urban and rural areas, periods, and regions in China. Conclusions: Special attention should be given to women aged 35–54 years due to mortality trends and rural–urban disparities. Focusing on vulnerable age groups and addressing rural–urban differences in the delivery of cancer control programs can enhance resource efficiency and promote health equity. [ABSTRACT FROM AUTHOR]

Objective To analyze the trend of disease burden of colorectal cancer attributed to alcohol consumption in China from 1990 to 2019 and provide evidence for the colorectal cancer prevention and control in China. Methods Data on colorectal cancer mortality and disability-adjusted life years (DALYs) rates attributable to alcohol from 1990 to 2019 were extracted from the GBD 2019 database. The age-period-cohort (APC) model was used to assess the effects of age, period, and cohort, and the ARIMA model was used to predict the disease burden of colorectal cancer attributable to alcohol in the next 10 years. Results From 1990 to 2019, the number of deaths, crude mortality rate, and crude DALY rate of colorectal cancer attributable to alcohol in China increased from 56 000, 0.47/100 000, and 1433/100 000 in 1990 to 245 000, 1.72/100 000, and 46.57/100 000 in 2019. The age -standardized mortality rate and age -standardized DALY rate increased from 0,66/100 000 and 17.79/100 000 in 1990 to 1.24/100 000 and 32.51/100 000 in 2019, with an average annual increase of 2,16 (1.94-3.89, £=19.95) and 2.07 (L85-230, £=18.22). The death risk of colorectal cancer attributable to alcohol in China reached its peak at 16,61/100 000 (95%CI: 15.98%-17.26%) in the 5-80 years old group from 1990 to 2019, The period effect showed that the death risk RR reached its highest at 142 (95%CI: 138%-1.46%) between 2012 and 2017. The cohort effect showed that the death risk RR increased from 0.30 (95%CI: 0.27%-0.33%) in 1910 to 2.71 (95%CI: 2.18%-3.36%) in 1990. The prediction model showed that the age -standardized mortality rate and DALY rate of colorectal cancer attributable to alcohol in China would continue to rise from 2020 to 2030, Conclusion The burden of colorectal cancer attributed to alcohol consumption among the Chinese population has been on the rise from 1990 to 2019, with significant gender and age differences. Middle aged and elderly men are the main population increasing the disease burden, and health education for both men and middle-aged and elderly people should be strengthened to reduce the burden of colorectal cancer. [ABSTRACT FROM AUTHOR]

Background Inflammatory bowel disease (IBD) has become highly prevalent in recent years characterized by a prolonged disease course and high disease burden. However, there is a lack of data to understand the burden of IBD in China, which may hinder health care planning and resource allocation for the disease. Objective To investigate the burden of IBD and its variation tendency in China from 1990 to 2019, and analyze the influence of age, gender and period on IBD. Methods The incidence, mortality and disability adjusted life year (DALY) rate of IBD in China from 1990 to 2019 were collected using the Global Burden of Disease Database 2019. Joinpoint software was used to analyze the variation tendency and characteristics of standardized incidence, standardized mortality and standardized DALY rate of IBD, and Excel 2019 software was used for data processing. Results From 1990 to 2019, the standardized incidence increased from 1.47/100 000 to 3.01/100 000 with avevage annual percent change (AAPC) of 2.50%〔95%CI (2.4%, 2.6%) 〕, the standardized mortality decreased from 0.86/100 000 to 0.35/100 000 with AAPC of -1.6%〔95%CI (-3.8%, -3.4%) 〕, the standardized DALY rate decreased from 24.47/100 000 to 16.31/100 000, with AAPC of -2.2%〔95%CI (-2.3%, -2.0%) 〕, the changes of trends were all statistically significant (P

Abstract Background China has a high mortality from nasopharyngeal carcinoma (NPC). The NPC mortality trends in China from 2006 to 2020 were described and analyzed to understand its epidemiological characteristics by region and sex and to explore age, period, and cohort effects. Methods This study utilized NPC mortality data from the China Health Statistical Yearbook. A joinpoint regression model was used to fit the standardized NPC mortality and age-specific mortality. The age-period-cohort model was applied to investigate age, period, and cohort effects on NPC mortality risk. Results The results showed that the NPC mortality rate in China has been declining steadily. From 2006 to 2020, the standardized NPC mortality rate in most age groups showed a significant downward trend. The annual percentage change was smaller in rural areas than in urban areas. The mortality risks of rural males and rural females from 2016 to 2020 were 1.139 times and 1.080 times those from 2011 to 2015, respectively. Both urban males born in 1984–1988 and rural males born in 1979–1983 exhibited an increasing trend in NPC mortality risk. Conclusions Our study confirmed the effectiveness of NPC prevention and treatment strategies in China from 2006 to 2020. However, it underscored the urgent need for targeted interventions in rural areas to further reduce NPC mortality rates.

Background: China has a high mortality from nasopharyngeal carcinoma (NPC). The NPC mortality trends in China from 2006 to 2020 were described and analyzed to understand its epidemiological characteristics by region and sex and to explore age, period, and cohort effects. Methods: This study utilized NPC mortality data from the China Health Statistical Yearbook. A joinpoint regression model was used to fit the standardized NPC mortality and age-specific mortality. The age-period-cohort model was applied to investigate age, period, and cohort effects on NPC mortality risk. Results: The results showed that the NPC mortality rate in China has been declining steadily. From 2006 to 2020, the standardized NPC mortality rate in most age groups showed a significant downward trend. The annual percentage change was smaller in rural areas than in urban areas. The mortality risks of rural males and rural females from 2016 to 2020 were 1.139 times and 1.080 times those from 2011 to 2015, respectively. Both urban males born in 1984–1988 and rural males born in 1979–1983 exhibited an increasing trend in NPC mortality risk. Conclusions: Our study confirmed the effectiveness of NPC prevention and treatment strategies in China from 2006 to 2020. However, it underscored the urgent need for targeted interventions in rural areas to further reduce NPC mortality rates. [ABSTRACT FROM AUTHOR]

Abstract Background As populations age, cancer burden becomes increasingly conspicuous. This study quantified the cancer burden of the elderly (≥ 60 years) in China, based on the China Cancer Registry Annual Report to provide epidemiological evidence for cancer prevention and control. Methods Data on cancer cases and deaths among the elderly aged ≥ 60 years were collected from the China Cancer Registry Annual Report, 2008–2019. Potential years of life lost (PYLL) and disability-adjusted life years (DALY) were calculated to analyze fatalities and the non-fatal burden. The time trend was analyzed using the Joinpoint model. Results From 2005 to 2016, the PYLL rate of cancer in the elderly was stable between 45.34‰ and 47.62‰, but the DALY rate for cancer decreased at an average annual rate of 1.18% (95% CI: 0.84–1.52%). The non-fatal cancer burden in the rural elderly was higher than that of the urban elderly. Lung, gastric, liver, esophageal, and colorectal cancers were the main cancers causing the cancer burden in the elderly, and accounted for 74.3% of DALYs. The DALY rate of lung cancer in females in the 60–64 age group increased (annual percentage change [APC] = 1.14%, 95% CI: 0.10–1.82%). Female breast cancer was one of the top five cancers in the 60–64 age group, with DALY rates that also increased (APC = 2.17%, 95% CI: 1.35–3.01%). With increasing age, the burden of liver cancer decreased, while that of colorectal cancer rose. Conclusions From 2005 to 2016, the cancer burden in the elderly in China decreased, mainly reflected in the non-fatal burden. Female breast and liver cancer were a more serious burden in the younger elderly, while colorectal cancer burden was mainly observed in the older elderly.

Background: As populations age, cancer burden becomes increasingly conspicuous. This study quantified the cancer burden of the elderly (≥ 60 years) in China, based on the China Cancer Registry Annual Report to provide epidemiological evidence for cancer prevention and control. Methods: Data on cancer cases and deaths among the elderly aged ≥ 60 years were collected from the China Cancer Registry Annual Report, 2008–2019. Potential years of life lost (PYLL) and disability-adjusted life years (DALY) were calculated to analyze fatalities and the non-fatal burden. The time trend was analyzed using the Joinpoint model. Results: From 2005 to 2016, the PYLL rate of cancer in the elderly was stable between 45.34‰ and 47.62‰, but the DALY rate for cancer decreased at an average annual rate of 1.18% (95% CI: 0.84–1.52%). The non-fatal cancer burden in the rural elderly was higher than that of the urban elderly. Lung, gastric, liver, esophageal, and colorectal cancers were the main cancers causing the cancer burden in the elderly, and accounted for 74.3% of DALYs. The DALY rate of lung cancer in females in the 60–64 age group increased (annual percentage change [APC] = 1.14%, 95% CI: 0.10–1.82%). Female breast cancer was one of the top five cancers in the 60–64 age group, with DALY rates that also increased (APC = 2.17%, 95% CI: 1.35–3.01%). With increasing age, the burden of liver cancer decreased, while that of colorectal cancer rose. Conclusions: From 2005 to 2016, the cancer burden in the elderly in China decreased, mainly reflected in the non-fatal burden. Female breast and liver cancer were a more serious burden in the younger elderly, while colorectal cancer burden was mainly observed in the older elderly. [ABSTRACT FROM AUTHOR]

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• The pandemic state of emergency resulted in overall increases of opioid toxicities. • Important differences were noted among people with and without opioid use disorder. • People with opioid use disorder experienced a sustained rise in opioid toxicities. • Similar increases were not observed in people without opioid use disorder. • Adaption of supports in public health emergencies is needed for undisrupted access. Across Canada, the COVID-19 pandemic occurred amidst an ongoing drug toxicity crisis. Although elevated rates of substance-related harms have been observed nationally, it remains unknown if the pandemic state of emergency led to disproportionate increases in opioid toxicities among people with opioid use disorder (OUD) compared to those without. We conducted a population-based repeated cross-sectional time series analysis of fatal and non-fatal opioid toxicities between January 1, 2014, and December 31, 2021, in Ontario, Canada. We used interventional autoregressive integrated moving average models to examine the impact of the pandemic on monthly rates of opioid toxicities per 100,000 Ontario residents stratified by people with and without OUD. We identified 80,296 opioid toxicities of which 53.5 % occurred among people with OUD. Among 52,052 unique individuals, 60.5 % were male and 46.2 % were 25–44 years old. Between January 2014 and December 2021, the rate of opioid toxicities increased from 2.6 to 10.5 per 100,000 (rate ratio [RR]=4.07). The magnitude of this increase differed among people with OUD (0.8 to 7.4 per 100,000; RR=9.35) and without OUD (1.8 to 3.1 per 100,000; RR=1.74). We observed a significant ramp increase in the overall rate of opioid toxicities following the declaration of the pandemic emergency in March 2020 (+0.19 per 100,000 monthly, 95 % CI: 0.029, 0.36, p = 0.021). In a stratified analysis, we found a similar ramp increase among people with OUD (+0.19 per 100,000 monthly, 95 % CI: 0.10, 0.28, p < 0.001); however, this was not observed among people without OUD (p = 0.95). The rate of opioid toxicities accelerated across Ontario following the pandemic-related state of emergency, with the majority of this increase among people with OUD. The important differences observed among people with OUD compared with those without, highlights the critical need for improved access to harm reduction and treatment interventions among this population. [ABSTRACT FROM AUTHOR]

Analysis of trends in health data collected over time can be affected by instantaneous changes in coding that cause sudden increases/decreases, or "jumps," in data. Despite these sudden changes, the underlying continuous trends can present valuable information related to the changing risk profile of the population, the introduction of screening, new diagnostic technologies, or other causes. The joinpoint model is a well-established methodology for modeling trends over time using connected linear segments, usually on a logarithmic scale. Joinpoint models that ignore data jumps due to coding changes may produce biased estimates of trends. In this article, we introduce methods to incorporate a sudden discontinuous jump in an otherwise continuous joinpoint model. The size of the jump is either estimated directly (the Joinpoint-Jump model) or estimated using supplementary data (the Joinpoint-Comparability Ratio model). Examples using ICD-9/ICD-10 cause of death coding changes, and coding changes in the staging of cancer illustrate the use of these models. [ABSTRACT FROM AUTHOR]

The present paper continues a work that has recently begun to estimate long-term incidence rates for Germany starting from 1970 up until 2010 (Haberland et al. 2014). National incidence is estimated by multiplying modeled national mortality with modeled incidence to mortality ratios obtained from regional German cancer registries. To achieve a greater stability in the results the included indicators are previously estimated (smoothed) using joinpoint models. Regarding the analyzed cancer sites, breast cancer incidence rates in women and prostate cancer incidence rates in men showed highest increase since 1970. These developments are accompanied by a decline in the corresponding mortality rates since the 1990s. The estimated incidence rates of colorectal cancer in both sexes increased since 1970 for more than 20 years with a higher level in men. However, since the 1990s the rates have stagnated and even declined in the last decade. Again, the standardized mortality rates are declining since the mid-1990s. The estimated lung cancer incidence and mortality rates run mainly parallel in both sexes. However, in men the standardized rates only increase in the 1970s and have declined significantly since the 1990s. In contrast, in women the incidence and mortality rates rise permanently for the whole observation period, at a lower level compared to men.

Many countries, including the USA, publish predicted numbers of cancer incidence and death in current and future years for the whole country. These predictions provide important information on the cancer burden for cancer control planners, policymakers and the general public. Based on evidence from several empirical studies, the joinpoint (segmented-line linear regression) model (JPM) has been adopted by the American Cancer Society to estimate the number of new cancer cases in the USA and in individual states since 2007. Recently, cancer incidence in smaller geographic regions such as counties, and local policy makers are increasingly interested with Federal Information Processing Standard code regions. The natural extension is to directly apply the JPM to county-level cancer incidence data. The direct application has several drawbacks and its performance has not been evaluated. To address the concerns, we developed a spatial random-effects JPM for county-level cancer incidence data. The proposed model was used to predict both cancer incidence rates and counts at the county level. The standard JPM and the proposed method were compared through a validation study. The proposed method outperformed the standard JPM for almost all cancer sites, especially for moderate or rare cancer sites and for counties with small population sizes. As an application, we predicted county-level prostate cancer incidence rates and counts for the year 2011 in Connecticut. Published 2013. This article is a US Government work and is in the public domain in the USA. [ABSTRACT FROM AUTHOR]

Objective: To analyze the level and trend of respiratory disease mortality in China from 2002 to 2016. Methods: The standardized mortality rates were calculated based on the China health statistics yearbook (2003-2012) and China statistical yearbook of health and family planning (2013-2017) data released by the statistical information center of National health Commission of the People's Republic of China. Joinpoint model was used to calculate the standardized mortality rates (SMR), Annual percentage change (APC) and the average annual percentage change (AAPC) for standardized mortality rates. Results: The SMR of respiratory diseases and chronic lower respiratory diseases were decreased significantly in 2002 to 2016 (AAPC=-3.6%, AAPC=-6.4%, P< 0.001, respectively). The SMR of lung cancer showed a significant increase trend (AAPC=1.6%, P= 0.001). There were no significant differences in the SMR of pneumonia and pneumonoconiosis (APCC=1.0%, P= 0.242; APCC=-0.2%, P= 0.905). Both urban and rural SMR of respiratory diseases were declining significantly (AAPC=-2.9%, P= 0.001; AAPC=-4.2%, P< 0.001). Both urban and rural SMR of lung cancer showed an increasing trend (AAPC=0.6%, P= 0.022; AAPC=2.1%, P= 0.003, respectively). The SMR of pneumonia in urban areas showed an upward trend (AAPC=2.7%, P= 0.017). The SMR of respiratory disease of all age groups (<35 years old, 35-65 years old and ≥65 years old) showed a downward trend (AAPC=-3.8%, P= 0.001; AAPC=-2.6%, P< 0.001; AAPC=-3.9%, P< 0.001). The SMR of pneumonia between 35 and 65 years old and SMR of lung cancer over 65 years old showed an increasing trend (AAPC=2.8%, P= 0.001; AAPC=2.4%, P< 0.001). The SMR of respiratory diseases among males and females showed a downtrend (AAPC=-3.1%, P< 0.001; AAPC=-4.3%, P< 0.001). However, the SMR of lung cancer in males and females increased significantly (AAPC=1.2%, P< 0.001; AAPC=2.5%, P< 0.001, respectively). There were no significant trends in the SMR of pneumonia and pneumoconiosis in males (AAPC=1.5%, P= 0.096; AAPC=-1.6%, P= 0.218). There was no obvious trend in the SMR of pneumonia in females (AAPC=-0.1%, P= 0.872). Conclusions: The SMR of respiratory diseases in China generally shows a downward trend. The overall SMR and SMR of major respiratory diseases varies among different regions, genders and age groups.