The Lancet Regional Health: Western Pacific最新文献

{"title":"Harnessing large multimodal models in pulmonary CT: the generative AI edge in lung cancer diagnostics","authors":"Lihaoyun Huang,&nbsp;Junyi Shen,&nbsp;Anqi Lin,&nbsp;Jian Zhang,&nbsp;Peng Luo,&nbsp;Ting Wei","doi":"10.1016/j.lanwpc.2024.101336","DOIUrl":"10.1016/j.lanwpc.2024.101336","url":null,"abstract":"<div><h3>Background</h3><div>Generative Artificial Intelligence (Gen-AI) has rapidly advanced in multimodal information processing, particularly in medical applications such as the refinement of instruments and interpretation of medical images. However, limited evidence exists on the diagnostic performance of Gen-AI models in tumor recognition, particularly using computed tomography (CT) images. This study aimed to evaluate the diagnostic capabilities of several prevelant Gen-AI models (GPT-4-turbo, Gemini-pro-vision, Claude-3-opus) in the context of lung CT image analysis.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed chest CT scans from 404 patients with lung conditions with lung neoplasms (n=184) and non-malignancy (n=210). After standardizing CT images, the diagnostic performance and reliability of three Gen-AI (GPT-4-turbo, Gemini-pro-vision, and Claude-3-opus) were assessed using chi-square tests and Receiver Operating Characteristic (ROC) curves across various clinical scenarios. Likert scale scoring and response rate analysis were employed to evaluate internal diagnostic tendencies, while regression analyses were conducted for model optimization.</div></div><div><h3>Findings</h3><div>In a cueing environment limited to a single CT image, Gemini demonstrated the highest diagnostic accuracy (92.21%), followed by Claude (91.49%), while GPT exhibited the lowest performance (65.22%). As the complexity of the cueing environment increased, all models experienced a decline in diagnostic accuracy. Claude showed a marginal decrease, whereas Gemini's accuracy fluctuated significantly. Under simplified cueing conditions, the performance of all models improved notably (Gemini AUC = 0.76, Claude AUC = 0.69, GPT AUC = 0.73). Feature identification analysis revealed that Claude and GPT excelled in recognizing key features, particularly prioritizing “Morphology/Margins” when diagnosing primary malignancies, with “spiculated” and “irregular” serving as critical indicators. However, in cases of misdiagnosis or missed diagnoses, Gen-AI exhibited significant deviations across multiple feature dimensions—some even completely contradicted the actual findings. Following optimization through Lasso and stepwise regression, the diagnostic performance of the models was significantly enhanced (AUC = 0.896 and AUC = 0.894, respectively).</div></div><div><h3>Interpretation</h3><div>Gen-AI shows promising potential in pulmonary CT imaging, particularly in simplified diagnostic settings. However, their limitations in processing complex multi-modal information highlight significant challenges for clinical integration. Ongoing efforts to improve the robustness and reliability of these models are crucial for their successful adoption in healthcare.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101336"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between sleep disturbance, treatment-related adverse events, and psychological distress in patients with breast cancer: a prospective cohort study","authors":"Yuqiu Li ,&nbsp;Fang Zhao ,&nbsp;Yanjun Zhou ,&nbsp;Enfeng Fu ,&nbsp;Shanshan Zhu ,&nbsp;Lulu Yu ,&nbsp;Hangcheng Xu ,&nbsp;Qing Li ,&nbsp;Qiao Li ,&nbsp;Pin Zhang ,&nbsp;Jiani Wang ,&nbsp;Hongnan Mo","doi":"10.1016/j.lanwpc.2024.101325","DOIUrl":"10.1016/j.lanwpc.2024.101325","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;This study aimed to explore the relationship between sleep disturbance, treatment-related adverse events, and psychological distress in Chinese patients with breast cancer.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This prospective cohort study reported on 300 female patients with breast cancer recruited from two medical centers across China between January 1, 2023, and October 31, 2023. Sleep disturbance and psychological health were assessed before and after every cycle of treatment using the Pittsburgh Sleep Quality Index (PSQI) and the Symptom Checklist-90 questionnaire (SCL-90). Statistical tests including t-test, Mann–Whitney U test, Spearman’s rank correlation analysis and multivariate linear regression analysis were used. The study was approved by the ethics committee of the National Cancer Center and written informed consent was obtained from each participant (22/272-3474).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Patients were dichotomized into two groups: those with normal sleep (control; N=168) vs. those with sleep disorder (N=132). The incidence of most treatment-related adverse events such as nausea and vomiting (P=0.04), fatigue (P&lt;0.001), numbness in the hands or feet (P=0.004), alopecia (P=0.02), memory deterioration (P=0.02), and photophobia (P=0.02) were significantly higher in the sleep disorder group at baseline compared to the normal sleep group. The baseline sleep quality of the patients was significantly correlated with the severity of adverse events (rs=0.16, P=0.007). Psychological health at baseline was also correlated with the adverse events score (rs=0.57, P&lt;0.001). Multivariate analysis showed that psychological health was independently associated with the occurrence of adverse events (β=0.19, P &lt;0.001). Besides, the pre-treatment total psychological health score in the baseline sleep disorder group was significantly higher than that in the normal sleep group (Z=-3.42, P=0.001). Furthermore, the severity of treatment-related adverse events (rs=0.32, P&lt;0.001) and baseline sleep quality (rs=0.20, P=0.001) were respectively associated with psychological health.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Poor baseline sleep quality is correlated with increased occurrence and severity of treatment-related adverse events in breast cancer patients. Besides, baseline psychological health is correlated with the occurrence of adverse events in breast cancer patients. Both baseline sleep quality and the severity of treatment-related adverse events significantly affect the psychological health of patients after treatment for breast cancer. We fill the knowledge gap and provide new insights for the factors affecting adverse events in breast cancer patients, which could reduce the incidence and severity of treatment-related adverse events and improve quality of life in patients with breast cancer. Our limitations are that we recorded only recent treatment-related adverse events instead of long-ter","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101325"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burdens of gastric and colorectal cancers and their attributable risk factors among 31 countries and territories in the Western Pacific region, 2000-2021","authors":"Liangyu Kang ,&nbsp;Wenxin Yan ,&nbsp;Wenzhan Jing ,&nbsp;Ning Zhang ,&nbsp;Min Liu ,&nbsp;Wannian Liang","doi":"10.1016/j.lanwpc.2024.101415","DOIUrl":"10.1016/j.lanwpc.2024.101415","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Stomach cancer (SC) and colorectal cancer (CRC) are two leading gastrointestinal cancers worldwide, with particularly heavy burdens in the Western Pacific region (WPR). This study aimed to comprehensively describe the regional landscape, temporal trends, and risk factors for the burdens of SC and CRC in the WPR.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Estimates of incidence, disability-adjusted life years (DALYs), and deaths for SC and CRC were obtained from the Global Burden of Disease Study 2021. We calculated the percentage of relative changes in incident cases, DALYs, and deaths between 2000 to 2021. Estimated annual percentage changes (EAPCs) were used to reflect trends of age-standardized incidence rates (ASIR), age-standardized DALY rates (ASDR), and age-standardized mortality rates (ASMR). Risk factors for SC and CRC were also presented.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;In 2021, the numbers of incident cases of SC and CRC were 756,303 and 933,200 in the WPR, constituting 61.77% and 43.07% of the global totals, respectively. From 2000 to 2021, the ASIR (EAPC=-2.30, 95% CI -2.44 to -2.16), ASDR (EAPC=-3.41, 95% CI -3.59 to -3.23), and ASMR (EAPC=-3.11, 95% CI -3.29 to -2.94) of SC decreased. Despite the increase in incident cases (24.00%) and deaths (8.33%) of SC, the DALYs declined by 6.20%. The ASIR of CRC increased by an average of 1.32% (95% CI 1.25% to 1.39%), while ASDR (EAPC=-0.48, 95% CI -0.59 to -0.38) and ASMR (EAPC=-0.45, 95% CI -0.53 to -0.37) declined. China exhibited the highest numbers of incident cases, DALYs, and deaths for both cancers among the 31 WPR countries or territories. Although the ASDRs of SC decreased in 27 countries, an increase was detected in Guam. Meanwhile, Viet Nam showed the fastest increase in ASIR of CRC, followed by China and Philippines. The incident cases, DALYs, and deaths of both SC and CRC peaked in individuals aged 65-74 years. The rates of incidence, DALY, and mortality increased non-linearly with age and were generally higher in males than in females. The slowest decline in incidence rates of SC (EAPC=-0.50, 95% CI -0.80 to -0.20) and the fastest increase in incidence rates of CRC (EAPC=2.57, 95% CI 2.19 to 2.95) were observed among individuals aged 25-29 years. The rates of DALY and mortality for both cancers decreased slowly or even increased among the elderly over 80 years. Smoking and diet high in sodium were attributable to 59.66 and 36.16 DALYs of SC per 100,000 population in 2021. Diet low in milk, diet low in whole grains, and diet high in red meat were three leading risk factors for DALYs and deaths of CRC. There were increasing trends in the ASDR and ASMR of CRC due to high body-mass index and alcohol use (EAPC range: 0.54-1.97).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;SC and CRC remain noticeable public health issues in the WPR. There is a critical need to address the early onset of both cancers and improve management and prognosis for the elderly. ","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101415"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of an artificial intelligence-based program for managing fatigue in Chinese young breast cancer survivors: a randomized controlled trial","authors":"Yun Hu ,&nbsp;Joshua Wiley ,&nbsp;Lulu Jiang ,&nbsp;Ran Yi ,&nbsp;Eun-Ok Im","doi":"10.1016/j.lanwpc.2024.101288","DOIUrl":"10.1016/j.lanwpc.2024.101288","url":null,"abstract":"<div><h3>Background</h3><div>Fatigue is a common problem among breast cancer survivors, particularly among young breast cancer survivors (YBCSs) who often juggle work and family responsibilities. This demographic frequently experiences high levels of fatigue, which adversely impacts their quality of life. The study aimed to examine the effectiveness of an artificial intelligence (AI) -based program in managing cancer-related fatigue among Chinese YBCSs.</div></div><div><h3>Methods</h3><div>A randomized clinical trial was conducted from Jan2021 to Dec 2022, involving 115 YBCSs. The intervention group received multimodal support combing artificial intelligence (AI) interaction and humanities skills, while the control group received online information support only for 12 weeks. The outcomes were measured using the BFI (Fatigue, primary), and the FACT-B (quality of life, secondary). An intention-to treat approach was used to analyze differences in fatigue and quality of life.</div></div><div><h3>Findings</h3><div>Both groups showed improvements in fatigue score(p&lt;0.05) from baseline(T0) to 4 weeks(T1) and 12 weeks(T2). Notably, at the 12-week mark, the intervention group demonstrated a more substantial reduction in fatigue compared to the control group. Additionally, the intervention group experienced a greater increase in quality of life from T1 to T2 (<em>β</em>=15.384, 95% CI:13.028–17.740, <em>P</em>&lt;.001).</div></div><div><h3>Interpretation</h3><div>This study demonstrates that an AI-based program could help effectively manage fatigue, subsequently enhancing the quality of life among YBCSs. The integration of AI and humanities skills offers a promising approach to improving health outcomes in this vulnerable population.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101288"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The feasibility, acceptability and preliminary outcomes of a financial navigation program among breast cancer in China: a pilot randomized controlled trial","authors":"Xiaoyi Yuan ,&nbsp;Yanling Sun ,&nbsp;Yi Kuang ,&nbsp;Junyi Ruan ,&nbsp;Lichen Tang ,&nbsp;Jiajia Qiu ,&nbsp;Linqin Chen ,&nbsp;Weijie Xing","doi":"10.1016/j.lanwpc.2024.101369","DOIUrl":"10.1016/j.lanwpc.2024.101369","url":null,"abstract":"<div><h3>Background</h3><div>Financial toxicity (FT) is a global challenge for breast cancer patients due to high costs of care. Financial navigation is a promising intervention to alleviate FT, but evidence remains limited, especially within the Chinese healthcare system. To assess the feasibility, acceptability, and preliminary effects of a financial navigation program among breast cancer patients in China.</div></div><div><h3>Methods</h3><div>In this single-center, single-blinded pilot randomized controlled trial, a financial navigation program comprising needs assessment, cost-related health education, resource/service referral, and personalized counseling was evaluated. Feasibility was assessed through recruitment, attrition, and adherence rates. Acceptability was measured via participant satisfaction surveys and semi-structured interviews. Preliminary effects were evaluated through cost-related health literacy and three domains of FT.</div></div><div><h3>Results</h3><div>Twenty-six breast cancer patients were recruited, with a consent rate of 55.9% and a 1-month attrition rate of 7.7%. All participants in the intervention group completed needs assessment and cost-related health education, with resource / service referral and personalized counseling provided as needed. The intervention significantly improved cost-related health literacy, although no statistically significant between-group difference in FT was observed. Most participants reported satisfaction and perceived the program as useful.</div></div><div><h3>Conclusions</h3><div>The financial navigation program was feasible, acceptable, and effective in improving cost-related health literacy among breast cancer patients in China.</div></div><div><h3>Implications for Practice</h3><div>This study generated insights to guide future implementation of full-scale RCTs with larger samples and longer durations to further explore the intervention’s effectiveness.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101369"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The responsiveness of surgical research to Māori in Aotearoa, New Zealand—a scoping review","authors":"Jamie-Lee Rahiri ,&nbsp;Noah Appleby ,&nbsp;Makayla Kahi ,&nbsp;Annaliese Wheeler ,&nbsp;Jason Tuhoe ,&nbsp;Shanthi Ameratunga ,&nbsp;Rachelle Love ,&nbsp;Wiremu MacFater ,&nbsp;Matire Harwood","doi":"10.1016/j.lanwpc.2025.101487","DOIUrl":"10.1016/j.lanwpc.2025.101487","url":null,"abstract":"<div><h3>Background</h3><div>Māori, the Indigenous people of Aotearoa, New Zealand (NZ), experience significant inequities in access to surgery and postoperative outcomes. This scoping review aimed to present a synopsis of the extent and nature of research concerning Māori in surgery in NZ and evaluated the responsiveness of this evidence base to Māori using two Indigenous frameworks.</div></div><div><h3>Methods</h3><div>Utilising a Kaupapa Māori methodological stance, a scoping review of all studies related to Māori and surgical care in NZ (2000–2024) was performed. The studies underwent thorough evaluation using the CONSIDER and MĀORI frameworks to assess responsiveness to Indigenous Māori.</div></div><div><h3>Findings</h3><div>A total of 254 studies were included, most being quantitative (N = 230, 91%) and most categorised under General Surgery (N = 139, 55%). Māori responsiveness assessments of each study highlighted significant shortcomings, with 96% of studies (N = 243/254) rated as low quality as per the adapted CONSIDER framework and 68% (N = 172/254) rated as low quality in accordance with the MĀORI framework. More than half of all studies (55%) did not report Māori leadership, governance, and co-authorship. Studies that utilised Kaupapa Māori research were more likely to be considered high-quality.</div></div><div><h3>Interpretation</h3><div>This study shows that the current surgical evidence base is not responsive to Māori. It calls for a review of research practices and encourages monitoring of the surgical evidence base for all Indigenous peoples.</div></div><div><h3>Funding</h3><div>This study was supported by a <span>Health Research Council of New Zealand</span> Health Delivery Research Activation Grant (21/860) and Māori Health Knowledge Translation Grant (25/234). The funders had no role in the study design, conception, data collection, analysis, interpretation, or report writing. They also had no role in submitting our study for publication.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101487"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143376493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of breast cancer genes and establishment of a prediction model after menopausal hormone therapy","authors":"Haiyan Li ,&nbsp;Jingjie Li ,&nbsp;Qiwen Liu ,&nbsp;Meiqing Xie ,&nbsp;Hongxia Wang ,&nbsp;Linjuan Ma ,&nbsp;Jie Wu ,&nbsp;Kai Kang ,&nbsp;Fan Wang ,&nbsp;Xiaoyan Liang ,&nbsp;Qi Yu","doi":"10.1016/j.lanwpc.2024.101350","DOIUrl":"10.1016/j.lanwpc.2024.101350","url":null,"abstract":"<div><div>Menopausal hormone therapy (MHT) is a widely employed approach for managing menopausal syndrome, entailing the administration of exogenous estrogen to alleviate diverse symptoms and mitigate associated diseases in perimenopausal women. However, recent studies have reported an increased risk of breast cancer associated with estrogen and progestin therapy, although there are notable variations among these studies. Therefore, it is imperative to identify individuals at high risk for breast cancer following MHT. This study conducted a comparative analysis of genes between breast cancer patients who received MHT and those who did not, identifying SNP loci closely associated with the risk of developing breast cancer in postmenopausal women undergoing MHT. A predictive model for assessing the risk of breast cancer in postmenopausal women undergoing MHT was established to facilitate personalized treatment recommendations and alleviate menopausal symptoms. Based on the sequencing data of perimenopausal patients with breast cancer (treated MHT) and unaffected breast cancer (treated MHT), effective SNP sites were obtained in the whole genome, and differential SNP sites associated with breast cancer and hormone therapy were initially screened based on association analysis. Finally, a group of 128 SNP sites for risk prediction of breast cancer in perimenopausal women after hormone therapy was determined. The score of Breast cancer (treated MHT) Cohort was significantly different from the other two groups (Breast cancer (untreated MHT) Cohort, and Unaffected breast cancer (treated MHT) Cohort) (P=0.0032 and P=1.8E-06), which showed that patients with a high risk of breast cancer undergoing MHT could be distinguished based on the above 128 MHT-SNPs. In addition, the efficient of four algorithms was evaluated and the RF method had the highest AUC value 0.813, indicating its superior predictive capability in assessing MHT-related breast cancer risk. The 128 MHT-SNPs presented in this study can be utilized for precise determination of the suitability of MHT for women during perimenopause. And the validated model risk prediction tool effectively forecasts the risk of breast cancer following MHT, thereby offering personalized diagnostic and therapeutic recommendations to clinical practitioners.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101350"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors of cancer among the working population in China: baseline findings of WECAN project","authors":"Kaige Sun ,&nbsp;Yuan Li ,&nbsp;Rong Luo ,&nbsp;Baohua Wang ,&nbsp;Ning Wang ,&nbsp;Changqiong Wang ,&nbsp;Guangming Yi ,&nbsp;Fengjun He ,&nbsp;Jing Wu ,&nbsp;Puhong Zhang","doi":"10.1016/j.lanwpc.2024.101345","DOIUrl":"10.1016/j.lanwpc.2024.101345","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Global cancer burden is growing rapidly, and the risk of cancer significantly increases in aged 40 and above, primarily the working population. This study aims to assess the status quo of cancer risk factors among the working population to develop targeted intervention strategies for workplace cancer prevention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We utilized the baseline data of a randomized controlled trial “Comprehensive Workplace Intervention for Cancer Prevention in China (WECAN)” to conduct the cross-sectional analysis. 937 employees from three cities in China were surveyed on demographics, lifestyle, exposures, disease history, cancer family history, women's reproductive history, and anthropometrics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The mean age was 40.4±8.9 years and 61.1% were males. 57.2% were blue-collars (from production workshops), while 42.8% were white-collars (from offices). The proportions of participants with junior high school or below, high school, junior college, and bachelor's degree or higher were 13.1%, 20.9%, 31.0%, and 35.0%, respectively. Overall smoking rate is 37.7%, with significantly higher rates among aged 40 and above (42.8% versus 32.1%, p&lt;0.0001), males (59.2% versus 3.9%, p&lt;0.0001), blue-collars (45.9% versus 26.7%, p&lt;0.0001). Smoking rates notably increased as educational levels decreased (p&lt;0.0001). Overall alcohol consumption rate was 62.9%, with an average alcohol intake of 12.7±20.4 g/day. Males reported a higher rate (74.7% versus 44.2%, p&lt;0.0001) and alcohol intake (15.9±22.1 g/day versus 4.4±11.6 g/day, p&lt;0.0001). Employees aged 40 or older consumed more alcohol (15.2±22.9 g/day versus 10.1±17.0 g/day, p=0.0020). As educational levels rose, drinking rate significantly increased (p&lt;0.0001), while alcohol intake substantially reduced (p=0.0012). The proportion of employees who achieved 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week was 51.9% and the average amount was 1740.2±2390.1 Mets·min. Overweight (BMI=24∼27.9 kg/m&lt;sup&gt;2&lt;/sup&gt;) and obesity (BMI≥28 kg/m&lt;sup&gt;2&lt;/sup&gt;) rates were 36.0% and 23.9%, with males significantly higher (40.1% versus 29.4%, 28.6% versus 16.5%, p&lt;0.0001). Obesity increased with lower education (p=0.0007). Central obesity affected 56.0%, particularly males (66.8% versus 39.0%, p&lt;0.0001), blue-collars (61.8% versus 48.4%, p&lt;0.0001), aged 40 or older (61.7% versus 49.8%, p=0.0002), and lower education (p&lt;0.0001). Daily average dietary intakes were: whole grains 48.0±80.2 g, tubers 37.8±47.3 g, vegetables 284.2±209.3 g, fruits 127.0±126.2 g, red meat 129.2±99.0 g, and processed meat 7.5±15.9 g. Males (98.4±104.2 g versus 172.0±143.6 g, p&lt;0.0001), blue-collars (114.3±112.5 g versus 144.0±140.7 g, p=0.0005) consumed less fruits. Males (140.9±106.2 g vs 110.6±83.5 g, p&lt;0.0001) and aged under 40 (141.2±113.7 g versus 118.2±82.2 g, p=0.0005) ate more","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101345"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The spatiotemporal dynamics and disease burden of liver cancer among the elderly in Yunnan of China, 2012-2020","authors":"Jianhua Yang ,&nbsp;Teng Zhang ,&nbsp;Yang Chen ,&nbsp;Yuemei Feng ,&nbsp;Shun Zha ,&nbsp;Ying Qian ,&nbsp;Jizhuo Yang ,&nbsp;Junyi Liu ,&nbsp;Hongmei Wen ,&nbsp;Jianzhong Yin","doi":"10.1016/j.lanwpc.2024.101328","DOIUrl":"10.1016/j.lanwpc.2024.101328","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The burgeoning incidence and mortality rates of tumors, exacerbated by an aging population, pose a significant public health challenge in China. While global and domestic trends from 2018 to 2022 indicate a stabilization or decline in liver cancer rates, the spatiotemporal dynamics and disease burden among the elderly in Yunnan, China, remain insufficiently characterized.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This study encompasses a retrospective analysis of 26,328 liver cancer patients aged 60 and above, drawn from the household population of Yunnan, China, between 2012 and 2020. The evaluation adheres to the China Cancer Registry Guidance Manual (2016) and aligns with data standards set by the International Agency for Research on Cancer (IARC) and the International Association of Cancer Registries (I-ACR). The Joinpoint software was utilized to ascertain the annual percentage change (APC) in liver cancer incidence and mortality from 2012 to 2020.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between 2012 and 2020, the incidence rate of liver cancer among the elderly in Yunnan, China, stood at 71.76 per 100,000 (CSR of 70.87 per 100,000 and WSR of 69.55 per 100,000), with a male incidence rate of 99.39 per 100,000 (CSR 99.10 per 100,000 and WSR 97.78 per 100,000) and a female rate of 45.91 per 100,000 (CSR 43.95 per 100,000 and WSR 42.54 per 100,000). The mortality rate for liver cancer in this demographic was 70.12 per 100,000 (CSR 68.43 per 100,000 and WSR 66.73 per 100,000), with males at 96.65 per 100,000 (CSR 95.61 per 100,000 and WSR 93.69 per 100,000) and females at 45.31 per 100,000 (CSR 42.63 per 100,000 and WSR 41.05 per 100,000). Liver cancer incidence among elderly males in Yunnan Province ranked third among all malignant tumors in 2012 and maintained this ranking in 2020. For elderly females, liver cancer rose from the fourth to the third position, marking an increase of one rank. Mortality rankings placed liver cancer second among males and third among females, with no change observed. Over the 2012-2020 period, the incidence rate of liver cancer in Yunnan's elderly exhibited an overall upward trajectory (APC 95% CI: 0.37%-3.8%), with male and female trends remaining stable (males: APC 95% CI: -0.35%-5.83%; females: APC 95% CI: -3.67%-7.26%). The overall mortality trend for liver cancer in the elderly was upward (APC 95% CI: 1.35% to 4.12%), with males showing an increasing trend (APC 95% CI: 0.74% to 4.51%) and females maintaining a stable rate (APC 95% CI: -0.85% to 8.0%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;The incidence of malignant tumors correlates with the Human Development Index (HDI), with liver cancer prevalent in regions of lower HDI. While the incidence rate of liver cancer among the elderly in China has been on a downward trajectory in recent years, mirroring trends in Asia, Yunnan's elderly population defies this pattern with increasing incidence and mortality rates. This divergence from t","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101328"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual and joint exposure to PM2.5 constituents and incidence of esophageal cancer: evidence from China cancer registry annual report 2019","authors":"Junqi Wang ,&nbsp;Yafeng Liang ,&nbsp;Hangyu Li ,&nbsp;Dan Lin ,&nbsp;Shuangqing Zhai","doi":"10.1016/j.lanwpc.2024.101412","DOIUrl":"10.1016/j.lanwpc.2024.101412","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;In recent years, air pollution, particularly fine particulate matter (PM2.5), has been widely recognized as a significant risk factor for various health issues. PM2.5 consists of multiple components, including organic carbon, elemental carbon, and heavy metals, each of which may have varying potential toxic effects on human health. Esophageal cancer is a common malignant tumor worldwide, especially in China, where its incidence and mortality rates remain high. Although studies have suggested associations between air pollution and various cancers, limited research has focused on the specific components of PM2.5 and their associations with esophageal cancer, particularly the impact of joint exposure to different constituents on the incidence of this disease. This study, based on data from the China Cancer Registry Annual Report 2019, aims to explore the association between individual and joint exposure to PM2.5 constituents and the incidence of esophageal cancer, providing scientific evidence for environmental pollution control and strategies for esophageal cancer prevention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This study analyzed data from the “China Cancer Registry Annual Report 2019” to examine the association between PM2.5 and its major constituents with the incidence of esophageal cancer. Air pollution exposure assessment data were obtained from the Tracking Air Pollution in China (TAP) database. Population density-weighted methods were used to calculate the average exposure levels over different time scales (1-year, 2-year, 5-year). Generalized linear models were employed to assess the relationship between single pollutants and esophageal cancer incidence, while weighted quantile sum regression (WQS) and Bayesian kernel machine regression models (BKMR) were used to analyze the effects of joint exposure to multiple pollutants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The study found significant associations between exposure to PM2.5 and its components and the incidence of esophageal cancer, particularly within a 2-year exposure window, where the associations were strongest. Specifically, each 1 μg/m³ increase in the concentration of PM2.5 constituents significantly raised the incidence of esophageal cancer: PM2.5 (0.03, 95% CI: 0.02-0.04, P&lt;0.001), nitrate (NO3) (0.14, 95% CI: 0.09-0.19, P&lt;0.001), sulfate (SO4) (0.12, 95% CI: 0.09-0.19, P&lt;0.001), ammonium (NH4+) (0.20, 95% CI: 0.09-0.19, P&lt;0.001), organic matter (OM) (0.10, 95% CI: 0.09-0.19, P&lt;0.001), and black carbon (BC) (0.18, 95% CI: 0.09-0.19, P&lt;0.001). Subgroup analysis showed that female were slightly more affected than male. Analysis of joint exposure revealed that ammonium (NH4+) and nitrate (NO3−) contributed the most to the risk of esophageal cancer. The WQS and BKMR models further confirmed the significant effects of joint exposure to PM2.5 components, with a stronger linear positive correlation observed in the female population. Additi","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"55 ","pages":"Article 101412"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}