Objective To examine the association between tooth loss and the risk of gastric cancer mortality among gastric cancer cases.Methods A prospective study was conducted with a 24-year follow-up among the subjects of Linxian Population General Cohort Study.Via Cox proportional hazards regression,the association between tooth loss and gastric cancer mortality was examined.Results In a 5-year follow up analysis,tooth loss was not associated with an elevated risk of gastric cancer mortality after controlling for potential confounders.In the 15-year and 24-year follow up analyses,tooth loss was not associated with gastric cancer survival.Tooth loss was divided into three groups(light,medium,and severe) for further analysis,which were not associated with the survival of gastric cancer cases with the 5-year survival rates of 26.79%,18.28%,and 17.61%in the three groups,respectively.There were significanct differences in the survival rate of gastric cancer among three groups(χ2=21.521,P0.001).Conclusion In this cohort,tooth loss did not significantly increase the risk of gastric cancer mortality.

Objective To examine the association between tooth loss and the risk of esophageal cancer mortality.Methods A prospective study was conducted with a 24-year follow-up of the Linxian Population General Cohort Study′s 2743 esophageal cancer cases.Via Cox Proportional hazards regression,the association between tooth loss and esophageal cancer mortality risk was examined.The baseline questionnaire included questions regarding demography,smoking,alcohol drinking,height,weight and tooth loss status,etc.Results In a 5-year follow up analysis,tooth loss was associated with a significantly elevated risk of esophageal cancer mortality 1.11(RR=1.11,95%CI: 1.01,1.21) after controlling for potential confounders.We found the similar results in 15-year and 24-year follow up analyses.In 5-year,15-year and 24-year follow up analyses,severe tooth loss(defined as losing more teeth than the median tooth loss,stratified by age) was associated with the increased risk of esophageal cancer mortality in men(RR=1.21,95%CI: 1.01-1.44,RR=1.18,95%CI: 1.00-1.40 and RR=1.26,95%CI: 1.06-1.50,respectively).For women,moderate and severe tooth loss was not statistically associated with the risk of esophageal cancer mortality.Conclusion In this cohort,severe tooth loss may significantly increase the risk of esophageal cancer mortality in men and may be not associated with esophageal cancer mortality in women.

Abstract Objectives: Gastric cancer is the second leading cause of cancer death worldwide and has been hypothesized to be associated with iodine deficiency. While iodine concentrations are highest in the thyroid, iodine also concentrates in gastric tissue where it may act as an antioxidant for the stomach and possibly the esophagus. We previously showed that self-reported goiter was associated with significantly increased risk of gastric noncardia adenocarcinoma (GNCA) and non-significantly increased risks of gastric cardia adenocarcinoma (GCA) and esophageal squamous cell carcinoma (ESCC). Iodine deficiency is correlated with increased serum thyroglobulin, and this study aimed to determine whether serum thyroglobulin is associated with GNCA, GCA, and ESCC in a Chinese population with very high rates of upper gastrointestinal (UGI) cancers. Methods: We examined the association between serum thyroglobulin levels and the three UGI cancers in a study nested in the Linxian General Population Nutrition Intervention Trial. At baseline, blood was drawn from participants, ages 40-69 years, and outcomes were identified during 15 years of follow-up. Approximately 200 subjects of each case type and 400 non-case controls were selected for serum thyroglobulin concentration measurements. All samples were first screened for thyroglobulin antibody, and thyroglobulin concentrations were then measured by radioimmunoassay (RIA) for thyroglobulin-antibody-positive samples or by immunometric assay (IMA) for thyroglobulin-antibody-negative samples. Thyroglobulin concentrations were analyzed as quartiles using logistic regression models adjusted for numerous potentially confounding factors. Results: 25% of females and 5% of males in the controls were thyroglobulin-antibody-positive. Compared to participants in the lowest quartile, those in the highest quartile of serum thyroglobulin had adjusted odds ratios of 0.82 (95% confidence interval 0.50-1.36) for GNCA, 1.12 (0.66-1.90) for GCA, and 0.73 (0.44-1.21) for ESCC. Conclusions: Using serum thyroglobulin, a sensitive biomarker of iodine deficiency, we found no association between serum thyroglobulin concentrations and risk of UGI cancer in the overall study population. Our results do not support the hypothesis that iodine deficiency is associated with an increased risk of UGI cancers in this population. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4713.

Background Primary liver cancer is a common malignancy with a dismal prognosis. New primary prevention strategies are needed to reduce mortality from this disease. We examined the effects of supplementation with four different combinations of vitamins and minerals on primary liver cancer mortality among 29450 initially healthy adults from Linxian, China.Methods Participants were randomly assigned to take either a vitamin-mineral combination ("factor") or a placebo daily for 5.25 years (March 1986-May 1991). Four factors (at doses one to two times the US Recommended Daily Allowance) - retinol and zinc (factor A); riboflavin and niacin (factor B); ascorbic acid and molybdenum (factor C); and beta-carotene, alpha-tocopherol, and selenium (factor D) - were tested in a partial factorial design. The study outcome was primary liver cancer death occurring from 1986 through 2001. Adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of liver cancer death with and without each factor. All P values are two-sided.Results A total of 151 liver cancer deaths occurred during the analysis period. No statistically significant differences in liver cancer mortality were found comparing the presence and absence of any of the four intervention factors. However, both factor A and factor B reduced liver cancer mortality in individuals younger than 55 years at randomization (HR = 0.59, 95% CI = 0.34 to 1.00, and HR = 0.54, 95% CI = 0.31 to 0.93, respectively) but not in older individuals (HR = 1.06, 95% CI = 0.71 to 1.59, and HR = 1.12, 95% CI = 0.75 to 1.68, respectively). Factor C reduced liver cancer death, albeit with only borderline statistical significance in males (HR = 0.70, 95% CI = 0.47 to 1.02) but not in females (HR = 1.30, 95% CI = 0.72 to 2.37). Cumulative risks of liver cancer death were 6.0 per 1000 in the placebo arm, 5.4 per 1000 in the arms with two factors, and 2.4 per 1000 in the arm with all four factors.Conclusion None of the factors tested reduced overall liver cancer mortality. However, three factors reduced liver cancer mortality in certain subgroups.

OBJECTIVE:To analyze the tendency in the incidence of malignant tumors in nutrition-intervened population of Lin County.METHODS:Subjects who had been enrolled in the General Population Trial, Lin County Nutrition Intervention Trial were followed up and the data of malignant tumors were collected with collaboration of National Cancer Institute/National Institute of Health. Incidences of malignant tumors during and after nutrition intervention were calculated and compared.RESULTS:Esophageal cancer, cardiac cancer, and stomach cancer were constantly the three leading cancers, accounting for 84.06% and 83.74% of the malignant tumors in men and women, respectively. The incidences of lung cancer and liver cancer in men showed increasing tendencies, while similar tendencies were found in those of stomach cancer, colorectal cancer, and liver cancer in women. With the prolonging of the follow-up, the incidences of upper digestive tract cancers declined (except stomach cancer in women).CONCLUSIONS:The upper digestive tract cancers remain the leading malignant tumors, although their incidences may decline with longer-term follow-up. Prevention and control of tumors in Lin County should still be focused on the esophageal cancer, cardiac cancer, and stomach cancer, as well as lung cancer and liver cancer.

Each year, esophageal and gastric cancers cause more than 900,000 deaths worldwide. Human papilloma virus (HPV), especially type 16, has been suggested to have a role in the etiology of esophageal cancer, however, the results of previous seroepidemiological studies have not been consistent. We conducted a large prospective study to examine the association between serum antibodies to HPV 16, HPV 18 and HPV 73 and subsequent development of esophageal squamous cell carcinoma (ESCC), gastric cardia adenocarcinoma (GCA), and gastric noncardia adenocarcinoma (GNCA) in a high-risk population for these cancers in Linxian, China. Case and control subjects for this study were selected from the 29,584 participants of the Linxian General Population Trial. Prediagnostic serum samples from 99 cases of ESCC, 100 cases of GCA, 70 cases of GNCA, and 381 age- and sex- matched controls were selected for this study. The presence of antibodies to HPV virus-like particles was determined by type-specific enzyme-linked immunosorbent assays. Fewer than 15% of ESCC, GCA, or GNCA cases were positive for each HPV type, and no significant associations were found. The adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for HPV 16 seropositivity and ESCC, GCA, and GNCA risk were 1.6 (0.8-3.3), 1.3 (0.6-2.8) and 0.4 (0.1-1.6), respectively. The comparable ORs (95% CIs) for HPV 18 were 1.0 (0.4-2.2), 0.9 (0.4-2.1) and 1.5 (0.6-3.4). For HPV 73, these figures were 1.3 (0.6-2.5), 1.2 (0.6-2.3) and 0.9 (0.4-2.1). The results of this study do not support a major role for HPV 16, HPV 18 and HPV 73 in the etiology of esophageal and gastric cancers in Linxian, China.

Fifth AACR International Conference on Frontiers in Cancer Prevention Research, Nov 12-15, 2006 B145 We examined the effect of supplementation with four different combinations of vitamins and minerals on the prevention of hepatocellular carcinoma (HCC) mortality among 29,450 healthy adults from a nutrient-inadequate population in Linxian, China. In accord with a partial factorial design, the participants were randomly assigned to take either a vitamin/mineral combination or a placebo daily for 5 ¼ years. The combinations tested in this trial were: factor A = retinol and zinc; factor B = riboflavin and niacin; factor C = ascorbic acid and molybdenum; factor D = beta-carotene, alpha-tocopherol, and selenium. All doses were 1-2 times US RDAs. HCC deaths (n = 151) identified during the trial period (1986 - 1991) and ten years after the trial ended (1991 - 2001) were the study outcome. No significant differences in HCC death rates were found for any of the four combinations of supplements tested in this study, using log-rank tests (all P-values >0.20), or Cox proportional hazards models adjusted for age, sex, commune, and other treatments. However, age and sex significantly modified the effects of the supplements. Factor A and factor B significantly reduced the risk of HCC death in individuals younger than 55 years of age at randomization (P = 0.049 and 0.025, respectively) but not in individuals ≥ 55 years of age (P = 0.79 and 0.57, respectively). Factor C marginally significantly reduced the risk of HCC death in males (P = 0.058) but not in females (P = 0.37). Supplementation with combinations of vitamins and minerals at nutrient-repletion levels for 5 ¼ years reduced HCC mortality in certain subgroups of this nutrient-inadequate population in Linxian, China.

We examined the effect of supplementation with four different combinations of vitamins and minerals in the prevention of lung cancer mortality among 29,584 healthy adults from Linxian, China. In accord with a partial factorial design, the participants were randomly assigned to take either a vitamin/mineral combination or a placebo for 5.25 years. The combinations tested in this trial were as follows: factor A, retinol and zinc; factor B, riboflavin and niacin; factor C, ascorbic acid and molybdenum; factor D, β-carotene, α-tocopherol, and selenium. Lung cancer deaths (n = 147) identified during the trial period (1986-1991) and 10 years after the trial ended (1991-2001) were the study outcome. No significant differences in lung cancer death rates were found for any of the four combinations of supplements tested in this study, using log-rank tests (all P values are >0.20) or Cox proportional hazards models adjusted for age, sex, commune, and other treatments. No significant interactions were seen for age, sex, or smoking status. Supplementation with combinations of vitamins and minerals at nutrient-repletion levels for 5.25 years did not reduce lung cancer mortality in this nutrient-inadequate population in Linxian, China. (Cancer Epidemiol Biomarkers Prev 2006;15(8):1562–4)

BACKGROUND1,1,1-Trichloro-2,2-bis(p-chlorophenyl)ethane (DDT) exposure has been demonstrated to cause liver tumors in laboratory rodents. DDT's persistent metabolite and environmental degradation product, 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE), has also been associated with liver tumors in laboratory animals. Whether DDT and DDE are associated with hepatocarcinogenesis in humans is not clear.METHODSWe carried out a nested case-control study among the participants of the Nutritional Intervention Trials in Linxian, China. The case group included 168 individuals who developed liver cancer during the trials, and the control group included 385 individuals frequency-matched on age and sex who were alive and well at the end of the study. Serum concentrations of DDT and DDE were measured by gas chromatography-mass spectrometry. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable analysis.RESULTSIn multivariable-adjusted models, the risk of developing liver cancer increased with increased serum DDT concentration (OR for quintile 1 versus quintile 5 = 3.8, 95% CI = 1.7 to 8.6, P(trend) = .0024). In contrast, there was no statistically significant association between liver cancer and serum DDE concentration. The association between high serum DDT concentration and liver cancer was stronger among individuals with DDE concentrations below the median value (odds ratio for tertile 3 versus tertile 1 = 3.55, 95% CI = 1.45 to 8.74) than those with concentrations above the median (OR = 1.70, 95% CI = 0.97 to 2.98). A calculation of crude liver cancer risk found that there would be 26 liver cancers per 100 000 persons per year in the lowest quintile of DDT exposure versus 46 liver cancers per 100 000 persons per year in the highest quintile of DDT exposure.CONCLUSIONSDDT may be a risk factor for liver cancer, particularly among persons with lower DDE concentrations. Risk may be particularly increased among persons exposed directly to DDT (resulting in a higher ratio of DDT to DDE) or, alternatively, risk may be associated with individual ability to metabolize DDT to DDE.

In a cohort of 29 584 residents of Linxian, China, followed from 1985 to 2001, we conducted a case–cohort study of the magnitude of the association of Helicobacter pylori seropositivity with cancer risk in a random sample of 300 oesophageal squamous cell carcinomas, 600 gastric cardia adenocarcinomas, all 363 diagnosed gastric non-cardia adenocarcinomas, and a random sample of the entire cohort ( N =1050). Baseline serum was evaluated for IgG antibodies to whole-cell and CagA H. pylori antigens by enzyme-linked immunosorbent assay. Risks of both gastric cardia and non-cardia cancers were increased in individuals exposed to H. pylori (Hazard ratios (HRs) and 95% confidence intervals=1.64; 1.26–2.14, and 1.60; 1.15–2.21, respectively), whereas risk of oesophageal squamous cell cancer was not affected (1.17; 0.88–1.57). For both cardia and non-cardia cancers, HRs were higher in younger individuals. With longer time between serum collection to cancer diagnosis, associations became stronger for cardia cancers but weaker for non-cardia cancers. CagA positivity did not modify these associations. The associations between H. pylori exposure and gastric cardia and non-cardia adenocarcinoma development were equally strong, in contrast to Western countries, perhaps due to the absence of Barrett's oesophagus and oesophageal adenocarcinomas in Linxian, making all cardia tumours of gastric origin, rather than a mixture of gastric and oesophageal malignancies.

BACKGROUND: Linxian County of China is one of the areas with the highest incidence of esophageal cancer and gastric cardia cancer in the world, and nutrition-deficiency is widely existing in local people. In recent years, many researches around the world revealed that the cause of Parkinson disease (PD) is related to factors of gene, age, environment, diet, nutrition and smoking. More and more studies confirmed that primary hypertension may be in relation to vascular Parkinsonism (VP) and long-term hypertension was apt to VP.OBJECTIVE: To investigate the relationship between hypertension and clinical probable Parkinson disease (PPD) in nutrition-deficient population of Linxian County and provide a theoretical basis for early prevention and treatment of PD.DESIGN: Cross-sectional study.PARTICIPANTS: A total of 4 335 subjects aged over 55 years were selected. These subjects have taken part in the nutritional intervention study of Linxian County and first entered in the cohort study in 1985. They were enrolled in the nutritional intervention study in Linxian County in 1985.METHODS: A prospective cohort study was conducted. ①Case screening: PD questionnaire (used in American Gebai County) combined with general neurological examination were adopted. ②The diagnosis of PD: Clinical diagnostic criteria of UK Parkinson Disease Society Brain Bank were taken as the criteria for screening PD. Further evaluations were undertaken for clinical PPD and clinical possible PD on subjects who had PD symptoms.The diagnostic criteria of clinical PPD: Subjects were diagnosed as having clinical PPD if they presented any two of the following two cardinal features (resting tremor, hypermyotonia, bradykinesia and impairment of postural reflexes) or presented any one of the following features (resting tremor, hypermyotonia and bradykinesia). Diagnostic criteria of clinical possible PD: Subjects were diagnosed as having clinical possible PD when presented any one of the following four cardinal features (resting tremor, hypermyotonia, bradykinesia, and impairment of postural reflexes).③Definition of hypertension: Hypertension was defined as the systolic blood pressure (SBP) ≥ 140 mm Hg or the diastolic blood pressure (DBP) ≥ 90 mm Hg. Data were processed with linear trend test and nonconditional logistic regression.MAIN OUTCOME MEASURES: Status of final diagnoses on patients and relationship between hypertension and clinical PPD.RESULTS: A total of 4 335 subjects including 2 008 males (46.32%)and 2 327 females (53.68%) participated in the screening of PD.①Results of final diagnosis on patients: Among all the 4 459 survival participants,46 subjects were diagnosed as having PD, 118 as having clinical PPD and 78 as having clinical possible PD. After excluding patients with PD or clinical possible PD, only 118 patients were diagnosed as having clinical PPD. These patients and 4 217 normal controls were analyzed and a total of 2 035 patients had hypertension. ②There were statistical correlation between hypertension and clinical PPD, RR was 1.648 (1.147-2.638), which was 1.668 (1.145-2.432) after being adjusted by possible confounding factors including age, gender, smoking, drinking and so on, the association mentioned above still existed (χ2=7.463,P=0.006). Analysis of gender showed statistically significant differences between female patients with hypertension and clinical PPD(χ2=9.669 P=0.002), and RR before adjust ment was 2.347 (1.347-4.091), which was 2.346 (1.327-4.150) after being adjusted and correlation still existed. While there were no statistical corre lations between male patients with hypertension and clinical PPD (χ2 =0.697 ,P=0.404)but there was also an ascending trend in RR value. ③ With the blood pressure increasing, the RR value correspondingly in creased with the linear trend test (χ2=11.325 ,P=0.003). And there was sta tistical significance in raw and adjusted RR value of hypertension with the BP ≥ 140/90 mm Hg. Respective statistics of SBP and DBP showed a dose-response relationship between SBP and clinical PPD; When the SBP ≥ 140 mm Hg, there were statistical significances in values of raw RR or adjusted RR of hypertension (χ2=8.007 ,P=0.018). While there were no sta tistical significances in RR values before and after adjustment of DBP (χ2 =2.569,P=0.227). CONCLUSION: Hypertension is one of the risk factors of clinical PPD in female residents older than 55 and the incidence of getting clinical PPD is increased with the heightening of BP.

帕金森病(Parkinson's Disease,PD)是老年人常见的神经系统变性疾病,严重危害人类的健康.尽管做了种种推测与假说,PD的病因迄今未明.目前认为,PD是遗传与环境共同作用的结果.许多危险因素被认为与PD有关[1].关于PD与遗传因素的关系,已见多处报道,但PD与生活方式的关系目前研究很少.我们利用人群为基础的病例对照研究,探讨帕金森病与生活方式之间的关系,期望找到与帕金森病有关的生活方式,为预防和控制该疾病提供科学依据.

Esophageal cancer incidence and mortality rates in Linxian, China are among the highest in the world. We examined risk factors for esophageal squamous cell carcinoma (ESCC), gastric cardia cancer (GCC), and gastric noncardia cancer (GNCC) in a population-based, prospective study of 29,584 adults who participated in the Linxian General Population Trial. All study participants completed a baseline questionnaire that included questions on demographic characteristics, personal and family history of disease, and lifestyle factors. After 15 years of follow-up, a total of 3,410 incident upper gastrointestinal cancers were identified, including 1,958 ESCC, 1,089 GCC and 363 GNCC. Cox proportional hazard models were used to estimate risks. Increased age and a positive family history of esophageal cancer (including ESCC or GCC) were significantly associated with risk at all 3 cancer sites. Additional risk factors for ESCC included being born in Linxian, increased height, cigarette smoking and pipe smoking; for GCC, male gender, consumption of moldy breads and pipe smoking; and for GNCC, male gender and cigarette smoking. Protective factors for ESCC included formal education, water piped into the home, increased consumption of meat, eggs and fresh fruits and increased BMI; for GCC, formal education, water piped into the home, increased consumption of eggs and fresh fruits and alcohol consumption; and for GNCC, increased weight and BMI. General socioeconomic status (SES) is a common denominator in many of these factors and improving SES is a promising approach for reducing the tremendous burden of upper gastrointestinal cancers in Linxian.

Bloodborne viruses may have spread in rural China during the past 25 years, but population-based prevalence estimates are lacking. We examined the frequency of hepatitis C virus (HCV) and HIV type 1 (HIV-1) among residents of Linxian, a rural community in Henan Province. In 2000, blood was collected from participants (> or = 55 years of age) who had enrolled in a population-based nutritional intervention trial in 1985. We randomly selected 500 participants for HCV testing and 200 participants for HIV-1 testing. For HCV, 48 (9.6%) of 500 participants were positive by enzyme immunoassay and recombinant immunoblot assay (95% confidence interval, 7.0%-12.2%), and prevalence was lowest in the most geographically isolated participants. Among the HCV-infected participants, 42 had a specimen available from 1985, of which 16 (38.1%) were positive for HCV. For HIV-1, 0/200 participants were positive. We conclude that HCV is now a common infection among older adults in Linxian, China.

Purpose] To investigate the effect on cancer incidence in Riboflavin Fortified Salt Intervention population. [Methods] The cancer incidence of the population with Riboflavin Fortified Salt Intervention during the intervention period (1992~1996) and the period after intervention (1997~2001) were analyzed.[Results]The incidence rates of esophageal cancer, lung cancer and colorectal cancer for male, esophageal cancer, leukemia and cervical cancer for female among the intervention population were higher than those in control group during the intervention period, while they were lower than that in control group during the period after intervention. Compared with control group, lower incidence rates of all the other cancers except for stomach cancer were observed among the trial group in the period after intervention, especially for esophageal cancer and cervical cancer. Although the increase incidence of lung cancer and colorectal cancer were observed between both groups. A less extent of increase was found among the trial group than that in control group. [Conclusion] The difference of incidence in trial group and control group suggests that supplement of riboflavin might decrease the cancer risk, it is worthy extending for a large scale of high risk population.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的　探讨林县营养缺乏人群高血压与临床很可能帕金森病 （ClinicallyProbableParkinson’sdisease,PPD）之间的关系 ,为早期防治帕金森病 （PD）提供理论依据。方法　采用前瞻性队列研究方法。人群血压资料来源于1985年林县营养干预试验开始时研究对象的基线调查。病例的诊断 ,通过两个步骤完成 ,即第一步采用调查问卷与体格检查相结合的办法 ,对队列人群进行PPD的筛查 ,第二步对可疑病例 ,由中美神经科专家联合诊断 ,并依据英国帕金森病协会脑库临床诊断标准进行PPD的临床诊断。资料处理采用线性趋势检验 ,及非条件Logistic回归。 结果　单因素分析显示 :高血压与PPD有统计学关联 ,其RR值为 1 6 4 8（ 1 14 7～ 2 36 8） ;用年龄、性别、吸烟、饮酒等可能的混杂因素进行调整后 ,上述关联依然存在。分性别后统计显示 ,男性高血压与PPD无统计学关联。女性高血压与PPD统计学上有显著性相关 ,其RR值调整前为 2 347（ 1 347～ 4 0 91） ,经混杂因素进行调整后关联依然存在。随着血压的增高 ,其对应的RR值也随之增加 ,经线性趋势检验 （ χ2 =11 32 5 ,P =0 0 0 3） ,表明血压与PPD存在剂量 -反应关系。结论　在林县营养缺乏地区 ,高血压是 5 5岁以后女性居民罹患PPD的危险因素之一 ,并且患PPD的危险性随血压的增</span>

BACKGROUNDWe previously reported an inverse association between prediagnostic serum selenium concentrations and the risk of esophageal squamous cell carcinoma (ESCC) and gastric cardia cancer (GCC) but not gastric noncardia cancer (GNCC) in a nested study from the Nutrition Intervention Trial in Linxian, China.OBJECTIVEWe examined the relation between baseline serum selenium and the subsequent risk of death from ESCC, GCC, GNCC, heart disease (HD), stroke, and total death over 15 y of follow-up (1986-2001).DESIGNWe measured baseline serum selenium concentrations in 1103 subjects randomly selected from a larger trial cohort. We identified 516 deaths during the 15-y follow up, including 75 from ESCC, 36 from GCC, 116 from HD, and 167 from stroke. Relative risks (RRs) and 95% CIs were estimated by using Cox proportional hazards regression models. Reported RRs estimated the change in risk conferred by a 25% increase in serum selenium relative to the population distribution. All estimates were adjusted for sex, age, smoking, drinking, and serum cholesterol.RESULTSWe found significant inverse associations between baseline serum selenium and death from ESCC (RR: 0.83; 95% CI: 0.71, 0.98) and GCC (0.75; 0.59, 0.95). Trends toward inverse associations were noted for death from HD (0.89; 0.78, 1.01; P = 0.07), but no association was noted for total death (0.96; 0.90, 1.02) or stroke (0.99; 0.88, 1.11).CONCLUSIONPopulation-wide selenium supplementation in the region of China with low serum selenium and high incidences of ESCC and GCC merits serious consideration.

To investigate the relationship between tooth loss and the occurrence of esophageal carcinoma,cardia carcinoma and stomach cancer.All the persons who had taken part in the General Population Study, Linxian Nutrition Intervention Trails were followed up for 11 years, to investigate the relationship between tooth loss and the occurrence of esophageal carcinoma,cardia cancer and stomach cancer by prospective study.The data were analyzed by non-conditional Logistic regression by SPSS10.0 software.For male,teeth loss significantly increased the risk of esophageal and cardia carcinoma,the relative risk (RR) was 1.265 (95% CI=1.115~1.435,P=0.000) and 1.170 (95% CI=1.009~1.356,P=0.037) respectively.For female,teeth loss had significantly increased risk of stomach cancer (RR=1.470,95%CI=1.042~2.074,P=0.027).After adjusting the confounding factors such as age,smoking,body mass index(BMI) and family history of cancer, tooth loss increased risk of esophageal cancer in male and gastric cancer in female.There were dose-response relationship between the number of tooth lose and esophageal,gastric cancer.[Conclusions]Teeth loss significantly increases risk of esophageal and cardia carcinoma in males and increase risk of stomach cancer in female in Linxian.

To assess the impact of stomach cancer on the Chinese population by epidemiological analysis of its distributional mortality.

OBJECTIVE:To analyze and predict the trend in mortality rate of stomach cancer in twenty years in China.METHODS:Stomach cancer mortality data collected from the China national survey over the period 1970s - 1990s for the cause of death were analyzed.RESULTS:The adjusted mortality rate of stomach cancer in 1990s increased by 11.0% and 6.3% for males and females, respectively. The urban mortality in 1970s was slightly higher than the rural mortality, while in 1990s the rural mortality rate was about 60% higher than the urban mortality. In 1990s, the adjusted urban mortality rate decreased by 22.2% and 26.7% for males and females, respectively. In contrast, the rural mortality rate increased by 26.4% and 22.1% for males and females, respectively. The sex ratio of stomach cancer deaths in 1990s, both in cities and rural areas, was slightly greater than that in 1970s, being more marked in the latter areas. In 1990s, the mortality rate decreased in 12 provinces, accounting for 44% in both sexes (12/27), but the decrease was more marked for females than for males except in Kiangs province. In provinces where the increased rates ranked top six positions, the magnitude of increase in rates was higher in males than in females.CONCLUSION:The overall mortality rates of stomach cancer in the past 20 years in China presented an increasing trend, despite there were upward and downward changes in 27 provinces and decrease in cities while increase in rural areas. Compared with other countries, the world-adjusted mortality rate of stomach cancer for both sexes in China ranks first. The increasing trend in stomach cancer mortality was seen in the older age groups (> 60 years) while a decreasing trend was seen in the younger age groups (30 - 59 years). Aging of the population could be an important factor responsible for the increase in mortality rates of stomach cancer in China.