Background:Although tobacco smoking is one of the established risk factors for liver cancer, results from epidemiological studies remain inconclusive on the relationship between second-hand smoke (SHS) and liver cancer, particularly among nonsmokers.Objectives:This study aimed to examine the association between SHS and liver cancer, and to assess its potential interaction with major risk factors such as hepatitis B virus (HBV) infection.Methods:A population-based case-control study was conducted in Jiangsu, China, from 2003 to 2010, including 2011 newly diagnosed primary liver cancer cases and 7933 population-based controls. Data on SHS exposure at home and in the workplace, along with other major liver cancer risk factors such as alcohol consumption, were collected through self-reported questionnaires. SHS exposure was assessed as a dichotomous variable, categorizing participants as either exposed or unexposed to SHS. HBV infection status was determined by testing serum samples for serum hepatitis B virus surface antigen. Multivariable unconditional logistic regression models were used to examine the association between SHS and risk of liver cancer. Besides stratified analyses, interactions on additive and multiplicative scales were further evaluated between SHS and other risk factors for liver cancer.Results:Exposure to SHS was associated with liver cancer, shown as adjusted odds ratios (ORs) of 1.84 (95% confidence interval [CI]: 1.56, 2.18) in the overall population and 2.11 (95% CI: 1.67, 2.65) among never smokers. Stratified analyses showed that the association between SHS and liver cancer was stronger among HBV-positive participants (OR: 2.09, 95% CI: 1.48, 2.93) compared with HBV-negative participants (OR: 1.87, 95% CI: 1.54, 2.27) (P = 0.02). Both super-additive and super-multiplicative interactions were observed between SHS and HBV infection, with relative excess risk due to interaction (RERI) of 12.56 (95% CI: 6.60, 18.53) and ratio of ORs of 1.55 (95% CI: 1.07, 2.23) in the total population, and RERI of 12.87 (95% CI: 4.93, 20.81) and ratio of ORs of 1.78 (95% CI: 1.06, 2.99) among never smokers.Conclusion:SHS is independently associated with liver cancer, and this association is further modified by HBV infection, leading to a substantially elevated risk, particularly among nonsmokers.

Introduction Oesophageal cancer is a highly lethal malignancy with geographic disparity and a heavy burden in developing countries. While smoking and alcohol are established risk factors, emerging evidence suggests that indoor air pollution (IAP) may also play a role through the inhalation of aerosols along the aerodigestive tract, but its relationship with oesophageal cancer remains poorly understood. Previous studies have focused on how IAP is associated with lung cancer, and evidence on oesophageal cancer is sparse, underpowered and inconclusive. Methods This population-based case–control study was conducted in the Jiangsu Province, China, from 2003 to 2010. We analysed 2969 cases and 8019 controls using unconditional logistic regression, adjusting for potential confounders. In addition to the six individual household air pollution sources, we also studied their combined effect by calculating the unweighted and weighted sum of these IAP sources to improve comparability. Furthermore, we conducted subgroup analyses by sex and smoking status, as well as by sex exclusively among non-smokers. Results In both the overall sample and subgroups, higher exposure to various individual or combined IAP sources was associated with a dose-response increase in oesophageal cancer risk (weighted risk score (WRS) semi-Bayesian (SB)-adjusted OR (aOR): 2.70; 95% CI 2.36 to 3.07). Solid fuels appeared to have the strongest association (SB-aOR: 1.76; 95% CI 1.56 to 1.98), followed by coal used for cooking, passive smoking and poor ventilation in the kitchen and bedrooms. The vulnerability to different sources varied by sex and smoking status, and females among non-smokers consistently experienced a more profound impact from combined IAP exposure using WRS. Conclusions Exposure to common IAP is associated with an increased risk of oesophageal cancer among the Chinese population, with variations in susceptibility observed across sex and depending on smoking status.

ABSTRACTAimsTo investigate the associations of tea consumption with all‐cause and cause‐specific mortality among type 2 diabetes mellitus (T2DM) Chinese patients.Materials and MethodsThe present study included 15 718 participants from the Comprehensive Research on the Prevention and Control of Diabetes between 2013 and 2014 in Jiangsu, China. Information on tea consumption (including frequency, amount, and duration) was collected at baseline using interviewer‐administered questionnaires. Death data were identified by linkage to the Death Certificate System. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsDuring a median follow‐up of 9.77 (9.69, 9.82) years, 3046 deaths were documented, including 922 from cardiovascular disease (CVD) and 736 from cancer. Compared with nonconsumers, regular tea consumption (≥ 3 times/week, 1 cup/day, > 30 years) was associated with reduced all‐cause mortality risk in T2DM, with HRs (95% CIs) of 0.82 (0.74, 0.91), 0.80 (0.72, 0.89), and 0.77 (0.68, 0.86). For cardiovascular mortality, the HRs (95% CIs) were 0.79 (0.65, 0.96), 0.72 (0.59, 0.89), and 0.75 (0.60, 0.93). The exposure‐response relationship suggested that consuming 4 g/day may offer the most evident health benefits.ConclusionsAmong Chinese T2DM patients, higher tea frequency and amount intake were associated with lower risk of all‐cause and CVD mortality. It is suggested that consuming 4 g/day of tea could potentially serve as an intervention target. These findings suggest that tea consumption can be a part of a healthy diet for T2DM patients.

Though indoor air pollution (IAP) is associated with elevated lung cancer risk, an integrated measure is imperative to thoroughly investigate this association. The interplay between sex and IAP on lung cancer remains unclear. We conducted a population-based case-control study in Jiangsu Province, China, from 2003 to 2010, with 2871 lung cancer cases and 8019 controls. Exposures and covariates information were collected via in-person interviews using a standardized questionnaire. An integrated weighted risk score (WRS), accounting for the effect sizes of each source of IAP, was introduced. Unconditional logistic regression was employed to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs). Interactions between sex and IAP by tobacco smoking status were evaluated. Environmental tobacco smoking (ETS) (aOR = 1.54, 95% CI: 1.40, 1.69), poor ventilation (aOR = 1.18, 95% CI: 1.07, 1.30), and coal used for cooking (aOR = 1.27, 95% CI: 1.15, 1.41) were associated with lung cancer. Dose-response relationships between lung cancer and WRS were observed, with p for trend less than 0.001. aOR for individuals at the highest quartile of the WRS of IAP was 1.74 (95% CI: 1.52, 2.00) compared to the lowest quartile. The associations were more profound among never-smokers than ever-smokers. Females tended to be more vulnerable to IAP, and sex interacted with IAP beyond multiplicativity on the odds scale. IAP is associated with lung cancer, with a stronger impact among never-smokers. An interaction between IAP and sex was observed. These results underscore the importance of controlling IAP, especially ETS in order to reduce the risk of lung cancer.

This study examined the associations of diabetes status, duration, and age at onset with lung cancer risk in the China Kadoorie Biobank. We prospectively assessed the association between diabetes status and lung cancer risk in 510,148 cancer‐free participants, with analyses of duration and age at onset among 29,962 participants with diabetes at baseline. Multivariable‐adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models, and effect modification was assessed across stratified subgroups using likelihood ratio tests. During a median 9.17‐year follow‐up, 5007 lung cancer cases occurred. Compared with participants without diabetes, those with diabetes had a higher lung cancer risk (HR = 1.15, 95% CI: 1.01–1.32). Diabetic patients with onset <40 years showed a 2.81‐fold higher lung cancer risk (95% CI: 1.31–6.02) compared to ≥60‐year onset groups. Longer duration (≥15 vs. <1 year) was associated with increased risk (HR = 2.06, 95% CI: 1.33–3.19). The association with diabetes status was stronger among individuals with below‐median physical activity, while the association with diabetes duration was more pronounced in overweight participants. Overall, these findings indicate that diabetes, especially with earlier onset and longer duration, significantly increases lung cancer risk, highlighting the need for screening and targeted management in high‐risk populations.

The triglyceride-glucose index (TyG) and C-reactive protein (CRP) are key biomarkers on clinical diagnosis, each related to lung dysfunction. However, the relationship of both indexes with the risk of chronic obstructive pulmonary disease (COPD) is still unclear. This study purposes to focus on the individual and joint associations of TyG and CRP levels with COPD risk. This cohort study utilized baseline TyG and CRP data from the UK Biobank. Hazard ratios (HRs) and 95

Abnormal kidney function is associated with adverse outcomes in patients with type 2 diabetes mellitus (T2DM). However, the evidence between kidney function and mortality among Chinese patients with T2DM were still limited. This cohort study included 19,919 participants with baseline T2DM from 2013 to 2014 in Jiangsu, China. Serum estimated glomerular filtration rate (eGFR), urea, and uric acid were measured at baseline, and Cox regression models were used to evaluate hazard ratios (HRs) and 95

Background/Objectives: Identifying dietary factors influencing liver cancer is crucial for developing preventive measures. While tea polyphenols have demonstrated cancer-preventive activities in animal models, the evidence in humans is not definitive. This study aims to explore the association between tea consumption and liver cancer, as well as the interaction between tea drinking and other risk factors, in China, a country with a high incidence of liver cancer and substantial tea consumption. Methods: A population-based case-control study was conducted in Jiangsu Province from 2003 to 2010. Socio-demographic data, history of tea consumption, and serum markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections were evaluated. Unconditional logistic regression was used to examine the associations between tea consumption and the odds of liver cancer. Potential interactions between tea consumption and other major liver cancer risk factors were assessed. Results: A total of 2011 incident liver cancer cases and 7933 controls were included in the analysis. Regular tea drinking showed an inverse association with the risk of liver cancer compared with those who never drank tea (OR: 0.79; 95% CI: 0.63-0.99). Current tea drinking showed an inverse association with liver cancer (OR: 0.51; 95% CI: 0.39-0.66), while former tea drinking showed a positive association (OR: 3.56; 95% CI: 2.42-5.23). Current tea consumption was inversely associated with liver cancer incidence among both hepatitis B surface antigen (HBsAg) positive (OR: 0.45; 95% CI: 0.28-0.73) and HBsAg negative participants (OR: 0.51, 95% CI: 0.36-0.73), among both never and ever tobacco smokers, ever alcohol drinkers (OR: 0.46; 95% CI: 0.33-0.63), and among those without family history of liver cancer. Multiplicative and additive interactions were observed between tea drinking and HBsAg, alcohol consumption, and history of raw water drinking. Conclusions: Tea consumption is inversely associated with the development of primary liver cancer, with potential interactions involving HBV infection, alcohol consumption, and raw (unsafe) water drinking. Increasing tea consumption-particularly among high-risk populations such as individuals who consume alcohol-may serve as an additional preventive measure for liver cancer. This should be considered alongside established strategies, including HBV vaccination, alcohol cessation, and avoidance of drinking raw water, to help reduce liver cancer risk.

AIM:To investigate the associations of individual and combined healthy lifestyle factors (HLS) with the risk of stroke in individuals with diabetes in China. METHODS:This prospective analysis included 41 314 individuals with diabetes [15 191 from the Comprehensive Research on the Prevention and Control of the Diabetes (CRPCD) project and 26 123 from the China Kadoorie Biobank (CKB) study]. Associations of lifestyle factors, including cigarette smoking, alcohol consumption, physical activity, diet, body shape and sleep duration, with the risk of stroke, intracerebral haemorrhage (ICH) and ischaemic stroke (IS) were assessed using Cox proportional hazard models. RESULTS:During median follow-up periods of 8.02 and 9.05 years, 2499 and 4578 cases of stroke, 2147 and 4024 of IS, and 160 and 728 of ICH were documented in individuals with diabetes in the CRPCD and CKB cohorts, respectively. In the CRPCD cohort, patients with ≥5 HLS had a 14% lower risk of stroke (hazard ratio (HR): 0.86, 95% confidence interval (CI): 0.75-0.98) than those with ≤2 HLS. In the CKB cohort, the adjusted HR (95% CI) for patients with ≥5 HLS were 0.74 (0.66-0.83) for stroke, 0.74 (0.66-0.83) for IS, and 0.57 (0.42-0.78) for ICH compared with those with ≤2 HLS. The pooled adjusted HR (95% CI) comparing patients with ≥5 HLS versus ≤2 HLS was 0.79 (0.69-0.92) for stroke, 0.80 (0.68-0.93) for IS, and 0.60 (0.46-0.78) for ICH. CONCLUSIONS:Maintaining a healthy lifestyle was associated with a lower risk of stroke, IS and ICH among individuals with diabetes.

The Jiangsu Biobank for the Prevention and Control of Diabetes (JBPCD) is a community-based prospective cohort study initiated in Jiangsu province, to examine the burden of complications associated with type 2 diabetes mellitus (T2DM). This study aims to better understand the incidence, risk factors, and long-term outcomes of T2DM complications to inform prevention and control strategies. From October 2013 to July 2014, 20,053 T2DM patients (7,862 males and 12,191 females) were recruited from Suzhou city and Huai'an city. Baseline data were collected through questionnaire survey, physical examination and biochemical testing, with blood samples stored in a biobank. The follow-up focused on the incidence and mortality related to T2DM complications, linked to national and local medical datasets. Between August 2019 and October 2020, the repeated assessments were completed for 13,973 participants, including questionnaire, physical examination and repeated blood collection. The study identified 1,479 new cancer cases and 3,324 cardiovascular disease cases, with an overall mortality rate of 25.66 per 1,000 person-years. JBPCD welcomes research collaborations and data access requests via email. Currently, there are no plans to provide cohort data for free public access, but specific proposals for further collaboration are welcome. For further information and collaboration, please email [jswuming@vip.sina.com] and [sc@njmu.edu.cn].

Pneumoconiosis is the occupational disease with the highest proportion in China. This study conducted a retrospective analysis of 5,791 deceased pneumoconiosis patients. In this study, males comprised 93.02% of cases, with primary affected industries being mining (58.47%), manufacturing (20.55%), and public management (16.42%). Silicosis (69.42%) and coal worker's pneumoconiosis (20.57%) were the predominant diagnoses. Most patients (66.47%) were diagnosed at stage one. Significant differences were observed in both diagnosis age and post-diagnosis survival time across disease stages (P<0.05). The proportion of patients who died directly from lung infections was the highest (37.32%). The primary underlying causes of death in pneumoconiosis patients include pulmonary infections, cardiovascular and cerebrovascular diseases, and digestive tract and lung tumors. Life expectancy for patients aged 30-35 years was 15.83 years. After excluding the effects of pulmonary infections, cardiovascular diseases, digestive tract tumors, and lung tumors, life expectancy increased by 3.75, 1.11, 1.31, and 0.63 years, respectively. Pneumoconiosis patients with concurrent lung tumors showed a 7.797-fold increased mortality risk, while pulmonary infections elevated mortality risk by 3.030-fold. Management strategies for pneumoconiosis should emphasize both primary disease treatment and comprehensive care for complications, particularly pulmonary infections, cardiovascular diseases, and malignancies. This integrated approach could extend survival time and enhance of life for affected

Esophageal cancer continues to pose a significant public health issue in areas with increased incidence rates such as China. Although involuntary smoking was defined as a group 1 carcinogen for lung cancer, few studies have explored the impact of environmental tobacco smoking (ETS) on esophageal cancer. In this paper, we examined the association between ETS and esophageal cancer in high-risk groups in Jiangsu Province, China. Epidemiologic data were collected for 2969 newly diagnosed cases and 8019 population controls including exposure to active/passive smoking and risk factors. The unconditional logistic regression model and the semi-Bayes (SB) method were applied to assess adjusted odds ratios (ORs) and confidence intervals (CIs). ETS exposure (ever vs. never) was positively associated with esophageal cancer with an SB-adjusted OR (95% CI) of 1.44 (1.31-1.58) among overall population, and 1.56 (1.35-1.82) among non-smokers (i.e., non-active smokers), with corresponding population attributable fractions of 15.0% (95% CI: 10.3%-18.9%) and 12.1% (95% CI: 8.8%-19.8%), respectively. The association was more prominent in men at work and in women at home, with SB-adjusted OR (95% CI) of 1.36 (1.17-1.58) and 1.61 (1.35-1.58), respectively. A dose-response relationship between ETS exposure and the disease was detected across the entire population as well as in non-smokers. This is the largest population-based case-control study of ETS and esophageal cancer and the first study to evaluate such association among non-smokers in a Chinese population. We recommend strengthening the ongoing anti-tobacco public health initiatives in China with a particular emphasis on creating a tobacco-free work/home environment.

Abstract Background The rising prevalence of Type 2 diabetes (T2D) in China poses a critical health challenge, necessitating effective management strategies. The National Essential Public Health Services Program (NEPHSP), initiated in 2009, focuses on equitable access to health services, including T2D management. This study investigates the associations between perceived care quality, self-care behaviors, and glycemic control in Chinese adults with T2D under NEPHSP, particularly examining the mediating role of self-care behaviors. Methods Conducted from April to November 2020 in Huai’an City, Jiangsu Province, this study involved 1,577 T2D patients enrolled in NEPHSP. We assessed perceived care quality using the Patient Assessment of Chronic Illness Care (PACIC) scale and developed a comprehensive self-care behavior score, covering nine essential health practices. Glycemic control was evaluated using HbA1c levels. Linear regression models were used to explore these associations, adjusting for demographic and clinical factors, while causal mediation analyses examined the role of intermediate variables. Results Higher PACIC scores significantly correlated with improved self-care behaviors (β = 0.294, 95% CI: 0.233 to 0.354) and were negatively associated with HbA1c levels (β=-0.109, 95% CI: -0.192 to -0.026). The self-care behavior score inversely related to HbA1c levels (β=-0.197, 95% CI: -0.263 to -0.132). Notably, self-care behaviors mediated 50.41% (P < 0.05) of the effect of perceived care quality on HbA1c levels. Conclusions This study demonstrates a substantial association between perceived care quality and better glycemic control in Chinese adults with T2D under NEPHSP, with self-care behaviors playing a crucial mediating role. These findings suggest that patient-centered care and comprehensive self-care practices are essential for effective T2D management within NEPHSP.

[目的]分析2009-2021年江苏省淮河流域早诊早治项目地区食管癌高危人群内镜筛查情况.[方法]采取整群抽样的方法,选取淮安市洪泽区、金湖县、涟水县,盐城市盐都区40～69岁常住居民进行患癌风险评估,对评估出的高危人群进行内镜下碘染色和必要性病理活检.[结果]2009-2021年项目评估出高危人群120 901人,其中54 712人完成内镜筛查,筛查率为45.25％(54 712/120 901);2009-2021年筛查率整体呈上升趋势(x2趋势=52.634,P＜0.001).19 046人参与临床病理活检,活检率为34.81％(19 046/54 712).检出食管癌前病变1 246例,检出率2.28％(1 246/54 712),阳性病变530例,检出率0.97％(530/54 712),早期病例440例,早诊率83.02％(440/530).随着时间变化,癌前病变及阳性病变检出率整体呈下降趋势(P＜0.001),早诊率呈先降后升趋势(P＜0.001).[结论]江苏省淮河流域食管癌早诊早治工作已取得一定的成效,但还应精准评估食管癌高危人群,有效实施临床筛查,及时发现食管病变,进一步提高项目筛查效果.

BackgroundWhether lifestyle improvement benefits in reducing cardiovascular diseases (CVD) events extend to hypertensive patients and whether these benefits differ between hypertensive and normotensive individuals is unclear. This study aimed to investigate the associations of an overall healthy lifestyle with the subsequent development of CVD among participants with hypertension and normotension.MethodsUsing data from the Suzhou subcohort of the China Kadoorie Biobank study of 51,929 participants, this study defined five healthy lifestyle factors as nonsmoking or quitting for reasons other than illness; nonexcessive alcohol intake; relatively higher physical activity level; a relatively healthy diet; and having a standard waist circumference and body mass index. We estimated the associations of these lifestyle factors with CVD, ischemic heart disease (IHD) and ischemic stroke (IS).ResultsDuring a follow-up of 10.1 years, this study documented 6,151 CVD incidence events, 1,304 IHD incidence events, and 2,243 IS incidence events. Compared to those with 0–1 healthy lifestyle factors, HRs for those with 4–5 healthy factors were 0.71 (95% CI: 0.62, 0.81) for CVD, 0.56 (95% CI: 0.42, 0.75) for IHD, and 0.63 (95% CI: 0.51, 0.79) for IS among hypertensive participants. However, we did not observe this association among normotensive participants. Stratified analyses showed that the association between a healthy lifestyle and IHD risk was stronger among younger participants, and the association with IS risk was stronger among hypertensive individuals with lower household incomes.ConclusionAdherence to a healthy lifestyle pattern is associated with a lower risk of cardiovascular diseases among hypertensive patients, but this benefit is not as pronounced among normotensive patients.

Objective To investigate the effects of different obesity indicators on the risk of death in diabetes mellitus type 2（T2DM） patients in Huai ’an City. Methods A total of 9 759 T2DM patients were followed up in Huai ’an City from 2013 to 2020, and the cause of death was matched through the cause of death monitoring platform. The follow-up population was classified according to BMI, WC, waist-to-hip ratio（WHR）, and Cox proportional risk model was adopted to explore the effect of obesity indicators on all-cause mortality risk of T2DM patients. Sensitivity analysis was then used to exclude smokers, those with less than three years of follow-up, and those who died in the first year of follow-up, and baseline patients with cardiovascular and cerebrovascular risk for all-cause mortality. Results The research results indicated the BMI groups in different age, WC, WHR and other indexes were different（P＜0.05）. After adjusting for confounding factors, it was found that the risk of death decreased by 17% and 27% in overweight and obese people compared with normal people, respectively, with statistical significance（P＜0.05）. Compared with non-central obesity, the waist circumference of patients with central obesity can reduce the risk of death in both pre-central obesity and central obesity, and there was no statistical significance in the risk of death among people with different WHR ratios. Conclusions The “obesity paradox” exists in the risk of death. It is found that BMI has a protective effect on the risk of death in overweight and obesity, as well as in the early stage of central obesity.

Aim: To investigate the associations of diabetes, prediabetes and diabetes duration with chronic obstructive pulmonary disease (COPD) risk and survival in the UK Biobank.Materials and Methods: We conducted a prospective analysis among 452 680 participants without COPD at baseline using UK Biobank data. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox regression models. The dose-response relationship was explored using restricted cubic splines. A separate survival analysis was conducted for 12 595 patients with incident COPD.Results: Over a median follow-up of 12.3 years, 12 595 cases of COPD were documented. Compared with the reference group, those with prediabetes and diabetes were associated with an 18% (HR 1.18 [95% CI: 1.13-1.24]) and 35% (HR 1.35 [95% CI: 1.24-1.47]) higher risk of COPD, respectively. Diabetes duration was associated with COPD risk, with multivariable HRs (95% CIs) of 1.23 (1.05-1.44), 1.20 (1.04-1.39) and 1.18 (1.01-1.37) for diabetes duration of 7 years or longer, 3 to less than 7 years, and 1 to less than 3 years versus less than 1 year, respectively. Dose-response analysis revealed a non-linear relationship between diabetes duration and COPD risk. Regarding COPD survival, COPD patients with prediabetes and diabetes had a 9% (HR 1.09 [95% CI: 1.00-1.19]) and 21% (HR 1.21 [95% CI: 1.05-1.41]) higher risk of overall death, respectively. Compared with the cases with a diabetes duration of less than 1 year, those with a diabetes duration of 7 years or longer were associated with a 46% higher risk of overall death (HR 1.46 [95% CI: 1.11-1.92]).Conclusions: Our findings indicate that diabetes, prediabetes and a longer diabetes duration are associated with a higher risk of and worse survival for COPD. Future studies are warranted to determine the optimal way of diabetes control that might reduce COPD risk.

新型冠状病毒肺炎(corona virus disease 2019,COVID-19)是危害全球的新发传染性疾病,糖尿病是COVID-19患者常见合并症之一.COVID-19相关糖尿病主要包括COVID-19患者中出现的新发糖尿病和高血糖症,及合并糖尿病的COVID-19患者出现多种并发症且重症和死亡风险增加.现对COVID-19相关糖尿病研究进行综述,探讨其潜在发生机制.

[目的]分析1990-2019年江苏省居民食管癌疾病负担及其危险因素变化趋势.[方法]利用2019年全球疾病负担研究结果,通过采用Joinpoint 4.9.0.0软件计算平均年度变化百分比(AAPC),分析1990-2019年江苏省居民食管癌发病率、死亡率、伤残调整寿命年(DALY)和过早死亡率的变化趋势.利用人群归因危险百分比估计食管癌不同危险因素的归因水平.[结果]1990-2019年间,江苏省居民食管癌标化发病率变化趋势差异无统计学意义(t=0.45,P=0.653),标化死亡率 AAPC 为-0.50％(t=-2.26,P=0.024),过早死亡率 AAPC 为-1.20％(t=-3.89,P＜0.001),标化 DALY 率 AAPC 为-0.93％(t=-4.04,P＜0.001),男女性整体变化趋势与全人群相似.食管癌DALY以过早死亡损失寿命年(YLL)为主,但伤残损失寿命年(YLD)的占比不断增加.男性食管癌疾病负担高于女性;随着年龄的增长,疾病负担呈现先升后降趋势,中老年人群疾病负担较重.江苏省食管癌的主要危险因素有吸烟、饮酒、饮食因素(低水果饮食、低蔬菜饮食)和高体质指数(BMI),其中归因于吸烟和饮酒的比例较大,男女性存在差异.[结论]1990-2019年,江苏省居民食管癌疾病负担整体呈下降趋势,但发病人数仍在上升,应将中老年男性人群作为重点防控人群,以戒烟限酒为主要措施,倡导健康生活方式,针对高危人群开展癌症早期筛查项目,从而进一步降低江苏省居民食管癌疾病负担.

ObjectiveThe aims of this study were to estimate the rates of regular exercise and its trends among the adult population in Jiangsu, from 2010 to 2018, China, and to assess associations with sociodemographic factors. MethodsChronic disease and risk factor surveillance data from adults aged & GE;18 years were gathered in Jiangsu Province from 2010 to 2018. Rates of regular exercise were calculated after post-stratification weighting, and time trends were compared among participants with different characteristics, including gender, age, urban-rural region, educational level, occupation, annual household income, body mass index (BMI), baseline self-reported chronic diseases, smoking status, alcohol consumption, and region. Multivariable logistic regression analyses were performed to assess the associations of sociodemographic characteristics with regular exercise. ResultsA total of 33,448 participants aged 54.05 & PLUSMN; 14.62 years and 55.4% female (8,374 in 2010, 8,302 in 2013, 8,372 in 2015, and 8,400 in 2018) were included in this study. The weighted rate of regular exercise was 12.28% (95% confidence interval [CI]: 9.11-15.45%) in 2010 and 21.47% (95% CI, 17.26-25.69%) in 2018, showing an overall increasing trend (P for trend = 0.009). Nevertheless, stratification analysis showed that the regular exercise rate decreased from 33.79% in 2010 to 29.78% in 2018 among retired adults. Significant associations were observed between regular exercise and age >45 years (45- < 60 years, odds ratio [OR]: 1.24, 95% CI: 1.14-1.34; & GE;60 years, OR: 1.20, 95% CI: 1.08-1.34), urban residence (OR: 1.43, 95% CI: 1.32-1.54), higher education (primary, OR: 1.30, 95% CI: 1.16-1.46; secondary, OR: 2.00, 95% CI: 1.79-2.25; college or higher, OR: 3.21, 95% CI: 2.77-3.72), occupation (manual work, OR: 1.52, 95% CI: 1.33-1.73; non-manual work, OR: 1.69, 95% CI: 1.54-1.85; not working, OR: 1.22, 95% CI: 1.03-1.44; retired, OR: 2.94, 95% CI: 2.61-3.30), higher income ( yen 30,000- < yen 60,000, OR: 1.16, 95% CI: 1.06-1.28; & GE; yen 60,000, OR: 1.20, 95% CI: 1.10-1.32), higher BMI (overweight, OR: 1.12, 95% CI: 1.05-1.20), self-reported chronic disease at baseline (OR: 1.24, 95% CI:1.16-1.33), former smoking (OR: 1.15, 95% CI: 1.01-1.31) and ever (30 days ago) drinking (OR: 1.20, 95% CI: 1.11-1.29). ConclusionThe rate of regular exercise among adults in Jiangsu Province was low, but this rate increased by 9.17% from 2010 to 2018, showing an upward trend. There were differences in the rate of regular exercise among different sociodemographic factors.