Can China achieve a one-third reduction in premature mortality from non-communicable diseases by 2030?

Li, Yichong; Zeng, Xinying; Liu, Jiangmei; Liu, Yunning; Liu, Shiwei; Yin, Peng; Qi, Jinlei; Zhao, Zhenping; Yu, Shicheng; Hu, Yuehua; He, Guangxue; López, Alan D.; Gao, George F.; Wang, Lınhong; Zhou, Maigeng

doi:10.1186/s12916-017-0894-5

Cited by 62 publications

(63 citation statements)

References 27 publications

(32 reference statements)

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“…WHO reported that the prevalence of hypertension in developed countries was declining, but rising rapidly in developing countries [7]. In our study, we found that the population SBP level in Sichuan would be continuously rising, while the death rates of NCDs, CVD and CKD would be declining, which was similar to the national trend [34]. It's good to see that there would be generally downward trend of deaths, mortality and probability of dying for people aged 30-69.…”

Section: Discussionsupporting

confidence: 73%

Death burden of high systolic blood pressure in Sichuan Southwest China 1990–2030

et al. 2020

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Background: Hypertension is highly prevalent and is the primary risk factor for cardiovascular disease (CVD) and chronic kidney disease (CKD). While declining in some developed countries, it is increasing rapidly in some developing countries. Sichuan province is the largest and underdeveloped region in southwest China, with 486 thousand square kilometers, more than 80 million residents, unbalanced economic development, and high prevalence, low awareness, low treatment and low control rate of hypertension. We forecasted the death burden due to high systolic blood pressure (SBP) in Sichuan from 1990 to 2030, to raise the awareness of public and government of the importance and benefits of hypertension control. Methods: We conducted secondary analysis based on data of Global Burden of Disease (GBD) 1990-2015, and predicted the population SBP level, population attributable fraction, and death burden for people aged 30-69 under different scenarios in 2030. Results: Comparing with natural trend, if the prevalence of high SBP can be reduced relatively by 25% by 2030, the deaths of non-communicable chronic diseases (NCDs), CVD and CKD would be reduced by 27.1 thousand, 26.2 thousand and 0.8 thousand for people aged 30-69; the mortality would be reduced by 10.8, 32.8 and 16.0%; and the premature mortality would be reduced by 9.9, 32.0 and 16.0%, respectively. Conclusions: Controlling or decreasing the prevalence of high SBP can significantly reduce the deaths, death rate and premature mortality of NCDs, CVD and CKD for the 30-69 years old population in Sichuan. There would be huge benefits for the governments to take cost-effective measures to control or reduce the prevalence of hypertension.

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Section: Discussionsupporting

confidence: 73%

Death burden of high systolic blood pressure in Sichuan Southwest China 1990–2030

et al. 2020

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“…The finding of an inverse relationship between uncontrolled hypertension and age is not new [17,18]. It is noted that the inverse association between uncontrolled hypertension and age was detected in the regression model despite adjustment for management and compliance, which is consistent with the 2017 study by Li et al [29]. Some younger people are part of a floating population and tend not to consider hypertension as a risk [30,31] which may contribute to poorer control among younger people.…”

Section: Discussionsupporting

confidence: 57%

The Role of the Public Health Service Equalization Program in the Control of Hypertension in China: Results from a Cross-sectional Health Interview Survey

Qin

Zhang

Fridman

et al. 2019

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ObjectivesNon-communicable diseases (NCDs) have become the main cause of mortality in China. In 2009, the Chinese government introduced the Public Health Service Equalization (PHSE) program to restore the primary healthcare system in both essential medical care and public health service provision. This study evaluates the impact of management on hypertension control and evaluate how the program works. MethodsThe China National Health Development Research Centre (CNHDRC) undertook the Crosssectional Health Service Interview Survey (CHSIS) of 62,097 people from primary healthcare reform pilot areas, across 17 provinces from eastern, central and western parts of China in 2014. This study is based on CHSIS survey responses from 9,607 participants, who had been diagnosed with hypertension. Regression analysis was used to estimate the impact of management provided under PHSE on hypertension control adjusting for the effects of other known determinants of hypertension control. FindingsUncontrolled hypertension was markedly lower among respondents, whose hypertension had been managed (22.4% in managed patients versus 31.1% in unmanaged patients, p<0.001). The interaction between PHSE management and the geographical region was highly significant in the model (p<0.001), suggesting that the PHSE program was not equally effective in all regions. Further analysis suggested that approximately 10% of regional variability was attributed to differences in administrative systems, as there was a significant association (P=0.014) between the presence of established regional Information Management Systems (IMS) and increased PHSE effectiveness. Insurance (χ2(5)=4.4, p=0.496) and Hukou (χ2(1)=2.4, p=0.121), which denote social security and urban rural differences, respectively, were not significant predictor of hypertension control. ConclusionActive management of hypertension through the PHSE program was effective with 7.31 million more patients receiving hypertension control and equalization of service delivery was reflected to some extent. The link between established IMS and regional variability in the impact of PHSE highlights the importance of effective management of patient referrals and follow-up. Further investigation is needed to explore the factors that influence the effectiveness of PHSE.

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“…Thus, tobacco control measures taken now may not substantially impact cancer rates for another decade or more. Indeed, a recent analysis projected that even if all risk reduction targets are met under the United Nations Agenda for Sustainable Development, which sets a target to reduce premature mortality from non‐communicable diseases by one‐third by 2030, this goal could be met for cardiovascular disease and chronic respiratory diseases, but not for cancer . Nevertheless, if action is not taken to reduce tobacco use, the burden for cancer and other non‐communicable diseases will surely continue to grow.…”

Section: Discussionmentioning

confidence: 99%

Tobacco smoking and trends in histological subtypes of female lung cancer at the Cancer Hospital of the Chinese Academy of Medical Sciences over 13 years

et al. 2019

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Background Lung cancer is the leading cause of cancer mortality among women in China, and incidence and mortality continue to rise despite the fact that smoking prevalence is very low among Chinese women. Aim This study investigated tobacco smoking and trends in histological subtypes of female lung cancer in a central cancer hospital in China. Methods Demographic, smoking history and histological information on female lung cancer patients diagnosed or treated from 2000 to 2012 was collected from the Cancer Hospital, Chinese Academy of Medical Science (CHCAMS). The classification of histological subtypes and clinical stages were conducted using the ICD‐O‐3 and Eighth AJCC Cancer Staging Manuals. Time‐trends of histological subtypes were analyzed based on annual percentage change (APC). Results Overall, 5870 female cases of lung cancer were included in the analysis. The number of female lung cancer patients increased from 509 (2000–2002) to 1744 (2011–2012). The most common histological type of lung cancer was adenocarcinoma (ADC) (72.93%), followed by small cell lung cancer (SCLC) (11.06%), squamous cell carcinoma (SCC) (8.38%) and other (7.63%). Among smokers, the proportion of SCC decreased from 40.5% to 23.7% (P = 0.005), while ADC increased from 35.7% to 50.7% (P = 0.009). In non‐smokers, ADC increased from 63.1% to 80.6% (P = 0.006) and SCC decreased from 13.6% to 4.5% (P = 0.016). Among SCC cases, smokers made up a larger proportion of early stage (I/II: 47.1%) compared with late stages (III, 34.3%; IV, 18.6%). Conclusion The number of female lung cancer patients has increased in CHCAMS. In both smoking and non‐smoking cases, the proportion of adenocarcinoma increased. Squamous cell carcinomas were more likely to be diagnosed in early stages among smokers.

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Can China achieve a one-third reduction in premature mortality from non-communicable diseases by 2030?

Cited by 62 publications

References 27 publications

Death burden of high systolic blood pressure in Sichuan Southwest China 1990–2030

Death burden of high systolic blood pressure in Sichuan Southwest China 1990–2030

The Role of the Public Health Service Equalization Program in the Control of Hypertension in China: Results from a Cross-sectional Health Interview Survey

Tobacco smoking and trends in histological subtypes of female lung cancer at the Cancer Hospital of the Chinese Academy of Medical Sciences over 13 years

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