Smoking and solid fuel are common exposures among Chinese adults, yet evidence regarding their associations with cancer mortality remains inconsistent, and their joint effects are insufficiently studied. Using data from the Pengzhou site of the China Kadoorie Biobank in Sichuan Province, we applied Cox proportional hazards models to examine associations of smoking, cooking fuel use, and co-exposure with mortality from overall cancer and major site-specific cancers. Among 55,404 participants, 61.63% were women, 75.15% reported cooking, and 46.38% reported smoking; 2030 cancer deaths occurred during follow-up. Current smoking and solid fuel cooking were associated with 27% and 18% higher risks of overall cancer mortality. Initiation before 18 years increased overall cancer mortality by 37%, esophageal cancer mortality by 107%, and lung cancer mortality by 86%. Higher daily cigarette consumption, longer smoking duration, and greater cumulative smoking were each positively associated with mortality from overall cancer, esophageal cancer, and lung cancer. Compared with individuals who neither smoked nor used solid fuels, solid fuel use alone increased overall cancer mortality by 24%, while smoking alone increased overall mortality by 32% and esophageal cancer mortality by 144%. Individuals exposed to both smoking and solid fuel use had higher mortality risks, reaching 49% for overall cancer, 198% for esophageal cancer, and 94% for lung cancer. These findings highlight the critical importance of quitting smoking and promoting clean cooking fuels for cancer prevention.
Di Wu, Boke Chen, Xiao-Fang Chen et al.· International Journal of Can...· 0 citations
BACKGROUND
The national and subnational burden of asthma in China remains insufficiently characterized. We aimed to assess the long-term trends in asthma burden and associated risk factors across China from 1990 to 2023.
METHODS
Using data from the Global Burden of Disease 2023 study, we assessed asthma deaths, prevalence, and disability-adjusted life years (DALYs) in China and its provincial-level administrative regions from 1990 to 2023, stratified by age and sex. Decomposition analyses were conducted to quantify the contributions of demographic changes and level 2 risk factors to changes in the asthma burden estimates.
RESULTS
Between 1990 and 2023, the age-standardized asthma death rate (95% uncertainty interval [UI]) in China declined from 2.4 (1.1-4.0) to 1.1 (0.7-2.0) per 100,000, while the age-standardized prevalence rate (95% UI) increased from 2902.7 (2392.7-3550.4) to 3066.8 (2529.4-3675.7) per 100,000. Age-standardized DALY rates decreased overall, with years lived with disability (YLDs) accounting for an increasing proportion of total DALYs. Substantial provincial heterogeneity was also observed. Tobacco use remained the leading contributor to the asthma burden, particularly among males, whereas the contribution of high body mass index (BMI) increased steadily. Population aging was the main driver of changes in asthma mortality, while increasing exposure to high BMI drove increases in DALYs.
CONCLUSIONS
Asthma mortality in China has declined substantially, but the nonfatal burden continues to rise, driven by increasing prevalence and metabolic risk factors. Integrated strategies targeting both respiratory risk factors and metabolic risks are required to reduce asthma-related disabilities, especially in high-burden regions.
Zhuo Wang, Yi-Ding Zhuang, Jin-Lei Qi et al.· Chinese Medical Journal· 0 citations
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