Publications by authors named "Jufang Shi"
Background: The incidence of early-onset colorectal cancer (EOCRC) is increasing globally. This study aims to describe the temporal trends of incidence and explore related risk exposures in early-life at the country level based on the .
Methods: Data on the incidence and attributable risk factors of EOCRC were obtained from the .
Objective: To determine the role of social health insurance programs in reducing inequality in the incidence and intensity of catastrophic health expenditure (CHE) of cancer patients in China.
Method: A convenient sample of 2534 cancer patients treated in nine hospitals in 2015 and 2016 were followed up through face-to-face interviews in March-December 2018. The incidence and intensity (mean positive overshoot) of CHE (≥ 40% household consumption) were calculated.
Article Synopsis
- Colorectal cancer (CRC) screening in China includes organized programs, opportunistic screening, and physical exams, but accurately measuring coverage rates is challenging.* -
- As of 2020, organized screening programs had very low coverage rates of only 2.7% for those aged 40-74, with cumulative rates showing gradual improvement over the years.* -
- The study indicates a total estimated screening coverage rate of 3.0% for the 40-74 age group, highlighting the need for enhanced access and more research on opportunistic screening methods.*
Background: Screening reduces colorectal cancer (CRC) burden by allowing early resection of precancerous and cancerous lesions. An adequate selection of high-risk individuals and a high uptake rate for colonoscopy screening are critical to identifying people more likely to benefit from screening and allocating healthcare resources properly. We evaluated whether combining a questionnaire-based interview for risk factors with fecal immunochemical test (FIT) outcomes for high-risk assessment is more efficient and economical than a questionnaire-based interview-only strategy.
View Article and Find Full Text PDFBackground: The current one-size-fits-all screening strategy for lung cancer is not suitable for personalized screening.
Research Question: What is the risk-adapted starting age of lung cancer screening with comprehensive consideration of risk factors?
Study Design And Methods: The National Lung Cancer Screening program, a multicenter, population-based, prospective cohort study, was analyzed. Information on risk factor exposure was collected during the baseline risk assessment.
Background: Colorectal cancer (CRC) is one of the most common cancers worldwide. Comprehensive data on the economic burden of CRC at a population-level is critical in informing policymaking, but such data are currently limited in China.
Methods: From a societal perspective, the economic burden of CRC in 2019 was estimated, including direct medical and nonmedical expenditure, disability, and premature-death-related indirect expenditure.
Background: Screening adherence is important in reducing colorectal cancer (CRC) incidence and mortality. Disparity in CRC screening adherence was observed in populations of different socioeconomic status (SES), but the direction and strength of the association remained unclear.
Objective: We aimed to systematically review all the observational studies that have analyzed the association between SES and adherence to organized CRC screening based on fecal occult blood tests.
Background: The rising incidence of thyroid cancer (TC) has generated growing concern globally; yet there are no studies examining whether this incidence was followed by a rise in related mortality. We aimed to comprehensively quantify current trends and future projections of TC incidence and mortality, and to explore the association between the TC burden and socioeconomic inequality in different income strata.
Methods: We obtained incidence and mortality data on TC and population from the 2019 Global Burden of Disease (GBD) study and the United Nations' World Population Prospects 2022.
Background: There were limited studies on the quantification of the modifiable and nonmodifiable lung cancer burden over time in China. Furthermore, the potential effect of risk factor reduction for lung cancer on gains in life expectancy (LE) remains unknown.
Methods: This study explored temporal trends in lung cancer deaths and disability-adjusted life years (DALY) attributable to modifiable risk factors from 1990 to 2019, based on the 2019 Global Burden of Disease Study.
Background: The ability of lung cancer screening to manage pulmonary nodules was limited because of the high false-positive rate in the current mainstream screening method, low-dose computed tomography (LDCT). We aimed to reduce overdiagnosis in Chinese population.
Methods: Lung cancer risk prediction models were constructed using data from a population-based cohort in China.
Objective: Circulating tumor DNA (ctDNA) and alpha-fetoprotein (AFP) plus ultrasound (US) have been considered to have high diagnostic accuracy for cancer detection, however, the efficacy of ctDNA methylation combined with the traditional detection modality of liver cancer has not been tested in a Chinese independent cohort.
Methods: The high-risk individuals aged between 35 and 70 years who were diagnosed with liver cirrhosis or had moderate and severe fatty liver were eligible for inclusion. All participants were invited to receive a traditional examination [referring to AFP plus US], and ctDNA methylation, respectively.
Article Synopsis
- The study evaluated cancer literacy across China and found a national literacy rate of about 70%, with knowledge of cancer management being the highest.
- The research revealed geographic disparities, with higher literacy rates in East and Central China, while Southwest and Northwest regions showed significant gaps.
- Demographic factors such as urban living, ethnic background, education level, and income were linked to higher cancer health knowledge, indicating a need for targeted educational policies.
Background & Aims: A one-size-fits-all approach to colorectal cancer (CRC) screening that does not account for CRC risk factors is not conducive to personalized screening. On the basis of the principle of equal management of equal risks, we aimed to tailor and validate risk-adapted starting ages of CRC screening for individuals with different CRC risk factors.
Methods: A multi-center community-based population cohort (N = 3,165,088) was used to evaluate the starting age of CRC screening with comprehensive consideration of risk factors.
Article Synopsis
- - The study focused on estimating disability-adjusted life years (DALYs) for breast cancer in Chinese women, highlighting the significance of local disability weights over generic ones, showing that approximately 17.3% of DALYs in 2015 were due to years lived with disability (YLDs).
- - Using various methods including prevalence modeling and mortality rates, the research projected that DALYs for breast cancer could rise by 26.7% by 2030 under unchanged screening conditions but could drop by 1.5% with increased screening coverage as per the "Healthy China Initiative."
- - The findings indicate that the estimated DALYs in China are lower and have a higher proportion of YLDs compared to global estimates,
[Thirty-year changes in disability adjusted life years for colorectal cancer in China: a screening perspective analysis].
Zhonghua Liu Xing Bing Xue Za Zhi
September 2022
From a screening-focused perspective, to analyze the 30-year changes in disability adjusted life years (DALYs) caused by colorectal cancer (CRC) in China and in some other selected populations, to inform extent of burden of CRC and future related prevention and control in populations in China. Based on the data of Global Burden of Disease 2019 (GBD 2019), the DALYs, world standardized DALY rate, and the composition of different subgroups in China were collected. Joinpoint regression model was used to analyze the trend during 1990-2019, and comparison was made with the international data and population screening situation.
View Article and Find Full Text PDFBackground & Aims: The screening yield and related cost of a risk-adapted screening approach compared with established screening strategies in population-based colorectal cancer (CRC) screening are not clear.
Methods: We randomly allocated 19,373 participants into 1 of the 3 screening arms in a 1:2:2 ratio: (1) one-time colonoscopy (n = 3883); (2) annual fecal immunochemical test (FIT) (n = 7793); (3) annual risk-adapted screening (n = 7697), in which, based on the risk-stratification score, high-risk participants were referred for colonoscopy and low-risk ones were referred for FIT. Three consecutive screening rounds were conducted for both the FIT and the risk-adapted screening arms.
Background: Optimal uptake rates of low-dose computed tomography (LDCT) scans are essential for lung cancer screening (LCS) to confer mortality benefits. We aimed to outline the process model of the LCS programme in China, identify the high-risk individuals with low uptake based on a prospective multi-centre population-based cohort, and further explore associated structural characteristics.
Methods: A total of 221,955 individuals at high-risk for lung cancer from the National Lung Cancer Screening cohort were included.
Risk-stratified Approach for Never- and Ever-Smokers in Lung Cancer Screening: A Prospective Cohort Study in China.
Am J Respir Crit Care Med
January 2023
Over 40% of lung cancer cases occurred in never-smokers in China. However, high-risk never-smokers were precluded from benefiting from lung cancer screening as most screening guidelines did not consider them. We sought to develop and validate prediction models for 3-year lung cancer risks for never- and ever-smokers, named the China National Cancer Center Lung Cancer models (China NCC-LC models).
View Article and Find Full Text PDFUnlabelled: C-reactive protein (CRP), a systemic marker of diagnosing chronic inflammation, has been associated with the incidence of multiple types of cancer. However, little is known about the impact of CRP on lung cancer incidence in Chinese population. A total of 97,950 participants without cancer at baseline (2006-2007) of the Kailuan Cohort Study were followed up.
View Article and Find Full Text PDFArticle Synopsis
- The economic burden of liver cancer in China was estimated at CNY 76.7 billion (US$ 11.1 billion) in 2019, making up about 0.047% of the country's GDP.
- The costs include direct expenditures of CNY 21.6 billion (US$ 3.1 billion) primarily for medical care, along with significant indirect costs due to disability and premature death.
- Projections indicate a rise in this burden to CNY 234.3 billion (US$ 34.0 billion) by 2030, unless effective health initiatives are implemented to reduce non-communicable diseases.
Background: Non-smokers account for a large proportion of lung cancer patients, especially in Asia, but the attention paid to them is limited compared with smokers. In non-smokers, males display a risk for lung cancer incidence distinct from the females-even after excluding the influence of smoking; but the knowledge regarding the factors causing the difference is sparse. Based on a large multicenter prospective cancer screening cohort in China, we aimed to elucidate the interpretable sex differences caused by known factors and provide clues for primary and secondary prevention.
View Article and Find Full Text PDFArticle Synopsis
- Many studies on catastrophic health expenditures (CHE) have focused on general populations, but this research specifically examines the financial impact on households with lung cancer patients in China.
- A survey conducted across seven provinces revealed that a significant percentage (78.1%) of these households experienced CHE, with health insurance providing some protection, especially among those with higher income and shorter disease duration.
- The findings highlight the need for better financial support for vulnerable groups like lung cancer patients, suggesting that policymakers should work on enhancing economic protections to alleviate their financial burdens.
Background And Aims: Risk-stratified endoscopic screening (RSES) has been suggested to improve screening efficiency. We aimed to assess the cost-effectiveness of RSES and identify the optimal risk-score thresholds for once in a lifetime esophageal cancer (EC) screening in high-risk areas of China.
Methods: From a healthcare system perspective, a Markov model was constructed to compare the cost-effectiveness of 13 RSES strategies (under different score thresholds for EC risk), universal endoscopic screening strategy, and no screening.
Article Synopsis
- - Lung cancer is the most common cancer and a major cause of cancer deaths in China, prompting a study to assess the direct medical costs associated with its care from 2002 to 2011.
- - The study analyzed data from 15,437 patients across 13 provinces, revealing that the average medical expenditure per lung cancer case in 2011 was 39,015 CNY (about US$6,041), with a 7.55% annual increase over the period.
- - Drug costs constituted the largest share of medical expenses at 54.27%, with treatment and surgical costs following behind; costs varied significantly depending on regional factors and hospital types.
Optimizing Positivity Thresholds for a Risk-Adapted Screening Strategy in Colorectal Cancer Screening.
Clin Transl Gastroenterol
August 2021
Introduction: Risk-adapted screening combining the Asia-Pacific Colorectal Screening score, fecal immunochemical test (FIT), and colonoscopy improved the yield of colorectal cancer screening than FIT. However, the optimal positivity thresholds of risk scoring and FIT of such a strategy warrant further investigation.
Methods: We included 3,407 participants aged 50-74 years undergoing colonoscopy from a colorectal cancer screening trial.