Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 1, 2022
Open Peer Review Period: Nov 1, 2022 - Nov 15, 2022
Date Accepted: Jan 30, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Projection of premature cancer mortality in Hunan, China through 2030: a modeling study based on multiple risk factors
ABSTRACT
Background:
The United Nations Sustainable Development Goals for 2030 include reducing premature mortality from non-communicable diseases by one-third. Although previous modeling studies have predicted premature mortality from non-communicable diseases, cancer and its subcategories are less well understood in China.
Objective:
In this study, we aimed to project premature cancer mortality of ten leading cancers in Hunan Province, China, based on various scenarios of risk factor control, so as to establish the priority for future interventions.
Methods:
We used data between 2009 and 2017 from Hunan cancer registry annual report as empirical data for projections. Cancer deaths were disaggregated into parts attributable and unattributable to 10 risk factors: smoking, alcohol use, high body mass index, diabetes, physical inactivity, low vegetable and fruit intake, high red meat intake, high salt intake, and high ambient PM2.5 levels. Simulated scenarios were then constructed reflecting how premature mortality would be affected if the targets for risk factor control were achieved by 2030.
Results:
The cancer burden in Hunan significantly increased during 2009-2017. If current trends for each risk factor continued to 2030, the total premature deaths from cancers in 2030 would increase to 97,787 in Hunan Province, and the premature mortality would be 44.47% higher than that in 2013. In the combined scenario where all risk factor control targets were achieved, 14.41% of premature cancer mortality among 30- to 70-year-olds would be avoided compared with the business-as-usual scenario in 2030. Reductions in the prevalence of diabetes, high BMI, ambient PM2.5 levels, and insufficient fruit intake played relatively important roles in decreasing cancer premature mortality. However, the one-third reduction goal would not be achieved for most cancers except gastric cancer.
Conclusions:
Existing targets on cancer-related risk factors may have important roles in cancer prevention and control. However, they are not sufficient to achieve the one-third reduction goal in premature cancer mortality in Hunan Province. More aggressive risk control targets should be adopted based on local conditions. Clinical Trial: Not applicable.
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