Associations between elevated C-reactive protein (CRP) and breast cancer risk have been reported for many years, but the results remain controversial. To address this issue, a meta-analysis was therefore conducted. Eligible studies were identified by searching the PubMed and EMBASE up to December 2014. Study-specific risk estimates were combined using a random-effects model. Altogether fifteen cohort and case-control studies were included in this meta-analysis, involving a total of 5,286 breast cancer cases. The combined OR per natural log unit change in CRP for breast cancer was 1.16 (95% CI: 1.06-1.27). There was moderate heterogeneity among studies (I² = 45.9%). The association was stronger in Asian population (OR = 1.57, 95% CI: 1.25-1.96) compared to European (OR = 1.12, 95% CI: 1.02-1.23) and American (OR = 1.08, 95% CI: 1.01-1.16). Prediagnostic high-sensitivity CRP concentrations (OR = 1.22, 95% CI: 1.10-1.35) was superior to common CRP (OR = 1.08, 95% CI: 1.01-1.15) in predicting breast cancer risk. The meta-analysis indicated that elevated CRP levels was associated with increased risk of breast cancer. Further research effort should be performed to identify whether CRP, as a marker of inflammation, plays a direct role in breast carcinogenesis.

The increasing prevalence of colorectal cancer (CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China. We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan (CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup (hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure. A total of 2356 patients with a mean age of 57.4 years were included, 57.1% of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY. The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage I, II, III, and IV disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3% of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups (P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spend more, whereas those with a lower household income and those who underwent surgery spent less (all P < 0.05). For patients in China, direct expenditure for the diagnosis and treatment of CRC seemed catastrophic, and non-medical expenditure was non-ignorable. The financial burden varied among subgroups, especially among patients with different clinical stages of disease, which suggests that, in China, CRC screening might be cost-effective.

Background: Lung cancer is the most common cancer and a leading cause of cancer-related deaths globally. The aim of this study was to evaluate the incidence and mortality of lung cancer worldwide in 2022 and to project the number of new cases and deaths due to lung cancer in China and the United States in 2050. Methods: In this study, data from the GLOBCAN 2022 database were used to analyze lung cancer incidence and mortality. The current status of lung cancer incidence and deaths was described by country/region, sex, age, and the human development index (HDI), and future lung cancer incidence and deaths in China and the United States were projected for 2050. Results: Globally, an estimated 2,480,675 new lung cancer cases and 1,817,469 lung cancer-related deaths occurred in 2022, with age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs) of 23.6/100,000 and 16.8/100,000, respectively. In China, the ASIR and ASMR for male lung cancer patients were approximately 1.7 times and 2.7 times greater than those for female lung cancer patients, respectively. The ASIR and ASMR in high-HDI countries were approximately 8.5 times and 6.5 times those in low-HDI countries, respectively. It is estimated that in 2050, there will be approximately 1120 thousand new cases and 960 thousand deaths among Chinese men, 680 thousand new cases and 450 thousand deaths among Chinese women, approximately 170 thousand new cases and 110 thousand deaths among American men, and 160 thousand new cases and 90 thousand deaths among American women. Conclusions: There are significant differences in the incidence and mortality of lung cancer among different regions and sexes. Therefore, sex factors need to be considered in the prevention, screening, and treatment strategies of lung cancer, and the implementation of tertiary prevention measures for lung cancer, especially primary and secondary prevention, needs to be actively promoted.

In China, a large burden of gastric cancer has remained, and endoscopic screening was expected to reduce gastric cancer mortality. Therefore, a population‐based case–control study was conducted to evaluate the screening effect. The gastric cancer screening program was initiated in Linzhou in the year 2005, and endoscopic examination with indicative biopsy, for residents aged 40–69 years, was used to detect early cancer and precancerous lesion. In this study, cases were defined as individuals who had died of gastric cancer, which were selected from Linzhou Cancer Registry database. Controls were residents (six per case), who had not died of gastric cancer, from the same area as the case, and matched by gender and age (±2 years). The exposure status, whether cases and controls ever attended the screening or not, was acquired by inspecting the well‐documented screening records. Conditional logistic regression model was used to estimate the odds ratios (OR) and their 95% confidence intervals (95% CI). A total of 313 cases and 1876 controls were included in our analysis. Compared with subjects who never participated in screening, the overall OR for individuals who ever participated in screening was 0.72(95% CI: 0.54–0.97). The OR for lag time 4 years or longer was 0.68(95% CI: 0.47–0.98) and the OR for those who were aged 50–59 years were 0.56 (0.37–0.85). The results suggest a 28% reduction in risk of gastric cancer mortality by endoscopic screening, which may have significant implications for gastric cancer screening in rural areas of China.

Upper gastrointestinal cancer (UGC) screening has been widely implemented in many Asian countries. However, there is little evidence of participation and diagnostic yields in population‐based UGC screening in China. The participation rate and detection of upper gastrointestinal lesions in this program were reported and related factors were explored. The analysis was conducted in the context of the Cancer Screening Program in Urban China, which recruited 179 002 eligible participants aged 40‐74 years from three cities in Henan province from 2013 to 2017. A total of 43 423 participants were evaluated to be high risk for esophageal cancer or gastric cancer by an established risk score system and were subsequently recommended for endoscopy. Of 43 423 with high risk for UGC, 7996 subjects undertook endoscopy (participation rate of 18.4%). We found that male sex, high level of education, marriage, smoking, current alcohol drinking, lack of physical activity, history of upper gastrointestinal system disease, and family history of UGC were associated with increased participation of endoscopy screening. Overall, 15 UGC (0.19%), 275 squamous epithelial dysplasia (3.44%), and 33 intraepithelial neoplasm (0.41%) cases were detected. Several factors including age, sex, smoking, current alcohol drinking, lack of physical activity, and dietary intake of processed meat were identified to be associated with the presence of upper gastrointestinal lesions. Health promotion campaigns targeting the specific group of individuals identified in our study will be helpful for improvement of the adherence of UGC screening in population‐based cancer screening programs. Participant rate and yield of UGC screening will provide important references for evaluating the effectiveness and cost‐effectiveness of cancer screening in China.