2016 International Academic Conference on Human Society and Culture (HSC 2016) ISBN: 978-1-60595-381-6

The Fulfillment Index Analysis of the Malignant Tumor Death in Qingyunpu from 2012 to 2015 Ming-yang WU 1, Yan-ling SHU 2, Jiao YANG 3, Chen-hui YANG 4 5,a,* and Xiao-jun ZHOU 1,2,3,4,5 School of Public Health, University, Nanchang City, 330006, aEmail: [email protected] *Corresponding author

Keywords: Death-surveillance, Malignant tumors, Mortality rate, Fulfillment index.

Abstract. Purposes To understand the death level of malignant tumor and its influencing degree in all age groups in Qingyunpu district from 2012 to 2015. Methods choosing all deaths from death-surveillance data as the research objects, to analyze the mortality rate and Fulfillment index and other descriptive analysis indicators of malignant tumors by SPSS18.0 software. Comparing with proportion by Chi-Square Test. Results Standardized mortality of the malignant tumors was 125.20/100000 in Qingyun district from 2012 to 2015. Leukemia influenced on teenagers mostly. The youth age, middle age and old age were influenced by the lung cancer, liver cancer and stomach cancer mostly. The distribution in age of Fulfillment index: Lung cancer up to 13.38 between 60sand 64s, liver cancer up to 13.46 between 35s and 39s, stomach cancer up to 7.61 between 40s and 44s. Conclusion Malignant tumors have threatened residents of all ages and we should carry out prevention measures to reduce the incidence of malignant tumors.

Introduction With the improvement of people's living standards, life expectancy increased gradually, entering the aging society. The distribution of disease, the lifestyle and the behaviors of people have changed, and the malignant tumors become the leading cause of death, affecting the health of the residents seriously. To investigate the influence of malignant tumors of different age residents, the main method, proposed by the Prithwis Das Gupta [1], is Fulfillment index which is about the percent recovery of wastage of life potential. The analysis of monitoring data of the death cause from 2012 to 2015 are shown as follows.

Materials and Methods Data Source The mortality data is from Qingyunpu National Death-surveillance and Reporting System. The population data is from the Bureau of Nanchang City from January 2012 to December 2015. Statistical Analysis Methods According to The Tenth Edition of the International Classification of Diseases (ICD-10), diseases are classified as different types on the basis of death causes. To summarized and analyzed the data by Excel and SPSS18.0 software, taking α=0.05 to compare with the proportion by Chi-Square Test. National Census Data in 2010

standardized region's population. Data processing: in life table Group margin was five years (0~1, 1~4, ... 85~). According to International age stages: children and teenager age (0~14), youth age (15~ 44), middle age (45~64), old age (65~ ) . The Calculative Formula of the Main Index (1)Mortality: Mortality (‰) =death toll during the year / annual average population × 1000 ‰. (2)Fulfillment index: Fulfillment Index =( ni - n )/(n - n )× 100,{Note: “ ni” is the average number of years of survival after removing specific causes in this age group population, “ n ” is the average survival years of full death cases in this age group population, “n” is the age group interval}. Quality Control All medical institutions checked inputted data regularly. The registration system of the death cause was established soundly. The death cause data was inputted by professionals, and was checked by the superior department. We have looked up “Medical Certificate of Death” when the deaths cause date was doubtful.

Results The Death Level of Cancer Over the period from 2012 to 2015, the numbers of deaths were 265305, 267821, 267821, 269955, 269194 respectively, including 554811 men, 517464 women. The numbers of cancer deaths were 475, 398, 505, 417 respectively, including 1142 men, 653 women, and the ratio of men and women was about 1.75. In Qingyunpu district from 2012 to 2015, the average mortality rate of malignant tumors was 167.40/100000, ranking first in all death causes, and the average standardized mortality rate of malignant tumors was 125.20/100000. Male and female standardized mortality rates of malignancies were 145.74/100000, 100.21/100000 respectively. The mortality rate of men was significantly higher than women ( χ2 = 101.622, P <0.001). The sex ratio of the top five death cause of malignant tumors and the mortality rate are shown in the following table1. Table 1. The ratio between men and women and their top five malignant tumor mortality from 2012 to 2015 in Qingyunpu district.

Colorectal Pancreatic Lung cancer Liver cancer Stomach cancer cancer cancer Mortality Mortality Mortality Mortality Mortality Ratio * Ratio * Ratio * Ratio * Ratio * (10-5) (10-5) (10-5) (10-5) (10-5) 2012 3.23 41.46 2.86 40.71 1.44 29.40 1.88 11.34 1.75 4.15 2013 2.96 39.95 3.92 23.90 1.35 17.55 1.17 14.56 1.71 7.09 2014 2.85 57.05 2.87 21.49 1.95 20.74 1.26 19.26 2.88 11..48 2015 2.29 41.61 1.83 18.95 1.82 23.03 1.29 14.49 0.80 6.69

Note:’*’ means the ratio of men and women

The Malignant Tumor Sequence of Residents in Different Ages InQingyunpu district from 2012 to 2015, the malignant tumors in the top 10 are described in the following sections: lung cancer, liver cancer, stomach cancer, colorectal cancer, pancreatic cancer, esophageal cancer, breast cancer, female genital cancer, leukemia, urinary tract cancer. The primary malignant tumor was leukemia in Children, and the primary malignancy was liver cancer in youth. In middle age and old age, the primary malignancy was lung cancer. The top 10 malignant tumors in each age group are shown in the following table 2. Table 2. The death-level of the top 10 malignancy in each age group in Qingyun Pu district from 2012 to 2015.

Children and adolescence (0~14s) Youth age (15~44s) Death Death Mortality Death Mortality Sequence Death causes Death causes count rate(10-5) count rate(10-5) 1 Leukemia 3 2.11 Liver cancer 27 5.77 2 Lung cancer 0 0 Lung cancer 23 4.91 3 Liver cancer 0 0 Lung cancer 15 3.20 4 Stomach cancer 0 0 Breast Cancer 0 2.35 5 Colorectal cancer 0 0 Leukemia 10 2.14 6 Pancreatic cancer 0 0 Female genital cancer 9 1.92 7 Esophageal cancer 0 0 Colorectal cancer 8 1.71 8 Breast Cancer 0 0 Brain cancer 5 1.07 9 Female genital cancer 0 0 Lymphoma 4 0.85 10 Urinary tract cancer 0 0 Urinary tract cancer 3 0.64 Total 3 2.11 Total 115 24.56 Continued from the above table 2 Middle age (45~64s) Old age (65~) Death Death Mortality Death Mortality Sequence Death causes Death causes count rate(10-5) count rate(10-5) 1 Lung cancer 123 39.38 Lung cancer 337 225.29 2 Liver cancer 87 27.86 Stomach cancer 176 117.66 3 Stomach cancer 52 16.65 Live r c ancer 167 111.64 4 Colorectal cancer 44 14.09 Colorectal cancer 124 82.90 5 Breast Cancer 34 10.89 Pancreatic cancer 65 43.45 6 Female genital cancer 28 8.97 Esophageal cancer 49 32.76 7 Esophageal cancer 24 7.68 Urinary tract cancer 30 20.06 8 Leukemia 13 4.16 Gallbladdercancer 27 18.05 9 Small Intestine Cance r 12 3.84 Female genital cancer 24 16.04 10 Pancreatic cancer 12 3.84 Male genital cancer 23 15.38 Total 429 137.36 Total 1022 683.22 The Age Distribution of the Fulfillment Index of Malignant Tumors in the Top Ten In the Qinyunpu district from 2012 to 2015, the residents’ life expectancy was 79.94 years. The women’ life expectancy at birth was 82.15 years and the men’ was 78.09 years. The malignant tumors eliminated life expectancy increased by 2.86 years. As we can see from the Fulfillment index in age distribution: the lung cancer mainly affected people at the age between 30s and 79s and the Fulfillment index was between 7.06 and 13.38. The index of the age group of 60 to 64 years old was the highest. The Fulfillment index of liver cancer shows that it mainly affected people over the age of 30 years old. The Fulfillment index was from 2.11 to 13.46 and the index of the age

group of 30 to 39 years old was the highest, then decreasing with age. The Fulfillment index of stomach cancer was between 2.24 and 7.61. The stomach cancer mainly effected residents whose age were over 35s and influenced on the age between 40s and 44s mostly. The colorectal cancer mainly affected residents whose ages were over 35s and the residents were affected mostly on the age between 55s and 59s. The Fulfillment index of pancreatic Cancer was between 0.57 and 1.38. The pancreatic Cancer increasing with age influenced greatly over 40 years old. The details are shown in the following table 3. Table 3. The Fulfillment index of eliminated death cause in Qinyunpu district from 2012 to 2015.

Female Urinary Age Lung Liver Stomach Colorectal Pancreatic Esophageal Breast genital Leukemia tract group cancer cancer cancer cancer cancer cancer cancer cancer cancer 0~ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1~ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5~ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 7.69 0.00 10~ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 24.99 0.00 15~ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5.88 0.00 20~ 3.33 0.00 6.66 0.00 0.00 0.00 0.00 0.00 3.33 0.00 25~ 3.12 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6.24 0.00 30~ 9.37 12.49 0.00 0.00 0.00 0.00 3.12 0.00 6.24 0.00 35~ 7.85 13.46 2.24 3.36 0.00 0.00 3.36 1.12 0.00 0.00 40~ 7.61 7.61 7.61 3.46 1.38 0.69 4.84 5.54 2.77 2.08 45~ 7.53 6.99 3.23 2.15 1.08 1.08 4.84 2.15 2.69 0.00 50~ 7.12 9.21 5.02 2.51 1.26 2.09 4.60 3.77 0.84 0.84 55~ 9.10 7.39 5.40 5.40 0.57 3.41 1.70 1.70 1.14 0.28 60~ 13.38 5.79 3.34 3.34 1.11 1.11 1.78 2.00 0.45 0.89 65~ 11.58 6.01 4.16 3.54 1.54 0.92 0.77 1.08 0.92 1.23 70~ 8.38 4.24 4.68 2.67 1.78 1.11 0.56 0.67 0.45 1.00 75~ 7.06 3.32 3.40 3.00 1.42 1.50 0.55 0.55 0.39 0.08 80~ 4.24 2.11 2.62 1.67 0.80 0.43 0.07 0.07 0.36 0.36

Discussion This study shows that the average standardized mortality rate of cancer in Qingyunpu was 125.20/100000, which was higher than the level of province in the same period [2]. The mortality rate of lung cancer, increasing with age, ranked first in the middle age and old age, but its ratio of men and women gradually declined and its mortality rate didn’t change obviously from 2012 to 2015.Fulfillment index study of lung cancer shows that it mainly occurred between 30 to 79 years old., and the Fulfillment index was from 7.06 to13.38. The highest index was 13.38 in the age group of 60 to 64 years old and 65 to 69 years old group followed by 11.58.It indicated that lung cancer had greatest influence on the age group from 60 to 64 years old and the age group from 65 to 69 years old followed. The reason of the result may be the community locating in the city center and the residents exposing to the air pollutants for long time. Many studies have shown that much factors are associated with lung cancer, such as smoking, exposure to air pollution and etc. It suggests that the relevant departments should strengthen environmental protection, tobacco control, reducing emission from cars. Health education and promotion activities should be organized to increase the residents’ awareness and capability for self-protection. Liver cancer mortality, declining year by year, ranked the top three in the youth age, middle age and old age, especially being top one in the youth age. The Fulfillment index of liver cancer shows that it mainly affected people over the age of 30 years old, which Fulfillment index was between 2.11 and 13.46.The index of the age group of 30 to 39 years old was the highest, then decreasing with age. Many studies[3-6]have shown that dietary factors are associated with liver cancer, such as moldy food containing large amounts of aflatoxin [7],organic constituents in surface water and etc. After the ingestion of unboiled water or impure water, the by-product of chlorinated water and microcystin toxins are transported to the liver by blood to detoxificate. For long-term exposure to the risk factors, the risk will increase for liver, particularly immature children and young people whose liver detoxification capacity are more weaker than adults. Therefore, It suggests that schools and relevant departments should devote major efforts to developing health education, and help the students to develop healthy and reasonable dietary habits and lifestyles－eating more fresh food, being away from unboiled water and other unhealthy lifestyles. Residents over the age of 30 years old should take health examination regularly. Fulfillment index of stomach cancer was between 2.24 to 7.61, and the study shows that it was the main cancer effecting residents whose age were over 30s , the age from 40s to 44s influenced mostly. the mortality rate of colorectal cancer increased year by year. The colorectal cancer mainly affected residents whose ages were over 35s, the age from 55s to 59s impacted mostly. Digestive tumors mainly relate to dietary factors[8],dietary fiber preventing colorectal cancer. Besides, the occurrence of colorectal cancer is associated with obesity, physical activity, dietary calcium, alcohol, tobacco and ect [9, 10]. Being overweight will increase the risk of colorectal cancer in men, while women will not [10]. Hence the diet of the residents should refer to "Chinese Dietary Guidelines 2016" －No smoking and limited amount of liquor, eating more fresh fruits and vegetables, eating soy bean products and dairy products frequently, less fat meat and preserved foods, and participating in physical activity appropriately everyday[11]. The mortality rate of pancreatic cancer in old age was 43.45 / 100000. The study of Fulfillment Index shows that the people over 40 years were affected greatly, especially in the age group of 70 to 74 years old. The mortality of Pancreatic cancer ranks fifth in total population, which is great different from relevant study in Jiangxi province in the past. According to the analysis of malignant neoplasm in the third death cause retrospective review in Jiangxi province [12], the pancreatic cancer is not in the list of the top ten malignant neoplasms in Jiangxi. Therefore, we should pay more attention to pancreatic cancer of Qingyunpu district. Referring to the prevalence of pancreatic cancer in the region in recent years and considering the reason of rising mortality of pancreatic cancer in the area, If the prevalence of Pancreatic cancer is confirmed really high in the area, we must carry out special investigations and take intervention measures against the risk factors of pancreatic cancer of the local residents. In conclusion, according to the Fulfillment index, formulating policies or taking control measures to the relevant disease is of great significance for the improvement of residents’ life quality.

Acknowledgement This research was financially supported by the the Twelfth Five-year Program Project of Provincial Social Science Foundation.

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