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The incidence of cancer pain increases in discharged patients because of discontinued standard treatments and reductions in medication adherence. Motivated by the need for better pain management in discharged patients, we developed a mobile phone app (Pain Guard) to provide continuous treatment information and feedback to discharged cancer patients suffering from pain. The aim was to design, construct, and test the Pain Guard app in patients managing cancer pain, evaluate the total remission rate of pain and the improvement in quality of life (QoL) to improve pain management for cancer pain patients, and assess patient acceptance of the app. This randomized controlled double-arm study involved 58 patients with cancer pain symptoms. Participants were randomly assigned to a group receiving care through the Pain Guard app (n=31) or to a control group (n=27) who received only traditional pharmaceutical care. In a pretest, participants were rated using a baseline cancer pain assessment and QoL evaluation. During treatment, the consumption levels of analgesic drugs were recorded every week. After a 4-week study period, another round of cancer pain assessment and QoL evaluation was conducted. The system's usability, feasibility, app compliance, and satisfaction were also assessed. Our primary outcome was remission rate of pain, and secondary outcomes were medication adherence, improvements in QoL, frequency of breakthrough cancer pain (BTcP), incidence of adverse reactions, and satisfaction of patients. All participants (N=58) successfully completed the study. There were no significant differences in baseline pain scores or baseline QoL scores between groups. At the end of the study, the rate of pain remission in the trial group was significantly higher than that in the control group (P<.001). The frequency of BTcP in the app group was considerably lower than that in the control group (P<.001). The rate of medication adherence in the trial group was considerably higher than that in the control group (P<.001). Improvements in global QoL scores in the trial group were also significantly higher than those in the control group (P<.001). The incidence of adverse reactions in the trial group (7/31) was lower than that in the control group (12/27), especially constipation, with significant differences (P=.01). The 31 participants in the trial group completed a satisfaction survey regarding Pain Guard: 23 (74%) indicated that they were satisfied with receiving pharmaceutical care by Pain Guard, 5 (16%) indicated that they were somewhat satisfied, 2 (6%) indicated neutral feelings, and 1 (3%) indicated that they were somewhat dissatisfied; no participants indicated that they were very dissatisfied. Pain Guard was effective for the management of pain in discharged patients with cancer pain, and its operability was effective and easily accepted by patients. Chinese Clinical Trials Registry ChiCTR1800016066; http://www.chictr.org.cn/showproj.aspx?proj=27153.

Larynx cancer poses a significant public health challenge in China, with rising incidence and mortality rates over the past decades. Understanding the long-term trends and underlying factors is crucial for effective intervention and policy formulation. Data were utilized from the global burden of disease (GBD) Study 2021 to analyze the incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) due to larynx cancer in China from 1990 to 2021. Joinpoint regression analysis identified key changes in trends, while age-period-cohort (APC) analysis and decomposition analysis quantified the contributions of aging, epidemiological changes, and population growth to these trends. Our study found a significant increase in the incidence and prevalence of larynx cancer in China, particularly among males. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for males were substantially higher than those for females. Decomposition analysis revealed that aging was the primary driver of increasing incidence and mortality rates, while epidemiological changes had a mitigating effect. Joinpoint analysis identified periods of rapid urbanization and economic growth as key turning points for increased incidence. Bayesian APC models projected a continued upward trend in incidence rates up to 2030. The rising burden of larynx cancer in China underscores the need for targeted public health interventions, including smoking cessation programs, environmental pollution control, and early detection strategies. Addressing gender disparities and implementing effective prevention measures are crucial to mitigating the impact of larynx cancer in China.

Liver cancer remains a significant public health issue in China, exhibiting high incidence, mortality, and burden. Understanding its temporal trends and projections is essential for designing targeted prevention and treatment strategies. This study analyzes long-term trends in liver cancer incidence, prevalence, mortality, and burden from 1990 to 2021, assessing age, period, and cohort effects, and projecting future trends. Data on liver cancer incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) were analyzed from 1990 to 2021. Joinpoint regression analysis, age-period-cohort (APC) analysis, and BAPC modeling were applied to examine trends and project future trends. Decomposition analysis examined contributions of aging, epidemiological changes, and population growth. The study also compared China’s liver cancer trends with global data. From 1990 to 2021, China experienced a decrease in age-standardized rates for liver cancer incidence, prevalence, mortality, and burden. Notably, Age-standardized incidence rates (ASIR) exhibited a decline after 2016, with a significant reduction in the male population. In 2021, there were 196,637 new cases of liver cancer in China, with a higher burden in males. ASIR were 14.34 per 100,000 for males and 4.89 per 100,000 for females. Mortality also followed a declining trend, with a notable decrease in age-standardized mortality rates. The age-standardized mortality rate (ASMR) for males was 12.4 per 100,000, significantly higher than for females (4.57 per 100,000) in 2021. Additionally, the age-standardized prevalence rate (ASPR) was 20.0 for males and 6.64 for females, with 265,539 total cases. The burden, measured by DALYs, YLDs, and YLLs, also showed a notable decline in age-standardized rates and significant gender disparities. Despite this, the absolute number of cases, deaths, and DALYs has continued to rise due to population growth and aging, with males bearing a significantly higher burden than females. The study also highlights the impact of aging, population growth, and epidemiological changes on liver cancer incidence and mortality in China. Projections for 2030 suggest a continued decrease in liver cancer incidence, especially among females, reflecting the effectiveness of public health interventions and medical advancements. However, gender disparities remain significant, and further efforts are needed to reduce the overall liver cancer burden, with an emphasis on early detection and prevention strategies.

Pancreatic cancer is one of the most lethal malignancies globally, with increasing incidence and mortality trends. In China, the disease burden has escalated over the past three decades, yet comprehensive national assessments remain limited. This study aims to evaluate the long-term trends, driving factors, and future projections of pancreatic cancer burden in China from 1990 to 2021. Data on incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) were extracted from the Global Burden of Disease (GBD) Study 2021. Temporal trends were analyzed using Joinpoint regression and age-period-cohort models, while decomposition analysis quantified the contributions of population aging, growth, and epidemiological change. Bayesian age-period-cohort (BAPC) models were applied to project disease burden trends through 2030. In 2021, pancreatic cancer accounted for 118,665 new cases and over 2.9 million DALYs in China, with a significantly higher burden among males. Age-standardized rates of incidence, prevalence, and DALYs increased markedly between 1990 and 2021, outpacing global trends. The burden was concentrated in older age groups and driven primarily by years of life lost. Joinpoint regression identified periods of accelerated increase after 2015. Age-period-cohort analysis revealed that disease burden rises sharply after age 50 and is highest among more recent birth cohorts. Decomposition analysis showed that population aging and epidemiological transitions were the main contributors to increased burden. Projections using BAPC models indicate that incidence, prevalence, and DALY rates will continue to rise through 2030. The burden of pancreatic cancer in China has increased substantially over the past three decades and is projected to rise further. These findings highlight the need for intensified public health interventions focused on prevention, early detection, and effective treatment strategies.

Stomach cancer remains a significant public health concern in China, with dietary factors, particularly high sodium intake, being major contributors. This study aimed to quantify the trends, demographic disparities, and contributing factors to this burden from 1990 to 2021. Data from the Global Burden of Disease Study (GBD) 2021 were used to assess the burden of stomach cancer attributable to high sodium intake. The study included age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Joinpoint regression and age-period-cohort (APC) analysis were performed to identify significant trends and changes. Decomposition analysis was used to identify the impacts of aging, epidemiological changes, and population growth. In 2021, stomach cancer attributable to high sodium intake resulted in 36,958 deaths in China, with males (26,171) being more affected than females (10,786). The ASMR was significantly higher in males (2.71 per 100,000) than in females (0.99 per 100,000). DALYs totaled 883,435, with males contributing 643,008 and females 240,427. Age-standardized DALY rates were 62.16 for males and 22.15 for females. The age-standardized rates for YLDs and YLLs were also higher in males than females. Although ASMR and age-standardized DALYs rates declined overall (AAPC: -2.45% and -2.76%, respectively), absolute burden increased due to aging and population growth. Compared to global averages, China's age-standardized rates remained higher, despite notable improvements since 1990. APC analysis showed elevated risks in older age groups, declining period effects, and lower burden among recent birth cohorts. Decomposition analysis indicated that aging and population growth contributed to increased deaths, while epidemiological changes led to a reduction. Despite declining age-standardized rates, the absolute burden of stomach cancer linked to high sodium remains substantial in China. Males and older adults are disproportionately affected. Population aging and growth are key contributors, while public health interventions have mitigated the burden to some extent. Sustained, gender-sensitive strategies focused on sodium reduction are essential to further lower disease impact.

Laryngeal cancer attributable to occupational asbestos exposure remains a significant public health concern, particularly in industrialized regions. This study analyzes the burden, trends, and contributing factors of laryngeal cancer due to asbestos exposure in China from 1990 to 2021. Data were obtained from the Global Burden of Disease Study (1990-2021). We analyzed age-standardized death rates, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Temporal trends were assessed using joinpoint and decomposition analyses, and an age-period-cohort (APC) model was applied to examine mortality and DALY trends across different cohorts. In 2021, there were 234 deaths and 4,430 DALYs due to laryngeal cancer attributable to occupational asbestos exposure, predominantly affecting males. Mortality rates declined from 1990 to 2008, followed by a rise until 2012, and a subsequent decline. YLDs showed a consistent increase over time. APC analysis revealed higher mortality and DALY rates in older age groups and earlier birth cohorts. Decomposition analysis indicated that epidemiological changes were the largest driver of increased deaths in men, followed by population growth and aging. For DALYs, aging and population growth were key drivers, while epidemiological changes mitigated the burden. The burden of laryngeal cancer attributable to asbestos exposure has declined overall, but disability rates continue to rise, particularly among males. Effective strategies targeting prevention, early detection, and management of asbestos exposure are needed to reduce the disease burden in China.

Stomach cancer continues to be a major public health concern in China, with its incidence, prevalence, mortality, and overall burden showing notable changes over time. This study set out to analyze the long-term trends of stomach cancer from 1990 to 2021, figure out the effects of aging, epidemiological changes, and population growth, and also make projections for the future. To conduct the study, data from the Global Burden of Disease Study 2021 was used. This data allowed for the analysis of various aspects such as age-standardized incidence, prevalence, mortality rates, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) related to stomach cancer in China. Joinpoint regression analysis was carried out to spot significant trends and turning points. Decomposition analysis was done to assess how much aging, epidemiological changes, and population growth contributed. Additionally, the Bayesian age-period-cohort (BAPC) model was employed to predict what the trends might be from 2021 to 2030. In 2021, there were 611,799 new cases of stomach cancer in China. The age-standardized incidence rate was 29.05 per 100,000 people, with males having a much higher rate of 44.48 compared to females at 15.23. The age-standardized prevalence and mortality rates were 57.22 and 21.51 per 100,000 respectively, and both were higher in males as well. There were also significant gender differences in DALYs, YLDs, and YLLs, with males shouldering a greater burden. From 1990 to 2021, the incidence and mortality rates went down, especially after 2004. Through decomposition analysis, it was found that aging led to a decrease in incidence but an increase in mortality, especially among males. Epidemiological changes caused both the incidence and mortality rates to drop, and the effect was more pronounced in males. The BAPC model forecasts that the incidence and mortality rates will continue to decline for both genders from 2021 to 2030, with a more rapid decrease in males. Overall, this study emphasizes the changing trends of the stomach cancer burden in China, the significant gender differences, and the impacts of aging, epidemiological changes, and population growth. It’s crucial to keep monitoring and implement targeted public health strategies to further reduce the burden of stomach cancer.

Background Gallbladder and biliary tract cancer (GBTC) poses a growing public health challenge in China, with considerable disparities across age and sex. Understanding long-term epidemiological patterns is essential for informing cancer control strategies and future projections. Methods Data from the Global Burden of Disease Study 2021 were used to assess GBTC burden in China from 1990 to 2021. Indicators analyzed included incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Joinpoint regression, age-period-cohort (APC) analysis, decomposition analysis, and Bayesian APC (BAPC) models were employed to explore temporal trends and project future burden through 2030. Results In 2021, China reported 51,720 new GBTC cases, with an age-standardized incidence rate (ASIR) of 2.49 per 100,000. Males exhibited higher burden than females across all indicators. Incidence, prevalence, mortality, and DALYs were highest in older age groups. From 1990 to 2021, China experienced increasing trends in incidence and prevalence, while age-standardized mortality rates (ASMR) declined. Compared to global trends, China's ASIR rose while global rates declined. DALYs decreased in both contexts but more steeply globally. Joinpoint regression revealed sex-specific shifts, with males showing consistent increases in incidence and females experiencing periods of both decline and rise. APC analysis highlighted increasing incidence among post-1950 birth cohorts and decreasing mortality in recent cohorts. Decomposition analysis indicated that rising incidence was driven by epidemiological changes and population growth, while mortality reduction was linked to medical improvements. BAPC models projected a continued rise in incidence, particularly among males. Conclusions The burden of GBTC in China is rising, especially among men and older adults. While mortality has improved, incidence continues to grow, highlighting the need for targeted prevention, early detection, and gender-specific public health policies.

Blood-based biomarkers that capture systemic immunity could complement tissue-based assays for prognostication in advanced gastric cancer receiving programmed cell death protein 1 (PD-1)-based chemoimmunotherapy. We evaluated whether baseline plasma immune proteomics can stratify clinical outcomes and be operationalized into a clinically usable model. In a prospective cohort (n=40) treated with first-line PD-1 inhibitor plus chemotherapy, nano-ultra-high-performance liquid chromatography (nano-UHPLC) coupled with Orbitrap data-independent acquisition liquid chromatography-tandem mass spectrometry (DIA LC-MS/MS) was used to profile baseline plasma. Quality control (QC)-filtered protein intensities were median-normalized, log -transformed, and batch-adjusted as needed. Group structure was assessed by principal component analysis (PCA). Differential expression (two-sided testing; Benjamini-Hochberg false discovery rate [FDR] correction) and functional enrichment were performed, with an immune focus defined using Immunology Database and Analysis Portal (ImmPort) sets. Prognostic screening used univariate Cox proportional hazards regression; features were reduced by least absolute shrinkage and selection operator (LASSO)-Cox and entered into multivariable models. A risk score (linear predictor of z-scaled abundances) was evaluated by Kaplan-Meier analysis and time-dependent receiver operating characteristic (ROC) analysis. A prognostic nomogram integrating the proteomic score with clinical variables was calibrated by bootstrap resampling. PCA showed outcome-associated separation. Differential testing identified 322 proteins (179 up, 143 down in long-term survivors), including 36 immune-related differentially expressed proteins (DEPs). Penalized modeling selected a five-protein prognostic panel-LTB4R, GBP2, HLA-G, CYBB, HLA-B. The risk score, dichotomized at the cohort median, stratified overall survival (OS) and progression-free survival (PFS) with clear separation. Time-dependent ROC area under the curve (AUC) values for OS at 6/12/18/24 months were 0.850/0.838/0.911/0.844, exceeding age, sex, grade, and programmed death-ligand 1 (PD-L1) combined positive score (CPS). In multivariable Cox models adjusting for clinical covariates, the score remained independently associated with OS. A nomogram combining the score with clinicopathologic factors yielded individualized 6-, 12-, and 18-month OS estimates with good calibration. Median PFS and OS for the overall cohort were 5.5 and 10.0 months, respectively. Baseline plasma immune proteomics supports a compact, interpretable five-protein risk score that augments clinicopathologic variables for prognostic stratification under PD-1-based chemoimmunotherapy. The model is amenable to targeted assay translation and prospective validation for clinical deployment.

Re-irradiation with intensity-modulated radiotherapy (IMRT) remains the primary treatment modality for inoperable locally recurrent nasopharyngeal carcinoma (NPC). However, the rate of radiation-related late adverse effects is often substantially high. Therefore, we aimed to explore failure patterns and individualized treatment plans of re-irradiation for inoperable locally recurrent NPC. Ninety-seven patients who underwent IMRT were retrospectively analyzed. Sixty-two patients had clinical target volume of recurrence (rCTV) delineated, and thirty-five patients had only gross tumor volume of recurrence (rGTV) delineated. Twenty-nine patients developed second local failures after re-irradiation with IMRT (28 cases available). Among those patients, 64.3% (18/28) of patients and 35.7% (10/28) developed in-field or out-field, respectively. No statistical correlation was observed between target volume (rGTV or rCTV) and the local recurrence rate, local failure patterns, grade ≥ 3 toxicity, and survival. Multivariate analysis showed that recurrent T (rT) stage (HR 2.62, P  = 0.019) and rGTV volume (HR 1.73, P  = 0.037) were independent prognostic factors for overall survival (OS). Risk stratification based on rT stage and rGTV volume revealed that low risk group had a longer 3-year OS rate (66.7% vs. 23.4%), lower total grade ≥ 3 toxicity ( P  = 0.004), and lower re-radiation associated mortality rates (HR 0.45, P  = 0.03) than high risk group. This study demonstrates that the delineation of rCTV may not be beneficial for re-irradiation using IMRT in locally recurrent NPC. Patients with low risk were most suitable for re-irradiation, with maximizing local salvage and minimizing radiation-related toxicities. More precise and individualized plans of re-irradiation are warranted.