The high incidence of lung cancer in Xuanwei, Yunnan is a mystery

Located in the southwestern part of China, Xuanwei, a small town with a population of more than 1.3 million, has attracted the attention of the Chinese medical community because it is a high-risk area for lung cancer in China.

Information from the Department of Disease Control showed that from 1973 to 1975, the death rate of lung cancer in Xuanwei was 23.1 per 100,000, and the male and female mortality rates were 4 times and 8 times higher than the national average, respectively. From 2004 to 2005, the mortality rate of lung cancer in the region was 91.1 per 100,000. The male and female mortality rates were 3 times and 6 times higher than the national average, respectively, and nearly 4 times the local mortality rate in the 1970s.

At the 16th China Association for Science and Technology Annual Conference held recently, several experts and scholars conducted in-depth discussions on the status and causes of Xuanwei's lung cancer. For decades, many teams of experts have conducted long-term research on Xuanwei's lung cancer. However, the cause of the high incidence of lung cancer in the country is still a mystery. Some scholars have even called it the "major case of the medical profession."

It is noteworthy that from a global perspective, due to smoking, occupational exposure and other reasons, men's lung cancer mortality has been much higher than that of women. China's male lung cancer mortality rate is 2.33 times that of women, but male and female lung cancer death rates in Xuanwei area But basically the same. According to statistics, the mortality rate of female lung cancer in individual townships in Xuanwei is even higher than that of men.

According to Li Jihua, chief physician of the Qujing City Center for Disease Control and Prevention, who has long studied lung cancer in Longdong, the age at onset of lung cancer in Xuanwei is about 15 to 20 years earlier than the national average, and the incidence of local residents has risen rapidly since the age of 30. Mortality is 8.8 times the national average. At the same time, the phenomenon of local family clustering is also very prominent.

“I had contacted a family of five in the local village. Now that only the children and the mother are left at home, the remaining three people died of lung cancer,” Li Jihua said.

In a small western city where the economy is underdeveloped and industrial pollution is not serious, why is the incidence of lung cancer among residents more than Beijing, Shanghai and other developed cities?

Huang Yunchao, vice president of Yunnan Cancer Hospital pointed out that the smoking rate among rural women in Xuanwei is very low, but the incidence of lung cancer in non-smoking women is extremely high. At the same time, Xuanwei rural areas are dominated by agricultural production and industrial pollution is less. Therefore, the world-accepted cause of lung cancer, such as smoking and industrial pollution, is not the main cause of the high incidence of lung cancer in the Xuanwei region.

Some scholars believe that indoor coal-fired pollution may be the “mastermind” of Xuanwei’s high incidence of lung cancer. It is understood that there are abundant reserves of bituminous coal in the Xuanwei area. Local rural residents habitually burned bituminous coal to heat and cook at home. However, there are no air intakes and chimneys in coal-fired fire pits, and soot from coal-fired coal accumulates indoors, causing air pollution.

Li Jihua said that since the 80s of last century, Xuanwei has carried out a large-scale reform and reconstruction project. Since 2009, with the support of the central special funds, Xuanwei has conducted CT screening of key local populations to carry out early prevention and early treatment of lung cancer.

Assistant Professor Tian Linxuan of the Chinese University of Hong Kong pointed out that although the local indoor coal-burning situation has been greatly improved, the overall incidence and death rate of Xuanwei's lung cancer has been rising in recent years.

“This may be related to incomplete reform of the stove. Although many rural households have installed chimneys, they are only more than a meter high. After the smoke is discharged, the wind can easily be poured back.” Li Jihua said that the local terrain is surrounded by mountains. Not conducive to the proliferation of soot, even if the smoke from the home will be accumulated over the village over the long-term.

Sun Yan, an academician of the Chinese Academy of Engineering and a professor at the Chinese Academy of Medical Sciences, believes that the initiation of cancer is the result of a combination of factors. Previous research on high-risk cancer areas showed that no one place was caused by an etiology.

Although the research on the causes of the high incidence of lung cancer in Xuanwei remains unclear, most experts believe that this is the result of a combination of multiple factors such as local coal-fired pollution and resident genetic susceptibility.

According to the data from the annual meeting of the Association for Science and Technology, in recent years, with the increase of air pollution, lung cancer has become the most malignant tumor disease in China with a high morbidity and mortality rate, which poses a serious threat to people's lives and health. The researchers believe that through the study of Xuanwei lung cancer, we can further clarify the pathogenesis of lung cancer, and then provide a theoretical basis for the prevention and treatment of lung cancer.

Li Jihua suggested that local government departments should actively set up environmental monitoring sites in the country to formulate more feasible measures for prevention and comprehensive management to monitor the environmental quality of the local air.

A number of experts from the conference appealed that China should further strengthen the prevention of lung cancer such as smoking prevention, air pollution control, and prevention of knowledge popularization, and actively carry out screening and early detection of lung cancer.

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