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Chronic, non-communicable diseases account for an estimated 80% of total deaths and 70% of disability-adjusted life years (DALYs) lost in China. Cardiovascular diseases, chronic respiratory disease, and cancer are the leading causes of both death and of the burden of disease, and exposure to risk factors is high: more than 300 million men smoke cigarettes and 160 million adults are hypertensive, most of whom are not being treated. An obesity epidemic is imminent, with more than 20% of children aged 7–17 years in big cities now overweight or obese. Rates of death from chronic disease in middle-aged people are higher in China than in some high-income countries.〔Strong K, Mathers C, Leeder S, Beaglehole R. Preventing chronic diseases: how many lives can we save?. Lancet 2005;()〕 In China, as in many other parts of the world, the government has focused on communicable diseases—however, China now has a "double burden" of disease. The prevention of chronic diseases is now receiving a national response commensurate with the burden. The national cancer prevention and control plan (2004–10) is being implemented, and a national chronic disease prevention and control plan has been completed (in late-2005). Progress has been made in some areas, with current smoking prevalence in men declining at about 1% per year for a decade, and even better results in large demonstration programs. Much remains to be done, and resources and sustainability are major issues. However, the surveillance and intervention mechanisms needed to ameliorate the increasing burden of chronic diseases are developing rapidly, taking account of the lessons learned over the past two decades. It is said that about 25% of all cancer deaths globally - across planet Earth - are of Chinese persons in Mainland China and that one-fifth (20%) of all deaths inside China are from one or more cancers.〔(Nelson R., Cancer Needs to Become a National Priority in China, May 01, 2014, Accessed 5/3/2014 )〕〔(Challenges to effective cancer control in China, India, and Russia, The Lancet Oncology, 15(5), 489-538, April 2014, doi:10.1016/S1470-2045(14)70029-4, Accessed 5/3/2014 )〕 , ==Epidemiology== The ageing of the population is the major force driving the epidemic of chronic diseases. In 2000, 7% of the Chinese population were aged 65 years or older,〔Fifth National Population Census. Beijing: National Bureau of Statistics of China, 2000.〕 and more than 400 million Chinese adults are now aged 20–39 years. If current trends continue, by 2040 the group aged 65 years and older will have increased to almost 20% of the population.〔Leeder S, Raymond S, Greenberg H, et al. A race against time: the challenge of cardiovascular disease in developing economies. New York: Columbia University, 2005.〕 The ageing of the population alone is predicted to produce a 200% increase in deaths from cardiovascular disease in China between the years 2000 and 2040.〔 In addition to the ageing of the population, China is experiencing dramatic transformations in many social and economic conditions that will continue to increase the incidence of major chronic diseases. For example, the country has recorded spectacular economic growth since 1978 and, on average, people's standard of living is far higher than ever before in the rapidly expanding urban areas. From 1990 to 2000, the proportion of people living in urban settings in China increased from 26% to 36%, the number of cities increased to 663, and the number of towns also soared.〔 It is expected that urbanization in China will reach 45% by 2010, and 60% by 2030, with an extra 200 million more people expected in the urban areas before 2010.〔 This growth comes at a cost in health terms. For example, a clear relation exists between urbanization and the prevalence of diabetes in China (diabetes defined as diabetic symptoms and a random blood glucose concentration of 11.1 mmol/L or more, a fasting blood glucose of 7.0 mmol/L or more, or an abnormal result of 2-h oral glucose tolerance test).〔Ministries of Health and Science and Technology and the National Bureau of Statistics of the People's Republic of China. The nutrition and health status of the Chinese people. Beijing: State Information Office, 2004.〕 The rapid environmental changes that follow urbanization are increasing the prevalence of the major risk factors for chronic disease. Tobacco use, unhealthy nutrition, and physical inactivity leading to obesity and hypertension are already common, and physical inactivity is increasing.〔 The prevalence of current cigarette smoking in men (smoked in the past 30 days) was 57% in 2002, but had fallen from 63% in 1996; less than 3% of women are current smokers.〔Yang G, Ma J, Liu N, Zhou L. Smoking and passive smoking in Chinese. Chin J Epidemiol 2005; 26: 78-83.〕 This favorable trend must be continued, because lung cancer death rates are calculated to have more than doubled in men between 1991 and 1995, and are increasing at 2–5% per year in urban and rural working men aged 15–54 years.〔Yang L, Parkin DM, Li YD, et al. Estimation and projection of the national profile of cancer mortality in China: 1991–2005. Br J Cancer 2004; 90: 2157-2166.〕 The decrease in smoking is the only encouraging risk factor trend, and is consistent with the plateau of tobacco consumption over this same period in the face of a rising adult population, as has occurred in other countries where tobacco taxes have been raised sharply. In 1999 the first Global Youth Tobacco Survey in China showed that 22% of students aged 13–15 years had ever tried to smoke; the current smoking rate was only 5%.〔Wang Y, Huang Y, Li A, et al. A survey of adolescent smoking and tobacco knowledge in four areas of China. Chin J School Health 2000; 21: 456-457.〕 China's first comprehensive survey in the fields of nutrition and health was done in 2002. 71,971 households were chosen from 132 counties of 31 provinces, autonomous regions, and the municipalities, using the Central Government household census, and 243,479 people were included in the survey.〔 The prevalence of hypertension (blood pressure 140/90 or higher) in people aged 18 years or older was 19%—a 30% increase since 1991. The prevalence of adult overweight (23%) and obesity (7%) had increased by 39% and 97%, respectively, over a 10-year period.〔 Of particular note is the rapidly developing epidemic of obesity in Chinese children. The overall prevalence rates of overweight plus obesity in 2000 among students in six sites (Beijing, Tianjin, and Shanghai cities and Hebei, Liaoning, and Shandong provinces) increased from 1–2% in 1985 to 25% for boys aged 7–9 years, 25% for boys aged 10–12 years, 17% for girls aged 7–9 years, and 14% for girls aged 10–12 years.〔Ji C, Sun J, Chen T. Dynamic analysis on the prevalence of obesity and overweight school-age children and adolescents in recent 15 years in China. Chin J Epidemiol 2004; 25: 103-104.〕 In 2002, prevalence rates in children aged 7–17 years varied from 13% overweight and 8% obese in a range of big cities to 2% overweight and less than 1% obese in a range of rural sites.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Chronic disease in China」の詳細全文を読む スポンサード リンク
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