Gao Xudong, Wang Zhenkun, Kong Chan, Yang Fen, Wang Ying, Tan Xiaodong
Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan 430071, China.
Department of Nursing, College of Health Science & Nursing, Wuhan Polytechnic University, 68 Xuefunan Road, Wuhan 430023, China.
Int J Environ Res Public Health. 2017 Feb 23;14(3):218. doi: 10.3390/ijerph14030218.
: Esophageal cancer is one of the most common cancers in rural China. The aim of this study was to describe the time trends of esophageal cancer mortality in rural China and to better elucidate the causes of these trends. : The mortality data were obtained from the World Health Organization Mortality Database and the China Health Statistical Yearbook Database. The mortality data were analyzed with age-period-cohort (APC) analysis. : Our study indicates that the Age-Standardized Mortality Rates (ASMRs) in rural China generally decreased from 1989 to 2003, and thereafter increased until the year 2008 in both sexes. After 2008, the ASMRs decreased again. The results of APC analysis suggest that the general decrease in esophageal cancer mortality in rural China from 1989 to 2003 might be caused by the downtrend of the cohort effects and period effects, while the general increase in mortality from 2004 to 2008 might be caused by the uptrend of the period effects. The decrease in mortality after 2008 may be relevant to the Four Trillion RMB Investment Plan launched by the Chinese Government. : The declining cohort effects were probably related to the improvement of socioeconomic status in childhood and the decreasing consumptions of alcohol drinking and smoking, while the trends of the period effects were relevant to the changes in the dietary pattern. Our findings may help predict future changes in esophageal cancer mortality.
食管癌是中国农村地区最常见的癌症之一。本研究旨在描述中国农村地区食管癌死亡率的时间趋势，并更好地阐明这些趋势的原因。死亡率数据来自世界卫生组织死亡率数据库和《中国卫生统计年鉴》数据库。采用年龄-时期-队列（APC）分析方法对死亡率数据进行分析。我们的研究表明，1989年至2003年期间，中国农村地区的年龄标准化死亡率（ASMR）总体呈下降趋势，此后直至2008年，男女的ASMR均有所上升。2008年之后，ASMR再次下降。APC分析结果表明，1989年至2003年中国农村地区食管癌死亡率的总体下降可能是由于队列效应和时期效应的下降趋势所致，而2004年至2008年死亡率的总体上升可能是由于时期效应的上升趋势所致。2008年之后死亡率的下降可能与中国政府推出的四万亿人民币投资计划有关。队列效应的下降可能与儿童时期社会经济状况的改善以及饮酒和吸烟消费的减少有关，而时期效应的趋势则与饮食模式的变化有关。我们的研究结果可能有助于预测未来食管癌死亡率的变化。
