Montero-Oleas Nadia, Núñez-González Solange, Simancas-Racines Daniel
Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, Ecuador.
Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, Ecuador.
Cancer Epidemiol. 2017 Dec;51:92-97. doi: 10.1016/j.canep.2017.10.014. Epub 2017 Nov 5.
This study was aimed to describe the gastric cancer mortality trend, and to analyze the spatial distribution of gastric cancer mortality in Ecuador, between 2004 and 2015.
Data were collected from the National Institute of Statistics and Census (INEC) database. Crude gastric cancer mortality rates, standardized mortality ratios (SMRs) and indirect standardized mortality rates (ISMRs) were calculated per 100,000 persons. For time trend analysis, joinpoint regression was used. The annual percentage rate change (APC) and the average annual percent change (AAPC) was computed for each province. Spatial age-adjusted analysis was used to detect high risk clusters of gastric cancer mortality, from 2010 to 2015, using Kulldorff spatial scan statistics.
In Ecuador, between 2004 and 2015, gastric cancer caused a total of 19,115 deaths: 10,679 in men and 8436 in women. When crude rates were analyzed, a significant decline was detected (AAPC: -1.8%; p<0.001). ISMR also decreased, but this change was not statistically significant (APC: -0.53%; p=0.36). From 2004 to 2007 and from 2008 to 2011 the province with the highest ISMR was Carchi; and, from 2012 to 2015, was Cotopaxi. The most likely high occurrence cluster included Bolívar, Los Ríos, Chimborazo, Tungurahua, and Cotopaxi provinces, with a relative risk of 1.34 (p<0.001).
There is a substantial geographic variation in gastric cancer mortality rates among Ecuadorian provinces. The spatial analysis indicates the presence of high occurrence clusters throughout the Andes Mountains.
本研究旨在描述2004年至2015年期间厄瓜多尔胃癌死亡率趋势，并分析其空间分布情况。
数据收集自国家统计和普查研究所（INEC）数据库。计算每10万人的胃癌粗死亡率、标准化死亡率（SMR）和间接标准化死亡率（ISMR）。采用连接点回归进行时间趋势分析，计算每个省份的年变化率（APC）和平均年变化率（AAPC）。利用Kulldorff空间扫描统计方法对2010年至2015年的胃癌死亡率进行空间年龄调整分析，以检测高风险聚集区。
在厄瓜多尔，2004年至2015年期间，胃癌共导致19115人死亡，其中男性10679人，女性8436人。分析粗死亡率时发现显著下降（AAPC：-1.8%；p<0.001）。ISMR也有所下降，但这一变化无统计学意义（APC：-0.53%；p=0.36）。2004年至2007年以及2008年至2011年期间，ISMR最高的省份是卡尔奇；2012年至2015年期间是科托帕希。最有可能的高发病聚集区包括玻利瓦尔、洛斯里奥斯、钦博拉索、通古拉瓦和科托帕希等省份，相对风险为1.34（p<0.001）。
厄瓜多尔各省之间胃癌死亡率存在显著的地理差异。空间分析表明，安第斯山脉沿线存在高发病聚集区。
