School of Public Health and Social Work, Science and Engineering Faculty, Queensland University of Technology, Brisbane, QLD, Australia.
Institute of Health and Biomedical Innovation, and School of Mathematical Sciences, Science and Engineering Faculty, Queensland University of Technology, Brisbane, QLD, Australia.
Chest. 2019 Nov;156(5):972-983. doi: 10.1016/j.chest.2019.07.023. Epub 2019 Aug 14.
This study aimed to identify changing spatial and temporal trends of lung cancer mortality rates (LCMRs) among subpopulations in China (according to region, age, and sex).
Data on LCMRs from 2006 to 2015 were extracted from the Chinese National Death Surveillance. Joinpoint regression and seasonal decomposition were used to assess the temporal trends. A geographic information system and spatial kriging interpolation were used to examine the spatial trends.
LCMRs in men aged 30 to 49 years significantly declined nationally from 2009 to 2015 (annual percentage change, -2.7%; P < .05), but they continued to rise in men aged ≥ 70 years and women aged ≥ 50 years in the east, people aged 50 to 69 years in the south, and most groups in the southwest. Among provincial capital cities, Shenyang, Changsha, and Hohhot had the highest 10-year average LCMR for men aged 30 to 49 years, 50 to 69 years, and ≥ 70 years, respectively; among all ages of women, Harbin had the highest average LCMR. Over the 10 years, the odds of the increases in LCMRs in men and women aged 30 to 69 years decreased by 3% to 7% with the longitudes or latitudes increasing by 1° (ORs ranged from 0.93 [95% CI, 0.90-0.95) to 0.97 [95% CI, 0.95-0.99]).
Disparities in the spatial and temporal trends of LCMRs among subpopulations highlight the need for investigation into potential drivers, especially for the east, south, and southwest of China. These findings may help health authorities target interventions to those most in need to reduce the lung cancer burden in China.
本研究旨在确定中国亚人群（按地区、年龄和性别）肺癌死亡率（LCMR）的时空变化趋势。
从中国国家死因监测中提取 2006 年至 2015 年的 LCMR 数据。使用 Joinpoint 回归和季节分解评估时间趋势。使用地理信息系统和空间克里金插值检查空间趋势。
2009 年至 2015 年，30 至 49 岁男性的全国 LCMR 明显下降（年变化百分比为-2.7%；P<0.05），但东部 70 岁以上和 50 岁以上女性、南部 50 至 69 岁人群以及西南地区大多数人群的 LCMR 持续上升。在省会城市中，沈阳、长沙和呼和浩特的 30 至 49 岁男性、50 至 69 岁男性和 70 岁以上男性的 10 年平均 LCMR 最高；所有年龄段的女性中，哈尔滨的 LCMR 最高。在过去的 10 年中，男性和女性 30 至 69 岁人群的 LCMR 上升概率随着经度或纬度每增加 1°而降低 3%至 7%（OR 范围为 0.93 [95%CI，0.90-0.95]至 0.97 [95%CI，0.95-0.99]）。
亚人群 LCMR 的时空变化趋势存在差异，突出了需要调查潜在驱动因素，特别是中国东部、南部和西南部。这些发现可能有助于卫生当局针对那些最需要的人群进行干预，以减轻中国的肺癌负担。
