State Key Laboratory of Resources and Environmental Information System, Institute of GeographicSciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100190, China.
Int J Environ Res Public Health. 2020 Feb 26;17(5):1498. doi: 10.3390/ijerph17051498.
Epidemiological features of esophageal cancer (EC), as well as their associations withpotential influencing factors in a city, have seldom been seldom explored on a fine scale. The ECdeath cases in Guangzhou city during 2012-2017 were collected to describe the epidemiologicalcharacteristics such as EC mortality rate (ECMR) and health-seeking behaviors of deaths. Potentialinfluencing factors, including socioeconomic conditions (population density, gross domesticproduct density), medical resources, and ageing degree were also gathered for exploring theirrelationships with the epidemiological characteristics of EC. A total of 2,409 EC deaths werereported during 2012-2017 in Guangzhou with an age-standardized ECMR of 3.18/105. Theprevalence of EC in Guangzhou was spatially featured and was divided into three regions withobvious differentiated ECMR (ECMR of 6.41/105 in region A, ECMR of 5.51/105 in region B, ECMRof 2.56/105 in region C). The street/town-level ECMR was spatially clustered in Guangzhou city,especially two clusters of streets/towns with high ECMR were highlighted in region A and Brespectively. Meanwhile, demographic features including gender gap, death age, temporal intervalbetween diagnosis and death, health-seeking behaviors were remarkably different among the threeregions. Moreover, health-seeking behaviors (e.g., the proportion of hospital deaths) of the ECdeaths were obviously influenced by medical institution occupancy rate and socioeconomicconditions at street/town level. In addition, the street/town-level ECMR was significantly associatedwith ageing degree across Guangzhou city (r = 0.466, < 0.01), especially in region A (r = 0.565, <0.01). In contrast, the ECMR in region B was closely related to population density (r = -0.524, <0.01) and gross domestic product density (r = -0.511, < 0.01) when the ageing degree was controlled,while these associations were weak in region C. The epidemiological characteristics of EC inGuangzhou city were spatially featured and potentially associated with socioeconomic conditions,medical resources and ageing degree on a fine scale across Guangzhou city. This study couldprovide scientific basis for local authorities to implement more targeted EC interventions.
2012-2017 年广州市食管癌死亡病例的流行病学特征及其与潜在影响因素的关系
在细粒度尺度上，城市食管癌（EC）的流行病学特征及其与潜在影响因素的关系很少被探讨。本研究收集了 2012-2017 年广州市的食管癌死亡病例，描述了食管癌死亡率（ECMR）和死亡者的求医行为等流行病学特征。还收集了包括社会经济条件（人口密度、国内生产总值密度）、医疗资源和老龄化程度在内的潜在影响因素，以探讨它们与 EC 流行病学特征的关系。
2012-2017 年，广州市共报告 2409 例食管癌死亡，年龄标准化 ECMR 为 3.18/105。广州市食管癌的流行具有空间特征，分为三个区域，ECMR 明显不同（A 区 ECMR 为 6.41/105，B 区 ECMR 为 5.51/105，C 区 ECMR 为 2.56/105）。广州市街道/城镇级 ECMR 呈空间聚集性，尤其是 A 区和 B 区分别有两个 ECMR 高的街道/城镇聚集区。同时，三个区域的人口统计学特征（如性别差距、死亡年龄、诊断与死亡之间的时间间隔、求医行为）差异显著。此外，医疗设施入住率和街道/城镇社会经济条件明显影响食管癌死亡者的求医行为（如医院死亡比例）。此外，在整个广州市，街道/城镇级 ECMR 与老龄化程度显著相关（r = 0.466，<0.01），尤其是在 A 区（r = 0.565，<0.01）。相比之下，当控制老龄化程度时，B 区的 ECMR 与人口密度（r = -0.524，<0.01）和国内生产总值密度（r = -0.511，<0.01）密切相关，而在 C 区这些关联较弱。
综上所述，广州市 EC 的流行病学特征具有空间特征，并与社会经济条件、医疗资源和老龄化程度在一定程度上相关。本研究可为地方当局实施更有针对性的 EC 干预措施提供科学依据。
