Yuan Shuai, Xie Shao-Hua
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
BMJ Open. 2021 Apr 30;11(4):e042762. doi: 10.1136/bmjopen-2020-042762.
The substantial differences in socioeconomic and lifestyle exposures between urban and rural areas in China may lead to urban-rural disparity in cancer risk. This study aimed to assess the urban-rural disparity in cancer incidence in China.
Using data from 36 regional cancer registries in China in 2008-2012, we compared the age-standardised incidence rates of cancer by sex and anatomic site between rural and urban areas. We calculated the rate difference and rate ratio comparing rates in rural versus urban areas by sex and cancer type.
The incidence rate of all cancers in women was slightly lower in rural areas than in urban areas, but the total cancer rate in men was higher in rural areas than in urban areas. The incidence rates in women were higher in rural areas than in urban areas for cancers of the oesophagus, stomach, and liver and biliary passages, but lower for cancers of thyroid and breast. Men residing in rural areas had higher incidence rates for cancers of the oesophagus, stomach, and liver and biliary passages, but lower rates for prostate cancer, lip, oral cavity and pharynx cancer, and colorectal cancer.
Our findings suggest substantial urban-rural disparity in cancer incidence in China, which varies across cancer types and the sexes. Cancer prevention strategies should be tailored for common cancers in rural and urban areas.
中国城乡地区在社会经济和生活方式暴露方面存在的显著差异可能导致癌症风险的城乡差异。本研究旨在评估中国癌症发病率的城乡差异。
利用2008 - 2012年中国36个地区癌症登记处的数据,我们比较了城乡地区按性别和解剖部位划分的癌症年龄标准化发病率。我们计算了农村与城市地区按性别和癌症类型划分的发病率差异和发病率比。
农村地区女性所有癌症的发病率略低于城市地区,但农村地区男性的总癌症发病率高于城市地区。农村地区女性食管癌、胃癌、肝癌和胆管癌的发病率高于城市地区,但甲状腺癌和乳腺癌的发病率低于城市地区。农村地区男性食管癌、胃癌、肝癌和胆管癌的发病率较高,但前列腺癌、唇癌、口腔和咽喉癌以及结直肠癌的发病率较低。
我们的研究结果表明,中国癌症发病率存在显著的城乡差异,且因癌症类型和性别而异。癌症预防策略应针对城乡地区的常见癌症进行调整。