比较中国大陆 11 种常见癌症的空间模式。

Comparing spatial patterns of 11 common cancers in Mainland China.

机构信息

Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, 100084, China.

Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China.

出版信息

BMC Public Health. 2022 Aug 15;22(1):1551. doi: 10.1186/s12889-022-13926-y.

DOI:10.1186/s12889-022-13926-y

PMID:35971087

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9377081/

Abstract

BACKGROUND

A stronger spatial clustering of cancer burden indicates stronger environmental and human behavioral effects. However, which common cancers in China have stronger spatial clustering and knowledge gaps regarding the environmental and human behavioral effects have yet to be investigated. This study aimed to compare the spatial clustering degree and hotspot patterns of 11 common cancers in mainland China and discuss the potential environmental and behavioral risks underlying the patterns.

METHODS

Cancer incidence data recorded at 339 registries in 2014 was obtained from the "China Cancer Registry Annual Report 2017". We calculated the spatial clustering degree of the common cancers using the global Moran's Index and identified the hotspot patterns using the hotspot analysis.

RESULTS

We found that esophagus, stomach and liver cancer have a significantly higher spatial clustering degree ([Formula: see text]) than others. When by sex, female esophagus, male stomach, male esophagus, male liver and female lung cancer had significantly higher spatial clustering degree ([Formula: see text]). The spatial clustering degree of male liver was significantly higher than that of female liver cancer ([Formula: see text]), whereas the spatial clustering degree of female lung was significantly higher than that of male lung cancer ([Formula: see text]). The high-risk areas of esophagus and stomach cancer were mainly in North China, Huai River Basin, Yangtze River Delta and Shaanxi Province. The hotspots for liver and male liver cancer were mainly in Southeast China and south Hunan. Hotspots of female lung cancer were mainly located in the Pearl River Delta, Shandong, North and Northeast China. The Yangtze River Delta and the Pearl River Delta were high-risk areas for multiple cancers.

CONCLUSIONS

The top highly clustered cancer types in mainland China included esophagus, stomach and liver cancer and, by sex, female esophagus, male stomach, male esophagus, male liver and female lung cancer. Among them, knowledge of their spatial patterns and environmental and behavioral risk factors is generally limited. Potential factors such as unhealthy diets, water pollution and climate factors have been suggested, and further investigation and validation are urgently needed, particularly for male liver cancer. This study identified the knowledge gap in understanding the spatial pattern of cancer burdens in China and offered insights into targeted cancer monitoring and control.

摘要

背景

癌症负担的空间聚集程度越强，表明环境和人类行为因素的影响越大。然而，目前仍不清楚中国哪些常见癌症具有更强的空间聚集性，以及这些癌症的环境和人类行为因素的相关知识还存在哪些空白。本研究旨在比较中国大陆 11 种常见癌症的空间聚集程度和热点模式，并探讨这些模式潜在的环境和行为风险。

方法

我们从《中国肿瘤登记年报 2017》中获取了 2014 年 339 个登记处记录的癌症发病率数据。我们使用全局 Moran's I 指数来计算常见癌症的空间聚集程度，并使用热点分析来确定热点模式。

结果

我们发现食管癌、胃癌和肝癌的空间聚集程度显著高于其他癌症([Formula: see text])。按性别分层，女性食管癌、男性胃癌、男性食管癌、男性肝癌和女性肺癌的空间聚集程度显著更高([Formula: see text])。男性肝癌的空间聚集程度显著高于女性肝癌([Formula: see text])，而女性肺癌的空间聚集程度显著高于男性肺癌([Formula: see text])。食管癌和胃癌的高风险地区主要集中在中国北方、淮河流域、长江三角洲和陕西省。肝癌和男性肝癌的热点地区主要集中在中国东南部和湖南南部。女性肺癌的热点地区主要分布在珠江三角洲、山东、华北和东北地区。长江三角洲和珠江三角洲是多种癌症的高风险地区。

结论

中国大陆高度聚集的癌症类型包括食管癌、胃癌和肝癌，按性别分层，女性食管癌、男性胃癌、男性食管癌、男性肝癌和女性肺癌。其中，对于这些癌症的空间模式及其环境和行为风险因素的认识普遍有限。有研究提出了不健康饮食、水污染和气候因素等潜在因素，需要进一步进行调查和验证，特别是对于男性肝癌。本研究明确了中国癌症负担空间模式知识方面的空白，并为有针对性的癌症监测和控制提供了思路。