Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Korea.
Cancer Res Treat. 2023 Apr;55(2):603-617. doi: 10.4143/crt.2022.307. Epub 2022 Sep 6.
This study aimed to examine secular trends, age-period-cohort effects, and geographical differences in gastric cancer (GC) mortality in Korea.
Using cause of death data from the Korean Statistical Information Service for GC from 2000 to 2020, we calculated average annual percentage changes (AAPCs) in the age-standardized mortality of GC in 17 cities and provinces through joinpoint regression. Decomposition of age, period, and cohort effects on GC mortality were elucidated by applying a log-linear model and an intrinsic estimate method. Spatial patterns and the degree of spatial clustering in 250 administrative regions were explored via Moran's I statistics. Stratification by sex was performed for all analyses.
The age-standardized mortality of GC per 100,000 persons declined from 29.0 in 2000 to 7.9 in 2020 (AAPC, -6.28%). Age-period-cohort analyses of GC mortality showed a downward trend among five-year age groups from age 20-89 years across five-year periods from 2005-2020 and five-year birth cohorts from 1920-2000. Overall, the younger birth cohort showed lower mortality rates than the older cohort within the same period. In 2020, clusters of high GC mortality were observed in the central area for men (Chungcheongbuk, Jeollabuk, Gyeongsangbuk, and Gyeongsangnam) and in the eastern area for women (Gyeongsangbuk).
This study identified a downward trend in GC mortality among men and women from 2000 to 2020 in Korea. This trend was mainly attributed to birth cohort rather than period effects. Spatial analysis showed high GC mortality in the Chungcheong and Gyeongsangbuk areas.
本研究旨在探讨韩国胃癌（GC）死亡率的时间趋势、年龄-时期-队列效应和地理差异。
利用韩国统计信息服务局 2000 年至 2020 年 GC 死因数据，通过 Joinpoint 回归计算 17 个市/省胃癌死亡率的年龄标准化平均年变化率（AAPC）。通过应用对数线性模型和内在估计方法，阐明了 GC 死亡率的年龄、时期和队列效应的分解。通过 Moran's I 统计量探索了 250 个行政区域的空间格局和空间聚类程度。对所有分析进行了性别分层。
每 100,000 人年龄标准化的 GC 死亡率从 2000 年的 29.0 降至 2020 年的 7.9（AAPC，-6.28%）。GC 死亡率的年龄-时期-队列分析显示，2005-2020 年期间，五个年龄组（20-89 岁）和五个出生队列（1920-2000 年）的死亡率呈下降趋势。总体而言，同一时期出生的年轻队列死亡率低于年长队列。2020 年，男性中央地区（忠清北道、全罗北道、庆尚北道和庆尚南道）和女性东部地区（庆尚北道）的 GC 死亡率较高。
本研究发现韩国 2000 年至 2020 年男性和女性的 GC 死亡率呈下降趋势。这种趋势主要归因于出生队列，而不是时期效应。空间分析显示忠清和庆尚地区的 GC 死亡率较高。
