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胃癌的流行病学、风险区域和宏观决定因素:基于地理空间分析的研究。

Epidemiology, risk areas and macro determinants of gastric cancer: a study based on geospatial analysis.

机构信息

Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.

Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou, China.

出版信息

Int J Health Geogr. 2023 Nov 25;22(1):32. doi: 10.1186/s12942-023-00356-1.

Abstract

BACKGROUND

Both incidence and mortality of gastric cancer in Gansu rank first in china, this study aimed to describe the recent prevalence of gastric cancer and explore the social and environmental determinants of gastric cancer in Gansu Province.

METHODS

The incidence of gastric cancer in each city of Gansu Province was calculated by utilizing clinical data from patients with gastric cancer (2013-2021) sourced from the medical big data platform of the Gansu Province Health Commission, and demographic data provided by the Gansu Province Bureau of Statistics. Subsequently, we conducted joinpoint regression analysis, spatial auto-correlation analysis, space-time scanning analysis, as well as an exploration into the correlation between social and environmental factors and GC incidence in Gansu Province with Joinpoint_5.0, ArcGIS_10.8, GeoDa, SaTScan_10.1.1 and GeoDetector_2018.

RESULTS

A total of 75,522 cases of gastric cancer were included in this study. Our findings suggested a significant upward trend in the incidence of gastric cancer over the past nine years. Notably, Wuwei, Zhangye and Jinchang had the highest incidence rates while Longnan, Qingyang and Jiayuguan had the lowest. In spatial analysis, we have identified significant high-high cluster areas and delineated two high-risk regions as well as one low-risk region for gastric cancer in Gansu. Furthermore, our findings suggested that several social and environmental determinants such as medical resource allocation, regional economic development and climate conditions exerted significant influence on the incidence of gastric cancer.

CONCLUSIONS

Gastric cancer remains an enormous threat to people in Gansu Province, the significant risk areas, social and environmental determinants were observed in this study, which may improve our understanding of gastric cancer epidemiology and help guide public health interventions in Gansu Province.

摘要

背景

甘肃省胃癌的发病率和死亡率均居全国首位,本研究旨在描述甘肃省胃癌的近期流行情况,并探讨其社会和环境决定因素。

方法

利用甘肃省卫生健康委员会医疗大数据平台获取的 2013-2021 年胃癌患者临床数据和甘肃省统计局提供的人口数据,计算甘肃省各城市胃癌发病率。采用 Joinpoint_5.0、ArcGIS_10.8、GeoDa、SaTScan_10.1.1 和 GeoDetector_2018 软件对甘肃省胃癌发病率进行 Joinpoint 回归分析、空间自相关分析、时空扫描分析及社会环境因素与胃癌发病的相关性分析。

结果

共纳入 75522 例胃癌病例。研究结果显示,过去 9 年甘肃省胃癌发病率呈显著上升趋势。武威、张掖和金昌发病率最高,陇南、庆阳和嘉峪关发病率最低。空间分析显示,甘肃省胃癌发病率存在显著的高高聚集区,划定了 2 个高风险区和 1 个低风险区。此外,多项社会环境因素,如医疗资源配置、区域经济发展和气候条件,对胃癌发病具有显著影响。

结论

胃癌仍是甘肃省人民健康的巨大威胁,本研究发现了显著的高危地区和社会环境决定因素,可能有助于提高对甘肃省胃癌流行病学的认识,并为甘肃省的公共卫生干预提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ec3/10675916/79764498a382/12942_2023_356_Fig1_HTML.jpg

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