Lai S P, Su H M, Liu Y W, Zhang M Q, Huang Z Q, Liu J X, Huang H
School of Public Health, Wenzhou Medical University, Wenzhou 325035, China.
School of Public Health, Wenzhou Medical University/Zhejiang Provincial Key Laboratory of Watershed Sciences and Health, Wenzhou 325035, China.
Zhonghua Zhong Liu Za Zhi. 2024 Jul 23;46(7):657-662. doi: 10.3760/cma.j.cn112152-20230726-00040.
To explore the spatial distribution characteristics, trend changes, and spatial clustering of esophageal cancer among residents in China at the county (city, district) scale, a spatial epidemiological approach was used, with the aim of providing localized evidence for the prevention and treatment of esophageal cancer in China. The data source was the incidence (crude rate) and mortality (crude rate) of esophageal cancer from 2005 to 2016 in the 2008-2019 edition of China Cancer Registration Annual Report published by the National Cancer Center. The Joinpoint model was used for time trend analysis. The tumor registration area in 2016 was selected as the study area for spatial feature analysis, with a total of 487 counties (cities and districts), covering 27.6% of the national population. Spatial autocorrelation analysis was performed to reveal spatial distribution characteristics by using Arcgis 10.6 software, and spatial scanning statistics was used to analyze spatial clustering characteristics by using SaTScan 9.5 software. The log-likelihood ratio () and relative risk () were calculated in different windows, and the region with the largest value represented the most likely cluster. From 2005 to 2016, the incidence and mortality rate of esophageal cancer in China showed a trend of increasing at first and then decreasing. The incidence and mortality rate of esophageal cancer in 2016 were characterized by spatial positive correlation. High incidence and high mortality were mainly concentrated in the areas through which the Huaihe River flowed. The primary clusters (taking high incidence rate as an example =6 374.41, =2.37, ＜0.001) were mainly distributed in Jiangsu, Anhui and Shandong in eastern China and eastern Henan and southern Hebei in central China, and secondary clusters (taking high incidence rate as an example =1 971.19, =1.91, ＜0.001) in Gansu, Ningxia Hui Autonomous Region, Shaanxi, Sichuan and other central and western regions. The incidence and mortality of esophageal cancer in China have decreased since 2010. The disease burden of esophageal cancer has obvious spatial differences, and measures should be taken according to local conditions in high-risk cluster areas such as the Huaihe River basin.
为探讨中国居民食管癌在县（市、区）尺度上的空间分布特征、趋势变化及空间聚集性，采用空间流行病学方法，旨在为中国食管癌防治提供本土化依据。数据来源为国家癌症中心发布的《中国癌症登记年报（2008 - 2019年版）》中2005 - 2016年食管癌的发病率（粗率）和死亡率（粗率）。采用Joinpoint模型进行时间趋势分析。选取2016年肿瘤登记地区作为空间特征分析的研究区域，共487个县（市、区），覆盖全国27.6%的人口。利用Arcgis 10.6软件进行空间自相关分析以揭示空间分布特征，利用SaTScan 9.5软件进行空间扫描统计分析空间聚集特征。在不同窗口计算对数似然比（）和相对风险（），值最大的区域代表最可能的聚集区。2005 - 2016年，中国食管癌发病率和死亡率呈先上升后下降趋势。2016年食管癌发病率和死亡率呈现空间正相关。高发病率和高死亡率主要集中在淮河沿线地区。主要聚集区（以高发病率为例，=6374.41，=2.37，＜0.001）主要分布在中国东部的江苏、安徽和山东以及中部的河南东部和河北南部，次要聚集区（以高发病率为例，=1971.19，=1.91，＜0.001）分布在甘肃、宁夏回族自治区、陕西、四川等中西部地区。自2010年以来，中国食管癌发病率和死亡率有所下降。食管癌疾病负担存在明显的空间差异，应对淮河等流域等高风险聚集区因地制宜采取措施。
