| Objective:By sorting out the data of upper gastrointestinal cancer reported by Shanxi cancer registration areas from 2013 to 2017,this study analyzed the incidence and mortality status,regional distribution characteristics and the epidemiological trends of upper gastrointestinal cancer,estimated the incidence and mortality of upper gastrointestinal cancer in Shanxi Province in 2017,and predicted the incidence and mortality rates of upper gastrointestinal cancer from 2018 to 2023,which provided basic and essential data for formulating scientific cancer prevention strategies,and promoted the development of cancer prevention and control in Shanxi Province.Methods:The incidence,mortality and population data of upper gastrointestinal cancer in cancer registration areas in Shanxi Province from 2013 to 2017 were collected and sorted.In order to understand the basic epidemiological characteristics of upper gastrointestinal cancer,the crude rates,age-standardized rates by Chinese standard population(ASR China),age-standardized rates by world standard population(ASR World),the cumulative rates(0-74 years old),and age-specific rates of incidence and mortality were calculated from data that met the check standards.Chinese census standard population composition in 2000 and Segi’s world standard population composition were used to calculate the age-standardized rates.The Joinpoint 4.9.1.0 software was used to calculate the annual percent change(APC)of age-standardized rates by Chinese standard population of incidence and mortality of upper gastrointestinal cancer in Shanxi cancer registration areas,so as to understand the temporal changing trend characteristics of upper gastrointestinal cancer from 2013 to 2017.Based on the upper gastrointestinal cancer data of cancer registration in 2017,the incidence and mortality of upper gastrointestinal cancer in the whole province were estimated after weighting by urban and rural areas,gender and age groups.The GM(1,1)grey model was used to fit the crude incidence rates and mortality rates of upper gastrointestinal cancer in Shanxi cancer registration areas from 2013 to 2017,and predict the prevalence of upper gastrointestinal cancer in Shanxi Province from 2018 to 2023.Results:1.In Shanxi cancer registration areas,the incidence rates and mortality rates of upper gastrointestinal cancer were relatively stable from 2013 to 2017.The incidence rates fluctuated between 60.13/100,000 and 71.35/100,000,and the mortality rates fluctuated between 43.67/100,000 and 45.78/100,000.During the five years,there were 15837 new cases and 10849 deaths of upper gastrointestinal cancer,the crude incidence rate and mortality rate were 65.39/100,000 and 44.80/100,000 respectively,the ASR China of incidence and mortality were 46.68/100,000 and 31.75/100,000 respectively,the ASR World of incidence and mortality were 47.65/100,000 and 32.09/100,000 respectively,and the cumulative incidence rate and mortality rate(0-74 years old)were 6.14% and 3.85%respectively.In Shanxi cancer registration areas,the incidence rates and mortality rates of upper gastrointestinal cancer from 2013 to 2017 were different in gender and region,and the differences were statistical significance(P<0.001),showing that the rates were higher in males than those in females and higher in rural areas than those in urban areas.From2013 to 2017,the incidence rates and mortality rates of upper gastrointestinal cancer increased rapidly with age from the 40-year-old age group and the 45-year-old age group in cancer registration areas in Shanxi Province,and reached the peak in the 65-year-old age group and in the 85-year-old age group respectively.2.From 2013 to 2017,the ASR China of incidence of upper gastrointestinal cancer in entire population,males and females showed a downward trend,with an average annual decline of 4.08%,3.37% and 5.07%.The change trend of ASR China of incidence in urban areas and in rural areas was the same,and decreased by 3.01% and 5.55%,respectively,but the differences did not show statistical significance(P>0.05).The ASR China of mortality in entire population,males and females showed a slight downward trend,with an average annual decline of 2.08%,1.72% and 2.32%.The ASR China of incidence in urban areas showed a slight upward trend(APC= 2.11%),and the rural areas showed a downward trend,and decreased by 4.55%,but there were no statistical significance(P>0.05).3.In Shanxi cancer registration areas in 2017,the ASR China of incidence of upper gastrointestinal cancer in Yangcheng County(158.85/100,000)was the highest,and in Shouyang County(19.95/100,000)was the lowest.The ASR China of mortality of upper gastrointestinal cancer in Yangcheng County(106.60/100,000)was the highest,and in Xinghualing District(14.56/100,000)was the lowest.It is estimated that there were 29381 new cases and 20066 deaths of upper gastrointestinal cancer in Shanxi Province in 2017,with the highest incidence and mortality numbers in the 65-year-old age group.The number of new cases and deaths in males were 2.49 and 2.15 times greater than those in females,and the number of new cases and deaths in rural areas were 5.09 and 4.85 times greater than those in urban areas,respectively.4.The GM(1,1)grey model was established according to the data in Shanxi cancer registration areas from 2013 to 2017.The results showed that the fitting effect of overall and male incidence of upper gastrointestinal cancer were excellent,the fitting effect of female incidence was qualified,and the fitting results were all good for overall,male and female mortality of upper gastrointestinal cancer,which could be used to predict the incidence and mortality of upper gastrointestinal cancer in the next years from 2018 to2023.The predicted results showed that the overall,males and females incidence rates and mortality rates showed a slight upward trend of upper gastrointestinal cancer from 2018 to2023,and the incidence rates and mortality rates were higher in males than those in females.Conclusion:1.From 2013 to 2017,the ASR China of incidence and mortality of upper gastrointestinal cancer in Shanxi cancer registration areas were higher than those in the national average,and showed that the rates were higher in males than those in females and higher in rural areas than those in urban areas.The incidence rates and mortality rates of upper gastrointestinal cancer increased rapidly with age from the age of 40 and 45,respectively.Therefore,attention should be focused on the male population,the population in rural areas and the population over 40 years old.2.From 2013 to 2017,the ASR China of incidence and mortality of upper gastrointestinal cancer in Shanxi cancer registration areas showed a downward trend,reflecting that the current comprehensive prevention and control measures for upper gastrointestinal cancer have acquired certain effect,which need to be further promoted and improved,and the accurate prevention and control direction of upper gastrointestinal cancer should be continuously advanced.3.It is estimated that the number of new cases and deaths in males were 2.49 and 2.15 times greater than those in females,and the number of new cases and deaths in rural areas were 5.09 and 4.85 times greater than those in urban areas,respectively,showing that the numbers were higher in males than those in females and higher in rural areas than those in urban areas.The numbers of incidence and mortality of upper gastrointestinal cancer are the highest in the 65-year-old age group,and the burden of disease caused by the aging population is relatively heavy.4.The predicted results showed that the overall,males and females incidence rates and mortality rates of upper gastrointestinal cancer showed a slight upward trend from 2018 to2023 in Shanxi Province.We should promote upper gastrointestinal cancer early diagnosis and early treatment project,strengthen cancer screening efforts,and develop reasonable and effective cancer prevention and control strategies,so as to reduce the incidence and mortality of upper gastrointestinal cancer. |
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