An Age-Period-Cohort Model Analysis Of Gastrointestinal Cancer Mortality From 1990 To 2015 In China

Backgroud:Malignant tumors are one of the most important health problems in the world.In the case of malignant tumor mortality,the gastrointestinal malignancy is the third type of malignancy after lung cancer and liver cancer.According to the global burden of disease,the number of deaths in China's digestive tract in 2010 was 623,000,accounting for 33.4 percent of all deaths.Esophageal cancer,gastric cancer and colorectal cancer is a common gastrointestinal malignant tumor,accounts for a third of the total number of all malignant tumor.Object:In order to understand the death tendency of esophageal cancer,stomach cancer and colorectal cancer in our country,This paper provides a reference for the study of the etiology of the digestive tract malignancy in our country and the prevention and control measures.Method:This study draw the digestive tract malignant tumor(this study including esophageal cancer,gastric cancer and colorectal cancer)from the Global Burden of Diseases,Injuries,and Risk Factors Study 2015.The mortality data are divided into 12 age groups,6 period groups and 17 birth cohort groups.This study uses Age-Period-Cohort model and Intrinsic Estimator(IE)to analyze the death trend of malignant tumors in the digestive tract.The Stata 11 software is applied to fit the model.Results:From 1990 to 2015,there was a decline in the age-standardized mortality rates for esophageal and stomach cancer in the country,and the rate of mortality of esophageal and stomach cancer in male was higher than in women.The age-standardized mortality for colorectal cancer was down after rising,and the mortality for male and female show a similar trend.From 1990 to 2015,the mortality rate of esophageal cancer,stomach cancer and colorectal cancer increased with age in China.The mortality rates of esophageal and gastric cancer in males and females declined with periods,except for the 75-89 age group.The mortality rate for colorectal cancer in men between 70 and 79 years old increased significantly with period,and the mortality rate of colorectal cancer for other men and women in other age groups fluctuated with period.The mortality rate of esophageal and stomach cancers decreased with the birth cohort,and the mortality rate of colorectal cancer was not apparent in the birth cohort.Controlling period and birth cohort,the mortality risk of esophageal,stomach and colorectal cancers increased with ages.Controlling age and birth cohort,the mortality risk of esophageal cancer declined in male and not changed significantly in female;the mortality risk of stomach cancer declined after rising in men,and declined in women;the mortality risk of colorectal cancer in men and women increased with periods.Controlling age and period,the mortality risk of esophageal,stomach and colorectal cancers decreased slowly with the birth cohort.Conclusion:(1)The age-standardized mortality for gastrointestinal cancer in male were higher than female,because men might bear more social pressure,and have negative emotions.The rates of smoking and drinking rate in men was higher than women.In the course of disease prevention and control,men should be focused on primary prevention and secondary prevention,and they are actively conducting education and early screening.(2)Gastrointestinal cancer mortality for 45 years or older residents began to rise in China,so middle-aged and old people is high-risk groups to gastrointestinal cancer.Conducting early detection and prevention knowledge propaganda and education can obtain better effect of prevention and control,to reduce the digestive tract tumor mortality.(3)Esophageal and gastric cancer had the highest risk of death in 2005,perhaps with the health service market limiting the low-income for medical treatment.Since 2005,the risk of death from esophageal cancer and stomach cancer has declined,because of major national health care reform measures.The refrigerator penetration is higher and higher,and food storage method is more scientific,so the risk of death in esophageal and gastric cancer reduces.(4)Colorectal cancer death risk is on the rise along with time.On the one hand it may be associated with residents' eating habits.In recent years,eats eating habits became more and more westernized,in China.On the other hand it may be linked to lack of physical exercise,and obesity rates become higher and higher.