Comparative Analysis Of The Incidence And Mortality Of Gastric Cancer And Their Trends Between Qidong, Jiangsu And Yangpu, Shanghai During 1993 To 2011

The incidence of gastric cancer in Qidong,Jiangsu province of China,from 1993 to 2012 and Mortality analysis of gastric cancer in Qidong city from 1993-2011 and its comparison with Yangpu,ShanghaiObjective To investigate the incidence of gastric cancer in Qidong from 1993 to 2012.To obtain death data of gastric cancer from Qidong,Jiangsu and Yangpu,Shanghai,between 1993 and 2011,and compare mortality rate trend of gastric cancer in these nineteen years,hence acquire risk factors of gastric cancer,which provide clue and basic data support for establishing preventive strategy and clinical therapy fitting realistic status of community population.Methods Data of digestive system cancer cases were collected from database of cancer registration and management system in Qidong.Annual percent change(APC)model was applied to describe the annual percent changes of disease incidence.The incidence was standardized with the age structure of standard population from a national census taken in 2000.By systematically cleaning gastric cancer death data in registered population of Qidong city and Yangpu,Shanghai,during January 1993 to December 2012 from Qidong cancer registry and Shanghai cancer registry,separately.Age-standardized mortality rates were calculated by age proportions of standard population from national census in 2000.Mortality trend and difference of characteristics were compared on gastric cancer between two areas.Results A total of 8272 new cases were reported in Qidong from 1993 to 2012,and the number account for 13.6% of total cases diagnosis with malignant diseases.The median age of patients was 67.92(57.50-76.00).Among them,5269 male cases were reported with a median age of 67.25(57.75-74.75),while 3003 cases were female with a median age of 69.16(57.00-77.91).The crude incidence was 40.37/10~5 and age-adjusted incidence was 25.22/10~5.An decreasing trend was observed during 1993 to 2002(Crude incidence:APC=-1.59,t=-4.6,P<0.01)followed by an increasing trend during 2002 to 2007(Crude incidence:APC=8.88,t=-5.3,P<0.01).The standardized incidence shared the same trend with crude incidence.Gastric cancer increases fast with the growing of age and peaked in the age group of 75-80.In nineteen years during 1993 to 2011,6809 gastric cancer cases were demonstrated by Qidong cancer registry,constituting 16.85% of all cancer death cases.While 4051 gastric cancer cases were confirmed in registered population of Yangpu District by Shanghai cancer registry.Crude mortality rate analysis showed that change of gastric cancer crude mortality was not apparent during 1993 to 2000,whereas gastric cancer crude mortality showed upward trend when entering into twentieth century.After standardization,age-adjusted rate showed downtrend.Gastric cancer mortality in Qidong females was far lower than in Qidong males,but showed upward trend.After standardization,both male and female age-adjusted mortality rate showed downtrend.Gastric cancer mortality rate in Yangpu,Shanghai showed down trend during 1993 to 2011,before and after standardization.Age adjusted mortality rate in Qidong was lower than Yangpu District.Age adjusted mortality rate of male both in Qidong and Yangpu between 1993 and 2011 showed down trend,and age adjusted gastric mortality rate of male in Qidong was lower than that in Yangpu.Age adjusted mortality rate of female both in Qidong and Yangpu between 1993 and 2011 showed down trend,and age adjusted gastric mortality rate of female in Qidong was lower than that in Yangpu.Conclusion The incidence of gastric cancer remained high in Qidong.The male and old people are more susceptible.During 1993 to 2012,both gastric mortality rate of Qidong and that of Yangpu were showed down trend and male gastric mortality rate in each area was higher than females.Whereas age adjusted mortality rates of Qidong were lower than Yangpu.The reason behind were exposure of environmental risk factors and aging population of Yangpu.