Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2017; 23(14): 2625-2634
Published online Apr 14, 2017. doi: 10.3748/wjg.v23.i14.2625
Upper gastrointestinal cancer burden in Hebei Province, China: A population-based study
Dao-Juan Li, Di Liang, Guo-Hui Song, Yong-Wei Li, Deng-Gui Wen, Jing Jin, Yu-Tong He
Dao-Juan Li, Di Liang, Deng-Gui Wen, Jing Jin, Yu-Tong He, Cancer Institute, The Fourth Hospital of Hebei Medical University/The Tumour Hospital of Hebei Province, Shijiazhuang 050011, Hebei Province, China
Guo-Hui Song, Cixian Cancer Institute, Cixian 056500, Hebei Province, China
Yong-Wei Li, Shexian Cancer Institute, Shexian 056400, Hebei Province, China
Author contributions: He YT contributed to the study conception and design; Li DJ, Liang D, Song GH, Li YW and Wen DG contributed to the acquisition of data; Li DJ, Liang D, Jin J and He YT contributed to the data analysis and interpretation; Li DJ contributed to the drafting of the manuscript; Li DJ, Jin J and He YT contributed to critical revision of the manuscript.
Institutional review board statement: All procedures involving human participants were performed in accordance with the ethical standards and with the 2013 Helsinki declaration and its later amendments. The study was reviewed and approved by the Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China
Informed consent statement: All study participants or their legal guardian provided informed written consent prior to study enrolment.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest related to this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Yu-Tong He, The Fourth Hospital of Hebei Medical University/The Tumour Hospital of Hebei Province, No.12, Jiankang Road, Shijiazhuang 050011, Hebei Province, China. hytong69@yahoo.com
Telephone: +86-311-86095613 Fax: +86-311-86095613
Received: November 2, 2016
Peer-review started: November 2, 2016
First decision: January 19, 2017
Revised: January 22, 2017
Accepted: February 16, 2017
Article in press: February 16, 2017
Published online: April 14, 2017
Processing time: 163 Days and 7 Hours
Abstract
AIM

To investigate the incidence and mortality rates of upper gastrointestinal cancer (UGIC) in Hebei Province, China, and to identify high-risk populations to improve UGIC prevention and control.

METHODS

Data for UGIC patients were collected from 21 population-based cancer registries covering 15.25% of the population in Hebei Province. Mortality data were extracted from three national retrospective death surveys (1973-1975, 1990-1992 and 2004-2005). The data were stratified by 5-year age groups, gender and area (high-risk/non-high-risk areas) for analysis. The age-period-cohort and grey system model were used.

RESULTS

The crude incidence rate of UGIC was 55.47/100000, and the adjusted rate (Segi’s population) was 44.90/100000. Males in rural areas had the highest incidence rate (world age-standardized rate = 87.89/100000). The crude mortality rate of UGIC displayed a decreasing trend in Hebei Province from the 1970s to 2013, and the adjusted rate decreased by 43.81% from the 1970s (58.07/100000) to 2013 (32.63/100000). The mortality rate declined more significantly in the high-risk areas (57.26%) than in the non-high-risk areas (55.02%) from the 1970s to 2013. The median age at diagnosis of UGIC was 65.06 years in 2013. There was a notable delay in the median age at death from the 1970s (66.15 years) to 2013 (70.39 years), especially in the high-risk areas. In Cixian, the total trend of the cohort effect declined, and people aged 65-69 years were a population at relatively high risk for UGIC. We predicted that the crude mortality rates of UGIC in Cixian and Shexian would decrease to 98.80 and 133.99 per 100000 in 2018, respectively.

CONCLUSION

UGIC was the major cause of cancer death in Hebei Province, and males in rural areas were a high-risk population. We should strengthen early detection and treatment of UGIC in this population.

Keywords: Upper gastrointestinal cancer; Incidence; Mortality; Age-period-cohort; Grey system model

Core tip: This study is the first to examine the incidence and mortality trends of UGIC in Hebei Province. Data were collected from 21 population-based cancer registries covering 15.25% of the total population of Hebei Province in 2013. An age-period-cohort model was established to analyse the incidence rate of UGIC in a high-risk area of Hebei Province (Cixian). Additionally, we established the grey system model to predict the mortality rates of UGIC in high-risk areas of Hebei Province (Cixian and Shexian). The aim of the study was to provide epidemiological evidence for developing strategies for UGIC prevention and control.