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Int. J. Environ. Res. Public Health 2016, 13(12), 1252; doi:10.3390/ijerph13121252

Spatiotemporal Variations in Lung Cancer Mortality in China between 2006 and 2012: A Multilevel Analysis

1
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
2
Population Wellbeing and Environment Research Lab (PowerLab), Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
3
School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
4
Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
5
School of Medicine, University of Western Sydney, Sydney, NSW 2006, Australia
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: Peter Congdon
Received: 6 October 2016 / Revised: 15 November 2016 / Accepted: 21 November 2016 / Published: 16 December 2016
(This article belongs to the Section Global Health)
View Full-Text   |   Download PDF [863 KB, uploaded 16 December 2016]   |  

Abstract

We investigated temporal trends and geographical variations in lung cancer mortality in China from 2006 to 2012. Lung cancer mortality counts for people aged over 40 years were extracted from the China Mortality Surveillance System for 161 disease surveillance points. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region. Lung cancer mortality increased in China over the study period from 78.77 to 85.63 (1/100,000), with higher mortality rates evident in men compared to women. Median rate ratios (MRRs) indicated important geographical variation in lung cancer mortality between provinces (MRR = 1.622) and counties/districts (MRR = 1.447). On average, lung cancer mortality increased over time and was positively associated with county-level urbanization (relative risk (RR) = 1.15). Lung cancer mortality seemed to decrease in urban and increase in rural areas. Compared to the northwest, mortality was higher in the north (RR = 1.98), east (RR = 1.87), central (RR = 1.87), and northeast (RR = 2.44). Regional differences and county-level urbanization accounted for 49.4% and 8.7% of provincial and county variation, respectively. Reductions in lung cancer mortality in urban areas may reflect improvements in access to preventive healthcare and treatment services. Rising mortality in rural areas may reflect a clustering of risk factors associated with rapid urbanization. View Full-Text
Keywords: lung cancer; mortality; geographical variation; temporal trends; urbanization level lung cancer; mortality; geographical variation; temporal trends; urbanization level
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MDPI and ACS Style

Liu, Y.; Astell-Burt, T.; Liu, J.; Yin, P.; Feng, X.; You, J.; Page, A.; Zhou, M.; Wang, L. Spatiotemporal Variations in Lung Cancer Mortality in China between 2006 and 2012: A Multilevel Analysis. Int. J. Environ. Res. Public Health 2016, 13, 1252.

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