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Int. J. Environ. Res. Public Health 2017, 14(3), 218;

Trends of Esophageal Cancer Mortality in Rural China from 1989 to 2013: An Age-Period-Cohort Analysis

Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan 430071, China
Department of Nursing, College of Health Science & Nursing, Wuhan Polytechnic University, 68 Xuefunan Road, Wuhan 430023, China
Comprehensive Medical Department, Tongji Hospital of Tongji Medical College of HUST, 1095 Jiefang Avenue, Wuhan 430030, China
Department of Nursing, School of Nursing, Hubei University of Chinese Medicine, 1 Huangjiahuxi Road, Wuhan 430065, China
Author to whom correspondence should be addressed.
Academic Editor: William Chi-shing Cho
Received: 21 December 2016 / Revised: 6 February 2017 / Accepted: 11 February 2017 / Published: 23 February 2017
(This article belongs to the Section Global Health)
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Background: Esophageal cancer is one of the most common cancers in rural China. The aim of this study was to describe the time trends of esophageal cancer mortality in rural China and to better elucidate the causes of these trends. Methods: The mortality data were obtained from the World Health Organization Mortality Database and the China Health Statistical Yearbook Database. The mortality data were analyzed with age-period-cohort (APC) analysis. Results: Our study indicates that the Age-Standardized Mortality Rates (ASMRs) in rural China generally decreased from 1989 to 2003, and thereafter increased until the year 2008 in both sexes. After 2008, the ASMRs decreased again. The results of APC analysis suggest that the general decrease in esophageal cancer mortality in rural China from 1989 to 2003 might be caused by the downtrend of the cohort effects and period effects, while the general increase in mortality from 2004 to 2008 might be caused by the uptrend of the period effects. The decrease in mortality after 2008 may be relevant to the Four Trillion RMB Investment Plan launched by the Chinese Government. Conclusions: The declining cohort effects were probably related to the improvement of socioeconomic status in childhood and the decreasing consumptions of alcohol drinking and smoking, while the trends of the period effects were relevant to the changes in the dietary pattern. Our findings may help predict future changes in esophageal cancer mortality. View Full-Text
Keywords: esophageal cancer; mortality; APC; rural China esophageal cancer; mortality; APC; rural China

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Gao, X.; Wang, Z.; Kong, C.; Yang, F.; Wang, Y.; Tan, X. Trends of Esophageal Cancer Mortality in Rural China from 1989 to 2013: An Age-Period-Cohort Analysis. Int. J. Environ. Res. Public Health 2017, 14, 218.

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