Long-Term Trends of Liver Cancer Incidence and Mortality in China 1990–2017: A Joinpoint and Age–Period–Cohort Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources
2.2. Incidence and Mortality Data of Liver Cancer
2.3. Statistical Analysis
2.3.1. Age–Period–Cohort Analysis
2.3.2. Joinpoint Regression Analysis
3. Results
3.1. Descriptive Analysis of Incidence and Mortality Trends
3.2. Age–Period–Cohort Analysis
3.2.1. Age Effect
3.2.2. Period Effect
3.2.3. Cohort Effect
4. Discussion
4.1. Age Effects
4.2. Period Effects
4.3. Cohort Effects
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
Age Group | Mortality (AAPC) | Incidence (AAPC) | ||||
---|---|---|---|---|---|---|
Both Gender | Males | Females | Both Gender | Males | Females | |
Age-standardized Rate | −0.8 (−0.9, −0.6) | −0.5 (−0.6, −0.3) | −1.3 (−1.6, −1.0) | −0.2 (−0.2, −0.1) | 0.2 (0.1, 0.3.0) | −1.1 (−1.2, −1.0) |
5–9 | −3.6 (−4.3, −2.9) | −3.8 (−4.5, −3.0) | −3.6 (−4.9, −2.4) | −2.8 (−3.2, −2.5) | −2.8 (−3.2, −2.5) | −3.1 (−3.4, −2.8) |
10–14 | −2.6 (−3.2, −2.0) | −2.9 (−3.5, −2.3) | −2.7 (−4.1, −1.3) | −1.7 (−1.9, −1.4) | −1.9 (−2.2, −1.5) | −1.6 (−1.9, −1.3) |
15–19 | −2.7 (−3, −2.4) | −2.3 (−2.7, −1.9) | −3.8 (−4.4, −3.3) | −1.6 (−1.8, −1.4) | −1.1 (−1.4, −0.9) | −2.9 (−3.2, −2.6) |
20–24 | −3.4 (−4.6, −2.2) | −2.9 (−3.5, −2.4) | −4.5 (−6.3, −2.7) | −2.3 (−2.6, −2.0) | −1.8 (−2.1, −1.4) | −3.3 (−3.5, −3.1) |
25–29 | −2.2 (−4, −0.3) | −1.8 (−3, −0.5) | −3.3 (−4.2, −2.5) | −1.4 (−1.8, −1.0) | −0.9 (−1.3, −0.5) | −2.8 (−3.2, −2.4) |
30–34 | −2.5 (−3.6, −1.5) | −2.1 (−3.1, −1.1) | −3.7 (−4.5, −3.0) | −1.4 (−1.7, −1.1) | −1.0 (−1.3, −0.7) | −3.0 (−3.2, −2.7) |
35–39 | −2.7 (−3.1, −2.3) | −2.4 (−2.8, −1.9) | −3.9 (−4.2, −3.6) | −1.7 (−1.9, −1.4) | −1.3 (−1.6, −1.1) | −3.1 (−3.2, −2.9) |
40–44 | −2.9 (−3.7, −2.2) | −2.6 (−3.5, −1.8) | −3.9 (−4.4, −3.4) | −1.5 (−1.8, −1.3) | −1.1 (−1.3, −0.9) | −2.9 (−3, −2.8) |
45–49 | −1.6 (−1.9, −1.3) | −1.3 (−1.6, −1.0) | −2.8 (−3.2, −2.3) | −0.8 (−1, −0.5) | −0.3 (−0.5, −0.2) | −2.4 (−2.6, −2.2) |
50–54 | −0.9 (−1.3, −0.5) | −0.5 (−0.9, −0.1) | −1.9 (−2.8, −1.1) | −0.3 (−0.6, 0.0) | 0.3 (0, 0.7) | −1.6 (−1.9, −1.3) |
55–59 | −1.5 (−2.3, −0.6) | −1.2 (−1.9, −0.4) | −2.7 (−3.3, −2.1) | −0.6 (−0.8, −0.5) | −0.2 (−0.3, 0.0) | −2.0 (−2.1, −1.8) |
60–64 | −0.4 (−0.6, −0.2) | 0 (−0.3, 0.3) | −1.4 (−1.6, −1.2) | 0.1 (0, 0.2) | 0.6 (0.5, 0.7) | −1.0 (−1.2, −0.9) |
65–69 | 0.0 (−0.4, 0.5) | 0.5 (0.2, 0.9) | −0.7 (−1, −0.3) | 0.7 (0.4, 0.9) | 1.1 (0.9, 1.4) | −0.5 (−0.7, −0.2) |
70–74 | −0.5 (−0.7, −0.2) | −0.3 (−0.5, −0.1) | −1.0 (−1.3, −0.6) | 0 (−0.1, 0.1) | 0.3 (0.2, 0.4) | −0.9 (−1.1, −0.7) |
75–79 | −0.2 (−0.6, 0.1) | 0.1 (−0.4, 0.5) | −0.9 (−1.2, −0.6) | 0.2 (0.2, 0.3) | 0.7 (0.6, 0.8) | −0.8 (−0.8, −0.7) |
80–84 | 0.2 (−0.2, 0.6) | 0.4 (0, 0.8) | −0.3 (−0.9, 0.4) | 0.9 (0.8, 1.0) | 1.2 (1.1, 1.3) | 0.3 (0.2, 0.3) |
85–89 | 0.3 (0, 0.7) | 0.5 (0.2, 0.8) | −0.1 (−0.5, 0.4) | 1.0 (0.9, 1.0) | 1.3 (1.3, 1.4) | 0.4 (0.4, 0.5) |
90–94 | 0.7 (0.3, 1.1) | 1.0 (0.6, 1.4) | 0.5 (0.3, 0.7) | 1.5 (1.4, 1.6) | 1.8 (1.7, 1.9) | 1.2 (1.1, 1.3) |
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Segments | Both | Males | Females | |||
---|---|---|---|---|---|---|
Year | APC * (95% CI) | Year | APC (95% CI) | Year | APC (95% CI) | |
ASMR | ||||||
trend1 | 1990–2000 | 0.0 (−0.1, 0.2) | 1990–2000 | 0.5 * (0.4, 0.6) | 1990–2000 | −0.9 * (−1.2, −0.6) |
trend2 | 2000–2004 | −1.5 * (−2.1, −0.8) | 2000–2004 | −1.4 * (−2.1, −0.7) | 2000–2004 | −1.6 * (−2.7, −0.4) |
trend3 | 2004–2007 | −3.7 * (−4.6, −2.7) | 2004–2007 | −3.2 * (−4.1, −2.3) | 2004–2007 | −4.5 * (−6.2, −2.9) |
trend4 | 2007–2013 | −1.4 * (−1.7, −1.2) | 2007–2013 | −1.5 * (−1.7, −1.3) | 2007–2012 | −1.6 * (−2.2, −1.1) |
trend5 | 2013–2017 | 1.3 * (0.8, 1.8) | 2013–2017 | 1.6 * (1.1, 2.0) | 2012–2017 | 0.2(−0.3, 0.8) |
AAPC * | 1990–2017 | −0.8 * (−0.9, −0.6) | 1990–2017 | −0.5 * (−0.6, −0.3) | 1990–2017 | −1.3 * (−1.6, −1.0) |
ASIR | ||||||
trend1 | 1990–2000 | 0.2 * (0.1, 0.3) | 1990–2000 | 0.7 * (0.6, 0.7) | 1990–2000 | −0.9 * (−1, −0.8) |
trend2 | 2000–2010 | −1.9 *(−1.9, −1.9) | 2000–2009 | −1.7 * (−1.7, −1.6) | 2000–2006 | −2.2(−2.4, −2.1) |
trend3 | 2010–2013 | 0.9 * (0.5, 1.4) | 2009–2012 | 0.3(−0.2, 0.8) | 2006–2009 | −3.1 * (−3.4, −2.7) |
trend4 | 2013–2017 | 2.5 * (2.2, 2.7) | 2012–2015 | 2.4 * (1.9, 2.9) | 2009–2012 | −0.8 * (−1.4, −0.3) |
trend5 | - | - | 2015–2017 | 3.5 * (2.6, 4.5) | 2012–2017 | 0.9 * (0.7, 1.1) |
AAPC | 1990–2017 | −0.2 * (−0.2, −0.1) | 1990–2017 | 0.2 * (0.1, 0.3) | 1990–2017 | −1.1 * (−1.2, −1.0) |
Variables | Incidence (Coef, 95% CI) | Mortality (Coef, 95% CI) | ||
---|---|---|---|---|
Males | Females | Males | Females | |
Age | ||||
20–24 | −2.59 * (−4.98, −0.21) | −2.03 * (−3.58, −0.48) | −2.73 (−6.43, 0.97) | −2.19 (−4.75, 0.36) |
25–29 | −1.57 *** (−2.33, −0.8) | −1.53 *** (−2.31, −0.76) | −1.9 ** (−3.29, −0.52) | −1.86 * (−3.31, −0.41) |
30–34 | −0.83 ** (−1.3, −0.36) | −1.04 *** (−1.54, −0.54) | −1.1 ** (−1.90, −0.30) | −1.29 ** (−2.18, −0.40) |
35–39 | −0.52 ** (−0.91, −0.13) | −1.00 *** (−1.43, −0.57) | −0.68 * (−1.32, −0.04) | −1.17 ** (−1.9, −0.45) |
40–44 | −0.14 (−0.47, 0.19) | −0.63 *** (−0.95, −0.32) | −0.2 (−0.74, 0.33) | −0.73 ** (−1.26, −0.19) |
45–49 | 0.16 (−0.12, 0.45) | −0.27 * (−0.52, −0.02) | 0.06 (−0.4, 0.51) | −0.36 (−0.79, 0.06) |
50–54 | 0.31 * (0.06, 0.55) | −0.05 (−0.26, 0.15) | 0.24 (−0.15, 0.63) | −0.11(−0.45, 0.22) |
55–59 | 0.4 *** (0.19, 0.61) | 0.21 * (0.05, 0.37) | 0.38 * (0.06, 0.71) | 0.18 (−0.08, 0.44) |
60–64 | 0.57 *** (0.4, 0.75) | 0.48 *** (0.35, 0.61) | 0.59 *** (0.32, 0.86) | 0.49 *** (0.27, 0.70) |
65–69 | 0.66 *** (0.51, 0.81) | 0.69 *** (0.57, 0.81) | 0.72 *** (0.48, 0.95) | 0.76 *** (0.55, 0.98) |
70–74 | 0.72 *** (0.59, 0.85) | 0.88 *** (0.75, 1.00) | 0.84 *** (0.61, 1.06) | 1 *** (0.74, 1.26) |
75–79 | 0.72 *** (0.59, 0.84) | 0.99 *** (0.84, 1.14) | 0.89 *** (0.65, 1.13) | 1.18 *** (0.85, 1.50) |
80–84 | 0.69 *** (0.55, 0.83) | 1.05 *** (0.86, 1.23) | 0.97 *** (0.69, 1.25) | 1.32 *** (0.91, 1.73) |
85–89 | 0.71 *** (0.55, 0.86) | 1.15 *** (0.92, 1.38) | 0.97 *** (0.63, 1.30) | 1.41 *** (0.92, 1.91) |
90–94 | 0.72 *** (0.53, 0.90) | 1.12 *** (0.85, 1.39) | 0.96 *** (0.56, 1.36) | 1.37 *** (0.78, 1.96) |
Period | ||||
1992 | −0.22 *** (−0.33, −0.11) | −0.02 (−0.15, 0.1) | −0.19 (−0.39, 0.01) | −0.01 (−0.26, 0.24) |
1997 | −0.12 *** (−0.19, −0.05) | −0.04 (−0.12, 0.03) | −0.07 (−0.2, 0.05) | −0.01 (−0.16, 0.14) |
2002 | 0.00 (−0.04, 0.03) | 0.00 (−0.03, 0.03) | 0.06 * (0.01, 0.10) | 0.04 (−0.01, 0.09) |
2007 | 0.04 * (0, 0.07) | 0.00 (−0.03, 0.03) | 0.06 * (0.01, 0.11) | −0.02 (−0.07, 0.04) |
2012 | 0.08 * (0.01, 0.15) | −0.01 (−0.08, 0.07) | 0.04 (−0.09, 0.16) | −0.01 (−0.16, 0.14) |
2017 | 0.23 *** (0.12, 0.34) | 0.08 (−0.05, 0.20) | 0.11 (−0.09, 0.31) | 0.01 (−0.25, 0.26) |
Cohort | ||||
1898–1902 | 0.48 * (0.06, 0.90) | 0.41 (−0.03, 0.85) | 0.63 (−0.25, 1.50) | 0.54 (−0.39, 1.46) |
1903–1907 | 0.53 ** (0.13, 0.94) | 0.53 * (0.12, 0.95) | 0.67 (−0.18, 1.52) | 0.66 (−0.23, 1.55) |
1908–1912 | 0.54 ** (0.14, 0.93) | 0.59 ** (0.19, 0.99) | 0.66 (−0.18, 1.49) | 0.71 (−0.15, 1.57) |
1913–1917 | 0.53 ** (0.14, 0.91) | 0.63 ** (0.24, 1.02) | 0.63 (−0.19, 1.46) | 0.73 (−0.11, 1.57) |
1918–1922 | 0.53 ** (0.15, 0.91) | 0.64 ** (0.26, 1.03) | 0.62 (−0.21, 1.45) | 0.72 (−0.12, 1.55) |
1923–1927 | 0.5 * (0.12, 0.89) | 0.62 ** (0.23, 1.01) | 0.57 (−0.26, 1.41) | 0.68 (−0.16, 1.52) |
1928–1932 | 0.43 * (0.03, 0.83) | 0.57 ** (0.17, 0.96) | 0.48 (−0.37, 1.33) | 0.62 (−0.24, 1.48) |
1933–1937 | 0.35 (−0.06, 0.76) | 0.51* (0.09, 0.92) | 0.4 (−0.47, 1.27) | 0.57 (−0.32, 1.46) |
1938–1942 | 0.22 (−0.20, 0.65) | 0.39 (−0.04, 0.82) | 0.29 (−0.62, 1.19) | 0.46 (−0.47, 1.39) |
1943–1947 | 0.19 (−0.25, 0.64) | 0.35 (−0.11, 0.81) | 0.26 (−0.68, 1.20) | 0.42 (−0.56, 1.40) |
1948–1952 | 0.23 (−0.24, 0.70) | 0.36 (−0.13, 0.85) | 0.29 (−0.69, 1.27) | 0.43 (−0.60, 1.47) |
1953–1957 | 0.1 (−0.40, 0.59) | 0.18 (−0.34, 0.71) | 0.12 (−0.90, 1.15) | 0.23 (−0.87, 1.33) |
1958–1962 | −0.11 (−0.64, 0.42) | −0.09 (−0.66, 0.47) | −0.14 (−1.22, 0.94) | −0.12 (−1.29, 1.06) |
1963–1967 | −0.11 (−0.67, 0.45) | −0.12 (−0.72, 0.49) | −0.12 (−1.25, 1.01) | −0.1 (−1.35, 1.15) |
1968–1972 | −0.28 (−0.87, 0.32) | −0.34 (−1.01, 0.32) | −0.35 (−1.55, 0.84) | −0.38 (−1.74, 0.97) |
1973–1977 | −0.52 (−1.18, 0.13) | −0.63 (−1.45, 0.19) | −0.67 (−1.98, 0.63) | −0.75 (−2.37, 0.88) |
1978–1982 | −0.74 (−1.52, 0.04) | −0.9 (−2.03, 0.22) | −0.84 (−2.36, 0.68) | −1.02 (−3.22, 1.18) |
1983–1987 | −0.79 (−1.77, 0.19) | −1.02 (−2.48, 0.44) | −0.95 (−2.97, 1.08) | −1.21 (−4.30, 1.89) |
1988–1992 | −0.88 (−2.76, 1.00) | −1.13 (−3.69, 1.42) | −1.05 (−5.16, 3.06) | −1.37 (−7.16, 4.41) |
1993–1997 | −1.2 (−9.21, 6.82) | −1.54 (−9.38, 6.30) | −1.5 (−18.46, 15.46) | −1.83 (−18.78, 15.12) |
AIC | 6.94 | 4.93 | 7.04 | 5.16 |
BIC | 2099.21 | 77.97 | 2364.42 | 160.07 |
Deviance | 2333.19 | 311.96 | 2598.40 | 394.06 |
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Wang, F.; Mubarik, S.; Zhang, Y.; Wang, L.; Wang, Y.; Yu, C.; Li, H. Long-Term Trends of Liver Cancer Incidence and Mortality in China 1990–2017: A Joinpoint and Age–Period–Cohort Analysis. Int. J. Environ. Res. Public Health 2019, 16, 2878. https://doi.org/10.3390/ijerph16162878
Wang F, Mubarik S, Zhang Y, Wang L, Wang Y, Yu C, Li H. Long-Term Trends of Liver Cancer Incidence and Mortality in China 1990–2017: A Joinpoint and Age–Period–Cohort Analysis. International Journal of Environmental Research and Public Health. 2019; 16(16):2878. https://doi.org/10.3390/ijerph16162878
Chicago/Turabian StyleWang, Fang, Sumaira Mubarik, Yu Zhang, Lu Wang, Yafeng Wang, Chuanhua Yu, and Hao Li. 2019. "Long-Term Trends of Liver Cancer Incidence and Mortality in China 1990–2017: A Joinpoint and Age–Period–Cohort Analysis" International Journal of Environmental Research and Public Health 16, no. 16: 2878. https://doi.org/10.3390/ijerph16162878