Abstract
Lung cancer has long been a major health problem in China. This study aimed to examine the temporal trend and spatial pattern of lung cancer mortality in Shandong Province from 1970 to 2013. Lung cancer mortality data were obtained from Shandong Death Registration System and three nationwide retrospective cause-of-death surveys. A Purely Spatial Scan Statistics method with Discrete Poisson models was used to detect possible high-risk spatial clusters. The results show that lung cancer mortality rate in Shandong Province increased markedly from 1970-1974 (7.22 per 100,000 person-years) to 2011-2013 (56.37/100, 000). This increase was associated with both demographic and non-demographic factors. Several significant spatial clusters with high lung cancer mortality were identified. The most likely cluster was located in the northern region of Shandong Province during both 1970-1974 and 2011-2013. It appears the spatial pattern remained largely consistent over the last 40 years despite the absolute increase in the mortality rates. These findings will help develop intervention strategies to reduce lung cancer mortality in this large Chinese population.
Highlights
Lung cancer is the most frequently diagnosed cancer and the most common cause of cancer-related death worldwide [1, 2]
During 1970-1974, the age adjusted lung cancer mortality rate standardized according to the age structures of Chinese population in 1964 (ASMR) was 5.57 per 100,000
The only difference was that the average reported mortality rate (ARMR) of lung cancer in female had increased from 2004-2005 to 2011-2013, while the age standardized mortality rate (ASMR) of lung cancer in female had dropped during the same period
Summary
Lung cancer is the most frequently diagnosed cancer and the most common cause of cancer-related death worldwide [1, 2]. In 2012, lung cancer took the lives of about 1.59 million people worldwide, almost one in every five cancer caused deaths (19.4%) in the world [2]. There is a large variation in lung cancer incidence and mortality rate in both men and women across the world [3]. The lung cancer incidence and mortality rate have been decreasing. In the United States, the lung cancer incidence decreased significantly among men during 2004-2009, it remained stable among women during the same period [4]. In addition to the high incidence and mortality rate, lung cancer presents high lethality. The 5-year survival rate for lung cancer patients is lower than those www.impactjournals.com/oncotarget for other types of cancer, such as colon, breast, and prostate cancers [5, 6]
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