Lung Cancer Mortality in China: Spatial and Temporal Trends Among Subpopulations

Abstract

This study aimed to identify changing spatial and temporal trends of lung cancer mortality rates (LCMRs) among subpopulations in China (according to region, age, and sex). Data on LCMRs from 2006 to 2015 were extracted from the Chinese National Death Surveillance. Joinpoint regression and seasonal decomposition were used to assess the temporal trends. A geographic information system and spatial kriging interpolation were used to examine the spatial trends. LCMRs in men aged 30 to 49 years significantly declined nationally from 2009 to 2015 (annual percentage change, -2.7%; P< .05), but they continued to rise in men aged≥ 70 years and women aged≥ 50 years in the east, people aged 50 to 69 years in the south, and most groups in the southwest. Among provincial capital cities, Shenyang, Changsha, and Hohhot had the highest 10-year average LCMR for men aged 30 to 49 years, 50 to 69 years, and≥ 70 years, respectively; among all ages of women, Harbin had the highest average LCMR. Over the 10 years, the odds of the increases in LCMRs in men and women aged 30 to 69 years decreased by 3%to 7%with the longitudes or latitudes increasing by 1° (ORs ranged from 0.93 [95%CI, 0.90-0.95) to 0.97 [95%CI, 0.95-0.99]). Disparities in the spatial and temporal trends of LCMRs among subpopulations highlight the need for investigation into potential drivers, especially for the east, south, and southwest of China. These findings may help health authorities target interventions to those most in need to reduce the lung cancer burden in China.