Mortality and survival analysis of esophageal cancer in China

Abstract

To estimate the nationwide mortality of esophageal cancer in China in 2012, to investigate the trends of the disease, and to provide support data for esophageal cancer prevention and control in China. Data of population-based cancer registry of China were extracted by sex and geographical area. Joinpoint software was used to analyze the trends of esophageal cancer from 2000 to 2011 using the continuous data of 22 cancer registries. Average annual percentage change rates (AAPC) were calculated, and 17 cancer registries data during 2003-2005 were analyzed. In 2012, there were estimated 210.9 thousand new cases of esophageal cancer death in China, with 149 thousand in males and 61.9 thousand in females, accounting for 9.65% of overall cancer death. The crude mortality rate of esophageal cancer in 2012 was 15.58 per 100 000, accounting for the fourth-leading cause of overall cancer deaths. The age-standardized mortality rates by world population and China population were 10.67 per 100 000 and 10.62 per 100 000, respectively. The cumulative mortality rate for age 0-74 was 1.28%. The age-specific mortality rates were increasing with age, and there was a sharp increase after 50 years of age. From 2000 to 2011, there was a slight decreasing trend for crude mortality rate, with the AAPC of -1.1% (95% CI: -1.8% to -0.5%). However, the age standardized mortality rates were decreasing significantly with the AAPC of -4.6% (95% CI: -5.7% to -3.6%). The AAPCs for age-standardized esophageal cancer mortality were -3.8% in urban areas and -2.4% in rural areas. For combined 5-year age standardized relative survival was 20.9% (95%CI: 20.2% to 21.7%) and the 1-, 3- and 5-year observed survival rates were 54.0%, 25.5%, 18.4%, respectively. There is still a heavy burden of esophageal cancer in China. Prevention and early diagnosis of the disease in esophageal cancer high-risk areas is very essential.