Abstract
ObjectiveTo determine the characteristics and spatiotemporal distribution of major gastrointestinal (GI) neoplasms in inpatients from 1995 to 2016 in Wuwei city, northwestern China.MethodData from all paper and electronic medical records entered between 1995 and 2016 at 12 major public hospitals in Wuwei city were retrospectively collected. Patients with GI neoplasms were identified and classified according to the International Classification of Diseases (ICD)-10. Trends in the incidence of major GI neoplasms were expressed as an annual percentage change (APC), and the Z test was used to assess the time fluctuation trends. Age-standardized incidence rates (ASIRs) were also calculated and the corresponding APC was estimated by the Joinpoint software for long-term trend analysis. Thematic maps of annual incidence at the township level were produced.ResultsAmong the 19,137 new inpatients identified with GI neoplasms in Wuwei, gastric cancer was the leading cause of morbidity, followed by cancers of the esophagus, colorectum, gastric cardia, liver, and pancreas with ASIRs of 21.8, 11.0, 5.8, 5.7, 4.4, and 1.7 per 100,000 person-years, respectively. Overall, there was a steady increase in the ASIR for all GI neoplasms, and male cases were 2.1 times more frequent than female cases. The ASIR significantly increased by 12.2% per year from 1995 to 2009 for all GI neoplasms, and the increase rates ranged 9.4%-16.7% per year for the individual GI neoplasm. Despite an increase by 1.4% per year from 2009 to 2016, the ASIR decreased for esophageal and gastric cardia cancers by 4.6% and 17.3% per year, respectively. The annual incidence of all GI neoplasms showed significantly differential geographic distributions among different townships of the city during the study period.
Highlights
As the most common group of cancers globally, gastrointestinal (GI) neoplasms are responsible for considerable morbidity and mortality [1]
There was a steady rise in the crude incidence rates (CIRs) and Age-standardized incidence rates (ASIRs) for all GI neoplasms, and the numbers of male cases were 2.1 times higher than female cases, which presented different trends (Tables 1–3)
The ASIR for all GI neoplasms increased significantly from 1995 to 2009 by 12.2% per year; the ASIRs increased by 9.4% per year for esophageal cancer from 1995 to 2009, 10.5% per year for gastric cancer from 1995 to 2014, 11.0% per year for colorectal cancer from 1995 to 2009, 11.2% per year for pancreatic and hepatobiliary cancers from 1995 to 2016, 16.7% per year for liver cancer from 1995 to 2009, and 9.9% per year for gastric cardia cancer from 1995 to 2009
Summary
As the most common group of cancers globally, gastrointestinal (GI) neoplasms are responsible for considerable morbidity and mortality [1]. Gastric cancer was the leading cause of cancer mortality in China from 2010 to 2014, followed by esophageal and colorectal cancers [4]. Various studies have reported the annual mortality rates of common GI cancers [4,5,6], the annual linear trends of GI neoplasm rates among different age and sex groups have not been comprehensively assessed in China. According to the 2015 Cancer Statistics, the population in northwestern China has the highest incidence of gastric cancer and the second highest incidence of esophageal cancer [5]. With the highest incidence of gastric cancer in China, there were about 11,000 cases with GI neoplasms recorded in Wuwei during 2006 to 2011, with an annual incidence of 190.3 per 100,000 person-years, which is much higher than the national average [9]. The overall or age-sex specific trends in the incidence of GI neoplasms in Wuwei have not been systematically investigated
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