Abstract

We investigated temporal trends and geographical variations in lung cancer mortality in China from 2006 to 2012. Lung cancer mortality counts for people aged over 40 years were extracted from the China Mortality Surveillance System for 161 disease surveillance points. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region. Lung cancer mortality increased in China over the study period from 78.77 to 85.63 (1/100,000), with higher mortality rates evident in men compared to women. Median rate ratios (MRRs) indicated important geographical variation in lung cancer mortality between provinces (MRR = 1.622) and counties/districts (MRR = 1.447). On average, lung cancer mortality increased over time and was positively associated with county-level urbanization (relative risk (RR) = 1.15). Lung cancer mortality seemed to decrease in urban and increase in rural areas. Compared to the northwest, mortality was higher in the north (RR = 1.98), east (RR = 1.87), central (RR = 1.87), and northeast (RR = 2.44). Regional differences and county-level urbanization accounted for 49.4% and 8.7% of provincial and county variation, respectively. Reductions in lung cancer mortality in urban areas may reflect improvements in access to preventive healthcare and treatment services. Rising mortality in rural areas may reflect a clustering of risk factors associated with rapid urbanization.

Highlights

  • Lung cancer is the leading cause of cancer-related mortality worldwide

  • Lung cancer mortality during the study period decreased by 6%

  • Compared to the northwest areas, the relative risk of lung cancer mortality was higher in people living in the north (RR = 1.982, 95% confidence intervals (95% CI) 1.212, 3.241), east (RR = 1.866, 95% CI 1.187, 2.935), central (RR = 1.866, 95% CI 1.072, 3.250) and northeast (RR = 2.442, 95% CI 1.400, 4.262) areas

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Summary

Introduction

Lung cancer is the leading cause of cancer-related mortality worldwide. It accounts for 19.4%(1.6 million) of total cancer cases in 2012 [1]. Lung cancer is the leading cause of cancer-related mortality worldwide. (1.6 million) of total cancer cases in 2012 [1]. In China, lung cancer has risen to be the fourth leading cause of death [2]. The Global Burden of Disease Study 2013 [2] has shown an increasing trend in. Res. Public Health 2016, 13, 1252; doi:10.3390/ijerph13121252 www.mdpi.com/journal/ijerph

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