Abstract
Background: Gastrointestinal (GI) cancers are the common cause of morbidity and mortality in China which seriously threaten people's health and lives. The aim of this study was to describe the temporal trend in the epidemiology of GI cancers from 1991 to 2015, with an emphasis on the effects of age, period and cohort in Yangzhong City, Jiangsu province, a high-risk area of GI cancers in China.Methods: Our study extracted cases of gastric cancer, esophageal cancer and colorectal cancer diagnosed from 1991 to 2015 from Yangzhong Cancer Registry. Age-standardized rates (ASRs) were calculated and joinpoint regression was used to compute the estimated annual percent changes. Age-period-cohort (APC) model was performed to investigate the independent effects of age, calendar period, and birth cohort.Results: Between 1991 and 2015, 18,006 new cases and 10,262 deaths were registered with GI cancers in Yangzhong. The age-standardized incidence rates (ASIRs) of gastric cancer decreased in both sexes during the study period. And the incidence rates of esophageal cancer stabilized at first then continued to decline, the turning point was in 2005 for men and 2001 for women. Changes in the mortality rates of gastric cancer and esophageal cancer showed significant declined trends around 2000–2010 in both genders. The incidence rates of colorectal cancer increased steadily during the entire study period, and the increase was more pronounced in the mortality rates of men. The results of APC analysis suggest that general decreases in incidence and mortality of esophageal cancer and gastric cancer might be caused by the downward trend of the period and cohort effects, while the increases in colorectal cancer might be caused by the uptrend of the period effects.Conclusions: The incidence and mortality rates of esophageal and gastric cancers showed a downward trend and colorectal cancer was on the rise as a whole in Yangzhong City. The different burden of gastrointestinal cancer indicating heterogeneous risk factors exist and may have contributed to these temporal variations.
Highlights
Gastric cancer, esophageal cancer, and colorectal cancer are three most common types of gastrointestinal (GI) cancer, which is one of the most commonly diagnosed malignancies and one of the leading causes of cancer-related death worldwide, in China [1, 2]
It usually identifies patterns in cancer incidence or mortality rates from populationbased count and population data, which are often retrieved from cancer registry databases such as SEER in the form of a table showing the numbers of cancer cases or cancer deaths and corresponding person-years at risk for particular age groups and calendar time periods
A total of 9,400 gastric cancer cases, 7,107 esophageal cancer cases, and 1,499 colorectal cancer patients were registered during the period of 1991–2015 (Table 1)
Summary
Esophageal cancer, and colorectal cancer are three most common types of gastrointestinal (GI) cancer, which is one of the most commonly diagnosed malignancies and one of the leading causes of cancer-related death worldwide, in China [1, 2]. The age-periodcohort (APC) analysis plays an important role in understanding time-varying elements in epidemiology It usually identifies patterns in cancer incidence or mortality rates from populationbased count (numerator) and population (denominator) data, which are often retrieved from cancer registry databases such as SEER in the form of a table showing the numbers of cancer cases or cancer deaths (counts) and corresponding person-years at risk (population) for particular age groups and calendar time periods. This analysis can help us separate the independent effects of age, period and cohort patterns, and further explores factors affecting the incidence and mortality of GI cancers from a macro perspective, such as social conditions, economic changes, environmental development [10, 11]. The aim of this study was to describe the temporal trend in the epidemiology of GI cancers from 1991 to 2015, with an emphasis on the effects of age, period and cohort in Yangzhong City, Jiangsu province, a high-risk area of GI cancers in China
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