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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Oncol. | doi: 10.3389/fonc.2018.00638

Time trends of gastrointestinal cancers incidence and mortality in Yangzhong from 1991 to 2015: an updated Age-period-cohort analysis

Yi Shao1,  Zhaolai Hua2, Lei Zhao3,  Yi Shen1,  Xudong Guo1, Chen Niu1,  Wenqiang Wei4, 5* and  Fen Liu1*
  • 1Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, China
  • 2Yangzhong Tumour Prevention And Treatment Institute, China
  • 3Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, United States
  • 4National Cancer Center of China, China
  • 5Chinese Academy of Medical Sciences and Peking Union Medical College, China

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, 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:
Different trends of incidence and mortality in GI cancers indicating heterogeneous etiologies exist between upper gastrointestinal cancers and colorectal cancer. Early detection and treatment programs are effective in reducing mortality of upper GI cancers and early childhood nutritional deficiencies may promote the development of GI cancers.

Keywords: Gastrointestinal cancers, Incidence, Mortality, Trends, Age-Period-Cohort analysis

Received: 28 Sep 2018; Accepted: 06 Dec 2018.

Edited by:

Xiaochen Shu, Soochow University, China

Reviewed by:

Lital Keinan-Boker, University of Haifa, Israel
Ju-Fang Shi, Cancer Hospital (CAMS), China  

Copyright: © 2018 Shao, Hua, Zhao, Shen, Guo, Niu, Wei and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Prof. Wenqiang Wei, National Cancer Center of China, Beijing, Beijing, China, weiwq@cicams.ac.cn
Prof. Fen Liu, Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China, liufenmail@sina.com