Trends of Esophageal Cancer Incidence and Mortality and Its Influencing Factors in China

PURPOSE: To explore the esophageal cancer (EC) incidence and mortality trends and risk factors in China during 2005–2015. MATERIALS AND METHODS: The data were stratified by area (urban, rural), gender (male, female), and age groups (0 ~, 5 ~, …, 85 ~). The age-standardized incidence rate (ASIR) and mortality rate (ASMR), age-specific incidence and mortality were calculated to describe the trends, which were analyzed by Joinpoint software, negative binomial regression model, and age-period-cohort model. RESULTS: Trends in EC ASIR decreased markedly during 2010–2015 (APC=−6.14%, P<0.05), and the average annual percent change (AAPC) value was −8.07% (95% confidence interval (CI): −9.98~−6.12) for rural areas during 2005–2015. The ASMR was on a fast-downward trend after 2011 (APC=−6.67%, P<0.05), with AAPC values of −1.34% (95% CI: −2.56~−0.19) for males, −3.39% (95% CI: −5.65, −1.07) for females, and −9.67% (95% CI: −10.56~−8.77) for rural areas during 2005–2015. The age-specific incidence and mortality increased with age. The risk of EC for males was 3.1675 times higher than females (P<0.001), and for urban areas, it was 0.58 times larger than rural (P<0.001). The age and period effects presented an increasing trend, with a decreasing trend for the cohort effects in incidence and mortality risk. Later birth cohorts presented lower risks than previous birth cohorts. CONCLUSION: ASIR and ASMR in China are higher in males than females, and higher in rural than urban areas, which have decreased during 2005–2015, especially in rural areas. The incidence increased with age up to the peak age group of 75. Area, gender, and age were independent risk factors for EC incidence.