Received: 12 October 2017
Accepted: 8 February 2018
DOI: 10.1002/pro6.38
ORIGINAL ARTICLE
Incidence and mortality of stomach cancer in Shandong Province in 2012 Guigang Li3 ∗
Zhentao Fu1,2 ∗ Zilong Lu1,2
Jie Chu1,2
1 Academy of Preventive Medicine, Shandong
University, Jinan, Shandong, China 2 Shandong Center for Disease Control and
Jandong Sun4 ∗
Gaohui Zhang1,2
Yuting Zhai3 ∗
Xiaolei Guo1,2
Jiyu Zhang1,2
Aiqiang Xu1,2
Abstract Stomach cancer is common in the Chinese population. The present study aimed to analyze the
Prevention, Jinan, Shandong, China
incidence and mortality as a result of stomach cancer in Shandong Province, in order to provide
3 Zhaoyuan Center for Disease Control and
a reference for cancer prevention and control. We analyzed the incidence and mortality data
Prevention, Zhaoyuan, Shandong, China 4 School of Public Health, Queensland University
of Technology, Brisbane, Queensland, Australia Correspondence Xiaolei Guo, Shandong Center for Disease Control and Prevention, 16992# Jingshi Road, Jinan 250014, Shandong, PR of China. Email:
[email protected] Aiqiang Xu, Shandong Center for Disease Control and Prevention, 16992# Jingshi Road, Jinan 250014, Shandong, PR of China. Email:
[email protected] Funding information Shandong Science and Technology Development Plan Project, Grant/Award Number: 2016GSF201231; National Natural Science Foundation of China, Grant/Award Number: 81302505
of stomach cancer collected from 15 cancer registries in 2012. We calculated the crude, agestandardized, and truncated incidence and mortality rates for the registered population, and estimated the numbers of new cases and deaths that might have occurred in the total provincial population by applying the age-specific rates to the corresponding populations. The estimated numbers of new cases and deaths of stomach cancer were 36 796 and 25 343, respectively, among the total Shandong population in 2012. Both the incidence and mortality rates were higher in men than in women. The incidence in rural areas was similar with that in urban areas, whereas mortality was markedly higher in rural than in urban areas. Age-specific incidence and mortality of stomach cancer increased with age, particularly after 40 years-of-age and peaked at 80–84 or ≥85 years-ofage. Stomach cancer is common in Shandong province, particularly among men and residents in rural areas. Targeted prevention, early detection, and treatment programs should be carried out. KEYWORDS
cancer registry, incidence, mortality, Shandong Province, stomach cancer
∗ These authors contributed equally to this work.
1
INTRODUCTION
ously reported. These data will provide important information regarding potential cancer prevention and control. The aim of the present
Cancer is a leading cause of death worldwide.1,2 The global burden of
study was to examine the disease burden as a result of stomach cancer
cancer is increasing rapidly as the population ages.3 In China, it is now
in the Shandong population in terms of incidence and mortality, with
the leading cause of death, accounting for approximately one-quarter
the goal to assist developing future strategies for the prevention and
of all
deaths.4
Stomach cancer contributes significantly to the global
control of cancers.
cancer burden. According to GLOBOCAN 2012, it was estimated that 951 600 new cases were diagnosed and 723 100 deaths occurred as a result of stomach cancer in 2012. Stomach cancer is the fifth most common cancer globally. The incidence and mortality of stomach cancer vary widely across countries and regions. Geographically, almost two-thirds of all gastric cancer cases occur in Asia, particularly in China (43% of total global cases).5
2 2.1
METHODS Data source
The Shandong Center for Disease Control and Prevention manages
Shandong is the second most populous province of China, with a
the population-based cancer registry, responsible for data collection,
population of >95 million. Population-based data on the incidence
evaluation, and publication from local cancer registries in Shandong
and mortality of stomach cancer in Shandong have not been previ-
Province. The cancer registration data reported to cancer registries
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. c 2018 The Authors. Precision Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Shandong Cancer Hospital & Institute. Prec. Radiat. Oncol. 2018;1–6.
wileyonlinelibrary.com/journal/pro
1
2
FU ET AL .
were from local hospitals, community health service centers, the Basic Medical Insurances for Urban Residents, and the New-Rural Coopera-
TA B L E 1 Data quality of the stomach cancer registration in Shandong Province in 2012
tive Medical System. As of 1 June 2015, 21 cancer registries (7 in cities
Areas
Sex
M/I
MV%
DOC%
UB%
and 14 in counties) have been providing data to the National Center for
All areas
Both
0.66
71.08
3.10
0.20
Cancer Registration (NCCR). Data covered approximately 22 628 604 people, accounting for 23.59% of the whole population of Shandong Province at the end of 2012. All cancer cases were classified according
Urban
to the International Classification of Diseases for Oncology, 3rd edition and the International Statistical Classification of Diseases and Related Health Problems 10th Revision. A total of 15 qualified registries were Rural
finally accepted for the estimation of incidence and mortality, which covered 17.92% of the provincial population at the end of 2012.
2.2
Population estimates
The provincial population in 2012 was obtained from the Public Secu-
Male
0.65
72.59
2.90
0.19
Female
0.68
67.06
3.62
0.23
Both
0.56
66.41
4.13
0.37
Male
0.55
67.55
4.04
0.38
Female
0.59
63.28
4.39
0.35
Both
0.75
75.76
2.07
0.03
Male
0.74
77.70
1.75
0.00
Female
0.77
70.70
2.89
0.11
DOC%, the percentage of death certificate-only cases; M/I, mortality/incidence ratio; MV%, the percentage of cases morphologically verified; UB%, the percentage of diagnosis of unknown basis.
rity Bureau of Shandong Province and was estimated based on the fifth National Census data (2000) provided by the Statistics Bureau of Shandong Province, taking into account the changes in age composition, sex ratio, and the proportion of urban and rural transformation released
Albert Thomas, Lyon, France) issued by IARC/IACR, was used for data checking and evaluation.8 SAS software (SAS Institute, Cary, NC, USA) was used to calculate the incidence and mortality rates.
by the National Bureau of Statistics (http://www.stats-sd.gov.cn/). The provincial population in 2012 was stratified by location (urban/rural), sex (male/female), and age (0–, 1–4, 5–84 years with 5-year increments and ≥85 years). The age-specific death probability was adjusted
3
RESULTS
according to the Sixth National Census in 2010. Linear changes were
Data quality
assumed in each age group between the fifth and sixth Population
3.1
Census.
The percentage of cases morphologically verified, percentage of death certificate-only cases, M/I, and percentage of the diagnosis of unknown
2.3
Quality control
basis of stomach cancer in 2012 were 71.08%, 3.10%, 0.66, and 0.20% in the 15 registries, 66.41%, 4.13%, 0.56, and 0.37% in urban
We checked and evaluated the quality and comparability of submitted
areas, and 75.76%, 2.07%, 0.75, and 0.03% in rural areas, respectively
data based on the “Guideline for Chinese Cancer Registration” and the
(Table 1).
data quality criterion of “Cancer Incidence in Five Continents Volume IX” by International Agency for Research on Cancer/International Association of Cancer Registries (IARC/IACR; 150 cours Albert
3.2
Overall incidence of stomach cancer
Thomas, 69372 Lyon Cedex 08, France).6 The data included in the final
The estimated new stomach cancer cases were 36 796, accounting
analysis met the following criteria: the percentage of cases morpholog-
for 14.54% of all new cancer cases and making stomach cancer the
ically verified was not
