Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 29, 2023
Date Accepted: May 22, 2024
Liver Cancer Mortality Disparities at Fine-Scale Among Subpopulations in China: A Nationwide Analysis of Spatial and Temporal Trends
ABSTRACT
Background:
China has the highest number of liver cancers worldwide and liver cancer is at the forefront of all cancers in China. However, current research on liver cancer in China primarily relies on extrapolated data or relatively lagging data, with limited focus on subregions and specific population groups.
Objective:
The purpose of this study is to identify geographic disparities in liver cancer by exploring the spatial and temporal trends of liver cancer mortality and the years of life lost (YLL) caused by it within distinct geographical regions, climate zones and population groups in China.
Methods:
Data on National Death Surveillance System between 2013 and 2020 were used to calculate age-standardized mortality of liver cancer (LASMR) and YLL from liver cancer in China. The spatial distribution and temporal trends of liver cancer were analyzed in subgroups by sex, age, region, and climate classification. Estimated annual percentage change (EAPC) was employed to describe liver cancer trends in various regions, and Partial Correlation was applied to explore associations between LASMR and latitude.
Results:
In China, LASMR decreased from 28.14 in 2013 to 24.26 per 100,000 in 2020 among men and 10.45 to 8.81 per 100,000 among women. This decline in mortality was consistent across all age groups. Geographically, the high LASMR regions for men primarily occurred in the south such as Guangxi, reporting LASMR ranges from 54.86 to 74.98 per 100,000, whereas they tended to be higher for women in the northeast, particularly in Heilongjiang. The trend of LASMR varied among regions. For both men and women, Guizhou showed an increasing trend in LASMR from 2013 to 2020, with EAPCs ranging from 10.05 to 29.07 % and from 10.09 to 21.71 %, respectively. High LASMR areas among men aligned with subtropical zones, like Cwa and Cfa. The YLL rates were found in the age group >65, the south, and Cwa, but the overall trends were downward.
Conclusions:
Despite the declining overall trend of liver cancer in China, the disparities between regions and populations suggested that potentially modifiable environmental risk factors may contribute to liver cancer mortality. Future prevention and control should precisely focus on high-risk regions and populations to further reduce the burden of liver cancer in China.
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