Dataset Information

Long-term trends of liver cancer mortality by gender in urban and rural areas in China: an age-period-cohort analysis.

ABSTRACT: OBJECTIVES:To provide an up-to-date overview of long-term trends of liver cancer mortality and evaluate the effects attributable to age, period and cohort in Chinese population stratified by gender and urban/rural areas. METHODS:Population and liver cancer mortality data were obtained based on the Disease Surveillance Points in China from 1991 to 2014. To examine the time trends of liver cancer mortality by gender in urban and rural areas in China, Joinpoint analysis was used to estimate the annual per cent change. The intrinsic estimator, a method of age-period-cohort analysis to estimate age, period and cohort effects simultaneously, was used to analyse the underlying mechanisms for liver cancer mortality trends in the aforementioned four groups. RESULTS:We observed a significant decline in liver cancer mortality for urban men (average annual per cent change (AAPC)=-1.1%, P<0.05) and urban women (AAPC=-1.4%, P<0.05), while the liver cancer mortality remained stable for rural men (AAPC=-0.1%, P>0.05) and rural women (AAPC=-0.9%, P>0.05). Compared with the 15-19 age group, the liver cancer mortality risk of the 85 and above age group increased 65 and 42 times for urban and rural men, and 102 and 70 times for urban and rural women. From the 1990-1994 period to the 2005-2009 period, the risk increased 56% and 92% for urban and rural men, and 30% and 74% for urban and rural women. Compared with period and cohort effects, age effects were the most influential factor in liver cancer mortality. CONCLUSIONS:As the status of ageing population in China gets worse, the burden caused by liver cancer mortality could still be a great challenge for China in the future. The disparity of liver cancer mortality trends between urban and rural residents can be attributed to period effects, referring to the unequal medical levels and resources between urban and rural areas.

SUBMITTER: Sun Y

PROVIDER: S-EPMC5829896 | biostudies-other | 2018 Feb

REPOSITORIES: biostudies-other

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Long-term trends of liver cancer mortality by gender in urban and rural areas in China: an age-period-cohort analysis.

Sun Yuanyuan Y Wang Yanhong Y Li Mengmeng M Cheng Kailiang K Zhao Xinyu X Zheng Yuan Y Liu Yan Y Lei Shaoyuan S Wang Li L

BMJ open 20180208 2

<h4>Objectives</h4>To provide an up-to-date overview of long-term trends of liver cancer mortality and evaluate the effects attributable to age, period and cohort in Chinese population stratified by gender and urban/rural areas.<h4>Methods</h4>Population and liver cancer mortality data were obtained based on the Disease Surveillance Points in China from 1991 to 2014. To examine the time trends of liver cancer mortality by gender in urban and rural areas in China, Joinpoint analysis was used to e ...[more]

PMID: 29439081

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Project description:After decades of lower or comparable mortality rates in rural than in urban areas of the U.S., numerous studies have documented a rural mortality penalty that started in the 1990s and has grown since the mid-2000s. The widening of the gap appears to be especially pronounced among non-Hispanic (NH) whites. However, the rural U.S. is not monolithic, and some rural places have experienced much larger mortality rate increases than others over the past 30 years. Drawing on restricted mortality files from the National Vital Statistics System (NVSS), I examine metro versus nonmetro and intra-nonmetro (divisional and economic dependency) all-cause and cause-specific mortality trends among working-age (25-64) NH white males and females, 1990-2018. Results show that the nonmetro mortality penalty is wide and growing and is pervasive across multiple disease and injury categories. Trends for females are particularly concerning. Smaller nonmetro declines in mortality from cancers and cardiovascular disease (throughout the 1990s and 2000s) and larger increases in metabolic and respiratory diseases, suicide, alcohol-related, and mental/behavioral disorders (throughout the 2010s) collectively drove the growth in the nonmetro disadvantage. There are also large divisional disparities (which are growing for females), with particularly poor trends in New England, South Atlantic, ES Central, WS Central, and Appalachia and more favorable trends in the Mid-Atlantic, Mountain, and Pacific. Mining-dependent counties have diverged from the other economic dependency types since the mid-2000s due to multiple causes of death, whereas farming counties have comparatively lower mortality rates. High and rising mortality rates across a variety of causes and rural places, some of which have been occurring since the 1990s and others that emerged more recently, suggest that there is not one underlying explanation. Instead, systemic failures across a variety of institutions and policies have contributed to rural America's troubling mortality trends generally and within-rural disparities more specifically.

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Dataset Information

Long-term trends of liver cancer mortality by gender in urban and rural areas in China: an age-period-cohort analysis.

Publications

Long-term trends of liver cancer mortality by gender in urban and rural areas in China: an age-period-cohort analysis.

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