Lung cancer mortality clusters in Shandong Province, China: how do they change over 40 years?
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Zhentao Fu1,*, Yingmei Li2,*, Zilong Lu1,*, Jie Chu1, Jiandong Sun3, Jiyu Zhang1, Gaohui Zhang1, Fuzhong Xue4, Xiaolei Guo1,** and Aiqiang Xu1,**
1Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
2The Second People's Hospital of Jinan, Jinan, China
3School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
4School of Public Health, Shandong University, Jinan, China
*The first three authors contributed equally to this work
**The last two authors contributed equally to this work
Xiaolei Guo, email: email@example.com
Aiqiang Xu, email: firstname.lastname@example.org
Keywords: lung cancer, spatial scan statistics, mortality, epidemiology
Received: March 27, 2017 Accepted: August 06, 2017 Published: September 21, 2017
Lung cancer has long been a major health problem in China. This study aimed to examine the temporal trend and spatial pattern of lung cancer mortality in Shandong Province from 1970 to 2013. Lung cancer mortality data were obtained from Shandong Death Registration System and three nationwide retrospective cause-of-death surveys. A Purely Spatial Scan Statistics method with Discrete Poisson models was used to detect possible high-risk spatial clusters. The results show that lung cancer mortality rate in Shandong Province increased markedly from 1970-1974 (7.22 per 100,000 person-years) to 2011-2013 (56.37/100, 000). This increase was associated with both demographic and non-demographic factors. Several significant spatial clusters with high lung cancer mortality were identified. The most likely cluster was located in the northern region of Shandong Province during both 1970-1974 and 2011-2013. It appears the spatial pattern remained largely consistent over the last 40 years despite the absolute increase in the mortality rates. These findings will help develop intervention strategies to reduce lung cancer mortality in this large Chinese population.
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