| [Objective] To analyze the epidemiological status and long-term changing trends of esophageal cancer in cancer registration areas of Zhejiang Province, so as to provide evidence for formulating esophageal cancer prevention and control strategies.
[Methods] The surveillance data from all cancer registration areas in Zhejiang Province covering 2000 to 2021 were collected and sorted. Incidence and mortality data of esophageal cancer were extracted and subjected to quality control analysis. The crude incidence rate, crude mortality rate, age-standardized rate based on Chinese standard population (ASR-China) and age-standardized rate based on world standard population (ASR-world) of esophageal cancer in 2021 were calculated, and stratified statistical analyses were conducted by sex, age group and urban-rural residence. Joinpoint software was adopted to calculate the average annual percentage change (AAPC) together with the corresponding 95% confidence interval (95%CI).
[Results] In 2021, the crude incidence rate of esophageal cancer in cancer registration areas of Zhejiang Province was 11.22 per 100 000 population, the ASR-China was 4.88 per 100 000 population, and the ASR-world was 4.97 per 100 000 population. The incidence was higher in males than females and higher in rural areas than urban areas, and increased markedly with age, with the highest incidence observed in residents aged 65 years and above. The crude mortality rate of esophageal cancer was 8.48 per 100 000 population, the ASR-China for mortality was 3.48 per 100 000 population, and the ASR-world for mortality was 3.54 per 100 000 population. The distribution pattern of mortality was consistent with that of incidence, with males, rural residents and the elderly facing higher mortality risks. From 2000 to 2021, the AAPC of crude incidence rate was 0.98% (95%CI: 0.21–1.83, P=0.024), indicating a statistically significant upward trend. The AAPC of ASR-China incidence was ?1.53% (95%CI: ?2.38–?0.59, P=0.009), and the AAPC of ASR-world incidence was ?1.48% (95%CI: ?2.38–?0.47, P=0.016), both showing significant downward trends. The AAPC of crude mortality rate was ?0.08% (95%CI: ?0.61–0.96, P=0.817), with no statistically significant change. The AAPC of ASR-China mortality was ?2.03% (95%CI: ?2.57–?1.47, P＜0.001), and the AAPC of ASR-world mortality was ?1.93% (95%CI: ?2.52–?1.32, P＜0.001), both standardized mortality rates decreased significantly. The absolute values of AAPCs for standardized mortality were larger than those for standardized incidence, which suggested that esophageal cancer mortality declined faster than incidence. Stratified trend analyses revealed that the declining magnitudes of AAPCs for esophageal cancer incidence and mortality were greater in females, residents aged 15–44 years and rural populations compared with males, residents aged ≥45 years and urban populations, respectively, representing faster declining rates.
[Conclusion] From 2000 to 2021, the overall incidence and mortality rates of esophageal cancer across cancer registration sites in Zhejiang Province presented downward trends, and the decline of mortality was significantly faster than that of incidence. Males, rural residents and the elderly should be prioritized as key populations for esophageal cancer prevention and control. |
