Time Trends of Esophageal Cancer Mortality in Linzhou City During the Period 1988-2010 and a Bayesian Approach Projection for 2020

  • Liu, Shu-Zheng ;
  • Zhang, Fang ;
  • Quan, Pei-Liang ;
  • Lu, Jian-Bang ;
  • Liu, Zhi-Cai ;
  • Sun, Xi-Bin
  • Published : 2012.09.30


In recent decades, decreasing trends in esophageal cancer mortality have been observed across China. We here describe esophageal cancer mortality trends in Linzhou city, a high-incidence region of esophageal cancer in China, during 1988-2010 and make a esophageal cancer mortality projection in the period 2011-2020 using a Bayesian approach. Age standardized mortality rates were estimated by direct standardization to the World population structure in 1985. A Bayesian age-period-cohort (BAPC) analysis was carried out in order to investigate the effect of the age, period and birth cohort on esophageal cancer mortality in Linzhou during 1988-2010 and to estimate future trends for the period 2011-2020. Age-adjusted rates for men and women decreased from 1988 to 2005 and changed little thereafter. Risk increased from 30 years of age until the very elderly. Period effects showed little variation in risk throughout 1988-2010. In contrast, a cohort effect showed risk decreased greatly in later cohorts. Forecasting, based on BAPC modeling, resulted in a increasing burden of mortality and a decreasing age standardized mortality rate of esophageal cancer in Linzhou city. The decrease of esophageal cancer mortality risk since the 1930 cohort could be attributable to the improvements of socialeconomic environment and lifestyle. The standardized mortality rates of esophageal cancer should decrease continually. The effect of aging on the population could explain the increase in esophageal mortality projected for 2020.


Esophageal cancer;mortality;Linzhou;Bayesian APC model;projection


  1. Chen Y, Zhou LA (2007). The long-term health and economic consequences of the 1959-1961 famine in China. J Health Econ, 26, 659-81.
  2. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917.
  3. Han JY, Xu ZX, Xing HP, et al (2007). A historical cohort study on the effect of drinking water improvement to the mortality of esophageal carcinoma among Linzhou residents. Zhonghua Liu Xing Bing Xue Za Zhi, 28, 515-6.
  4. He YT, Hou J, Qiao CY, et al (2003). An analysis of esophageal cancer incidence in Cixian county from 1974 to 1996. World J Gastroenterol, 9, 209-13.
  5. Jie H, Ping Z, Chen W (2012). Chinese cancer registry annual report. Military medical science press, Beijing.
  6. Jin F, Devesa S, Zheng W, et al (1993). Cancer incidence trends in urban Shanghai, 1972-1989. Int J Cancer, 53, 764-70.
  7. Ma YT, Lian SY, Liu ZC, et al (2009). Period survival analysis of esophageal cancer in Linzhou city of Henan province. Zhonghua Yu Fang Yi Xue Za Zhi, 43, 1100-4.
  8. Schmid VJ, Held L (2007). Bayesian age-period-cohort modeling and prediction-BAMP. J Stat Software, 21, 1.
  9. Song F, He M, Li H, et al (2008). A cancer incidence survey in Tianjin: the third largest city in China-between 1981 and 2000. Cancer Causes Control, 19, 443-50.
  10. Song S (2009). Does famine have a long-term effect on cohort mortality? Evidence from the 1959-1961 great leap forward famine in China. J Biosoc Sci, 41, 469-91.
  11. Spiegelhalter DJ, Best NG, Carlin BP, et al (2002). Bayesian measures of model complexity and fit. J Royal Stat Soc Series B (Statistical Methodology), 64, 583-639.
  12. Sun G, Wang S, Hu X, et al (2007). Fumonisin B1 contamination of home-grown corn in high-risk areas for esophageal and liver cancer in China. Food Addit Contam, 24, 181-5.
  13. Sun XB, Lian SY, Liu ZC, et al (2007). The trends on the mortality for esophagus and stomach cancers in Linzhou city from 1988 to 2003. Zhonghua Yu Fang Yi Xue Za Zhi, 41, 66-9.
  14. Sun XB, Liu ZC, Liu SZ, et al (2007). Descriptive analysis of incidence and time trends of esophageal and gastric cancers in Linzhou city. Zhonghua Zhong Liu Za Zhi, 29, 764-7.
  15. Sun X, Chen W, Chen Z, et al (2010). Population-based casecontrol study on risk factors for esophageal cancer in five high-risk areas in China. Asian Pac J Cancer Prev, 11, 1631-6.
  16. Taylor PR, Li B, Dawsey SM, et al (1994). Prevention of esophageal cancer: the nutrition intervention trials in Linxian, China; Linxian Nutrition Intervention Trials Study Group. Cancer Res, 54, 2029-31.
  17. Tse LA, Yu LT, Mang OW, et al (2007). Time trends of esophageal cancer in Hong Kong: age, period and birth cohort analyses. Int J Cancer, 120, 853-8.
  18. Wei WQ, Yang J, Zhang SW, et al (2011). Esophageal cancer mortality trends during the last 30 years in high risk areas in China: comparison of results from national death surveys conducted in the 1970's, 1990's and 2004-2005. Asian Pac J Cancer Prev, 12, 1821-6.
  19. Xibib S, Meilan H, Moller H, et al (2003). Risk factors for oesophageal cancer in Linzhou, China: a case-control study. Asian Pac J Cancer Prev, 4, 119-24.

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