%0 Journal Article %T Spatial Analysis of Esophageal Cancer Mortality in a High-risk Population in China: Consistent Clustering Pattern in 1970-74 and 2011-13 %J Asian Pacific Journal of Cancer Prevention %I West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter. %Z 1513-7368 %A Kou, Kou %A Guo, Xiaolei %A Baade, Peter %A Lu, Zilong %A Fu, Zhentao %A Chu, Jie %A Xu, Aiqiang %A Sun, Jiandong %D 2018 %\ 11/01/2018 %V 19 %N 11 %P 3161-3166 %! Spatial Analysis of Esophageal Cancer Mortality in a High-risk Population in China: Consistent Clustering Pattern in 1970-74 and 2011-13 %K Esophageal Cancer %K mortality %K Spatial Pattern %K temporal change %K China %R 10.31557/APJCP.2018.19.11.3161 %X Purpose: Almost half of the global esophageal cancer (EC) deaths occurred in China. This study aims to examinethe geographic spread of EC mortality in two periods in a large Chinese population. Methods: Age-standardizedmortality rates (ASMRs) for 140 county-level units in Shandong Province during the periods 1970-74 and 2011-13were derived using data from the First National Cause-of-Death Survey and the Shandong Death Registration System,respectively. ASMRs were smoothed using Area-to-Area Poisson kriging technique. Spatial scan statistics were used todetect spatial clusters with higher EC mortality and clusters with greater temporal changes in EC mortality. Results:The provincial average ASMR decreased from 13.0 per 100,000 in 1970-74 to 5.8 in 2010-13. Almost all counties ordistricts have experienced a decrease in EC mortality, while the reduction was particularly pronounced in the mid-westregion. This study has identified a geographical cluster with much higher EC mortality rates and the clustering patternhas largely unchanged over the past 40 years. Residents living in the cluster during 1970-74 were 2.7 (95% CI: 2.2-3.4)times more likely to die from EC than the rest of the province. The corresponding risk ratio for the 2011-13 cluster was3.7 (95% CI: 2.8-5.0). Conclusions: This study detected a geographically defined subpopulation in Shandong, Chinawith much higher risk of dying from EC. This spatial pattern has been consistent over the past few decades. The resultssuggest the key drives for geographic variations in esophageal cancer may not have changed. %U https://journal.waocp.org/article_76649_7cbf5dc204847cff4211459ff173dab0.pdf