Esophageal Cancer Mortality Trends during the Last 30 Years in High Risk Areas in China: Comparison Results from National Death Surveys Conducted in the 1970’s, 1990’s and 2004-2005

Background and Aims. China was one of the countries with the highest esophagus cancer (EC) mortalityin the world during the 1970’s. This report provides data on time trends of esophagus cancer mortality duringthe 1970’s-21st century in high risk areas, considering the remarkable geographic variation of EC mortalityin China. The aim was to explore changing trends of EC mortality during past 30 years, and provide basicinformation on prevention and control of EC in high risk areas in China.
Methods: Among the high risk areas ofEC defined in the 1970’s, ten that have joined in all the three death causes sampling surveys were selected in thisstudy. Subjects included all cases dying from esophageal cancer in these sites during 1973-1975, 1990-1992, and2004-2005. The EC mortality data and relevant demographic data of ten areas covered by all the three surveyswere extracted from the national death causes survey database.
Results: Compared with the EC mortality ofthe ten high risk areas in the 1970’s, the crude mortality rates (CMR) in the 1990’s reduced by 0.04%~47.3%,and the CMRs in the early 21st century decreased by 9.25%~62.0% from the 1990’s; the age specific mortalityrate adjusted by China standard population (ASMRc) in the 1990’s reduced by 8.22%~53.5%, and the ASWRcin the early 21st century decreased by 25.0%~78.0% from the 1990’s; the age-specific mortality rates adjustedby world standard population (ASMRw) in the 1990’s reduced by 7.54%~51.9%, and the ASMRw in the early21st century decreased by 24.5%~79.2% from the 1990’s; the proportional mortality ratios (PMR) in the 1990’sreduced by 12.3%~41.3%, and the PMRs in the early 21st century decreased by 6.76%~52.6% from the 1990’s.
Conclusion: Our study indicated that the mortality of esophageal cancer in high risk areas of China had declinedafter three decades, but still remained high compared with the national level. Esophageal cancer is still a majorcancer burden in high risk areas. It is necessary to further promote the prevention and control program ofesophageal cancer in these areas of China.