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

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 esophagealcancer in China, during 1988–2010 and make a esophageal cancer mortality projection in the period 2011–2020using a Bayesian approach. Age standardized mortality rates were estimated by direct standardization to theWorld population structure in 1985. A Bayesian age–period–cohort (BAPC) analysis was carried out in orderto investigate the effect of the age, period and birth cohort on esophageal cancer mortality in Linzhou during1988–2010 and to estimate future trends for the period 2011–2020. Age-adjusted rates for men and womendecreased from 1988 to 2005 and changed little thereafter. Risk increased from 30 years of age until the veryelderly. Period effects showed little variation in risk throughout 1988-2010. In contrast, a cohort effect showedrisk decreased greatly in later cohorts. Forecasting, based on BAPC modeling, resulted in a increasing burden ofmortality and a decreasing age standardized mortality rate of esophageal cancer in Linzhou city. The decreaseof esophageal cancer mortality risk since the 1930 cohort could be attributable to the improvements of socialeconomicenvironment and lifestyle. The standardized mortality rates of esophageal cancer should decreasecontinually. The effect of aging on the population could explain the increase in esophageal mortality projectedfor 2020.