Urban-Rural Disparity in Cancer Incidence, Mortality, and Survivals in Shanghai, China, During 2002 and 2015

Xiaopan Li; Yang Deng; Weina Tang; Qiao Sun; Yichen Chen; Chen Yang; Bei Yan; Yingying Wang; Jing Wang; Shuo Wang; Fan Yang; Yibo Ding; Genming Zhao; Guangwen Cao

doi:10.3389/fonc.2018.00579

Urban-Rural Disparity in Cancer Incidence, Mortality, and Survivals in Shanghai, China, During 2002 and 2015

Front Oncol. 2018 Dec 3:8:579. doi: 10.3389/fonc.2018.00579. eCollection 2018.

Authors

Xiaopan Li^{1

2}, Yang Deng³, Weina Tang³, Qiao Sun², Yichen Chen², Chen Yang², Bei Yan², Yingying Wang², Jing Wang², Shuo Wang³, Fan Yang³, Yibo Ding³, Genming Zhao¹, Guangwen Cao³

Affiliations

¹ The Key Laboratory of Public Health and Safety of Education Ministry, School of Public Health, Fudan University, Shanghai, China.
² Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China.
³ Department of Epidemiology, Second Military Medical University, Shanghai, China.

Abstract

Introduction: Disparities in the incidence, mortality, and survival of cancer types between urban and rural areas in China reflect the effects of different risk factor exposure, education, and different medical availability. We aimed to characterize the disparities in the incidence, mortality, and survivals of cancer types between urban and rural areas in Shanghai, China, 2002-2015. Materials and Methods: The incidence and mortality were standardized by Segi's world standard population. Trends in the incidence and mortality of cancers were compared using annual percent change. The 5-year observed and relative survivals were calculated with life table and Ederer II methods. Results: Age-standardized incidences and mortalities were 212.55/10⁵ and 109.45/10⁵ in urban areas and 210.14/10⁵ and 103.99/10⁵ in rural areas, respectively. Female breast cancer and colorectal cancer occurred more frequently in urban than in rural areas, quite in contrast to liver cancer and cervical cancer. Cancers of lung and bronchus, liver, stomach, and colon and rectum were the leading causes of cancer death in both areas. Age-standardized incidence of female breast cancer and colorectal cancer in urban areas increased while gastric cancer and liver cancer decreased in both areas. Age-standardized mortalities of cancers of breast, esophagus, stomach, colon and rectum, liver, and lung and bronchus decreased in both areas. For all cancers combined, the 5-year observed and relative survivals of cancer patients were higher in urban than in rural areas. The 5-year observed and relative survivals of cancers of liver, pancreas, stomach, brain and central nervous system (CNS), and prostate were higher in urban than in rural areas. The 5-year observed and relative survivals of cervical cancer were higher in rural than in urban areas. Conclusions: Factors promoting female breast cancer and colorectal cancer in urban areas and liver cancer and cervical cancer in rural areas should be specifically intervened in cancer prophylaxis. Improved medical services can greatly prolong the survival of major cancers in rural areas.

Keywords: China; cancers; incidence; mortality; survival; urban-rural disparity.