Objective: To investigate the distribution characteristics and trends of mortality and spatial aggregation of gastric cancer in Shandong Province from 1970 to 2013. Methods: The mortality data of gastric cancer from 1970 to 1974, 1990 to 1992 and 2004 to 2005 were collected from the first, second and third retrospective sampling survey of causes of death in Shandong Province, respectively. The mortality data of gastric cancer from 2011 to 2013 were collected from the all-cause surveillance data of Shandong Province. The crude mortality rate and age-standardized mortality rate were used to describe the death level of gastric cancer. The age-standardized mortality rate of Shandong Province was calculated based on Segi's world standard population, and the age-standardized mortality rate of counties (cities and districts) was calculated based on the Chinese population in 1964.The factors influencing the difference of gastric cancer mortality in different periods were decomposed by using the method of differential decomposition of mortality, and the contributions of population and non-population factors in different periods were estimated.Using ArcGIS 10.2 software, the death level of gastric cancer in different counties (cities and districts) in Shandong province from 1970 to 1974 and 2011 to 2013 were visualized. DeoDa 1.12 software was used for global and local spatial autocorrelation analysis. Results: The crude death rate and age-standardized death rate of gastric cancer in Shandong province increased firstly and then decreased during 1970-2013, and the crude death rate of gastric cancer increased from 18.33/100 000 in 1970-1974 to 28.51/100 000 in 2011-2013. Segi's age-standardized mortality rate for gastric cancer decreased from 20.94 per 100 000 in 1970-1974 to 18.17 per 100 000 in 2011-2013.From 1990 to 1992, from 2004 to 2005 and from 2011 to 2013, the contribution value of non-population factors to the increase of crude gc mortality was 95.59%, 48.45% and -20.57%, respectively, showing a continuous downward trend. The Moran's I index of crude mortality of gastric cancer in Shandong province from 1970 to 1974 and from 2011 to 2013 were 0.77 and 0.57, respectively, and the Moran's I index of age-normalized mortality was 0.75 and 0.44, respectively. Local autocorrelation analysis showed that there were 31 and 19 high aged-mortality areas of gastric cancer in 1970-1974 and 2011-2013 respectively, and 7 overlapping counties (cities and districts), 6 of which were located in Jiaodong area. Conclusion: The crude mortality and age-standardized mortality of gastric cancer in Shandong province increased first and then decreased from 1970 to 2013, and the distribution of gastric cancer mortality had obvious spatial aggregation and changed with time.
目的： 了解1970—2013年山东省胃癌死亡率和空间聚集性分布特征及其变化趋势。 方法： 1970—1974、1990—1992和2004—2005年胃癌死亡资料分别源自全国第一次、第二次和第三次死因回顾抽样调查（山东省部分），2011—2013年胃癌死亡资料源自山东省全死因监测数据。以粗死亡率和年龄标化死亡率为指标描述胃癌死亡水平，其中山东省年龄标化死亡率以Segi′s世界标准人口计算，各县（市、区）年龄标化死亡率以1964年中国人口计算。应用死亡率差别分解法对不同年代胃癌死亡率差异的影响因素进行分解，估计不同时期人口和非人口因素的贡献度。采用ArcGIS 10.2软件对1970—1974年和2011—2013年山东省各县（市、区）胃癌死亡水平进行地图可视化展示。采用DeoDa 1.12软件进行全局和局部空间自相关分析。 结果： 1970—2013年山东省胃癌粗死亡率和年龄标化死亡率均呈先升后降趋势，胃癌粗死亡率由1970—1974年的18.33/10万上升至2011—2013年的28.51/10万，胃癌Segi′s世界人口年龄标化死亡率由1970—1974年的20.94/10万降至2011—2013年的18.17/10万。1990—1992年、2004—2005年和2011—2013年非人口因素对粗胃癌死亡率上升的贡献值分别为95.59%、48.45%和-20.57%，呈持续下降趋势。山东省1970—1974年和2011—2013年各县（市、区）胃癌粗死亡率Moran′s I指数分别为0.77和0.57，年龄标化死亡率Moran′s I指数分别为0.75和0.44。局部自相关分析显示1970—1974年和2011—2013年胃癌年龄标化死亡率高高聚集区分别为31和19个，重叠的县（市、区）为7个，其中6个位于胶东地区。 结论： 1970—2013年山东省胃癌粗死亡率和年龄标化死亡率均呈先升后降，胃癌死亡率分布存在明显空间聚集性且随时间变化。.