Analysis Of Trends In Incidence Of Lung Cancer In Shenzhen During 2001-2015 With Age-period-cohort Model

Objective: First,to analyse and report the basic information and the trends about the incidence of lung cancer among the registered population in Shenzhen during 2001~2015 with the cancer register information collected by the cancer registry in Shenzhen,then to estimate the influences from the age,period and cohort effects on the incidence of lung cancer so as to provide accurate information for epidemiological study of lung cancer or in planning measures to prevent and control lung cancer in Shenzhen for decision makers.Methods: First,we calculated the crude incidence rate,the age-standardized rate,the age-specific incidence rates and other indexes of lung cancer by using the lung cancer cases and population.Then,the trends for Chinese age-standardized rates(ASR-China)of lung cancer were analysed by using the joinpoint regression analysis and the annual percentage change rates should be calculated.Next,we estimated the age,period and cohort effects on incidence of lung cancer with Age-Period-Cohort model and used the Intrinsic Estimator operator to let the model get the unique solution.Finally,we compared the goodness of fit of the model in the study with other conventional two factors models.Results: 1.The crude incidence rates of all cancers in Shenzhen during 2001~2005,2006~2010 and 2011~2015 were 136.44/100000,179.01/100000 and 196.53/100000,respectively.The incidence rates increased year by year for both males and females.2.The crude incidence rates of lung cancer in Shenzhen during 2001~2005,2006~2010 and 2011~2015 were 19.92/100000,25.03/100000 and 27.15/100000,respectively.During the three periods,lung cancer was all the most common cancer.The incidence rate of lung cancer for males was higher than females,though both of them increased year by year.3.The joinpoint regression analysis showed no joinpoint was found in ASR-China for both males and females,ASR-China for males had a non-significant increase of 0.57% per year while ASR-China for females had a non-significant decrease of 0.04% per year.4.The Age-Period-Cohort model showed that the incidence rate of lung cancer increased rapidly with age effect,taken 20~24 years old as reference,the incidence rate peaked for males in 65~69 years old and for females in 80~84 years old,with incidence risk 41 fold and 53 fold to 20~24 years respectively.The same as period effect,taken 2001~2005 as reference,the incidence risk during 2011~2015 was 1.59 fold and 1.39 fold to 2001~2005 for males and females respectively.While the incidence rate of lung cancer both decreased rapidly with cohort effect.The incidence risk for the newest birth cohort was only 1/18 fold and 1/16 fold to that for the oldest birth cohort for males and females respectively.Conclusions: The lung cancer incidence cases number in Shenzhen ranked first(males:ranked first;females:ranked third)in all cancers incidence cases number during the three periods,accounting for about 14% of the number of all cancers cases.The crude incidence rates of lung cancert increased slowly year by year for both males and females.No joinpoint was found in ASR-China for both males and females,ASR-China for males had a slow increase while ASR-China for females had a slow decrease.Age effect was the most important factor contributing to the increase of lung cancer incidence,period effect caused an unconspicuous increase in the incidence of lung cancer.However,the cohort effect could lead a decline in the incidence of lung cancer.The key to prevention and treatment of lung cancer was to strengthen the propaganda and education among aged people and those with long-term exposure,making them understand and avoid all kinds of risk factors and exposures,at the same time the monitoring of lung cancer and early diagnosis and early treatment should also be strengthened.