| Objective: This stud y aims to understand the mortality and disease burden of upper digestive tract main malignant tumors in Qingdao from 2014 to 2018,and to analyze the time trend and geographical distribution characteristics of mortality,and to provide scientific evidence on the formulation of prevention and control strategies for upper digestive tract main malignant tumors in Qingdao and optimize the allocation of health resources.Methods: The death cases of upper digestive tract main malignant tumors from 2014 to 2018 were collected from the Tumor Registration System and the Death Cause Surveillance System in Qingdao,and the crude mortality and standardized mortality were calculated according to sex,urban and rural areas and age groups.Chi-square test was used to calculate the difference between gender and region mortality.The annual change percentage(APC)of standardized mortality was calculated to analyze the time trend of mortality from 2014 to 2018,and the disability-adjusted life year(DALY)was employed to evaluate disease burden of upper digestive tract main malignant tumors.GIS10.0 software was used to analyze the global trend of crude mortality and disease mapping;global Moran index(Moran's I),Moran's I scatter plot and local indicators of spatial autocorrelation(LISA)were used for spatial autocorrelation analysis;spatial-temporal scanning statistics were used to identify the high-value aggregation area of upper digestive tract main malignant tumor death.Results: 1.A total of 17296 death cases of main malignant tumors of the upper digestive tract were recorded in Qingdao from 2014 to 2018,the crude mortality rate was 43.47 / 100,000,and the standardized rate was 29.52 / 100,000.The standardized mortality rate of upper digestive tract main malignant tumors in males was 43.83 / 100,000,which was 2.94 times higher than in females(14.93 / 100,000).The standardized mortality rate of upper digestive tract tumors in rural areas was 31.48 / 100,000,which was 1.34 times higher than in urban areas(23.46 / 100,000).There were significant differences in gender and resident areas.The mortality rate in males was higher than in females,and in rural than in urban areas.The mortality of main malignant tumors of upper digestive tract increased with the increase of age,and climbed at the age of 45 ~ 80,and to the peak of death at the age of 85.2.The DALY rate caused by upper digestive tract main malignant tumor was 345.87 / 100,000 in urban residents,and 398.39 / 100,000 in rural residents.The DALY rate of males was higher than that of females in all age groups.The disease burden caused by upper digestive tract main malignant tumors had the greatest impact on people aged 70-79 years old.3.The results of time trend analysis showed that the standardized mortality rate of upper digestive tract malignant tumors only showed a significant downward trend in urban men,from 40.58 / 100,000 in 2014 to 33.23 / 100,000 in 2018,a decrease of 18.11%,with an average annual decline rate of 4.88%(APC=-4.88%,P=0.025).It was stable in both urban women and rural areas.4.The results of spatial analysis showed that the crude mortality rate of upper digestive tract main malignant tumors from 2014 to 2018 was moderate in the north-south direction,and decreased gradually from east to west in the east-west direction.Among them,the crude mortality rate of females decreased gradually from east to west and from north to south.The map of crude mortality showed that the high incidence area was mainly distributed in most villages and towns in the middle of Huangdao District and the northeast of Jimo District,while the low incidence area is mainly distributed in most villages and towns in the southwest of Pingdu City and the east of Shinan District.The distribution of crude mortality was significant difference between males and females,and the high incidence areas of crude mortality in males were more than in females.The analysis results of global spatial autocorrelation were Moran's I=0.13,P=0.006,showing a global spatial positive correlation distribution.Moran's I scatter chart revealed that most towns and streets were distributed in the first quadrant(high-high aggregation)and the third quadrant(low-low aggregation),showing a positive correlation distribution of both high value and low value aggregation.According to the results of local spatial autocorrelation analysis,it demonstrated that there were 27 significant aggregation areas in Qingdao,including 8 highhigh aggregation areas,15 low-low aggregation areas,3 low-high aggregation areas and 1 high-low aggregation area.There were 27 male gathering areas and 22 female gathering areas,and there are more male high gathering areas than female counterparts.A total of 25 high mortality areas were detected by spatial-temporal scanning analysis,29 for males and 10 for females.The most clustered areas were the east of Jimo District in 2018.Conclusion: First,the mortality rate of main malignant tumors of upper digestive tract in Qingdao was stable in recent 5 years,and the DALY of rural male population aged 70-85 years old are the highest.The disease burden need to be concern and the rural males should be taken as the key prevention and control group.Second,there is a positive correlation distribution of high and low value aggregation in spatial distribution,and there are abnormal areas of low-high and high-low aggregation.The east of Jimo District are the most likely areas with high mortality.We should determine the key areas for prevention and control of high mortality,further carry out the project of early identification and treatment of upper gastrointestinal cancer,rationally optimize the allocation of public health resources,and reduce the risk for mortality of malignant tumors of the upper digestive tract. |
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