Urban Rural Disparity in Westernization Related Cancers and the Increasing Incidence in Parallel with Socioeconomic Development and Urbanization from 2000-2015 among a Rural Chinese Population: An Observational Study

摘要

China used to have great urban rural disparity in socioeconomic development. Since the late 1980s, rapid socioeconomic development and urbanization have been taking place in rural settings. It is epidemiologically established that cancer scale and profile will transit as economy prospers and urbanization develops. However, there are few published studies reporting what changes are undergoing in cancer pattern in Chinese rural settings. Population-based tumor registration data collected by us in urban Shijiazhuang city (available for 2,374,827 people in 2012) and in rural Shexian County (available for 408,995 people since 2000) were used for urban rural comparison of age standardized incidence rate (ASIR) of westernization-related cancers in 2012, and the trend of biennial ASIR of these cancers for 2000-2015 in Shexian County was examined following a decade of rapid socioeconomic development and urbanization. From 1988-2015, the Gross Domestic Product per Capita (GDP) in rural Shexian County increased from 860 to 3000 US$, and urbanization rate from 22.4% to 54.8%. The biennial ASIRs of lung, colorectal, gallbladder cancer and leukemia in both sexes, and that of breast, ovary, thyroid, and kidney cancer in women increased significantly from 2000 - 2015. The increase from 2000-2001 to 2014-2015 in man and women for lung cancer was from 15.9 to 34.7 per 10~5 (P = 0.05) and 9.6 to 16.7 (P = 0.00), for colorectal cancer from 6.6 to 15.9 (P = 0.00) and 4.0 to 11.7 (P = 0.00), for gallbladder cancer from 0.1 to 2.4 (P = 0.00) and 0.3 to 2.7 (P = 0.00), for leukemia from 2.8 to 7.7 (P = 0.00) and 2.3 to 6.2 (P = 0.00); and in women for cancer of breast from 2.8 to 17.3 (P = 0.00), kidney from 0.2 to 2.4 (P = 0.00), ovary from 0.2 to 4.3 (P = 0.00), and thyroid from 0.2 to 4.2 (P = 0.00). Notwithstanding these increases, their ASIRs in 2012 in Shexian County were still significantly lower than that in Shijiazhuang city. Westernization-related cancer is increasing rapidly in rural China. Comprehensive measures are needed to strengthen prevention to ensure sustainable development.