Urban-Rural Disparity in Helicobacter Pylori Infection-Related Upper Gastrointestinal Cancer in China and the Decreasing Trend in Parallel with Socioeconomic Development and Urbanization in an Endemic Area
机构：[1]Medical Image, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China河北医科大学第四医院[2]Cancer Center, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China河北医科大学第四医院
BACKGROUND Globally China has the largest urban-rural disparity in socioeconomic development, and the urban-rural difference in upper gastrointestinal cancer (UGIC) is similar to the difference between developed and developing countries. OBJECTIVES To describe urban-rural disparity in UGIC and to emphasize prevention by socioeconomic development and urbanization in China. METHODS Age-standardized incidence rates (ASRs) of cancers in 2012 were compared between urban Shijiazhuang city and rural Shexian County, and trends from 2000-2015 in Shexian County were analyzed. FINDINGS Compared with urban Shijiazhuang city, the ASR of gastroesophageal cancers in rural Shexian County was 5.3 times higher in men (234.1 vs 44.2/100,000, P < .01) and 9.1 times higher in women (107.7 vs 11.8/100,000, P < .01). This rural-urban disparity in UGIC is associated with differences in socioeconomic development in annual gross domestic product (GDP) per capita of US$ 2700 vs US$ 6965, in urbanization rate of 48% vs 100%, and in adult Helicobacter pylori infection prevalence of 75% vs 50%. From 2000-2015, the GDP per capita in Shexian County increased from US$ 860 to US$ 3000, urbanization rate increased from 22.4% to 54.8%, and prevalence of H pylori infection among 3- to 10-year-old children decreased from 60% to 46.1% (P < .01). Meanwhile, the biennial ASR of esophagogastric cancer decreased 42% in men, from 313.5 to 182.1 per 100,000 (P < .01), and 57% in women, from 188.6 to 80.4 per 100,000 (P = .00). However, lung, colorectal, and gallbladder cancers and leukemia in both sexes and breast, ovary, thyroid, and kidney cancer in women increased significantly. Despite this offset, ASR of all cancers combined decreased 25% in men (from 378.2 to 283.0/100,000, P = .00) and 19% in women (from 238.5 to 193.6/100,000, P = .00). CONCLUSIONS Urban-rural disparity in UGIC is related to inequity in socioeconomic development. Economic growth and urbanization is effective for prevention in endemic regions in China and should be a policy priority.
基金：
Key Medical Research Subjects in Hebei Province [2012] No 2056, and by the Key Subject Development Program in
universities of Hebei Province, which are headed by Prof Baoen Shan, 4th Hospital of Hebei Medical University.
第一作者机构：[1]Medical Image, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China
通讯作者：
推荐引用方式(GB/T 7714)：
Wen Xiaoduo,Wen Denggui,Yang Yi,et al.Urban-Rural Disparity in Helicobacter Pylori Infection-Related Upper Gastrointestinal Cancer in China and the Decreasing Trend in Parallel with Socioeconomic Development and Urbanization in an Endemic Area[J].ANNALS OF GLOBAL HEALTH.2017,83(3-4):444-462.doi:10.1016/j.aogh.2017.09.004.
APA：
Wen, Xiaoduo,Wen, Denggui,Yang, Yi,Chen, Yuetong,Wang, Guiying&Shan, Baoen.(2017).Urban-Rural Disparity in Helicobacter Pylori Infection-Related Upper Gastrointestinal Cancer in China and the Decreasing Trend in Parallel with Socioeconomic Development and Urbanization in an Endemic Area.ANNALS OF GLOBAL HEALTH,83,(3-4)
MLA：
Wen, Xiaoduo,et al."Urban-Rural Disparity in Helicobacter Pylori Infection-Related Upper Gastrointestinal Cancer in China and the Decreasing Trend in Parallel with Socioeconomic Development and Urbanization in an Endemic Area".ANNALS OF GLOBAL HEALTH 83..3-4(2017):444-462
