Temporal Trends in Geographical Variation in Breast Cancer Mortality in China, 1973–2005: An Analysis of Nationwide Surveys on Cause of Death

Abstract

To describe geographical variation in breast cancer mortality over time, we analysed breast cancer mortality data from three retrospective national surveys on causes of death in recent decades in China. We first calculated the age-standardized mortality rate (ASMR) for each of the 31 provinces in mainland China stratified by survey period (1973–1975, 1990–1992 and 2004–2005). To test whether the geographical variation in breast cancer mortality changed over time, we then estimated the rate ratio (RR) for the aggregated data for seven regions and three economic zones using generalized linear models. Finally, we examined the correlation between mortality rate and several macro-economic measures at the provincial level. We found that the overall ASMR increased from 2.98 per 100,000 in 1973–1975 to 3.08 per 100,000 in 1990–1992, and to 3.85 per 100,000 in 2004–2005. Geographical variation in breast cancer mortality also increased significantly over time at the regional level (p = 0.002) but not at the economic zone (p = 0.089) level, with RR being generally lower for Western China (Northwest and Southwest) and higher in Northeast China over the three survey periods. These temporal and spatial trends in breast cancer mortality were found to be correlated with per capita gross domestic product, number of hospitals and health centres’ beds per 10,000 population and number of practicing doctors per 10,000 population, and average number of live births for women aged 15–64. It may be necessary to target public health policies in China to address the widening geographic variation in breast cancer mortality, and to take steps to ensure that the ease of access and the quality of cancer care across the country is improved for all residents.

Female Breast Cancer Mortality Clusters in Shandong Province, China: A Spatial Analysis

“…Some previous studies have reported a positive correlation between the socioeconomic level and breast cancer mortality 34, 35 . In Shandong, the economy in the eastern region is more developed compared to the central and western regions.…”

Determinantes espaciais das internações hospitalares do Sistema Único de Saúde por câncer de mama nas microrregiões do Brasil

“…Inicialmente são consideradas pesquisas que utilizaram somente o mapeamento geográfico para analisar a distribuição da incidência e mortalidade por câncer de mama, destacando-se em termos internacionais: Fukuda et al (2005), Vieira et al (2008), Alvarez et al (2009) Xia et al (2016). Já em nível nacional, tem-se: Wünsch Filho & Moncau (2002), Santos et al (2009) e Zapponi & Melo (2010).…”

“…Já Xia et al (2016) avaliaram dados de mortalidade por câncer de mama em 31 províncias da China em três diferentes períodos: de 1973 a 1975, 1990 a 1992 e 2004 a 2005. Baixas taxas de mortalidade pela doença foram observadas na China Ocidental (Noroeste e Sudoeste), enquanto altas taxas foram encontradas no Nordeste da China.…”

“…O câncer de mama é a segunda neoplasia mais comum entre as mulheres em nível mundial e nacional, depois do câncer de pele não melanoma (Santos et al 2013, Guerra et al 2015, Brasil 2017a. É uma doença crônica que apresenta altas taxas de incidência, internações hospitalares e mortalidade, sendo classificada como um problema de saúde pública (Brasil 2013, Mohaghegh et al 2015, Rodrigues et al 2015, Xia et al 2016.…”

Multivariate Feature Selection of Image Descriptors Data for Breast Cancer with Computer-Assisted Diagnosis

“…A set of diagnosis methods for breast cancer have been studied by experts, looking for early detection, finding that the primary method—breast self-examination—is not adequate, since there is no evidence of a reduction in the mortality rate due to this disease in women who practice breast self-examination against to those who do not [8,9,10]. …”