Mortality and incidence trends from esophagus cancer in selected geographic areas of China circa 1970–90

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Abstract
China was one of the countries with the highest esophagus cancer risk in the world during the 1970s. This report provides data on time trends of esophagus cancer incidence and mortality during the 1970s–90s in selected geographic areas of China. Information on newly diagnosed cancer cases and cancer deaths is based on data collected by local population-based registries and Disease Surveillance Points (DSP). For the whole country, esophagus cancer mortality decreased slightly, 17.4 per 105 populations during 1990–92 in contrast to 18.8 per 105 populations in 1973–75. In the Linxian area, trends in the incidence and mortality rates for esophagus+gastric cardia cancer reversed over time; incidence rates increased significantly during 1959–72 but were decreased significantly on average −2.26% (95% Confidence Interval [CI]: −1.74, −2.77) and −1.10% (95% CI = −0.58, −1.62) per year for males and females, respectively, during 1972–97. In urban Shanghai, incidence trend for esophagus cancer decreased monotonically and significantly on average by −4.99% (95% CI = −4.28, −5.70) and −5.18% (95% CI = −4.99, −5.70) per year for males and females, respectively. In Nanao islet, esophagus+gastric cardia cancer mortality rates increased during 1970–82 but decreased slowly from 1982–99 (−0.96% per year; 95% CI = −0.14, −1.78). Our study indicates that incidence and mortality rates for esophagus or esophagus+gastric cardia cancer are now decreasing in China. The declines may be due to an unplanned success of prevention, such as changes in population dietary patterns and food preservation methods.