Characterization of esophageal cancer and its association with influencing factors in Guangzhou city, China

Abstract

Epidemiological features of esophageal cancer (EC), as well as their associations with potential influencing factors in a city, have seldom been seldom explored on a fine scale. The EC death cases in Guangzhou city during 2012−2017 were collected to describe the epidemiological characteristics such as EC mortality rate (ECMR) and health‐seeking behaviors of deaths. Potential influencing factors, including socioeconomic conditions (population density, gross domestic product density), medical resources, and ageing degree were also gathered for exploring their relationships with the epidemiological characteristics of EC. A total of 2,409 EC deaths were reported during 2012−2017 in Guangzhou with an age‐standardized ECMR of 3.18/105. The prevalence of EC in Guangzhou was spatially featured and was divided into three regions with obvious differentiated ECMR (ECMR of 6.41/105 in region A, ECMR of 5.51/105 in region B, ECMR of 2.56/105 in region C). The street/town‐level ECMR was spatially clustered in Guangzhou city, especially two clusters of streets/towns with high ECMR were highlighted in region A and B respectively. Meanwhile, demographic features including gender gap, death age, temporal interval between diagnosis and death, health‐seeking behaviors were remarkably different among the three regions. Moreover, health‐seeking behaviors (e.g., the proportion of hospital deaths) of the EC deaths were obviously influenced by medical institution occupancy rate and socioeconomic conditions at street/town level. In addition, the street/town‐level ECMR was significantly associated with ageing degree across Guangzhou city (r = 0.466, p < 0.01), especially in region A (r = 0.565, p < 0.01). In contrast, the ECMR in region B was closely related to population density (r = −0.524, p < 0.01) and gross domestic product density (r = −0.511, p < 0.01) when the ageing degree was controlled, while these associations were weak in region C. The epidemiological characteristics of EC in Guangzhou city were spatially featured and potentially associated with socioeconomic conditions, medical resources and ageing degree on a fine scale across Guangzhou city. This study could provide scientific basis for local authorities to implement more targeted EC interventions.