Spatial analysis of hepatocellular carcinoma and socioeconomic status in China from a Population-based Cancer Registry

Peng, Wenxiang; Chen, Yue; Jiang, Qingwu; Zheng, Yingjie

doi:10.1016/j.canep.2009.12.013

« Previous Next »Cancer Epidemiology
Volume 34, Issue 1 , Pages 29-33, February 2010

Spatial analysis of hepatocellular carcinoma and socioeconomic status in China from a Population-based Cancer Registry

Wenxiang Peng
- Department of Epidemiology, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai 200032, China
- Key Laboratory on Public Health Safety of the Ministry of Education at the Fudan University, Shanghai, China
Yue Chen
- Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
Qingwu Jiang
- Department of Epidemiology, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai 200032, China
- Key Laboratory on Public Health Safety of the Ministry of Education at the Fudan University, Shanghai, China
Yingjie Zheng
- Department of Epidemiology, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai 200032, China
- Key Laboratory on Public Health Safety of the Ministry of Education at the Fudan University, Shanghai, China
- Corresponding author at: Department of Epidemiology, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai 200032, China. Tel.: +86 21 54237052; fax: +86 21 54237052.

Accepted 20 December 2009. published online 04 January 2010.

Abstract

Background: Little is known about geographic variations in liver cancer at high incident regions. We aimed to identify spatial variation of hepatocellular carcinoma (HCC) at a high-risk area in China and determine its association with socioeconomic status (SES). Methods: Based on 2299 liver cancer cases diagnosed in Haimen from 2003 to 2006, we calculated age–sex standardized incidence ratios (SIRs) and used two spatial scan statistics to determine the geographic variations in HCC. Bayesian hierarchical model was used to explore the association between HCC incidence and SES. Results: Age and sex SIRs for HCC varied from 0.54 to 1.97 for 24 townships. The eastern region of Haimen was identified to have a significantly increased risk of HCC. Fitting of a Bayesian hierarchical model linking per-capita fiscal revenue with SIRs of HCC indicated that the area with a lower revenue had a significantly higher incidence of HCC [β_log(revenue)=−0.179, posterior 95% Bayesian credible interval (CI)=(−0.326, −0.04)]. Conclusions: This study demonstrated substantial geographic variation in the incidence of HCC within a high-risk region, which was associated with SES. HCC control and intervention should focus on disadvantaged areas to reduce the HCC disparities.