title: Spatial analysis of hepatocellular carcinoma and socioeconomic status in China from a population-based cancer registry.
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 [beta(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.
authors.affiliation: Department of Epidemiology, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai 200032, China.
authors.forename: Wenxiang
authors.initials: W
authors.lastname: Peng
authors.forename: Yue
authors.initials: Y
authors.lastname: Chen
authors.forename: Qingwu
authors.initials: Q
authors.lastname: Jiang
authors.forename: Yingjie
authors.initials: Y
authors.lastname: Zheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001499:Bayes Theorem; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003710:Demography; D005260:Female; D005843:Geography; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012042:Registries; D012923:Social Class; D055815:Young Adult