title: Secular trend analysis of lung cancer incidence in Sihui city, China between 1987 and 2011.
abstract: BACKGROUND
  With industrial and econom ic development in recent decades in South China, cancer incidence may have changed due to the changing lifestyle and environment. However, the trends of lung cancer and the roles of smoking and other environmental risk factors in the development of lung cancer in rural areas of South China remain unclear. The purpose of this study was to explore the lung cancer incidence trends and the possible causes of these trends.
  
  
  METHODS
  Joinpoint regression analysis and the age-period-cohort (APC) model were used to analyze the lung cancer incidence trends in Sihui, Guangdong province, China between 1987 and 2011, and explore the possible causes of these trends.
  
  
  RESULTS
  A total of 2,397 lung cancer patients were involved in this study. A 3-fold increase in the incidence of lung cancer in both sexes was observed over the 25-year period. Joinpoint regression analysis showed that while the incidence continued to increase steadily in females during the entire period, a sharp acceleration was observed in males starting in 2005. The full APC model was selected to describe age, period, and birth cohort effects on lung cancer incidence trends in Sihui. The age cohorts in both sexes showed a continuously significant increase in the relative risk (RR) of lung cancer, with a peak in the eldest age group (80-84 years). The RR of lung cancer showed a fluctuating curve in both sexes. The birth cohorts identified an increased trend in both males and females; however, males had a plateau in the youngest cohorts who were born during 1955-1969.
  
  
  CONCLUSIONS
  Increasing trends of the incidence of lung cancer in Sihui were dominated by the effects of age and birth cohorts. Social aging, smoking, and environmental changes may play important roles in such trends.
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. dujl3@mail2.sysu.edu.cn.|Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China. dujl3@mail2.sysu.edu.cn.|School of Public Health, Guangdong Medical University, Dongguan, Guangdong, 523808, P. R. China. dujl3@mail2.sysu.edu.cn.
authors.forename: Jin-Lin
authors.initials: JL
authors.lastname: Du
authors.affiliation: Sihui Cancer Institute, Sihui, Guangdong, 526200, P. R. China. 1197990059@qq.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Lin
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. zhanglf35@mail2.sysu.edu.cn.|Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China. zhanglf35@mail2.sysu.edu.cn.
authors.forename: Li-Fang
authors.initials: LF
authors.lastname: Zhang
authors.affiliation: Sihui Cancer Institute, Sihui, Guangdong, 526200, P. R. China. 362952922@qq.com.
authors.forename: Yan-Hua
authors.initials: YH
authors.lastname: Li
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. xieshh@sysucc.org.cn.|Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China. xieshh@sysucc.org.cn.
authors.forename: Shang-Hang
authors.initials: SH
authors.lastname: Xie
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. yangmj@sysucc.org.cn.|Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China. yangmj@sysucc.org.cn.
authors.forename: Meng-Jie
authors.initials: MJ
authors.lastname: Yang
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. guojiegina@126.com.|Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China. guojiegina@126.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Guo
authors.affiliation: Sihui Cancer Institute, Sihui, Guangdong, 526200, P. R. China. 13679567828@139.com.
authors.forename: Er-Hong
authors.initials: EH
authors.lastname: Lin
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. liuqing@sysucc.org.cn.|Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China. liuqing@sysucc.org.cn.
authors.forename: Qing
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. hongmh@sysucc.org.cn.|Department of Clinical Trial Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China. hongmh@sysucc.org.cn.
authors.forename: Ming-Huang
authors.initials: MH
authors.lastname: Hong
authors.affiliation: Sihui Cancer Institute, Sihui, Guangdong, 526200, P. R. China. gdshci@163.com.
authors.forename: Qi-Hong
authors.initials: QH
authors.lastname: Huang
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. Liaozhe@sysucc.org.cn.|Department of Cancer Screening, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China. Liaozhe@sysucc.org.cn.
authors.forename: Zheng-Er
authors.initials: ZE
authors.lastname: Liao
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. caosm@sysucc.org.cn.|Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China. caosm@sysucc.org.cn.
authors.forename: Su-Mei
authors.initials: SM
authors.lastname: Cao
mesh_terms: D000375:Aging; D002681:China; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms; D008297:Male; D012307:Risk Factors; D012907:Smoking