Cancer incidence in urban Shanghai, 1973-2010: an updated trend and age-period-cohort effects.
BACKGROUND
To provide a comprehensive overview of temporal trends in cancer incidence during 1973-2010 in urban Shanghai.


METHODS
The estimated annual percent changes (EAPCs) for the whole period and for the time segments in age-standardized incidence rates (ASR) were evaluated with Joinpoint analysis. Age-period-cohort (APC) models were modeled to examine the effects of age, period and birth cohort on cancer incidence.


RESULTS
The overall ASR decreased slightly and significantly in males (EAPC of -0.41) but increased significantly in females (EAPC of 0.57) during 1973-2010 in urban Shanghai. The incidence trend was not linear and varied by time segments. During the most recent 10 years (2001-2010), the ASR in males decreased by 1.65% per year and stabilized in females. Incidence rates continued to decline during 1973-2010 for esophagus, stomach, and liver cancer in both sexes, as well as male lung cancer and cervix cancer. It should be noted that it was the first time to document a significant decline in lung cancer incidence among males during 1973-2010 with EAPC of -0.58%, and a notable upward for cervix cancer since 1996 with EAPC of 8.94%. Unfavorable trends in incidence were observed for the most common cancer sites in the 38 years period: colorectum, gallbladder & biliary tract, pancreas, kidney, bladder, brain & central nervous system (CNS), thyroid, non-Hodgkin's lymphoma (NHL), prostate, female breast, corpus uteri, and ovary. APC analysis showed age, period and birth cohort yielded different effects by cancer sites.


CONCLUSIONS
The observed trends primarily reflect dramatic changes in socioeconomic development and lifestyles in urban Shanghai over the past four decades.
Department of Cancer Control & Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, People's Republic of China.
Ping-Ping
PP
Bao
Department of Cancer Control & Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, People's Republic of China.
Ying
Y
Zheng
Department of Cancer Control & Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, People's Republic of China.
Chun-Xiao
CX
Wu
Department of Cancer Control & Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, People's Republic of China.
Zhe-Zhou
ZZ
Huang
Department of Epidemiology, Shanghai Cancer Institute, Shanghai, 200032, People's Republic of China.
Yu-Tang
YT
Gao
Department of Epidemiology, Shanghai Cancer Institute, Shanghai, 200032, People's Republic of China.
Fan
F
Jin
Department of Epidemiology, Shanghai Cancer Institute, Shanghai, 200032, People's Republic of China.
Yong-Bing
YB
Xiang
Department of Cancer Control & Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, People's Republic of China.
Wei-Jian
WJ
Zhong
Department of Cancer Control & Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, People's Republic of China. weiloo@msn.com.
Wei
W
Lu
Department of Cancer Control & Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, People's Republic of China. fanwu@scdc.sh.cn.
Fan
F
Wu
D000328:Adult; D000367:Age Factors; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000145:classification* / Q000453:epidemiology* / Q000473:pathology; D014505:Urban Population
Age-period-cohort analysis; Cancer incidence; Shanghai; Time trend