title: The long-term spatial-temporal trends and burden of esophageal cancer in one high-risk area: A population-registered study in Feicheng, China.
abstract: BACKGROUND
  Feicheng County is a high-risk area for esophageal cancer in Shandong province, China. It is important to determine the long-term spatio-temporal trends in epidemiological characteristics and the burden of esophageal cancer, especially since the implementation of the national esophageal cancer screening program for early detection and treatment in 2005.
  
  
  METHODS
  The data collected in Feicheng County from 2001 to 2012 was extracted from the whole-population cancer registry system. The incidence, mortality, disability-adjusted life years (DALY) and changing trends in esophageal cancer according to age and sex were calculated and described.
  
  
  RESULTS
  The incidence rate of esophageal cancer in Feicheng was consistently high, and increased significantly for male, but not for female from 2001 to 2012, according to the joinpoint regression analysis. The highest and lowest yearly crude incidence rates were 160.78 and 95.97 per 100000 for males, and 81.36 and 52.17 per 100000 for females. The highest and lowest crude yearly mortality rates were 122.26 and 94.40 per 100000 for males, and 60.75 and 49.35 per 100000for females. Esophageal squamous cell carcinoma was the main pathology type and the tumor location changed significantly from 2001 to 2012. Overall, the DALY remained roughly stable and was estimated as 11.50 for males and 4.90 for females per 1000 people. The burden was mainly caused by premature death. There is an obvious spatial pattern in the distribution of incidence density and burden.
  
  
  CONCLUSIONS
  Esophageal cancer remains a public health issue in Feicheng County with a high incidence, mortality and disease burden. The incidence and burden have obvious spatial heterogeneity, and further studies should be conducted to identify geographical risk factors for precise local prevention and control measures.
authors.affiliation: Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong Province, China.
authors.forename: Xiubin
authors.initials: X
authors.lastname: Sun
authors.affiliation: Cancer Research Center, Feicheng People's Hospital (Tumor Preventative and Therapeutic Base of Shandong Province), Feicheng, Shandong Province, China.
authors.forename: Deli
authors.initials: D
authors.lastname: Zhao
authors.affiliation: Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong Province, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong Province, China.
authors.forename: Yunxia
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong Province, China.
authors.forename: Zhongshang
authors.initials: Z
authors.lastname: Yuan
authors.affiliation: Shandong Cancer Hospital, Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China.
authors.forename: Jialin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong Province, China.
authors.forename: Fuzhong
authors.initials: F
authors.lastname: Xue
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002681:China / Q000453:epidemiology; D017281:Cost of Illness; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000266:history / Q000473:pathology; D005260:Female; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009026:Mortality; D011159:Population Surveillance; D019057:Quality-Adjusted Life Years; D012042:Registries; D062211:Spatio-Temporal Analysis; D055815:Young Adult