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Original Research

Urban-Rural Disparity in Helicobacter Pylori Infection–Related Upper Gastrointestinal Cancer in China and the Decreasing Trend in Parallel with Socioeconomic Development and Urbanization in an Endemic Area

Authors:

Xiaoduo Wen ,

Medical Image, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China, CN
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Denggui Wen,

Cancer Center, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China, CN
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Yi Yang,

Medical Image, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China, CN
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Yuetong Chen,

Cancer Center, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China, CN
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Guiying Wang,

Cancer Center, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Baoen Shan

Cancer Center, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Abstract

Background

Globally China has the largest urban-rural disparity in socioeconomic development, and the urban-rural difference in upper gastrointestinal cancer (UGIC) is similar to the difference between developed and developing countries.

Objectives

To describe urban-rural disparity in UGIC and to emphasize prevention by socioeconomic development and urbanization in China.

Methods

Age-standardized incidence rates (ASRs) of cancers in 2012 were compared between urban Shijiazhuang city and rural Shexian County, and trends from 2000-2015 in Shexian County were analyzed.

Findings

Compared with urban Shijiazhuang city, the ASR of gastroesophageal cancers in rural Shexian County was 5.3 times higher in men (234.1 vs 44.2/100,000, P < .01) and 9.1 times higher in women (107.7 vs 11.8/100,000, P < .01). This rural-urban disparity in UGIC is associated with differences in socioeconomic development in annual gross domestic product (GDP) per capita of US$2700 vs US$6965, in urbanization rate of 48% vs 100%, and in adult Helicobacter pylori infection prevalence of 75% vs 50%. From 2000-2015, the GDP per capita in Shexian County increased from US$860 to US$3000, urbanization rate increased from 22.4% to 54.8%, and prevalence of H pylori infection among 3- to 10-year-old children decreased from 60% to 46.1% (P < .01). Meanwhile, the biennial ASR of esophagogastric cancer decreased 42% in men, from 313.5 to 182.1 per 100,000 (P < .01), and 57% in women, from 188.6 to 80.4 per 100,000 (P = .00). However, lung, colorectal, and gallbladder cancers and leukemia in both sexes and breast, ovary, thyroid, and kidney cancer in women increased significantly. Despite this offset, ASR of all cancers combined decreased 25% in men (from 378.2 to 283.0/100,000, P = .00) and 19% in women (from 238.5 to 193.6/100,000, P = .00).

Conclusions

Urban-rural disparity in UGIC is related to inequity in socioeconomic development. Economic growth and urbanization is effective for prevention in endemic regions in China and should be a policy priority.
How to Cite: Wen, X., Wen, D., Yang, Y., Chen, Y., Wang, G. and Shan, B., 2017. Urban-Rural Disparity in Helicobacter Pylori Infection–Related Upper Gastrointestinal Cancer in China and the Decreasing Trend in Parallel with Socioeconomic Development and Urbanization in an Endemic Area. Annals of Global Health, 83(3-4), pp.444–462. DOI: http://doi.org/10.1016/j.aogh.2017.09.004
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Published on 21 Nov 2017.
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