Age period cohort model analysis of the mortality trend of gastric cancer among urban and rural residents in China from 2002 to 2021
Objective To illustrate the trend of gastric cancer mortality and the relationship between mortality risk and age-period-cohort among Chinese residents in urban and rural areas,in order to provide a reference for gastric cancer preven-tion and treatment research.Methods Based on national urban and rural gastric cancer mortality data from 2002 to 2021,the trend of gastric cancer mortality was investigated using the Joinpoint regression model.The effect of age,period,and cohort on mortality change was analyzed with the age-period-cohort model.Results During the period 2002-2021,the ASMRC for urban and rural residents decreased from 24.10 per 100 000 and 28.88 per 100 000 in 2002 to 10.75 per 100 000 and 13.10 per 100 000 in 2021,with an average annual percent change(AAPC)of -2.96％(95％CI:-3.74％ to -2.18％,P＜0.001)and -4.14％(95％CI:-4.73％ to -3.55％,P＜0.001),respectively.According to the re-sults of age-period-cohort model analyses,the risk of death from gastric cancer increased with age and began to rise rapid-ly in the 55-60 and 45-50 age groups,respectively.The risks of death from gastric cancer among urban and rural resi-dents in the 80-84 age group were 97.00 and 128.50 times higher than that of those in the 20-24 age group.With risk coefficients of 1.11 and 0.88 in urban and rural areas,respectively,the risk of death from gastric cancer started to experi-ence a turning point in 2016.For both urban and rural populations,the risk of death was higher in the earlier birth cohort;besides,the chance of death from gastric cancer was reduced by 90％ and 86％,respectively,for those born in 2001-2005 compared to those born in 1926-1930.Conclusions The national mortality rate for gastric cancer exhibited a declining trend between 2002 and 2021,with rural areas having a greater mortality rate than urban areas,albeit the difference is rapidly narrowing.Age and birth cohort have a significant impact on the risk of death from gastric cancer in a community,and middle-aged and elderly residents in rural areas will be a priority demographic for gastric cancer prevention and treatment in the future.
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