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Comparison of Secular Trends in Cervical Cancer Mortality in China and the United States: An Age-Period-Cohort Analysis

Author

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  • Jinyao Wang

    (Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan 430071, China)

  • Zhiqiang Bai

    (College of Life Science and Technology, Huazhong Agriculture University, Wuhan 430070, China)

  • Zhenkun Wang

    (Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan 430071, China)

  • Chuanhua Yu

    (Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan 430071, China
    Global Health Institute, Wuhan University, 115 Donghu Road, Wuhan 430071, China)

Abstract

Background : As one of the most common cancers in the female population, cervical cancer has ranked as the second most incident gynecological cancer in recent years, trailing only breast cancer. We aimed to assess and compare the secular trends in cervical cancer mortality in China and the United States and analyze the independent effects of chronological age, time period and birth cohort using age-period-cohort (APC) analysis. Methods : We performed an age-period-cohort analysis using the intrinsic estimator method to estimate the independent effects of age, time period, and birth cohort on cervical cancer mortality. We collected mortality data for China and the United States from the WHO Mortality Database and China Health Statistical Yearbook database. Results : We examined the general trends in cervical mortality rates in China and the United States during the periods 1988–2012 and 1953–2012, respectively. The age-standardized mortality rates (ASMRs) for cervical cancer in urban China, rural China and the U.S. showed a general decreasing trend during the observation period, except for urban China, which experienced a significant increase beginning in 2002. The mortality rates for cervical cancer in the three areas showed a general increasing trend with age, regardless of the period effect. Period effects declined steadily in both rural China (from 0.19 to −0.26) and the U.S. (from −0.20 to −0.43); however, a slight increasing trend was identified (from −0.25 to 0.33) in urban China, which indicated that the risk of mortality increased with time. Cohort effects peaked in the cohort born in 1911–1915 in both rural China and urban China, declined consistently in the cohort born before 1950, and then decreased again in the cohort born after 1976–1980. The cohort effect in the U.S. peaked in the birth cohort born in 1876–1880, then leveled off and slightly decreased in younger generations. Conclusions : Our study showed that in general, cervical cancer mortality rates increased with age and decreased with birth cohort in the U.S., while the risk of mortality was highest in the cohort born during 1946–1975 in urban China. Additionally, the risk of mortality consistently increased with age in women younger than 64 years old in urban and rural China and began to decline in older groups. Although the age and cohort effects were relatively strong, the period effect may be the key factor affecting cervical cancer mortality trends, mainly reflecting the immediate effects of effective treatment and the implementation of screening.

Suggested Citation

  • Jinyao Wang & Zhiqiang Bai & Zhenkun Wang & Chuanhua Yu, 2016. "Comparison of Secular Trends in Cervical Cancer Mortality in China and the United States: An Age-Period-Cohort Analysis," IJERPH, MDPI, vol. 13(11), pages 1-16, November.
  • Handle: RePEc:gam:jijerp:v:13:y:2016:i:11:p:1148-:d:83121
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    References listed on IDEAS

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    1. Zhenkun Wang & Junzhe Bao & Chuanhua Yu & Jinyao Wang & Chunhui Li, 2015. "Secular Trends of Breast Cancer in China, South Korea, Japan and the United States: Application of the Age-Period-Cohort Analysis," IJERPH, MDPI, vol. 12(12), pages 1-10, December.
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    Cited by:

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    2. Jie Chang & Boyang Li & Jingjing Li & Yang Sun, 2017. "The Effects of Age, Period, and Cohort on Mortality from Ischemic Heart Disease in China," IJERPH, MDPI, vol. 14(1), pages 1-12, January.
    3. I-Shiang Tzeng & Jiann-Hwa Chen, 2022. "Exploring Hepatocellular Carcinoma Mortality Using Weighted Regression Estimation for the Cohort Effect in Taiwan from 1976 to 2015," IJERPH, MDPI, vol. 19(9), pages 1-10, May.
    4. Karina Cardoso Meira & Carinne Magnago & Angelo Braga Mendonça & Stephane Fernanda Soares Duarte & Pedro Henrique Oliveira de Freitas & Juliano dos Santos & Dyego Leandro Bezerra de Souza & Taynãna Cé, 2022. "Inequalities in Temporal Effects on Cervical Cancer Mortality in States in Different Geographic Regions of Brazil: An Ecological Study," IJERPH, MDPI, vol. 19(9), pages 1-22, May.
    5. Xiaoxue Liu & Chuanhua Yu & Yongbo Wang & Yongyi Bi & Yu Liu & Zhi-Jiang Zhang, 2019. "Trends in the Incidence and Mortality of Diabetes in China from 1990 to 2017: A Joinpoint and Age-Period-Cohort Analysis," IJERPH, MDPI, vol. 16(1), pages 1-14, January.
    6. Ruiqing Li & Jinyi Sun & Tong Wang & Lihong Huang & Shuwen Wang & Panglin Sun & Chuanhua Yu, 2022. "Comparison of Secular Trends in Esophageal Cancer Mortality in China and Japan during 1990–2019: An Age-Period-Cohort Analysis," IJERPH, MDPI, vol. 19(16), pages 1-15, August.

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