Esophageal cancer spatial and correlation analyses： Water pollution, mortality rates, and safe buffer distances in China

Esophageal cancer exhibits one of the highest incidence and mortality rates in China. Malignant tumors caused by esophageal cancer, and the relationship to environmental factors has been the focus of many public health studies. This study applied spatial analysis to ascertain the relationship between water pollution and esophageal cancer mortality rates nationwide. We employed two datasets, including a national investigation of esophageal cancer rates and distribution, and national water quality grades in China＇s primary rivers and lakes. Esophageal cancer data were grouped based on different water quality grades, which included a scaled buffer distance from rivers and lakes. Non-parametric correlation analyses were performed to examine the presence or absence of the following correlations： （i） eso- phageal cancer mortality and buffer distance from rivers and lakes; and （ii） esophageal can- cer mortality and water quality grade values. The present study revealed a significant positive correlation between widespread water pollution and esophageal cancer mortality nationwide; and a significant negative correlation between esophageal cancer mortality, and buffer dis- tance from rivers and lakes.