义乌市消化道恶性肿瘤空间格局分析

Geographic spatial pattern of digestive system cancers in Yiwu city

目的:探测消化道恶性肿瘤发病率的空间分布规律和风险聚集区,为进一步开展环境风险因子探索提供依据。方法:结合2010-2014年义乌市分村监测的食管癌、胃癌和结直肠癌发病数据以及2013年户籍人口资料数据,采用小单元区域化方法构建研究单元,使用全局自相关指数Moran's I值计算空间聚集性,运用局部聚集性和异常值探测癌症发病的空间聚类和异常值,采用空间扫描统计探索癌症发病空间格局,探测发病风险区。结果:2010—2014年,义乌市食管癌、胃癌和结直肠癌的平均发病率分别为9.99/100 000、34.01/100 000和31.46/100 000,男性发病率普遍高于女性,南部地区普遍高发。男性食管癌和男性胃癌在义乌南部有显著高风险区,相对风险(RR)分别为1.78和1.87;女性食管癌(RR=0.00)和男性胃癌(RR=0.63)在义乌中部城市地区存在低风险区;女性结直肠癌在义乌北部存在低风险区(RR=0.48)。结论:消化道恶性肿瘤在义乌南部存在普遍高发的现象。

Objective: To analyze the geographic spatial patterns and risk areas of main digestive system cancers in Yiwu city. Methods : Newly diagnosed cases of esophageal, gastric and colorectal cancer during 2010-2014 were obtained from Yiwu Center for Disease Control and Prevention( CDC). The household registration population data in 2013 were obtained from public security bureau. Hierarchy clustering and partitioning regionalization method was used to generate geographic units. Global Moran's I was used to evaluate whether cancer incidence was significantly clustered in space, Anselin Local Moran's I was used to identify statistically significant hot spots,cold spots, and spatial outliers, and Spatial Scan Statistics was implemented to analyze the relative risk of cancers in different areas. Results : The 5-year average incidence of esophageal, gastric and colorectal cancers were 9. 99/100 000, 34.01/100 000 and31. 46/100 000, respectively. Males showed significantly higher incidence than females. The incidence was heterogeneous throughout the study area. Spatial Scan analysis revealed that southern Yiwu presented a significantly higher male esophageal cancer(RR =1.78) and gastric cancer(RR = 1.87) risk. The central area of Yiwu showed a significantly lower female esophageal cancer risk( RR = 0. 00) and male stomach cancer risk(RR =0. 63) and the northern Yiwu exhibited a significantly lower female colorectal cancer risk(RR =0. 48). Conclusion: The incidence of main digestive tract cancers shows a heterogeneous distribution in Yiwu city.