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Mortality of Urinary Tract Cancer in Inner Mongolia 2008-2012

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Mortality of Urinary Tract Cancer in Inner Mongolia 2008-2012 DOI:http://dx.doi.org/10.7314/APJCP.2014.15.6.2831 Mortality of Urinary Tract Cancer in Inner Mongolia 2008-2012 RESEARCH ARTICLE Mortality of Urinary Tract Cancer in Inner Mongolia 2008- 2012 Ke-Peng Xin, Mao-Lin Du, Zhi-Jun Li, Yun Li, Wuyuntana Li, Xiong Su, Juan Sun* Abstract The aim of this study was to determine the mortality rate and burden of urinary tract cancers among residents of Inner Mongolia. We analyzed mortality data reported by the Death Registry System from 2008 to 2012. The rate of mortality due to urinary tract cancer was 2.04 per 100,000 person-years for the total population, 2.91 for men, and 1.11 for women. Therefore, the mortality rate for men was 2.62-fold the mortality rate for women, constituting a statistically significant difference (p<0.001). Over the period 2008 through 2012, the total potential years of life lost was 1388.1 person-years for men and 777.1 person-years for women, and the average years of life lost were 7.71 years per male decedent and 12.0 years per female decedent. Mortality due to urinary tract cancers is substantially greater among the elderly population. Further, the mortality rate associated with urinary tract cancers is greater for elderly men than it is for elderly women. Therefore, in Inner Mongolia, urinary tract cancers appear to pose a greater mortality risk for men than they do for women. Keywords: Urinary - mortality - potential years of life lost (PYLL) - Inner Mongolia - China Asian Pac J Cancer Prev, 15 (6), 2831-2834 Introduction western of China, the local gross domestic product (GDP) and proportion of rural dwellers, the total population of Of all deaths due to urinary tract cancers, the majority local areas. For the present study, data were used from are attributable to kidney and bladder cancers. The 8 monitoring points. Five of these were from the DRS mortality rate associated with urinary tract cancers is established by the Chinese Ministry of Health. Another higher in Western countries than it is in Asian countries three monitoring points were from Inner Mongolia, (Jemal et al., 2011), and among Asian countries, it is established by the Inner Mongolia CDC. We used data especially high in Japan and Korea (Jung et al., 2011). As from a total of 8 monitoring points, which were located of 2010, the Third National Death Sampling Retrospective in the eastern region and other regions of Inner Mongolia. Study indicated that the rate of urinary tract cancer The eastern and other regions were separated on the mortality was lower in China (0.64 per 100,000 person- basis of differences in geographical location, historical years) than it was in Western countries(1.41 per 100,000 evolution, traditional lifestyle, and certain policies and person-years) (Control et al., 2010). However, urinary tract laws. The Eastern region included the Yakeshi city, Kailu cancer mortality has increased in recent years (Gupta et County, and Bairin Youqi monitoring points. The other al., 2008; Sujun et al., 2013). Hence, accurate projections regions included the Sonid Youqi, Muslims District, Tumd of urinary tract cancer mortality are important for public Youqi, Ejin Horo Qi, and Linhe District monitoring points. health and public planning. However, few studies have The death database included information on primary evaluated urinary tract cancer mortality in Inner Mongolia. cause of death, date of death, sex, and age. Cause of death The aim of the present study was to determine the mortality was coded according to the International Classification of and burden associated with urinary tract cancers in Inner Disease, 10th Revision (ICD-10). For the purposes of the Mongolia over the period 2008-2012. present study, we included deaths that were assigned ICD- 10 codes for malignant neoplasm of the kidney, except Materials and Methods the renal pelvis (C64); malignant neoplasm of the renal pelvis (C65); malignant neoplasm of the ureter (C66); This study examined data from Inner Mongolia, bladder cancer (C67); and malignant neoplasms of other January 2008 to December 2012. Data on deaths were and unspecified urinary organs (C68). C64, C65, and C66 collected through the Death Registry System (DRS). DRS were each considered to be forms of kidney cancer. A death uses a multistage cluster probability sampling strategy was considered to be attributable to urinary tract cancer with stratification according to eastern, central and if any of the 5 codes (C64, C65, C66, C67, or C68) was Inner Mongolia Medical University, Hohhot, China *For correspondence: [email protected] Asian Pacific Journal of Cancer Prevention, Vol 15, 2014 2831 Ke-Peng Xin et al listed as the primary cause. women. PYLL are used to evaluate premature mortality Annual midyear population figures for 2008-2012 were by estimating the average time a person would have obtained from the Centers for Disease Control of Inner lived had he or she not died of the cancer. By estimating Mongolia, which allowed us to calculate age-specific PYLLs, we were able to assess how changes in urinary mortality rates and annual mortality rates per 100,000 tract mortality over the period 2008-2012 contributed to persons. Death percentages and rates of mortality from overall life expectancy. PYLL was specifically calculated urinary tract cancers were calculated on the basis of the as PYLL=Σ (ai×di), where ai=loss of life-years for a 8 monitoring points. We also calculated disease-specific certain age group, i, and di=the number of deaths in that mortality rates and proportions for kidney cancer, bladder particular age group. PYLLR=(PYLL/n)×1000‰, where cancer, and malignant neoplasms of other and unspecified n is the total population at risk. AYLL=PYLL/Σdi, that is urinary organs. the average difference value between the life expectancy Life expectancy (LE), life expectancy after elimination and the actual age at death (Qingyun et al., 2008). of urinary tract cancer (LEEUTC), potential years of Microsoft Excel software (Microsoft, Co., Redmond, life lost (PYLL), rate of PYLL (PYLLR), and average WA, USA) and SPSS 13.0 statistical software (IBM SPSS, years of life lost (AYLL) were calculated for men and Inc., Chicago, IL, USA) were used for data management and analyses. The χ2 test was used to assess differences Table 1. Urinary Tract Cancer Mortality (1/105) in in rates, with a significance level of 0.05. Different Regions of Inner Mongolia Monitoring points Total Men Women Results Yakeshi city 3.33 4.48 2.12 Table 1 presents rates of mortality due to urinary Kailu County 1.74 2.64 0.81 tract cancer for each of the 8 monitoring points in Inner Bairin Youqi 2.22 3.04 1.36 Sonid Youqi 2.69 4.19 1.10 Mongolia. The city of Yakeshi and Linhe District had Muslims District 1.73 2.97 0.48 the highest urinary tract cancer mortality rates (3.33 per Tumd Youqi 0.59 1.00 0.14 100,000 person-years and 2.79 per 100,000 person-years, Ejin Horo Qi 0.33 0.38 0.26 respectively). In contrast, urinary tract cancer mortality Linhe District 2.79 3.79 1.75 rates were lowest in Tumd Youqi and Ejin Horo Qi (0.59 per 100,000 person years and 0.33 per 100,000 person- years, respectively). Table 2. Age-specific Mortality and Constituent Ratio During 2008-2012, 245 deaths in Inner Mongolia were of Urinary Tract Cancer in Inner Mongolia, 2008- attributable to urinary tract cancers (180 in men and 65 in 2012 women), and the associated ages at death ranged from 4 Age group Mortality Mortality(1/105) Constituent Sex to 96 years (average age at death: 68.8 years). Across the 5 (Years) (1/10 ) Men Women Ratio (%) Ratio 5-year period of this study, urinary tract cancer mortality 0- 0.15 0.00 0.30 0.41 — did not change significantly among men (χ2=4.1, p=0.39) 5- 0.00 0.00 0.00 0.00 — or among women (χ2=9.0, p=0.06). We combined the 5 10- 0.32 0.30 0.34 0.82 0.91 years of data for all further analyses. The overall rate 15- 0.00 0.00 0.00 0.00 — of urinary tract cancer mortality was 2.91 per 100,000 20- 0.00 0.00 0.00 0.00 — person-years (95% confidence interval [CI]: 2.70-3.12) for 25- 0.00 0.00 0.00 0.00 — men and 1.11 per 100,000 (95%CI: 0.98-1.24) for women. 30- 0.00 0.00 0.00 0.00 — 2 35- 0.33 0.64 0.00 1.63 — These rates were not significantly different (χ =6.0, 40- 0.17 0.17 0.18 0.82 0.93 p=0.20). After combining the data on men and women, 45- 0.97 1.31 0.60 4.08 2.17 the overall rate of mortality due to urinary tract cancer 50- 2.03 3.50 0.46 7.35 7.56 55- 1.66 1.91 1.40 4.90 1.36 60- 4.58 7.89 1.36 8.16 5.80 Table 4. LE, LEEUTC, PYLL, PYLLR and AYLL of 65- 10.33 15.95 5.12 14.29 3.11 Inner Mongolia Population, 2008-2012 70- 17.23 23.00 11.48 20.82 2.00 Sex LE LEEUTC PYLL PYLLR AYLL 75- 24.53 36.45 12.57 17.55 2.90 (Years) (Years) (Person-years) (‰) (Years) 80- 46.22 70.48 23.18 14.29 3.04 Men 73.93 73.97 1388.1 0.22 7.71 85+ 52.67 83.74 24.93 4.90 3.36 Women 79.69 79.71 777.1 0.13 11.96 Total 2.04 2.91 1.11 100.00 2.62 Total 76.53 76.57 2296.7 0.19 9.37 Table 3.
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