Mortality and trend analysis of bladder cancer in China from 2004 to 2008

ObjectiveTo analyze bladder cancer mortality in China from 2004 to 2018.

MethodsThe dataset of bladder cancer mortality from 2004 to 2018， based on 605 national surveillance sites and regularly published by the Chinese Center for Disease Control and Prevention， was collected and age-standardized according to the demographic structure of China in 2000. The crude mortality rate （CMR）， the age-standard mortality rate （ASMR）， and the ratio of ASMRs of rural to urban areas（RR）were calculated to analyze the distributions of the mortality of bladder cancer stratified by age， sex， region （rural/urban areas， eastern/central/western areas） or time.

ResultsThe CMR of bladder cancer in China from 2004 to 2018 was 1.69/10⁵， and the ASMR was 1.09/10⁵. The temporal trend on the CMR of bladder cancer from 2004 to 2018 increased significantly （APC=2.91%，P<0.001）， whereas the trend on the ASMR decreased a little （APC=-1.29，P=0.008）. The temporal trend on the CMR of bladder cancer in the males increased （APC=3.29%，P<0.001）， whereas the trend on the ASMR did not change. The temporal trend on the CMR of bladder cancer in the female increased （APC=2.12%，P<0.001）， whereas the trend on the ASMR decreased （APC=-1.94，P=0.008）. Both the CMR and ASMR of urban areas were higher than those of rural areas （P<0.05）. However， the temporal trend on the ASMR of bladder cancer in the urban decreased significantly （APC=-2.05%，P=0.002）， mainly exhibited in eastern and western urban. The ASMR of eastern urban areas was higher than that of western urban areas. The temporal trend on the ASMR of bladder cancer in the rural did not change （P>0.05）， and no differences in the ASMR were detected between eastern， central and western rural areas. The gaps between rural and urban areas in the eastern （P<0.001） or western （P=0.002） region reduced. Although the temporal trend on the ASMR in urban people over 40 years old decreased significantly， the ASMR of urban people over 60 years old was much higher than that of other age groups in the urban or any age groups in rural areas.

ConclusionThe age group over 60 years old in the urban is the major target population for bladder cancer prevention and treatment. Screening， diagnosis and treatment for bladder cancer in rural should be strengthened.