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dc.contributor.authorKou, Kou
dc.contributor.authorBaade, Peter David
dc.contributor.authorGuo, Xiaolei
dc.contributor.authorGatton, Michelle
dc.contributor.authorCramb, Susanna
dc.contributor.authorLu, Zilong
dc.contributor.authorFu, Zhentao
dc.contributor.authorChu, Jie
dc.contributor.authorXu, Aiqiang
dc.contributor.authorSun, Jiandong
dc.date.accessioned2019-06-20T04:44:51Z
dc.date.available2019-06-20T04:44:51Z
dc.date.issued2019
dc.identifier.issn2045-2322
dc.identifier.doi10.1038/s41598-019-42774-x
dc.identifier.urihttp://hdl.handle.net/10072/384532
dc.description.abstractEsophageal cancer (EC) is a leading cause of cancer death in China. Within Shandong Province, a geographic cluster with high EC mortality has been identified, however little is known about how area-level socioeconomic status (SES) is associated with EC mortality in this province. Multilevel models were applied to EC mortality data in 2011-13 among Shandong residents aged 40+ years. Area-level SES factors consisted of residential type (urban/rural) of the sub-county-level units (n = 262) and SES index (range: 0-10) of the county-level units (n = 142). After adjustment for age and sex, residents living in rural areas had a 22% (95% CI: 13-32%) higher risk of dying from EC than those in urban areas. With each unit increase in the SES index, the average risk of dying from EC reduced by 10% (95% CI: 3-18%). The adjustment of area-level SES variables had little impact on the risk ratio of EC mortality between the high-mortality cluster and the rest of Shandong. In conclusion, rural residence and lower SES index are strongly associated with elevated risks of EC death. However, these factors are independent of the high mortality in the cluster area of Shandong. The underlying causes for this geographic disparity need to be further investigated.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherNATURE PUBLISHING GROUP
dc.relation.ispartoflocationEngland
dc.relation.ispartofpagefrom1
dc.relation.ispartofpageto8
dc.relation.ispartofissueArticle-6388
dc.relation.ispartofjournalSCIENTIFIC REPORTS
dc.relation.ispartofvolume9
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchcode32
dc.titleArea socioeconomic status is independently associated with esophageal cancer mortality in Shandong, China
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
gro.rights.copyright© The Author(s) 2019. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Te images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
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gro.griffith.authorBaade, Peter D.


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