Spatial patterns and the associated factors for breast cancer hospitalization in the rural population of Fujian Province, China.

BACKGROUND: Despite the known increasing incidence of breast cancer in China, evidence on the spatial pattern of hospitalization for breast cancer is scarce. This study aimed to describe the disparity of breast cancer hospitalization in the rural population of Southeast China and to explore the impacts of socioeconomic factors and heavy metal pollution in soil. METHODS: This study was conducted using the New Rural Cooperative Medical Scheme (NRCMS) claims data covering 20.9 million rural residents from 73 counties in Southeast China during 2015-2016. The associations between breast cancer hospitalization and socioeconomic factors and soil heavy metal pollutants were evaluated with quasi-Poisson regression models and geographically weighted Poisson regressions (GWPR). RESULTS: The annual hospitalization rate for breast cancer was 101.40/100,000 in the studied area and the rate varied across different counties. Overall, hospitalization for breast cancer was associated with road density (ß = 0.43, P = 0.02), urbanization (ß = 0.02, P = 0.002) and soil cadmium (Cd) pollution (ß = 0.01, P = 0.02). In the GWPR model, a stronger spatial association of Cd, road density and breast cancer hospitalization was found in the northeast regions of the study area while breast cancer hospitalization was mainly related to urbanization in the western regions. CONCLUSIONS: Soil Cd pollution, road density, and urbanization were associated with breast cancer hospitalization in different regions. Findings in this study might provide valuable information for healthcare policies and intervention strategies for breast cancer.

Spatial distribution and influencing factors of thyroid cancer hospitalization rate among rural residents in Fujian Province, China from 2012 to 2016.

This study aimed to explore the spatial distribution and influencing factors of thyroid cancer hospitalization rates in Fujian Province from 2012 to 2016. Hospitalization reimbursement records for thyroid cancer were obtained from 2025 hospitals in Fujian Province from 2012 to 2016. The Moran's I method was used for spatial autocorrelation analysis and to further draw a spatial cluster map in Fujian. Geographic detectors were used to explore the effect of risk factors on spatial heterogeneity of inpatient service utilization for thyroid cancer. The study showed that there was obvious temporal and spatial heterogeneity in the utilization rate of inpatient services for thyroid cancer in Fujian Province, which were mainly concentrated in Fuzhou, with Lianjiang County as the center, and the gathering area involves 26 counties and cities. Among a variety of environmental factors, air quality index (AQI) (q = 0.481), carbon sequestration (q = 0.161), and carbon emissions (q = 0.155) were the main factors affecting the hospitalization rates. AQI and carbon emissions were generally positively correlated with hospitalization rates, and carbon sequestration was negatively correlated. After the interaction of the two factors, the interpretation of the hospitalization rate was enhanced. The obvious spatial heterogeneity will help the relevant departments to adjust measures to local conditions and allocate medical resources rationally to ease the pressure of seeking medical attention in high-demand areas.

The spatiotemporal correlation of PM2.5 concentration on esophageal cancer hospitalization rate in Fujian province of China.

This paper aimed to explore the correlation between PM2.5 concentration and hospitalization rate of esophageal cancer in Fujian province, and tried to find out the accurate lag effect between PM2.5 and hospitalization rate in 70 counties from the linear and nonlinear aspects. We extracted inpatients data of esophageal cancer from the New Rural Cooperative Medical Scheme (NRCMS) database and air pollutant PM2.5 grid data published by the atmospheric composition analysis group. The study showed that the hospitalization rate of esophageal cancer presented spatial aggregation in 70 counties of Fujian province. Southeast urban agglomerations had high hospitalization rates, while central and western regions had low hospitalization rates. The study found that the spatial distribution of the hospitalization rate of esophageal cancer in 2016 was not consistent with that of the PM2.5 concentration in the same year. The concentration of PM2.5 in 2003 and 2004 had the strongest correlation with the hospitalization rate of esophageal cancer in 2016, with Pearson correlation coefficient r value of - 0.365 and Geodetector q-statistic value of 0.148 (p < 0.05). Our findings showed that there existed a 13-year lag period of air pollutant PM2.5 on the esophageal cancer hospitalization rate, which can provide helpful guidance in the early screening strategy of esophageal cancer in Fujian. The research progress of this paper will help to understand the lag period of the impact of air pollutants on the hospitalization rate of esophageal cancer, provide valuable information for the prevention and treatment strategy of esophageal cancer in Fujian province, and provide relevant experience for alike regions.