Temporal trend and difference decomposition of lung cancer mortality in Kunshan city,Jiangsu province,1993-2014

Objective To explore the temporal trend and quantitatively estimated influencing factors of lung cancer mortality in Kunshan city,Jiangsu province during the period of 1993-2014.Methods Records of lung cancer death were derived from data of vital registration system.Crude death rates and age standardized rate(ASR)were calculated and annual percentage change(APC)by sex was estimated.Difference decomposition was applied to estimate the contribution of demographic and non-demographic factors to the change of lung cancer mortality.Results We observed significantly upward trend in overall and gender-specific crude lung cancer mortality,with the APC of 2.9% (95% confidence interval95% CI:2.3%-3.5%)for total population,2.7% (95% CI:2.1%-3.4%)for the males,and 3.7% (95% CI:2.7%-4.7%)for the females(all P<0.0001)during the period;significantly upward trend in Chinese population ASR of lung cancer death was also observed in the whole population(APC=0.8%,95% CI:0.2%-1.5%;P=0.0165)and in the females(APC=1.7%,95% CI:0.7%-2.7%;P=0.0055)but not in the males(APC=0.4%,95% CI:-0.2%-1.0%;P=0.1962).The increase in crude lung cancer mortality was mainly due to demographic change and the proportions of demographic contribution to the mortality were 57.28% in whole population,69.16% in the males,and 40.92% in the females,respectively.Conclusion The mortality rate of lung cancer drastically increased in the past 22 years and demographic factor was one of the enhancement factors for the increase in Kunshan city.Prevention-oriented strategy is needed to explore nondemographic risk factors of lung cancer.