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Song M, Huang X, Wei X, Tang X, Rao Z, Hu Z, Yang H. Spatial patterns and the associated factors for breast cancer hospitalization in the rural population of Fujian Province, China. BMC Womens Health 2023; 23:247. [PMID: 37161393 PMCID: PMC10170828 DOI: 10.1186/s12905-023-02336-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/07/2023] [Indexed: 05/11/2023] Open
Abstract
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 (β = 0.43, P = 0.02), urbanization (β = 0.02, P = 0.002) and soil cadmium (Cd) pollution (β = 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.
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Affiliation(s)
- Mengjie Song
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350122, China
| | - Xiaoxi Huang
- Department of Breast, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujjan Medical University, Fuzhou, 350001, China
| | - Xueqiong Wei
- School of Geographical Sciences, Nanjing University of Information Science and Technology, Nanjing, 210044, China
| | - Xuwei Tang
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350122, China
| | - Zhixiang Rao
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350122, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350122, China
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, Xue Yuan Road 1, Fuzhou, 350122, China
| | - Haomin Yang
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350122, China.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, 17177, Sweden.
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, Xue Yuan Road 1, Fuzhou, 350122, China.
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