Mortality Trends and Quantitative Analysis of Influencing Factors for Non-neoplastic Anorectal Diseases Among Registered Population in Pudong New Area, Shanghai (1995-2017) / 胃肠病学

ABSTRACT

Background: It is difficult to evaluate the long-term outcome of colorectal cancer screening project in a short period because of the long course of disease. Aims: To explore the epidemiological characteristics and mortality trends of non-neoplastic anorectal diseases among registered population in Pudong New Area, Shanghai from 1995 to 2017, so as to reflect on other aspects or indirectly the efficacy of colorectal cancer screening project. Methods: According to the Mortality Registration System of household registered residents in Pudong New Area, the crude mortality rate, standardized mortality rate, annual percentage change (APC) and other indicators were used to analyze the mortality trends of non-neoplastic anorectal diseases (K50-K52, K55-K63); the contribution of demographic and non-demographic factors to disease death before and after the implementation of colorectal cancer screening project was calculated by the differential decomposition method. Results: From 1995 to 2017, the total crude mortality rate of non-neoplastic anorectal diseases in Pudong New Area was 2.79/100 000, and the standardized mortality rate was 1.23/100 000; the crude mortality rate showed an upward trend (APC=1.67, P=0.009), whereas the standardized mortality rate showed a downward trend (APC=-3.45, P<0.001). For population aged ≥65 years, the crude mortality rate showed an upward trend from 1995 to 2009, and a downward trend from 2009 to 2017, respectively (APC=2.19, P=0.044; APC=-6.85, P=0.007). Death predominantly occurred in population aged ≥80 years. Before and after the screening project (1995-2012 vs. 2013-2017), the added value of demographic and non-demographic factors on total mortality was 1.24/100 000 and -1.33/100 000, respectively. With 1995 as the baseline, the contribution of non-demographic factors to the added value of mortality after screening was -2.25/100 000, with a contribution rate of 48.94%, which was superior to that before screening (-0.92/100 000, with a contribution rate of 45.37%). Conclusions: Aging of the population is the main cause of increased crude mortality rate of non-neoplastic anorectal diseases in Pudong New Area. Screening for colorectal cancer is an effective intervention to reduce the mortality of anorectal diseases and deserves further promotion.