Lung Cancer Cluster in China: Shandong Province

During the past several decades, lung cancer cases and mortality rates have skyrocketed in China (Fu et al., 2017). Particularly, in Shandong Province, which is the second most populated province in China with over 96 million residents. In a study that tracked the lung cancer mortality rate from 1970 to 2013, researchers presented three major findings using the Spatial Scan Statistics method (Fu et al., 2017). 
First, lung cancer mortality rate in Shandong Province increased drastically between 2 time periods; 1970-1974 and 2011-2013 (Fu et al., 2017). More specifically, nearly 7.81 times from 7.22 per 100,000 person to 56.37 per 100,000 person. Second, researchers found that non-demographic factors, such as air pollution, accounted for about 97.88%, 79.65%, and 70.37% of the spike in lung cancer mortality rate in 1990-1992, 2004-2005, and 2011-2013. Third, cancer clusters have spread from the northern region to the Southwesteen region over time. This conclusion derives from the relative risk (RR) ratio, which compares the probability of an outcome in 2 groups. From 1970-1974, the northern region of Shandong Province has a RR of 1.81 compared to the rest of the Shandong Province. Yet, changes in RR were significant overtime in which by 2011-2013, the northeastern region had a lower RR of 1.72, while RR for the southwestern region increased to 1.21 (Fu et al., 2017). 
All of these results show that there is a lung cancer cluster in Shandong Province because the lung cancer mortality rate has increased significantly and lung cancer affected more regions within the Shandong Province over time. There is enough evidence to support this argument because researchers have pulled a lot of information from past studies in combination with their own studies. In addition, despite small changes in results over time, they are all in agreement for cancer cluster in Shandong Province. Hence, there is sufficient and strong data to prove lung cancer cluster at the Shandong Province. 
Reference: 
Fu, etal (2017). “Lung Cancer Mortality Clusters in Shandong Province, China: How do They Change Over 40 Years?” Oncotarget, 8(51), 88770-88781.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5687644/

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