Spatial distribution characteristics and influencing factors of bladder cancer in China

[Background] Under the dual pressures of environmental pollution and climate change, the high incidence of bladder cancer has become a major public health problem in many countries and regions, and the disease burden is increasing. [Objective] To analyze the spatial distribution patterns of the incidence of bladder cancer in China, and to identify the influences of socioeconomic, ecological, and meteorological factors. [Methods] The incidence of bladder cancer in 178 county-level administrative units was obtained from 'China Cancer Registry Annual Report 2017–2019', and data on air quality, meteorological conditions and economic development during the same period were collected through online public channels. Spatial scan statistics were used to analyze spatial patterns of bladder cancer incidence. Spatial regression model was use to identify the associations between the influence factors and bladder cancer incidence. [Results] The incidence of bladder cancer in men was 4.41 times to women. For men, there are regional differences in the incidence of bladder cancer, and the eastern region is significantly higher than the central region. For women, the incidence of bladder cancer in the eastern region is higher than that in the central and western regions. For men, number of beds in medical institutions per 1000 people was positively correlated with the incidence of bladder cancer, while air quality index (AQI) and annual average temperature were negatively correlated. For women, number of beds in medical institutions per 1000 people, the average annual sunshine hours, the average altitude and the topographic relief of the land surface were positively correlated with the incidence of bladder cancer, while average annual temperature and annual rainfall were negatively correlated. [Conclusions] The incidence of bladder cancer was higher in men than in women. Significant spatial heterogeneity exists in the distribution of bladder cancer in China, with high-risk clusters found in the eastern region. Air quality, climatic conditions, and medical level have an impact on the incidence of bladder cancer in men and women.