The lag effect of water pollution on the mortality rate for esophageal cancer in a rapidly industrialized region in China

The Huai River basin (located in eastern China) has a population of 180 million and has the highest risk of esophageal cancer (EC) mortality in China. Some studies found that contaminants in drinking water are a major risk factor for cancers of the digestive system. However, the effect of water pollution in the historical period on the current EC mortality remains unclear. Data were collected on the EC mortality rate in 2004 in the Huai River basin in 11 counties, and data on the surface water quality in the region from 1987 to 2004 were used. The Pearson correlation and the GeoDetector q-statistic were employed to explore the association between water pollution and the EC mortality rate in different lag periods, from linear and nonlinear perspectives, respectively. The study showed apparently spatial heterogeneity of the EC mortality rate in the region. The EC mortality rate downstream is significantly higher than that in other regions; in the midstream, the region north of the mainstream has a lower average mortality rate than that south of the area. Upstream, the region north of the mainstream has a higher mortality rate than that in the southern area. The spatial pattern was formed under the influence of water pollution in the historical period. 1996, 1997, and 1998 have the strongest linear or nonlinear effect on the EC mortality rate in 2004, in which the Pearson correlation coefficient and the q-statistic were the highest, 0.79 and 0.89, respectively. Rapid industrialization in the past 20 years has caused environmental problems and poses related health risks. The study indicated that the current EC mortality rate was mainly caused by water pollution from the previous 8 years. The findings provide knowledge about the lag time for pollution effects on the EC mortality rate, and can contribute to the controlling and preventing esophageal cancer.