Time trends in municipal distribution patterns of cancer mortality in Spain

BMC Cancer

Gonzalo López-Abente¹  Nuria Aragonés¹  Beatriz Pérez-Gómez¹  Marina Pollán¹  Javier García-Pérez¹  Rebeca Ramis¹  Pablo Fernández-Navarro¹ 

[1] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain

关键词: Spatial epidemiology;    Epidemiology;    Cancer mortality;    Disease mapping;   

Others  :  1125302
DOI  :  10.1186/1471-2407-14-535

 received in 2014-02-06, accepted in 2014-07-04,  发布年份 2014

【 摘 要 】

Background

New disease mapping techniques widely used in small-area studies enable disease distribution patterns to be identified and have become extremely popular in the field of public health. This paper reports on trends in the geographical mortality patterns of the most frequent cancers in Spain, over a period of 20 years.

Methods

We studied the municipal spatial pattern of stomach, colorectal, lung, breast, prostate and urinary bladder cancer mortality in Spain across four quinquennia, spanning the period 1989-2008. Case data were broken down by town (8073 municipalities), period and sex. Expected cases for each town were calculated using reference rates for each five-year period. For map plotting purposes, smoothed municipal relative risks were calculated using the conditional autoregressive model proposed by Besag, York and Mollié, with independent data for each quinquennium. We evaluated the presence of spatial patterns in maps on the basis of models, calculating the variance in relative risk corresponding to the structured spatial component and the unstructured component, as well as the proportion of variance explained by the structured spatial component.

Results

The mortality patterns observed for stomach, colorectal and lung cancer were maintained over the 20 years covered by the study. Prostate cancer and the tumours studied in women showed no defined spatial pattern, with the single exception of stomach cancer. The trend in spatial fractional variance indicated the possibility of a change in the spatial pattern in breast, bladder and colorectal cancer in women during the last five-year period. The paper goes on to discuss ways in which spatio-temporal data are depicted in the case of cancer, and review the risk factors that may possibly influence the respective tumours’ spatial patterns.

Conclusion

In men, the marked geographical patterns of stomach, colorectal, lung and bladder cancer remained stable over time. Breast, colorectal and bladder cancer in women show signs of the possible appearance of a spatial pattern in Spain and should therefore be monitored.

【 授权许可】

   
2014 López-Abente et al.; licensee BioMed Central Ltd.

【 图 表 】

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