Geographical Variations in Cancer Mortality and Social Inequalities in Southern Spain (Andalusia). 2002-2013

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2020 May 23

PMID 32442187

Citations 7

Authors

Vanessa Santos-Sanchez

Juan Antonio Cordoba-Dona

Francisco Viciana

Antonio Escolar-Pujolar

Lucia Pozzi

Rebeca Ramis

Affiliations

Soon will be listed here.

Abstract

Introduction: Geographical variations in cancer mortality can be explained, in part, by their association with social inequalities. The objective of our study was to analyse the spatial pattern of mortality in relation to the most common causes of cancer in the Spanish autonomous community of Andalusia and its possible association with social inequalities.

Materials And Methods: A small area cross-sectional study in Andalusia, with census tracts as units of spatial analysis, for the period 2002-2013. Cases and person-years, sex and age group came from the Longitudinal Population Database of Andalusia. Standardized mortality rates and smoothed risk ratios were calculated using the Besag, York and Mollié model for lung, colorectal, breast, prostate, bladder and stomach cancer. In order to evaluate the association with social inequalities we included the deprivation index of the census tract as a covariate.

Results: The results show an East-West mortality pattern with higher risk in the west for lung and bladder cancer among men, and breast cancer among women. For all of Andalusia, the association between deprivation index of the census tract and mortality relative risks is positive and significant for lung, stomach and bladder cancers in men, while in women we observed a negative association for lung cancer and a positive for stomach cancer.

Conclusions: Knowledge regarding the spatial distribution of cancer mortality and the socioeconomic inequalities related should contribute to the design of specific health and social policies-aimed at tackling cancer mortality and social inequalities in areas of high mortality and/or levels of deprivation.

Citing Articles

Exploring the geospatial epidemiology of breast cancer in Iran: identifying significant risk factors and spatial patterns for evidence-based prevention strategies.

Soleimani M, Ayyoubzadeh S, Jalilvand A, Ghazisaeedi M BMC Cancer. 2023; 23(1):1219.

PMID: 38082251 PMC: 10712175. DOI: 10.1186/s12885-023-11555-1.

Socio-economic inequalities in lung cancer mortality in Spain: a nation-wide study using area-based deprivation.

Redondo-Sanchez D, Fernandez-Navarro P, Rodriguez-Barranco M, Nunez O, Petrova D, Garcia-Torrecillas J Int J Equity Health. 2023; 22(1):145.

PMID: 37533035 PMC: 10399030. DOI: 10.1186/s12939-023-01970-y.

Age-period-cohort analysis of lung cancer mortality inequalities in Southern Spain: missed opportunities for implementing equitable tobacco control policies.

Cordoba-Dona J, Benitez-Rodriguez E, Escolar-Pujolar A, Santos-Sanchez V Int J Equity Health. 2023; 22(1):132.

PMID: 37438851 PMC: 10339480. DOI: 10.1186/s12939-023-01946-y.

Sex differences in the diagnosis, treatment and prognosis of cancer: the rationale for an individualised approach.

Vera R, Juan-Vidal O, Safont-Aguilera M, Ayala de la Pena F, Del Alba A Clin Transl Oncol. 2023; 25(7):2069-2076.

PMID: 36802013 PMC: 10250517. DOI: 10.1007/s12094-023-03112-w.

The role of multimorbidity in short-term mortality of lung cancer patients in Spain: a population-based cohort study.

Niksic M, Redondo-Sanchez D, Chang Y, Rodriguez-Barranco M, Exposito-Hernandez J, Marcos-Gragera R BMC Cancer. 2021; 21(1):1048.

PMID: 34556072 PMC: 8461961. DOI: 10.1186/s12885-021-08801-9.

References

Nur U, Rachet B, Parmar M, Sydes M, Cooper N, Lepage C . No socioeconomic inequalities in colorectal cancer survival within a randomised clinical trial. Br J Cancer. 2008; 99(11):1923-8. PMC: 2600684. DOI: 10.1038/sj.bjc.6604743. View

Kelsey J, Horn-Ross P . Breast cancer: magnitude of the problem and descriptive epidemiology. Epidemiol Rev. 1993; 15(1):7-16. DOI: 10.1093/oxfordjournals.epirev.a036118. View

Bentley R, Kavanagh A, Subramanian S, Turrell G . Area disadvantage, individual socio-economic position, and premature cancer mortality in Australia 1998 to 2000: a multilevel analysis. Cancer Causes Control. 2007; 19(2):183-93. DOI: 10.1007/s10552-007-9084-7. View

Ocana-Riola R, Montano-Remacha C, Mayoral-Cortes J . Geographical and Temporal Variations in Female Breast Cancer Mortality in the Municipalities of Andalusia (Southern Spain). Int J Environ Res Public Health. 2016; 13(11). PMC: 5129372. DOI: 10.3390/ijerph13111162. View

Lopez-Abente G, Aragones N, Perez-Gomez B, Pollan M, Garcia-Perez J, Ramis R . Time trends in municipal distribution patterns of cancer mortality in Spain. BMC Cancer. 2014; 14:535. PMC: 4124154. DOI: 10.1186/1471-2407-14-535. View

Borrell C, Mari-DellOlmo M, Serral G, Martinez-Beneito M, Gotsens M . Inequalities in mortality in small areas of eleven Spanish cities (the multicenter MEDEA project). Health Place. 2010; 16(4):703-11. DOI: 10.1016/j.healthplace.2010.03.002. View

Barcelo M, Saez M, Cano-Serral G, Martinez-Beneito M, Martinez J, Borrell C . [Methods to smooth mortality indicators: application to analysis of inequalities in mortality in Spanish cities [the MEDEA Project]]. Gac Sanit. 2008; 22(6):596-608. DOI: 10.1016/s0213-9111(08)75362-7. View

Ocana-Riola R, Fernandez-Ajuria A, Mayoral-Cortes J, Toro-Cardenas S, Sanchez-Cantalejo C . Uncontrolled migrations as a cause of inequality in health and mortality in small-area studies. Epidemiology. 2009; 20(3):411-8. DOI: 10.1097/EDE.0b013e318196aaf4. View

Antunes J, Borrell C, Rodriguez-Sanz M, Perez G, Biazevic M, Wunsch-Filho V . Sex and socioeconomic inequalities of lung cancer mortality in Barcelona, Spain and São Paulo, Brazil. Eur J Cancer Prev. 2008; 17(5):399-405. DOI: 10.1097/CEJ.0b013e3282f75f17. View

10.

Schiaffino A, Fernandez E, Kunst A, Borrell C, Garcia M, Borras J . Time trends and educational differences in the incidence of quitting smoking in Spain (1965-2000). Prev Med. 2007; 45(2-3):226-32. DOI: 10.1016/j.ypmed.2007.05.009. View

11.

Cayuela A, Rodriguez-Dominguez S, Lopez-Campos J, Vigil E . Lung cancer mortality trends by geographical area in Spanish women, 1980-2005. Int J Tuberc Lung Dis. 2008; 12(4):453-7. View

12.

Clayton D, Bernardinelli L, Montomoli C . Spatial correlation in ecological analysis. Int J Epidemiol. 1993; 22(6):1193-202. DOI: 10.1093/ije/22.6.1193. View

13.

Borrell C, Rue M, Pasarin M, Rohlfs I, Ferrando J, Fernandez E . Trends in social class inequalities in health status, health-related behaviors, and health services utilization in a Southern European urban area (1983-1994). Prev Med. 2001; 31(6):691-701. DOI: 10.1006/pmed.2000.0751. View

14.

Cozar J, Minana B, Palou-Redorta J, Medina R, de la Rosa-Kehrmann F, Lozano-Palacio F . Comparative analysis of the incidence of bladder cancer in the communities of Andalusia, Catalonia and Madrid in 2011. Actas Urol Esp. 2015; 39(7):420-8. DOI: 10.1016/j.acuro.2014.11.003. View

15.

Heck K, Wagener D, Schatzkin A, Devesa S, Breen N . Socioeconomic status and breast cancer mortality, 1989 through 1993: an analysis of education data from death certificates. Am J Public Health. 1997; 87(7):1218-22. PMC: 1380902. DOI: 10.2105/ajph.87.7.1218. View

16.

Uthman O, Jadidi E, Moradi T . Socioeconomic position and incidence of gastric cancer: a systematic review and meta-analysis. J Epidemiol Community Health. 2013; 67(10):854-60. DOI: 10.1136/jech-2012-201108. View

17.

Molina-Barcelo A, Salas Trejo D, Peiro-Perez R, Malaga Lopez A . To participate or not? Giving voice to gender and socio-economic differences in colorectal cancer screening programmes. Eur J Cancer Care (Engl). 2011; 20(5):669-78. DOI: 10.1111/j.1365-2354.2011.01263.x. View

18.

Lundqvist A, Andersson E, Ahlberg I, Nilbert M, Gerdtham U . Socioeconomic inequalities in breast cancer incidence and mortality in Europe-a systematic review and meta-analysis. Eur J Public Health. 2016; 26(5):804-813. PMC: 5054273. DOI: 10.1093/eurpub/ckw070. View

19.

Gonzalez C, Lopez-Abente G, Errezola M, Escolar A, Riboli E, Izarzugaza I . Occupation and bladder cancer in Spain: a multi-centre case-control study. Int J Epidemiol. 1989; 18(3):569-77. DOI: 10.1093/ije/18.3.569. View

20.

Ruiz-Ramos M, Escolar Pujolar A, Sanchez Perea J, Garrucho Rivero G . [Trends in social inequalities in mortality in the city of Seville [Spain] [1994-2002]]. Gac Sanit. 2006; 20(4):303-10. DOI: 10.1157/13091146. View