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The striking geographical pattern of gastric cancer mortality in Spain: environmental hypotheses revisited.
BMC Cancer 2009; 9:316BC

Abstract

BACKGROUND

Gastric cancer is decreasing in most countries. While socioeconomic development is the main factor to which this decline has been attributed, enormous differences among countries and within regions are still observed, with the main contributing factors remaining elusive. This study describes the geographic distribution of gastric cancer mortality at a municipal level in Spain, from 1994-2003.

METHODS

Smoothed relative risks of stomach cancer mortality were obtained, using the Besag-York-Molliè autoregressive spatial model. Maps depicting relative risk (RR) estimates and posterior probabilities of RR being greater than 1 were plotted.

RESULTS

From 1994-2003, 62184 gastric cancer deaths were registered in Spain (7 percent of all deaths due to malignant tumors). The geographic pattern was similar for both sexes. RRs displayed a south-north and coast-inland gradient, with lower risks being observed in Andalusia, the Mediterranean coastline, the Balearic and Canary Islands and the Cantabrian seaboard. The highest risk was concentrated along the west coast of Galicia, broad areas of the Castile & Leon Autonomous community, the province of Cáceres in Extremadura, Lleida and other areas of Catalonia.

CONCLUSION

In Spain, risk of gastric cancer mortality displays a striking geographic distribution. With some differences, this persistent and unique pattern is similar across the sexes, suggesting the implication of environmental exposures from sources, such as diet or ground water, which could affect both sexes and delimited geographic areas. Also, the higher sex-ratios found in some areas with high risk of smoking-related cancer mortality in males support the role of tobacco in gastric cancer etiology.

Authors+Show Affiliations

Environmental and Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. naragones@isciii.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19737377

Citation

Aragonés, Nuria, et al. "The Striking Geographical Pattern of Gastric Cancer Mortality in Spain: Environmental Hypotheses Revisited." BMC Cancer, vol. 9, 2009, p. 316.
Aragonés N, Pérez-Gómez B, Pollán M, et al. The striking geographical pattern of gastric cancer mortality in Spain: environmental hypotheses revisited. BMC Cancer. 2009;9:316.
Aragonés, N., Pérez-Gómez, B., Pollán, M., Ramis, R., Vidal, E., Lope, V., ... López-Abente, G. (2009). The striking geographical pattern of gastric cancer mortality in Spain: environmental hypotheses revisited. BMC Cancer, 9, p. 316. doi:10.1186/1471-2407-9-316.
Aragonés N, et al. The Striking Geographical Pattern of Gastric Cancer Mortality in Spain: Environmental Hypotheses Revisited. BMC Cancer. 2009 Sep 8;9:316. PubMed PMID: 19737377.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The striking geographical pattern of gastric cancer mortality in Spain: environmental hypotheses revisited. AU - Aragonés,Nuria, AU - Pérez-Gómez,Beatriz, AU - Pollán,Marina, AU - Ramis,Rebeca, AU - Vidal,Enrique, AU - Lope,Virginia, AU - García-Pérez,Javier, AU - Boldo,Elena, AU - López-Abente,Gonzalo, Y1 - 2009/09/08/ PY - 2008/09/10/received PY - 2009/09/08/accepted PY - 2009/9/10/entrez PY - 2009/9/10/pubmed PY - 2009/12/16/medline SP - 316 EP - 316 JF - BMC cancer JO - BMC Cancer VL - 9 N2 - BACKGROUND: Gastric cancer is decreasing in most countries. While socioeconomic development is the main factor to which this decline has been attributed, enormous differences among countries and within regions are still observed, with the main contributing factors remaining elusive. This study describes the geographic distribution of gastric cancer mortality at a municipal level in Spain, from 1994-2003. METHODS: Smoothed relative risks of stomach cancer mortality were obtained, using the Besag-York-Molliè autoregressive spatial model. Maps depicting relative risk (RR) estimates and posterior probabilities of RR being greater than 1 were plotted. RESULTS: From 1994-2003, 62184 gastric cancer deaths were registered in Spain (7 percent of all deaths due to malignant tumors). The geographic pattern was similar for both sexes. RRs displayed a south-north and coast-inland gradient, with lower risks being observed in Andalusia, the Mediterranean coastline, the Balearic and Canary Islands and the Cantabrian seaboard. The highest risk was concentrated along the west coast of Galicia, broad areas of the Castile & Leon Autonomous community, the province of Cáceres in Extremadura, Lleida and other areas of Catalonia. CONCLUSION: In Spain, risk of gastric cancer mortality displays a striking geographic distribution. With some differences, this persistent and unique pattern is similar across the sexes, suggesting the implication of environmental exposures from sources, such as diet or ground water, which could affect both sexes and delimited geographic areas. Also, the higher sex-ratios found in some areas with high risk of smoking-related cancer mortality in males support the role of tobacco in gastric cancer etiology. SN - 1471-2407 UR - https://www.unboundmedicine.com/medline/citation/19737377/The_striking_geographical_pattern_of_gastric_cancer_mortality_in_Spain:_environmental_hypotheses_revisited_ L2 - https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-9-316 DB - PRIME DP - Unbound Medicine ER -