Cancer mortality and poverty in Argentina: a geographical correlation study.
Age-standardized mortality rates of cancer were calculated for the Argentine provinces using deaths from 7 years of registration (1980-1986). Correlations between the geographical distributions of the rates for the main causes of death by cancer were analyzed. The correlations were adjusted for socioeconomic status using an indicator of low socioeconomic level (NBI) as a third variable in a multivariate analysis or stratifying by NBI. Correlations between the distribution of the age-standardized mortality rates in males and females for the same tumor site also were analyzed. Positive intersex correlations were observed for mortality rates of cancers of the colon, liver, pancreas, esophagus, stomach, gallbladder, and bladder. Negative correlations with NBI were observed for cancers of the breast and ovary in females, colon and pancreas in both sexes, and bladder in males. Positive correlations with NBI were observed for cancer of the cervix and for all uterine cancers. After adjusting by NBI, only the correlations between the distributions of cancer of the lung and cancers of the bladder, larynx, and pancreas in males remained statistically significant. The stratified analysis showed changes in the values of many of the correlation indexes by level of NBI. It is concluded that the socioeconomic level, measured by the NBI, is a strong confounder and an effective modifier of many correlations presented.
Matos
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Institute of Oncology Angel H. Roffo, University of Buenos Aires, Argentina.
Loria
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Vilensky
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D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001118:Argentina / Q000453:epidemiology; D015982:Bias; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D003644:Death Certificates; D015987:Effect Modifier, Epidemiologic; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000145:classification / Q000401:mortality*; D011159:Population Surveillance; D011203:Poverty; D012044:Regression Analysis; D012111:Residence Characteristics; D017678:Sex Distribution; D012959:Socioeconomic Factors