title: [Spatial analysis of mortality caused by malignant tumors, especially by digestive system tumors, using empirical Bayes estimates in Fejér County, Hungary].
abstract: General practitioners in the vicinity of Lake Velencei in Fejér County, Hungary, have reported an unusual pattern of recent cancer mortality. Our aim was to clarify whether the presumed mortality cluster is epidemiologically justified; whether it is restricted to the locations in question or also appears elsewhere in the county; and if it is associated with some particular disease group. County mortality from malignancies of the digestive system, other malignancies, and all other causes for the period 1994 to 1999 was analyzed in 15- to 64-year-old men and women, using conventional standardized mortality ratios and empirical Bayes estimates. A continuous surface was interpolated from settlement level data for mortality maps. A mortality cluster from men's digestive cancers is apparent north and east of Lake Velencei and also elsewhere in the county. Differences from the country average in the frequency of males' deaths from other malignancies are fairly limited. A number of problematic areas in men's mortality from other causes are identifiable, including some of the settlements under the primary focus. Women's digestive tract cancer mortality in the area of the men's cluster near Lake Velencei is below the national average. There are almost no differences from the country level in women's deaths from other malignancies. Female mortality from all other causes shows remarkable elevations in the south of the county. Our results suggest the possible role of geographically localized exposures. Men's high mortality from digestive tract cancers is a problem affecting a considerable area of the county, necessitating further investigation. Continued search for causes is also warranted by some estimates of exceptionally high death rates in women from causes other than malignancies.
authors.affiliation: Népegészségügyi Iskola, Debreceni Egyetem OEC, Debrecen.
authors.forename: László
authors.initials: L
authors.lastname: Kardos
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Papp
authors.forename: Piroska
authors.initials: P
authors.lastname: Vargáné Hajdú
authors.forename: Péter
authors.initials: P
authors.lastname: Ferencz
authors.forename: Róza
authors.initials: R
authors.lastname: Adány
mesh_terms: D000293:Adolescent; D000328:Adult; D001499:Bayes Theorem; D004067:Digestive System Neoplasms / Q000401:mortality*; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D017678:Sex Distribution