Municipal mortality due to thyroid cancer in Spain.
BACKGROUND
Thyroid cancer is a tumor with a low but growing incidence in Spain. This study sought to depict its spatial municipal mortality pattern, using the classic model proposed by Besag, York and Mollié.


METHODS
It was possible to compile and ascertain the posterior distribution of relative risk on the basis of a single Bayesian spatial model covering all of Spain's 8077 municipal areas. Maps were plotted depicting standardized mortality ratios, smoothed relative risk (RR) estimates, and the posterior probability that RR > 1.


RESULTS
From 1989 to 1998 a total of 2,538 thyroid cancer deaths were registered in 1,041 municipalities. The highest relative risks were mostly situated in the Canary Islands, the province of Lugo, the east of La Coruña (Corunna) and western areas of Asturias and Orense.


CONCLUSIONS
The observed mortality pattern coincides with areas in Spain where goiter has been declared endemic. The higher frequency in these same areas of undifferentiated, more aggressive carcinomas could be reflected in the mortality figures. Other unknown genetic or environmental factors could also play a role in the etiology of this tumor.
Lope
Virginia
V
Cancer and Environmental Epidemiology Area, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. vicarvajal@isciii.es
Pollán
Marina
M
Pérez-Gómez
Beatriz
B
Aragonés
Nuria
N
Ramis
Rebeca
R
Gómez-Barroso
Diana
D
López-Abente
Gonzalo
G
D001499:Bayes Theorem; D002947:Cities / Q000145:classification; D005260:Female; D005843:Geography; D006042:Goiter / Q000453:epidemiology; D006801:Humans; D008297:Male; D008377:Maps as Topic; D009026:Mortality / Q000639:trends; D012306:Risk; D018570:Risk Assessment; D013030:Spain / Q000453:epidemiology; D013964:Thyroid Neoplasms / Q000209:etiology / Q000401:mortality*; D014504:Urban Health / Q000145:classification / Q000706:statistics & numerical data*