title: Spatio-temporal evolution of female lung cancer mortality in a region of Spain, is it worth taking migration into account?
abstract: BACKGROUND
  The Comunitat Valenciana (CV) is a tourist region on the Mediterranean coast of Spain with a high rate of retirement migration. Lung cancer in women is the cancer mortality cause that has increased most in the CV during the period 1991 to 2000. Moreover, the geographical distribution of risk from this cause in the CV has been previously described and a non-homogenous pattern was determined. The present paper studies the spatio-temporal distribution of lung cancer mortality for women in the CV during the period 1987-2004, in order to gain some insight into the factors, such as migration, that have had an influence on these changes.
  
  
  METHODS
  A novel methodology, consisting of a Bayesian hierarchical model, is used in this paper. Such a model allows the handling of data with a very high disaggregation, while at the same time taking advantage of its spatial and temporal structure.
  
  
  RESULTS
  The spatio-temporal pattern which was found points to geographical differences in the time trends of risk. In fact, the southern coastal side of the CV has had a higher increase in risk, coinciding with the settlement of a large foreign community in that area, mainly comprised of elderly people from the European Union.
  
  
  CONCLUSIONS
  Migration has frequently been ignored as a risk factor in the description of the geographical risk of lung cancer and it is suggested that this factor should be considered, especially in tourist regions. The temporal component in disease mapping provides a more accurate depiction of risk factors acting on the population.
authors.affiliation: Dirección General de Salud Pública, Conselleria de Sanidad, Valencia, Spain. zurriaga_osc@gva.es
authors.forename: Oscar
authors.initials: O
authors.lastname: Zurriaga
authors.forename: Hermelinda
authors.initials: H
authors.lastname: Vanaclocha
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Martinez-Beneito
authors.forename: Paloma
authors.initials: P
authors.lastname: Botella-Rocamora
mesh_terms: D000328:Adult; D001499:Bayes Theorem; D015984:Causality; D002423:Cause of Death; D015897:Comorbidity; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005060:Europe / Q000208:ethnology; D005062:European Union / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008875:Middle Aged; D015233:Models, Statistical; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate