Municipal distribution of ovarian cancer mortality in Spain.
BACKGROUND
Spain was the country that registered the greatest increases in ovarian cancer mortality in Europe. This study describes the municipal distribution of ovarian cancer mortality in Spain using spatial models for small-area analysis.


METHODS
Smoothed relative risks of ovarian cancer mortality were obtained, using the Besag, York and Molliè autoregressive spatial model. Standardised mortality ratios, smoothed relative risks, and distribution of the posterior probability of relative risks being greater than 1 were depicted on municipal maps.


RESULTS
During the study period (1989-1998), 13,869 ovarian cancer deaths were registered in 2,718 Spanish towns, accounting for 4% of all cancer-related deaths among women. The highest relative risks were mainly concentrated in three areas, i.e., the interior of Barcelona and Gerona (north-east Spain), the north of Lugo and Asturias (north-west Spain) and along the Seville-Huelva boundary (in the south-west). Eivissa (Balearic Islands) and El Hierro (Canary Islands) also registered increased risks.


CONCLUSIONS
Well established ovarian cancer risk factors might not contribute significantly to the municipal distribution of ovarian cancer mortality. Environmental and occupational exposures possibly linked to this pattern and prevalent in specific regions, are discussed in this paper. Small-area geographical studies are effective instruments for detecting risk areas that may otherwise remain concealed on a more reduced scale.
Lope
Virginia
V
CIBER en Epidemiología y Salud Pública, Madrid, Spain. vicarvajal@isciii.es
Pollán
Marina
M
Pérez-Gómez
Beatriz
B
Aragonés
Nuria
N
Vidal
Enrique
E
Gómez-Barroso
Diana
D
Ramis
Rebeca
R
García-Pérez
Javier
J
Cabanes
Anna
A
López-Abente
Gonzalo
G
D002947:Cities / Q000453:epidemiology*; D003710:Demography; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
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