title: Municipal distribution of ovarian cancer mortality in Spain.
abstract: 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.
authors.affiliation: CIBER en Epidemiología y Salud Pública, Madrid, Spain. vicarvajal@isciii.es
authors.forename: Virginia
authors.initials: V
authors.lastname: Lope
authors.forename: Marina
authors.initials: M
authors.lastname: Pollán
authors.forename: Beatriz
authors.initials: B
authors.lastname: Pérez-Gómez
authors.forename: Nuria
authors.initials: N
authors.lastname: Aragonés
authors.forename: Enrique
authors.initials: E
authors.lastname: Vidal
authors.forename: Diana
authors.initials: D
authors.lastname: Gómez-Barroso
authors.forename: Rebeca
authors.initials: R
authors.lastname: Ramis
authors.forename: Javier
authors.initials: J
authors.lastname: García-Pérez
authors.forename: Anna
authors.initials: A
authors.lastname: Cabanes
authors.forename: Gonzalo
authors.initials: G
authors.lastname: López-Abente
mesh_terms: 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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