title: [The evolution of breast cancer mortality and the dissemination of mammography in Catalonia: an analysis by health region].
abstract: BACKGROUND
  The decrease of breast cancer (BC) mortality rates has been attributed to early detection programs and therapeutic advances. The objective is to compare BC mortality trend in health regions of Catalonia during the period 1993-2007. In parallel, dissemination of periodic mammography in the health regions has been analyzed.
  
  
  METHODS
  Mortality and health surveys data were used. Poisson and «joinpoint» regression analyses were used to compare regional BC mortality rates and quantify their temporal evolution. Mixed effects models were used to compare the rates and their evolution by region.
  
  
  RESULTS
  The BC mortality rate decreased 3% annually in Cataluña. Between 1993 and 2007, the standard mortality rate changed from 34.8 to 23.3 per 100,000 women. Barcelona ciutat showed higher mortality rates than the Centre (rate ratio (RR)=0.873), Costa de Ponent (RR=0.885), Tarragona (RR=0.9) and Lleida regions (RR=0.915), but these differences tend to disappear over time. There were no observed trend changes in the evolution of the regional mortality rates, except in the Centre region. The use of periodic mammography was similar across health regions. During the 90s, Barcelona ciutat had a 36.1% utilization of periodic mammography in women aged 40-74, in the 1994 survey, the Centre 23.7 and Costa de Ponent 25.2%.
  
  
  CONCLUSIONS
  The progressive increase in the use of periodic mammography and the decrease of BC mortality were similar in the eight health regions of Catalonia.
authors.affiliation: Departament d'Economia, Universitat Rovira i Virgili, España.
authors.forename: María José
authors.initials: MJ
authors.lastname: Pérez Lacasta
authors.forename: Aleix
authors.initials: A
authors.lastname: Gregori Gomis
authors.forename: Misericòrdia
authors.initials: M
authors.lastname: Carles Lavila
authors.forename: Rosa
authors.initials: R
authors.lastname: Gispert Magarolas
authors.forename: Montserrat
authors.initials: M
authors.lastname: Martínez Alonso
authors.forename: Ester
authors.initials: E
authors.lastname: Vilaprinyo Terré
authors.forename: Roger
authors.initials: R
authors.lastname: Pla Farnós
authors.forename: Montserrat
authors.initials: M
authors.lastname: Rué Monné
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality*; D002391:Catchment Area, Health; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology