Lung cancer and urbanization level in a region of Southern Europe: influence of socio-economic and environmental factors.
This study analysed the distribution of lung cancer deaths in areas with different urbanization levels in the Madrid Region and whether such differences persisted when deprivation and air pollution were considered.



This was a population-based cross-sectional study covering lung cancer deaths (2001-07). The exposure indicators were: a deprivation index based on 2001 census data; and the daily mean NO2 measurement (2002-07), both at the census tract level. Analysis was stratified by sex and age group and the Poisson regression models were applied to obtain rate ratios (RRs).



After adjustment for age, deprivation index and NO2, mortality was similar in the city and Greater Madrid areas and lower in the rural area for the over-64 age group (RR: 0.84 in men and RR: 0.66 in women, with respect to the city of Madrid), and significantly lower in the Greater Madrid area (RR: 0.84 in men and RR: 0.74 in women) and in the rural area (RR: 0.73 in men and RR: 0.51 in women) with respect to the city of Madrid for the under-65 age group.



The most urbanized areas of the Madrid Region are characterized by higher lung cancer mortality.
Subdirectorate-General for Health Promotion and Prevention, Madrid Regional Health Authority, Madrid, Spain.
María Felícitas
MF
Domínguez-Berjón
Subdirectorate-General for Health Promotion and Prevention, Madrid Regional Health Authority, Madrid, Spain.
Ana
A
Gandarillas
Directorate-General for Regulation and Inspection, Madrid Regional Health Authority, Madrid, Spain.
María José
MJ
Soto
D000328:Adult; D000368:Aged; D000397:Air Pollution / Q000009:adverse effects / Q000032:analysis; D019352:Censuses; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000009:adverse effects* / Q000032:analysis; D012044:Regression Analysis; D012307:Risk Factors; D012424:Rural Population; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*; D014507:Urbanization
D009585:Nitrogen Dioxide
Spain; air pollution; lung cancer; socio-economic factors; urbanization