title: Using lung cancer mortality to indirectly approximate smoking patterns in space.
abstract: Smoking is the leading cause of lung cancer. Non-smoking factors have been associated with the disease. Existing Swiss survey data only capture the country partially and temporal coverage does not allow for a time lag between exposure to tobacco and lung cancer outbreak. Knowledge about the distribution of tobacco-use is essential to estimate its contribution to disease burden. Bayesian regression models were applied to estimate spatial smoking patterns. Data were provided from the Swiss Health Survey (14521 participants). Regression models with spatial random effects (SREs) were employed to obtain smoking proxies based on mortality rates and SREs adjusted for environmental exposures. Population attributable fractions were estimated to assess the burden of tobacco-use on lung cancer mortality. Correlation between observed smoking prevalence with smoking proxies was moderate and stronger in females. In the absence of sufficient survey data, smooth unadjusted mortality rates can be used to assess smoking patterns in Switzerland.
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
authors.forename: Verena
authors.initials: V
authors.lastname: Jürgens
authors.affiliation: Cancer Registry of St. Gallen & Appenzell, Flurhofstrasse 7, CH-9000 St. Gallen, Switzerland.
authors.forename: Silvia
authors.initials: S
authors.lastname: Ess
authors.affiliation: Institute of Pharmaceutical Medicine (ECPM), University of Basel, Klingelbergstrasse 61, CH-4056 Basel, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwenkglenks
authors.affiliation: Department of Medical Oncology-Hematology, Kantonsspital St. Gallen, Rorschacherstrasse 95, CH-9007 St. Gallen, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Cerny
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland. Electronic address: penelope.vounatsou@unibas.ch.
authors.forename: Penelope
authors.initials: P
authors.lastname: Vounatsou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001499:Bayes Theorem; D004781:Environmental Exposure; D005260:Female; D006306:Health Surveys; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015995:Prevalence; D011886:Radon / Q000009:adverse effects / Q000032:analysis / Q000528:radiation effects; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000639:trends; D000068916:Spatial Regression; D013557:Switzerland / Q000453:epidemiology; D064424:Tobacco Use / Q000009:adverse effects / Q000453:epidemiology
chemical_list: D011886:Radon
keywords: Bayesian inference; Lung cancer mortality; Smoking prevalence; Switzerland