Maps and atlases of cancer mortality: a review of a useful tool to trigger new questions.
In this review we illustrate our view on the epidemiological relevance of geographically mapping cancer mortality. In the first part of this work, after delineating the history of cancer mapping with a view on interpretation of Cancer Mortality Atlases, we briefly illustrate the 'art' of cancer mapping. Later we summarise in a non-mathematical way basic methods of spatial statistics. In the second part of this paper, we employ the 'Atlas of Cancer Mortality in the European Union and the European Economic Area 1993-1997' in order to illustrate spatial aspects of cancer mortality in Europe. In particular, we focus on the cancer related to tobacco and alcohol epidemics and on breast cancer which is of particular interest in cancer mapping. Here we suggest and reiterate two key concepts. The first is that a cancer atlas is not only a visual tool, but it also contain appropriate spatial statistical analyses that quantify the qualitative visual impressions to the readers even though at times revealing fallacy. The second is that a cancer atlas is by no means a book where answers to questions can be found. On the contrary, it ought to be considered as a tool to trigger new questions.
International Prevention Research Institute, Lyon 69006, France.
Alberto
A
d'Onofrio
IstitutoEuropeo di Oncologia Milano 20141, Italy; Chiara passed away in November 2010.
Chiara
C
Mazzetta
Strathclyde University, Glasgow G1 1XQ, Scotland, UK.
Chris
C
Robertson
International Prevention Research Institute, Lyon 69006, France.
Michel
M
Smans
International Prevention Research Institute, Lyon 69006, France; Strathclyde University, Glasgow G1 1XQ, Scotland, UK.
Peter
P
Boyle
International Prevention Research Institute, Lyon 69006, France; Strathclyde University, Glasgow G1 1XQ, Scotland, UK.
Mathieu
M
Boniol
alcohol-related cancers; atlas; breast cancer; cancer; epidemiology; geographic medicine; geography; spatial statistics; tobacco-related cancers