Temporal evolution of brain cancer incidence in the municipalities of Navarre and the Basque Country, Spain
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Background: Brain cancer incidence rates in Spain are below the European’s average. However, there are two regions in the north of the country, Navarre and the Basque Country, ranked among the European regions with the highest incidence rates for both males and females. Our objective here was two-fold. Firstly, to describe the temporal evolution of the geographical pattern of brain cancer inci ... [++]
Background: Brain cancer incidence rates in Spain are below the European’s average. However, there are two regions in the north of the country, Navarre and the Basque Country, ranked among the European regions with the highest incidence rates for both males and females. Our objective here was two-fold. Firstly, to describe the temporal evolution of the geographical pattern of brain cancer incidence in Navarre and the Basque Country, and secondly, to look for specific high risk areas (municipalities) within these two regions in the study period (1986–2008). Methods: A mixed Poisson model with two levels of spatial effects is used. The model also included two levels of spatial effects (municipalities and local health areas). Model fitting was carried out using penalized quasi-likelihood. High risk regions were detected using upper one-sided confidence intervals. Results: Results revealed a group of high risk areas surrounding Pamplona, the capital city of Navarre, and a few municipalities with significant high risks in the northern part of the region, specifically in the border between Navarre and the Basque Country (Gipuzkoa). The global temporal trend was found to be increasing. Differences were also observed among specific risk evolutions in certain municipalities. Conclusions: Brain cancer incidence in Navarre and the Basque Country (Spain) is still increasing with time. The number of high risk areas within those two regions is also increasing. Our study highlights the need of continuous surveillance of this cancer in the areas of high risk. However, due to the low percentage of cases explained by the known risk factors, primary prevention should be applied as a general recommendation in these populations. [--]
Brain cancer incidence, Small areas, Space-time models, Relative risks
BMC Public Health (2015) 15:1018
Universidad Pública de Navarra. Departamento de Estadística e Investigación Operativa / Nafarroako Unibertsitate Publikoa. Estatistika eta Ikerketa Operatiboa Saila / InaMat - Institute for Advanced Materials
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This research has been supported by the Spanish Ministry of Science and Innovation (project MTM 2011-22664, jointly sponsored with FEDER grants and project MTM2014-51992-R), and by the Health Department of the Navarre Government (project 113, Res.2186/2014).
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