Open Access
Estimating LOCP cancer mortality rates in small domains in Spain using its relationship with lung cancer
(Nature Research, 2021) Retegui Goñi, Garazi; Etxeberria Andueza, Jaione; Ugarte Martínez, María Dolores; Estatistika, Informatika eta Matematika; Institute for Advanced Materials and Mathematics - INAMAT2; Estadística, Informática y Matemáticas; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
The distribution of lip, oral cavity, and pharynx (LOCP) cancer mortality rates in small domains (defined as the combination of province, age group, and gender) remains unknown in Spain. As many of the LOCP risk factors are preventable, specific prevention programmes could be implemented but this requires a clear specification of the target population. This paper provides an in-depth description of LOCP mortality rates by province, age group and gender, giving a complete overview of the disease. This study also presents a methodological challenge. As the number of LOCP cancer cases in small domains (province, age groups and gender) is scarce, univariate spatial models do not provide reliable results or are even impossible to fit. In view of the close link between LOCP and lung cancer, we consider analyzing them jointly by using shared component models. These models allow information-borrowing among diseases, ultimately providing the analysis of cancer sites with few cases at a very disaggregated level. Results show that males have higher mortality rates than females and these rates increase with age. Regions located in the north of Spain show the highest LOCP cancer mortality rates.
Open Access
Predicting cancer incidence in regions without population-based cancer registries using mortality
(Oxford University Press, 2023) Retegui Goñi, Garazi; Etxeberria Andueza, Jaione; Riebler, Andrea; Ugarte Martínez, María Dolores; Estadística, Informática y Matemáticas; Estatistika, Informatika eta Matematika; Institute for Advanced Materials and Mathematics - INAMAT2; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa, PJUPNA2018-11
Cancer incidence numbers are routinely recorded by national or regional population-based cancer registries (PBCRs). However, in most southern European countries, the local PBCRs cover only a fraction of the country. Therefore, national cancer incidence can be only obtained through estimation methods. In this paper, we predict incidence rates in areas without cancer registry using multivariate spatial models modelling jointly cancer incidence and mortality. To evaluate the proposal, we use cancer incidence and mortality data from all the German states. We also conduct a simulation study by mimicking the real case of Spain considering different scenarios depending on the similarity of spatial patterns between incidence and mortality, the levels of lethality, and varying the amount of incidence data available. The new proposal provides good interval estimates in regions without PBCRs and reduces the relative error in estimating national incidence compared to one of the most widely used methodologies.
Open Access
Prostate cancer incidence and mortality in Navarre (Spain)
(Gobierno de Navarra. Departamento de Salud, 2018) Etxeberria Andueza, Jaione; Guevara Eslava, Marcela; Moreno Iribas, Conchi; Burgui, Rosana; Delfrade Osinaga, J.; Floristan, Y.; Montesino Semper, Manuel F.; Ardanaz, Eva; Estatistika eta Ikerketa Operatiboa; Institute for Advanced Materials and Mathematics - INAMAT2; Estadística e Investigación Operativa
Fundamento. A nivel mundial, el cáncer de próstata es uno de los tumores malignos más comúnmente diagnosticados en los hombres. En este estudio, se analizan las tendencias de la incidencia y mortalidad de cáncer de próstata, global y por grupos de edad, para mostrar la situación epidemiológica pasada y actual de la enfermedad en Navarra (España). Método. Para el estudio se utilizaron los casos incidentes diagnosticados entre 1975 y 2010, y las muertes observadas entre 1975 y 2013. Los datos fueron proporcionados por el Registro de Cáncer de Navarra y el Instituto Nacional de Estadística respectivamente. Se calcularon las tasas de incidencia y mortalidad estandarizadas por edad, los puntos de cambio y el porcentaje de cambio anual (PCA) mediante modelos de regresión de joinpoint. Se usaron modelos unidimensionales de P-splines para estimar proyecciones hasta 2016. Resultados. Se observó un considerable incremento en las tasas de incidencia de cáncer de próstata en hombres de 45-74 años, con PCA de +4,5% (p<0,001), +9,5% (p<0,001) y +2,4% (p<0,05) en los periodos 1975-1990, 1990-2000 y 2000- 2010, respectivamente. En el grupo de mayores de 74 se registró un aumento de incidencia en el período 1975-1999 (PCA +3,3%, p<0,001), seguido de una disminución significativa hasta 2010 (PCA -4,0%, p<0,01). Las tasas de mortalidad aumentaron hasta 1995 (PCA +2,2%, p<0,001), mientras que descendieron en el periodo 1995-2013 (PCA -3.4%, p<0,001). Conclusión. Aunque las tasas globales de incidencia de cáncer de próstata parecen estabilizarse en 2002-2010 en Navarra, las tendencias fueron diferentes según los grupos de edad, aumentando en los hombres de 45-74 años y disminuyendo en el grupo de mayores de 74 años. Se observó una disminución en las tasas de mortalidad en ambos grupos de edad desde 1995. Cambios en el uso del antígeno prostático específico para cribado en los próximos años podrían afectar las futuras tendencias del cáncer de próstata. Palabras clave. Cáncer de Próstata. Incidencia. Mortalidad. Estimaciones. Tendencias
Open Access
Using mortality to predict incidence for rare and lethal cancers in very small areas
(VCH Publishers, 2022) Etxeberria Andueza, Jaione; Goicoa Mangado, Tomás; Ugarte Martínez, María Dolores; Estadística, Informática y Matemáticas; Estatistika, Informatika eta Matematika; Institute for Advanced Materials and Mathematics - INAMAT2
Incidence and mortality figures are needed to get a comprehensive overview of cancer burden. In many countries, cancer mortality figures are routinely recorded by statistical offices, whereas incidence depends on regional cancer registries. However, due to the complexity of updating cancer registries, incidence numbers become available 3 or 4 years later than mortality figures. It is, therefore, necessary to develop reliable procedures to predict cancer incidence at least until the period when mortality data are available. Most of the methods proposed in the literature are designed to predict total cancer (except nonmelanoma skin cancer) or major cancer sites. However, less frequent lethal cancers, such as brain cancer, are generally excluded from predictions because the scarce number of cases makes it difficult to use univariate models. Our proposal comes to fill this gap and consists of modeling jointly incidence and mortality data using spatio-temporal models with spatial and age shared components. This approach allows for predicting lethal cancers improving the performance of individual models when data are scarce by taking advantage of the high correlation between incidence and mortality. A fully Bayesian approach based on integrated nested Laplace approximations is considered for model fitting and inference. A validation process is also conducted to assess the performance of alternative models. We use the new proposals to predict brain cancer incidence rates by gender and age groups in the health units of Navarre and Basque Country (Spain) during the period 2005-2008.

Etxeberria Andueza, Jaione

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