Abstract
An ecological design was used to study the relationship between cancer incidence and both socio-economic and environmental features in Southern Spain. Twenty-four sites and 26,380 cases diagnosed in 1985–1996 were analysed. Generalised Additive Models were used for data analysis. Except for lip cancer, the urban areas showed an increase in cancer risk for all sites. The relative risks among urban and rural municipalities ranges between 1.09 for skin non-melanoma (95% CI: 1.00–1.18) and 1.64 for cervix cancer (95% CI: 1.28–2.12). The relative risk among areas with high and low unemployment was 1.29 for stomach cancer (95% CI: 1.07–1.57), 1.45 for oral cavity cancer (95% CI: 1.10–1.93) and 1.77 for oesophagus cancer (95% CI: 1.02–3.05). Areas with highest unemployment showed the lowest incidence of melanoma. Risk for leukaemia, gall bladder, breast and prostate cancer showed a significant decreases by approximately 28% in the municipalities with the highest illiteracy score. A high percentage of land under cultivation was related to uterine tumours, larynx, rectum, lung, skin non-melanoma and brain cancers. For these sites, the risk had a significant increase by between 23%(skin non-melanoma) and 70%(rectum). Areas with high intensive farming showed a significant increase in cancer risk for lip, oral cavity, larynx, oesophagus, colon, lung, and bladder cancer. The relative risks ranges between 1.16 for colon cancer (95% CI: 1.04–1.29) and 1.47 for oesophagus cancer (95% CI: 1.15–1.87). The results of this study reveal how important socio-economic and environmental factors are for the analysis of cancer incidence in small areas of Southern Spain.
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References
Instituto Nacional de Estadística. España en cifras 2001. Madrid: INE, 2002.
Martínez C (ed), El Cáncer en Granada. Incidencia y Mortalidad 1988–1990. Granada: EASP, 1994.
Teppo L, Pukkala E, Hakama M, Hakulinen T, Herva A, Saxen E. Way of life and cancer incidence in Finland. Scand J Soc Med 1980; 19(Suppl): 1–84.
Elliot P. Small-area studies. In: Bertollini R, Lebowitz MD, Saracci R, Savitz DA (eds), Environmental epidemiology: Exposure and disease. Boca Raton: CRC Press-Lewis Publishers, 1996: 187–199.
Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J (eds), Cancer incidence in five continents, Vol. VII. Lyon: IARC, 1997 (IARC Scientific Publications: No. 143). 648
Pukkala E. Cancer risk by social class and occupation: A survey of 109,000 cancer cases among Finns of working age. Basel: Karger, 1995.
Kogevinas M, Pearce N, Susser M, Boffetta P (eds), Social inequalities and cancer. Lyon: IARC, 1997 (IARC Scientific Publications: No. 138).
Mackenbach JP, Bakker MJ, Kunst AE, Diderichsen F. Socio-economic inequalities in health in Europe: An overview. In: Mackenbach JP, Bakker M (eds), Reducing inequalities in health: A European perspective. London: Routledge, 2002: 3–24.
International Agency for Research on Cancer. Occupational exposures in insecticide application and some pesticides. Lyon: IARC, 1991 (IARC Monographs on the evaluation of carcinogenic risks to humans and their supplements: Vol. 53).
Blair A, Zahm SH. Pesticides and cancer: Status and priorities. In: Bertollini R, Lebowitz MD, Saracci R, Savitz DA (eds), Environmental epidemiology: Exposure and disease. Boca Raton: CRC Press-Lewis Publishers, 1996: 83–97.
Viel JF, Challier B. Bladder cancer among French farmers: Does exposure to pesticides in vineyards play a part? Occup Environ Med 1995; 52: 587–592.
Ruiz GJ, CantúO, Gómez D, et al. Hairy cell leukaemia is frequent in Mexico and has a geographic distribution. Am J Hematol 1996; 52: 316–318.
Wesseling C, Antich D, Hogstedt C, Rodríguez AC, Ahlbom A. Geographical differences of cancer incidence in Costa Rica in relation to environmental and occupational pesticide exposure. Int J Epidemiol 1999; 28: 365–374.
Ward MH, Nuckols JR, Weigel SJ, Maxwell SK, Cantor KP, Miller RS. Identifying populations potentially exposed to agricultural pesticides using remote sensing and geographic information system. Environ Health Persp 2000; 108: 5–12.
Rosell J. Cànceres Esespecíficos de género en á reas rurales de Granada [Dissertation]. Granada: EASP, 1996, 46 pp.
Ocaña-Riola R, Gutiérrez-Cuadra P, Martínez-García C, et al. Variaciones geográficas de la incidencia de cáncer de mama en la provincia de Granada y su asociación con variables socioeconómicas. Gac Sanit 2000; 14(Suppl. 2): 76.
Instituto Nacional de Estadística. Poblaciones de derecho y hecho de los municipios españoles: Censo de población de 1991. Madrid: INE, 1993.
European Commission. The European Network of Cancer Registries. Luxembourg: Office for Official Publications of the European Communities, 1995.
Instituto de Estadística de Andalucía. Atlas estadístico interactivo de Andalucía en la Unión Europea (Sistema de Información Multiterritorial de Andalucía). Sevilla: IEA, 1998.
ESECA. EsAtlas económico de Andalucía, 1991. Málaga: UNICAJA, 1992.
Rothman KJ, Greenland S. Modern Epidemiology. Philadelphia: Lippincott-Raven, 1998.
Hastie TJ, Tibshirani RJ. Generalized additive models. London: Chapman and Hall, 1990.
Venables WN, Ripley BD. Modern applied statistics with S-PLUS, 4th edn. New York: Springer-Verlag, 2002.
Anderson TW. An introduction to multivariate statistical analysis. New York: John Wiley & Sons, 1984.
MathSoft International. S-PLUS 2000. Seattle: Math-Soft Inc., 1999.
Kee F, Wilson R, Currie S, Sloan J, Houston R, Rowlands B, Moorehead J. Socio-economic circumstance and the risk of bowel cancer in Northern Ireland. J Epidemiol Commun H 1996; 50: 640–644.
Selvin S, Merrill DW, Erdmann C, White M, Ragland K. Breast cancer detection: Maps of 2 San Francisco Bay area counties. Am J Public Health 1998; 88: 1186–1192.
Townsend P, Davidson N, Whitehead M. Inequalities in health: The black report. London: Penguin Books, 1992.
Carstairs V, Morris R. Deprivation and health in Scotland. Aberdeen: Aberdeen University Press, 1990.
Arias A, Rebagliato M, Palumbo MA, et al. Desigualdades en salud en Barcelona y Valencia. Med Clin-Barcelona 1993; 100: 281–287.
Benach J, Yasui Y. Geographical patterns of excess mortality in Spain explained by two indices of deprivation. J Epidemiol Commun H 1999; 53: 423–431.
Carstairs V.Deprivation indices, their interpretation and use in relation to health. J Epidemiol Commun H 1995; 49: 3–8.
Vioque J, Ferrer PJ, Bolúmar F. Renta per capita, población rural femenina, promedio de hijos y distribución provincial de la mortalidad por cáncer de mama en España, 1975-1991. Med Clin-Barcelona 1997; 108: 41–44.
Vioque J, Fenollar J. Distribución de la mortalidad por cáncer de cérvix en España (1981-1986). Med Clin-Barcelona 1995; 104: 287–292.
Sung JF, Blumenthal DS, Alema-Mensah E, McGrady GA. Racial and urban-rural differences in cervical carcinoma in Georgia Medicaid recipients. Cancer 1997; 80: 231–236.
Pukkala E, Söderman B, Okeanov A, et al. Cancer Atlas of Northern Europe. Helsinki: Cancer Society of Finland, 2001 (Cancer Society of Finland Publications: No. 62).
Ministerio de Agricultura Pesca y Alimentación. Panel de Alimentación 2001. Madrid: MAPA, 2002.
Berkman LF, Macintyre S. The measurement of social class in health studies: Old measures and new formulations. In: Kogevinas M, Pearce N, Susser M, Boffetta P (eds), Social inequalities and cancer. Lyon: IARC, 1997: 51–64 (IARC Scientific Publications: No. 138).
Giovannucci E, Rimm EB, Colditz GA, et al. A prospective study of dietary fat and risk of prostate cancer. J Natl Cancer I 1993; 85: 1571–1579.
Paraf F, Paraf A, Barge J. Are industrial toxic substances a risk factor in gallbladder cancer? Gastroentrol Clin Biol 1990; 14: 877–880.
Shore RE. Occupational radiation studies: Status, problems and prospects. Health Phys 1990; 59: 63–68.
Novo M, Hammarstrom A, Janlert U. Smoking habits, a question of trend or unemployment?: A comparison of young men and women between boom and recession. Public Health 2000; 114: 460–463.
Tseng M, Yeatts K, Millikan R, Newman B. Area-level characteristics and smoking in women. Am J Public Health 2001; 91: 1847–1850. 649
Pinilla J, Gonzalez B. Profile of the population of Spain with respect to the smoking habit, period 1993-1997. Eur J Public Health 2001; 11: 346–351.
Wynder EL, Mushinski MH. Tobacco and alcohol consumption in relation to the development of multiple primary cancers. Cancer 1997; 40: 1872–1878.
Pion IA, Rigel DS, Garfinkel L, Silverman MK, Kopf AW. Occupation and the risk of malignant melanoma. Cancer 1995; 75: 637–644.
Dich J, Zahm SH, Hanberg A, Adami HO. Pesticides and cancer. Cancer Causes Control 1997; 8: 420–443.
Vainio H, Matos E, Boffetta P, Kogevinas M, Wilbourn J. Occupational cancer in developing and newly industrialized countries. Ann Acad Med Singapore 1993; 22: 170–181.
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Ocaña-Riola, R., Sánchez-Cantalejo, C., Rosell, J. et al. Socio-Economic Level, Farming Activities and Risk of Cancer in Small Areas of Southern Spain. Eur J Epidemiol 19, 643–650 (2004). https://doi.org/10.1023/B:EJEP.0000036808.26094.43
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DOI: https://doi.org/10.1023/B:EJEP.0000036808.26094.43