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Nolasco A, Melchor I, Pina JA, Pereyra-Zamora P, Moncho J, Tamayo N, García-Senchermes C, Zurriaga O, Martínez-Beneito MA. Preventable avoidable mortality: evolution of socioeconomic inequalities in urban areas in Spain, 1996-2003. Health Place 2008; 15:702-11. [PMID: 19201247 DOI: 10.1016/j.healthplace.2008.12.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Revised: 11/26/2008] [Accepted: 12/09/2008] [Indexed: 11/16/2022]
Abstract
This study describes the inequalities in preventable avoidable mortality in relation to socioeconomic levels and analyses their evolution during the period 1996-2003 in the cities of Alicante, Castellon and Valencia. Four causes of preventable avoidable mortality were analysed according to sex: malignant tumour of the trachea, bronchus and lung, cirrhosis and other chronic diseases of the liver, motor vehicle accidents and AIDS, which had caused the death of non-institutionalised residents in the three cities during the period 1996-2003. The different census tracts were grouped into three socioeconomic levels. In general, socioeconomic inequalities in preventable avoidable mortality remain constant in time, except the ones caused by AIDS in Valencia, where they increase for men. Some census tracts in the three cities where the study was carried out were found to have significantly higher preventable mortality rates, and therefore require intervention.
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Affiliation(s)
- Andreu Nolasco
- Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, Apartado 99, 03080-Alicante, Spain.
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Sex and socioeconomic inequalities of lung cancer mortality in Barcelona, Spain and São Paulo, Brazil. Eur J Cancer Prev 2008; 17:399-405. [DOI: 10.1097/cej.0b013e3282f75f17] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ruiz-Ramos M, Expósito Hernández J. Tendencia de la mortalidad por cáncer en Andalucía entre 1975 y 2003. Med Clin (Barc) 2007; 128:448-52. [PMID: 17408537 DOI: 10.1157/13100561] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND OBJECTIVE To describe cancer mortality trends in Andalusia for cancer as a whole and for their main locations, by age and gender groups during 1975-2003. MATERIAL AND METHOD Mortality rates age and gender-adjusted have been estimated through cancer mortality data coming from mortality and polpulation official statistics. Joinpoint regression analysis has been used in order to quantify trends and their points of change. RESULTS Cancer as a whole has showed a descending trend among women and an ascending trend among men, for the period 1975-2003. Annual change rates were -0.45% and 0.42% for women and men respectively, and both of them, statistically significant (p < 0.05). By age, except for the elder group, a fall is noted, both among women and among men. Among women, breast cancer was the first cause of cancer death; in 1993 it appeared a statistically significant change from ascendent to descendent trend. Among men, lung cancer was the first mortality cause; in 1996 appeared a significant trend change and it began to go down. Colon and rectum cancer was the second one in magnitude, both among men and women, but far from the first one and with an ascendent trend, specially among men. CONCLUSIONS Cancer mortality shows a descending trend among andalusian women, with a similar rate to the Spanish average. Among men, the trend is ascendent with a higher magnitude than the national average.
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Alonso-Fernández MA, García-Clemente M, Escudero-Bueno C. [Characteristics of lung cancer in a region in northern Spain]. Arch Bronconeumol 2005; 41:478-83. [PMID: 16194509 DOI: 10.1016/s1579-2129(06)60266-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To gather information on the disease characteristics and survival rate of patients diagnosed with bronchogenic carcinoma in the respiratory medicine departments of hospitals in Asturias, Spain. PATIENTS AND METHODS This was a retrospective observational study carried out using a standardized data collection protocol. All cases of lung cancer diagnosed during 2001 were included provided there was cytologic or histologic confirmation or they fulfilled a series of clinical, radiological, and/or endoscopic criteria consistent with such a diagnosis. RESULTS Standard incidence rates adjusted to the world population were 22.4, 42.6, and 4.6 per 100,000 population for the whole population, men, and women respectively. The mean (SD) age was 67 (10.9) years, and 92% of the patients were men. Overall, 98% of the men and 44% of the women were smokers. Diagnosis was confirmed by cytologic or histologic findings in 92% of patients, and the majority were non-small cell tumors (81.4%). At the time of diagnosis, 65% of the patients had advanced disease, with distant metastasis in 26.6% of the non-small cell cancers and 52.8% of the small cell cancers. Patients received surgical treatment in 21.3% of cases, chemotherapy alone or combined with radiation therapy in 43.1%, and radiation therapy alone in 9.3%. In 26.2% of patients only palliative care was given. Overall, median survival in weeks was 36.4 (95% confidence interval [CI], 29.4-43.4). Median survival by treatment type was as follows: 69.3 (95% CI, 49-9.5) for surgery; 39.6 (95% CI, 31.2-48) for chemotherapy alone or with radiation therapy; 30 (95% CI, 15.4-44.6) for radiation therapy alone; and 13.3 (95% CI, 5.9-20.6) for patients who received palliative care alone (P< .05). CONCLUSIONS The findings with respect to age, sex, incidence, histology, extent of tumor, and smoking status of patients with bronchogenic carcinoma in our region does not differ significantly from those reported for other areas of Spain. Current smoking is the primary cause of the high prevalence of this disease. Twenty-six percent of patients received only palliative care. The percentage of patients treated with surgery was low.
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Affiliation(s)
- M A Alonso-Fernández
- Servicio de Neumología I, Hospital Universitario Central de Asturias, Asturias, Spain.
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Alonso-Fernández M, García-Clemente M, Escudero-Bueno C. Características del carcinoma broncopulmonar en una región del norte de España. Arch Bronconeumol 2005. [DOI: 10.1157/13078648] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Miravet L, Paradís A, Peláez S, Arnal M, Cabadés F. [Evolution of lung cancer in the North of the province of Castellón, Spain, 1993-2002]. Arch Bronconeumol 2005; 40:553-7. [PMID: 15574268 DOI: 10.1016/s1579-2129(06)60374-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the changes in lung cancer incidence, histological type, and survival in patients in the north of the province of Castellón, Spain, during a follow-up period of 10 years, and to compare the findings with other national and international studies. PATIENTS AND METHOD All patients diagnosed with lung cancer between January 1, 1993 and December 31, 2002 were included in this prospective, observational study. Disease was confirmed by biopsy or suspected from clinical, radiological, and/or bronchoscopic findings. RESULTS In the study period, 271 patients were diagnosed with lung cancer (239 men and 32 women), with a mean (SD) age of 66.8 (11.8) years. The age-adjusted incidence rate standardized to the world population was 20.42 cases per 100,000 population. Smokers or ex-smokers comprised 88.1% of the study population, and 72.6% of patients were over 60 years old. Biopsy confirmation was obtained in 262 cases (96.7%). Squamous cell carcinoma predominated (46.5%) but the proportion of adenocarcinoma increased (23.6%). Surgery was possible in only 22% of the patients. Mean overall 5-year survival was 15.7 months. CONCLUSIONS In the north of the province of Castellón, the incidence of lung cancer continues to increase in men but has decreased slightly in women. Squamous cell carcinoma is the most common type, but the incidence of adenocarcinoma has clearly increased. Overall, survival did not improve during the 10 years of follow up despite advances in treatment.
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Affiliation(s)
- L Miravet
- Unidad de Neumología, Servicio de Medicina Interna, Hospital Comarcal de Vinaroz, Vinaroz, Castellón, Spain.
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Cayuela A, Rodríguez-Domínguez S, López-Campos JL, Otero Candelera R, Rodríguez Matutes C. Joinpoint regression analysis of lung cancer mortality, Andalusia 1975–2000. Ann Oncol 2004; 15:793-6. [PMID: 15111349 DOI: 10.1093/annonc/mdh170] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previous analyses of lung cancer mortality were based on models of death rates within one time period, assuming that rates increase or decrease with time at a constant rate. The aim of this work is to analyse recent changes in lung cancer mortality trends in Andalusia (Spain) during the period of 1975-2000 using joinpoint regression models. PATIENTS AND METHODS Mortality data were obtained from the Death Registry of Andalusia. For each gender, age group-specific and standardised (overall and truncated) rates were calculated by the direct method (using the world standard population). The joinpoint analysis was used to identify the best-fitting points where a statistically significant change in the trend occurred. RESULTS Lung cancer is the leading cause of cancer mortality in men, with an increasing trend up to 1994. After that year, rates began to decrease significantly (-1.8% yearly from 1994 to 2000). Standardised rates in women exhibited a downward trend until the early 1990s, after which they levelled off (overall standardised rates) or increased significantly (truncated rates 35-64 years). CONCLUSIONS An increase in lung cancer mortality has been observed in young women. There seems to be a relationship with the prevalence in smoking in men and women.
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Affiliation(s)
- A Cayuela
- Research Department, Virgen del Rocío University Hospitals, Unided de Apoyo a la Investigación, Avenida de Manuel Siurot, s/n, 41013 Seville, Spain.
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Miravet L, Paradís A, Peláez S, Arnal M, Cabadés F. Evolución del carcinoma broncopulmonar en el norte de la provincia de Castellón, 1993–2002. Arch Bronconeumol 2004. [DOI: 10.1016/s0300-2896(04)75591-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hernández Hernández J, Tapias del Pozo J, Moreno Canelo P, Rodríguez Puebla A, Paniagua Tejo S, Sánchez Marcos J. Incidencia del cáncer de pulmón en la provincia de Ávila. Año 2002 y tendencias en una década. Arch Bronconeumol 2004. [DOI: 10.1016/s0300-2896(04)75530-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Montero C, Rosales M, Otero I, Blanco M, Rodríguez G, Peterga S, Pita S, Verea H. [Lung cancer in the health care area of A Coruña (Spain): incidence, clinical approach and survival]. Arch Bronconeumol 2003; 39:209-16. [PMID: 12749803 DOI: 10.1016/s0300-2896(03)75363-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the incidence, clinical approach, diagnostic delay and survival for bronchogenic carcinoma (BC) in the public health area of A Coruña (Spain). PATIENTS AND METHOD This was a retrospective study of patients with a diagnosis of BC made in 1995 and 1996 in a health care area with 509,000 inhabitants. For analysis we gathered demographic, clinical and cyto-histologic data and analyzed diagnostic delay, extension of disease and time of death. Crude, age-specific and age-standardized incidences were calculated. RESULTS BC was diagnosed in 378 patients (95% men and 5% women). The crude incidence was 37 per 100,000 inhabitants (73.7 per 100,000 men and 3 per 100,000 women) and the age-standardized incidence was 21.7 per 100,000. Diagnosis was by cyto-histology in 87% of the cases, and the most frequent biopsy finding was epidermoid carcinoma. Diagnosis was by clinical or radiologic findings for 13.7%, and patients in that group were older and had greater comorbidity. No symptoms were present in 13% and in those patients diagnosis was earlier, with non-small BC predominating and 60% treated surgically. The diagnostic delay (time from the first symptom to histologic confirmation) was 2.5 months (median, 2.1), and length of delay did not affect survival. Surgery was performed in 23% of the patients with non-small BC. The median survival was 7.1 months (5.2 months for patients who were not treated surgically, and 37.6 for those who were). CONCLUSIONS The incidence of BC in men in our study is consistent with that reported for other Spanish regions, although the incidence we observed for women is much lower. Diagnostic delay did not affect survival. The percentage of patients with surgical-stage disease is very low and survival is very short. These findings support the need for early diagnosis.
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Affiliation(s)
- C Montero
- Servicio de Neumología. Hospital Universitario Juan Canalejo. A Coruña. España
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Fernandez E, Schiaffino A, Borràs JM, Shafey O, Villalbí JR, La Vecchia C. Prevalence of cigarette smoking by birth cohort among males and females in Spain, 1910-1990. Eur J Cancer Prev 2003; 12:57-62. [PMID: 12548111 DOI: 10.1097/00008469-200302000-00009] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We analysed the prevalence of cigarette smoking among subsequent birth cohorts of Spanish males and females. Data were drawn from the Spanish NHIS conducted in 1993 ( = 26 400), 1995 ( = 8300) and 1997 ( = 8300). From the original computer files, the three surveys were pooled to obtain a single sample. A total of 33 223 subjects (16 036 men and 17 187 women) born between 1900 and 1979, >/= 16 years old, were directly interviewed and with complete information on the history of smoking included for analysis. Based on each respondent's sex and calendar year of birth, the person was classified into a particular sex-birth cohort in the decades from 1900-09 to 1970-79. For each year from date of birth to date of survey, respondents were further classified as either cigarette smoker or nonsmoker. The prevalence of cigarette smoking among successive cohorts of Spanish men and women was estimated, with correction for excess mortality of smokers. In men, the peak in smoking was reached in the 1950-59 birth cohort (prevalence rate of 68% at ages 20-29), after increases during the previous calendar years. Smoking among women was rare until 1960. Female smoking prevalence rates increased progressively among subsequent cohorts until 1980. The age distribution of smoking prevalence in women in 1990 mimics that observed in men 40 years earlier. A substantial delay in the spread of the tobacco epidemic among men is apparent. In women, the delay in the initiation of the smoking epidemic ended with a quick diffusion of the habit.
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Affiliation(s)
- E Fernandez
- Cancer Prevention and Control Unit, Institut Català d'Oncologia, L'Hospitalet, Barcelona, Spain.
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Cayuela Domínguez A, Rodríguez Domínguez S, Otero Candelera R, Rodríguez Matutes C, Díaz Moreno V. Mortalidad por cáncer de pulmón en Andalucía (1975–2000). Arch Bronconeumol 2003; 39:491-5. [PMID: 14588201 DOI: 10.1016/s0300-2896(03)75438-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe trends in lung cancer mortality in Andalucia, Spain, during the period from 1975 through 2000. SUBJECTS AND METHOD Records of lung cancer deaths for the period from 1975 through 2000 were obtained from the Statistical Institute of Andalucia. The following indicators were calculated: crude rates, age-adjusted rates, truncated rates, and cumulative rates. RESULTS Mortality rates for men dropped in all subject groups aged over 50 years during the period from 1994 through 2000. In women mortality rates were much lower, although we observed an increase in the 35-39 and 45-49 age groups, which is reflected in the 6.1% rise in the truncated rates (35-64 years) during the period from 1994 through 2000. In older women mortality rates fluctuated more within the different age groups, although on the whole the truncated rate for all those over 65 years old fell by 9.7% in the period between 1995 and 2000. CONCLUSION Lung cancer mortality rates among men in Andalusia began to decrease after 1994. In contrast, mortality increased among young women, although their rates are still very low.
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Affiliation(s)
- A Cayuela Domínguez
- Unidad de Investigación. Hospitales Universitarios Virgen del Rocío. Sevilla. España.
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Nerín I, Crucelaegui A, Mas A, Guillén D. Perfil de los fumadores que solicitan tratamiento en una unidad de tabaquismo. Arch Bronconeumol 2003. [DOI: 10.1016/s0300-2896(03)75389-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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