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. 2016 Nov 22;13(11):1162.
doi: 10.3390/ijerph13111162.

Geographical and Temporal Variations in Female Breast Cancer Mortality in the Municipalities of Andalusia (Southern Spain)

Ricardo Ocaña-Riola  1   2 , Carmen Montaño-Remacha  3 , José María Mayoral-Cortés  4
Affiliations

Geographical and Temporal Variations in Female Breast Cancer Mortality in the Municipalities of Andalusia (Southern Spain)

Ricardo Ocaña-Riola et al. Int J Environ Res Public Health. .

Abstract

The last published figures have shown geographical variations in mortality with respect to female breast cancer in European countries. However, national health policies need a dynamic image of the geographical variations within the country. The aim of this paper was to describe the spatial distribution of age-specific mortality rates from female breast cancer in the municipalities of Andalusia (southern Spain) and to analyze its evolution over time from 1981 to 2012. An ecological study was devised. Two spatio-temporal hierarchical Bayesian models were estimated. One of these was used to estimate the age-specific mortality rate for each municipality, together with its time trends, and the other was used to estimate the age-specific rate ratio compared with Spain as a whole. The results showed that 98% of the municipalities exhibited a decreasing or a flat mortality trend for all the age groups. In 2012, the geographical variability of the age-specific mortality rates was small, especially for population groups below 65. In addition, more than 96.6% of the municipalities showed an age-specific mortality rate similar to the corresponding rate for Spain, and there were no identified significant clusters. This information will contribute towards a reflection on the past, present and future of breast cancer outcomes in Andalusia.

Keywords: Andalusia; Bayesian analysis; Geographical Information System; Spain; breast cancer; mortality; small areas; spatial statistics; trend analysis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Andalusia (southern Spain) and its administrative division into eight provinces and 771 municipalities. Colored circles represent the female population of each municipality, which is directly proportional to the circle size.
Figure 2
Figure 2
Possible graphical forms of the age-specific mortality trend for each municipality of Andalusia (southern Spain) according to the value of the linear and the quadratic term of its time function.
Figure 3
Figure 3
Trend of age-specific mortality rate per 10,000 women with respect to female breast cancer in Spain, 1981–2012.
Figure 4
Figure 4
Trend of age-specific mortality rate from female breast cancer in the municipalities of Andalusia (southern Spain), 1981–2012.
Figure 5
Figure 5
Geographical variations of age-specific mortality rate per 10,000 women from female breast cancer in the municipalities of Andalusia (southern Spain), 1981–2012.
Figure 6
Figure 6
Geographical variations of the probability that the age-specific mortality rate ratio in each Andalusian municipality is greater than 1 using Spain as the reference, 1981–2012.
See this image and copyright information in PMC

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