Effects of deprivation on the geographical variability of larynx cancer incidence in men, Girona (Spain) 1994–2004
Accepted 14 January 2010. published online 17 February 2010.
Abstract
Objective: To assess the association between the incidence of larynx cancer and socioeconomic conditions in the province of Girona from a spatial viewpoint. Materials and methods: Incidence cases of larynx cancer (CL) in 1994–2004 were provided by the Girona Cancer Registry. A census tract (CT) was assigned to all patients. Socioeconomic data were extracted from the 2001 Census. A deprivation index for each CT was obtained by principal component analysis, using four socioeconomic indicators. The standardised incidence ratio (SIR) was calculated using the CL incidence rates in the men of the province of Girona assuming a Poisson distribution. Relative risk was obtained applying the Besag, York and Mollié model. The deprivation index was introduced into the model and was categorised in quartiles. Results: Four hundred and seventy-six incident cases in men were registered. CTs in the lowest deprivation index had a lower risk of larynx cancer, with a risk increase in the higher quartiles. In the highest quartile it was 1.91 times greater than in the lowest. This association was significant when the whole province was considered. Discussion: The deprivation index explains only part of the geographical variability of CL incidence. Other risk factors without spatial structure may contribute to this explaination.
aResearch Group in Statistics, Applied Economics and Health (GRECS), University of Girona, Spain1
bCIBER of Epidemiology and Public Health (CIBERESP), Spain
cEpidemiology Unit and Girona Cancer Registry (UERCG), Oncology Director Plan, Health Department, Girona, Spain
dDirección General de Salud Pública, Gobierno de Aragón, Zaragoza, Spain
eInstituto Aragonés de Ciencias de la Salud, Zaragoza, Spain
Corresponding author at: Research Group in Statistics, Applied Economics and Health (GRECS), University of Girona, Campus de Montilivi, 17071 Girona, Spain. Tel.: +34 972418736; fax: +34 972418032.