Ugarte María Dolores, Adin Aritz, Goicoa Tomás, Casado Itziar, Ardanaz Eva, Larrañaga Nerea
Department of Statistics and O.R., Public University of Navarre, Campus de Arrosadía, Pamplona, 31006, Spain.
Institute for Advanced Materials (INAMAT), Public University of Navarre, Campus de Arrosadía, Pamplona, 31006, Spain.
BMC Public Health. 2015 Oct 5;15:1018. doi: 10.1186/s12889-015-2354-5.
Brain cancer incidence rates in Spain are below the European's average. However, there are two regions in the north of the country, Navarre and the Basque Country, ranked among the European regions with the highest incidence rates for both males and females. Our objective here was two-fold. Firstly, to describe the temporal evolution of the geographical pattern of brain cancer incidence in Navarre and the Basque Country, and secondly, to look for specific high risk areas (municipalities) within these two regions in the study period (1986-2008).
A mixed Poisson model with two levels of spatial effects is used. The model also included two levels of spatial effects (municipalities and local health areas). Model fitting was carried out using penalized quasi-likelihood. High risk regions were detected using upper one-sided confidence intervals.
Results revealed a group of high risk areas surrounding Pamplona, the capital city of Navarre, and a few municipalities with significant high risks in the northern part of the region, specifically in the border between Navarre and the Basque Country (Gipuzkoa). The global temporal trend was found to be increasing. Differences were also observed among specific risk evolutions in certain municipalities.
Brain cancer incidence in Navarre and the Basque Country (Spain) is still increasing with time. The number of high risk areas within those two regions is also increasing. Our study highlights the need of continuous surveillance of this cancer in the areas of high risk. However, due to the low percentage of cases explained by the known risk factors, primary prevention should be applied as a general recommendation in these populations.
西班牙的脑癌发病率低于欧洲平均水平。然而，该国北部的两个地区，即纳瓦拉和巴斯克地区，在欧洲各地区中男性和女性的发病率均位居最高之列。我们在此的目标有两个。首先，描述纳瓦拉和巴斯克地区脑癌发病率地理模式的时间演变，其次，在研究期间（1986 - 2008年）在这两个地区内寻找特定的高风险区域（市镇）。
使用具有两个空间效应水平的混合泊松模型。该模型还包括两个空间效应水平（市镇和当地卫生区域）。使用惩罚拟似然法进行模型拟合。使用单侧上置信区间检测高风险区域。
结果显示，围绕纳瓦拉首府潘普洛纳存在一组高风险区域，并且在该地区北部，特别是在纳瓦拉与巴斯克地区（吉普斯夸省）的边界处有一些具有显著高风险的市镇。发现总体时间趋势呈上升趋势。在某些市镇的特定风险演变中也观察到差异。
纳瓦拉和巴斯克地区（西班牙）的脑癌发病率仍在随时间增加。这两个地区内的高风险区域数量也在增加。我们的研究强调了在高风险地区对这种癌症进行持续监测的必要性。然而，由于已知风险因素所解释的病例百分比较低，应将一级预防作为对这些人群的一般建议。
