Different spatial pattern of municipal prostate cancer mortality in younger men in Spain.
BACKGROUND:Prostate cancer (PC) primarily affects elderly men. However, the specific features of cases diagnosed at younger ages (<65 years) suggest that they may represent a different clinical subtype. Our aim was to assess this suggestion by contrasting the geographical PC mortality and hospita...
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doaj-dc97bf8d12e345ac84891af9a95a5e4c2021-03-03T20:56:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01141e021098010.1371/journal.pone.0210980Different spatial pattern of municipal prostate cancer mortality in younger men in Spain.Lara Rodriguez-SanchezPablo Fernández-NavarroGonzalo López-AbenteOlivier NuñezNerea Fernández de Larrea-BazJose Juan Jimenez-MoleónÁlvaro Páez BordaMarina PollánBeatriz Perez-GomezBACKGROUND:Prostate cancer (PC) primarily affects elderly men. However, the specific features of cases diagnosed at younger ages (<65 years) suggest that they may represent a different clinical subtype. Our aim was to assess this suggestion by contrasting the geographical PC mortality and hospital admissions patterns in Spain for all ages to those in younger men. METHODS:The Spanish National Institute of Statistics supplied data on PC mortality, hospital admission, and population data. We estimated the expected town-specific number of deaths and calculated the standardized mortality ratios. Spatial autoregressive models of Besag-York-Mollié provided smoother municipal estimators of PC mortality risk (all ages; <65 years). We computed the provincial age-standardized rate ratios of PC hospital admissions (all men; <60 years) using Spanish rates as the reference. RESULTS:A total of 29,566 PC deaths (6% among those <65 years) were registered between 2010-2014, with three high-mortality risk zones: Northwest Spain; Southwest Andalusia & Granada; and a broad band extending from the Pyrenees Mountains to the north of Valencia. In younger men, the spatial patterns shared the high risk of mortality in the Northwest but not the central band. The PC hospital discharge rates confirmed a North-South gradient but also low mortality/high admission rates in Madrid and Barcelona and the opposite in Southwest Andalusia. CONCLUSION:The consistent high PC mortality/morbidity risk in the Northwest of Spain indicates an area with a real excess of risk. The different spatial pattern in younger men suggests that some factors associated with geographical risk might have differential effects by age. Finally, the regional divergences in mortality and morbidity hint at clinical variability as a source of inequity within Spain.https://doi.org/10.1371/journal.pone.0210980 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lara Rodriguez-Sanchez Pablo Fernández-Navarro Gonzalo López-Abente Olivier Nuñez Nerea Fernández de Larrea-Baz Jose Juan Jimenez-Moleón Álvaro Páez Borda Marina Pollán Beatriz Perez-Gomez |
spellingShingle |
Lara Rodriguez-Sanchez Pablo Fernández-Navarro Gonzalo López-Abente Olivier Nuñez Nerea Fernández de Larrea-Baz Jose Juan Jimenez-Moleón Álvaro Páez Borda Marina Pollán Beatriz Perez-Gomez Different spatial pattern of municipal prostate cancer mortality in younger men in Spain. PLoS ONE |
author_facet |
Lara Rodriguez-Sanchez Pablo Fernández-Navarro Gonzalo López-Abente Olivier Nuñez Nerea Fernández de Larrea-Baz Jose Juan Jimenez-Moleón Álvaro Páez Borda Marina Pollán Beatriz Perez-Gomez |
author_sort |
Lara Rodriguez-Sanchez |
title |
Different spatial pattern of municipal prostate cancer mortality in younger men in Spain. |
title_short |
Different spatial pattern of municipal prostate cancer mortality in younger men in Spain. |
title_full |
Different spatial pattern of municipal prostate cancer mortality in younger men in Spain. |
title_fullStr |
Different spatial pattern of municipal prostate cancer mortality in younger men in Spain. |
title_full_unstemmed |
Different spatial pattern of municipal prostate cancer mortality in younger men in Spain. |
title_sort |
different spatial pattern of municipal prostate cancer mortality in younger men in spain. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2019-01-01 |
description |
BACKGROUND:Prostate cancer (PC) primarily affects elderly men. However, the specific features of cases diagnosed at younger ages (<65 years) suggest that they may represent a different clinical subtype. Our aim was to assess this suggestion by contrasting the geographical PC mortality and hospital admissions patterns in Spain for all ages to those in younger men. METHODS:The Spanish National Institute of Statistics supplied data on PC mortality, hospital admission, and population data. We estimated the expected town-specific number of deaths and calculated the standardized mortality ratios. Spatial autoregressive models of Besag-York-Mollié provided smoother municipal estimators of PC mortality risk (all ages; <65 years). We computed the provincial age-standardized rate ratios of PC hospital admissions (all men; <60 years) using Spanish rates as the reference. RESULTS:A total of 29,566 PC deaths (6% among those <65 years) were registered between 2010-2014, with three high-mortality risk zones: Northwest Spain; Southwest Andalusia & Granada; and a broad band extending from the Pyrenees Mountains to the north of Valencia. In younger men, the spatial patterns shared the high risk of mortality in the Northwest but not the central band. The PC hospital discharge rates confirmed a North-South gradient but also low mortality/high admission rates in Madrid and Barcelona and the opposite in Southwest Andalusia. CONCLUSION:The consistent high PC mortality/morbidity risk in the Northwest of Spain indicates an area with a real excess of risk. The different spatial pattern in younger men suggests that some factors associated with geographical risk might have differential effects by age. Finally, the regional divergences in mortality and morbidity hint at clinical variability as a source of inequity within Spain. |
url |
https://doi.org/10.1371/journal.pone.0210980 |
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