Estimating LOCP cancer mortality rates in small domains in Spain using its relationship with lung cancer

Garazi Retegui,Jaione Etxeberria,María Dolores Ugarte

doi:10.1038/s41598-021-01765-7

Garazi Retegui, Jaione Etxeberria + Show 1 more

Open Access

https://doi.org/10.1038/s41598-021-01765-7

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Abstract

The distribution of lip, oral cavity, and pharynx (LOCP) cancer mortality rates in small domains (defined as the combination of province, age group, and gender) remains unknown in Spain. As many of the LOCP risk factors are preventable, specific prevention programmes could be implemented but this requires a clear specification of the target population. This paper provides an in-depth description of LOCP mortality rates by province, age group and gender, giving a complete overview of the disease. This study also presents a methodological challenge. As the number of LOCP cancer cases in small domains (province, age groups and gender) is scarce, univariate spatial models do not provide reliable results or are even impossible to fit. In view of the close link between LOCP and lung cancer, we consider analyzing them jointly by using shared component models. These models allow information-borrowing among diseases, ultimately providing the analysis of cancer sites with few cases at a very disaggregated level. Results show that males have higher mortality rates than females and these rates increase with age. Regions located in the north of Spain show the highest LOCP cancer mortality rates.

Highlights

The distribution of lip, oral cavity, and pharynx (LOCP) cancer mortality rates in small domains remains unknown in Spain
The purpose of this study was to reveal the geographic distribution of LOCP cancer mortality rates in continental Spain by gender and age groups
We conclude that LOCP cancer mortality rates increase with age, reaching its maximum in the 75–89 and 90+ age groups for males and females respectively, but females present lower mortality rates than males in all age groups

Summary

Introduction

The distribution of lip, oral cavity, and pharynx (LOCP) cancer mortality rates in small domains (defined as the combination of province, age group, and gender) remains unknown in Spain. It is interesting to analyze possible differences of geographical LOCP cancer mortality patterns by gender and age groups. When LOCP cancer mortality cases are analyzed by a combination of region, age, and gender (small domains), counts are scarce and it becomes difficult to fit univariate spatial models including all effects and their possible interactions. Due to the inherent relationships between LOCP and lung cancers and tobacco consumption, LOCP and lung cancer mortality cases are jointly analyzed in this paper using different age- and gender-specific shared component models. In both diseases, higher crude rates are observed for males than for females and these differences are more pronounced in lung cancer. The five age groups will be considered: 30–44, 45–59, 60–74, 75–89 and 90+

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