Abstract
BackgroundOver the past decade, lung cancers have exhibited a disproportionately high mortality and increasing mortality trend in Thailand, especially in the northern region, and prevention strategies have consequently become more important in this region. Spatial analysis studies may be helpful in guiding any strategy put in place to respond to the risk of lung cancer mortality in specific areas. The aim of our study was to identify risk patterns for lung cancer mortality within the northern region of Thailand.MethodsIn the spatial analysis, the relative risk (RR) was used as a measure of the risk of lung cancer mortality in 81 districts of northern Thailand between 2008 and 2017. The RR was estimated according to the Besag-York-Mollié autoregressive spatial model performed using the OpenBUGS routine in the R statistical software package. We presented the overall and gender specific lung cancer mortality risk patterns of the region using the Quantum Geographic Information System.ResultsThe overall risk of lung cancer mortality was the highest in the west of northern Thailand, especially in the Hang Dong, Doi Lo, and San Pa Tong districts. For both genders, the risk patterns of lung cancer mortality indicated a high risk in the west of northern Thailand, with females being at a higher risk than males.ConclusionsThere was distinct geographical variation in risk patterns of lung cancer mortality in Thailand. Differences could be related to differences in risk factors such as ground-based radon and air pollution. This study provides a starting point for estimating the spatial pattern of the risk of lung cancer mortality and for examining associations between geographic risk factors and lung mortality for further studies.
Highlights
Over the past decade, lung cancers have exhibited a disproportionately high mortality and increasing mortality trend in Thailand, especially in the northern region, and prevention strategies have become more important in this region
Characteristics The lung cancer mortality data during 2008–2017 in the 6 northern Thailand provinces consisted of 10,468 deaths of which 6148 (58%) were male
The highest relative risk (RR) was found in Hang Dong district (Chiang Mai province) [RR = 1.666; 95% credible interval (CrI) = 1.611–1.729], Wiang Chai district (Chiang Rai province) [RR = 1.140; 95% CrI = 1.103–1.097], Sop Prap district (Lampang province) [RR = 1.089; 95% CrI = 1.053–1.130], Mueang Lamphun district (Lamphun province) [RR = 0.942; 95% CrI = 0.912–0.978], Den Chai district (Phrae province) [RR = 0.982; 95% CrI = 0.950–1.019], and Chun district (Phayao province) [RR = 0.972; 95% CrI = 0.941–1.009], in that order (Table 2) [see RR of lung cancer mortality for all districts in Additional file 2]
Summary
Lung cancers have exhibited a disproportionately high mortality and increasing mortality trend in Thailand, especially in the northern region, and prevention strategies have become more important in this region. Over the past few decades, a considerable number of studies have been conducted to investigate factors associated with the occurrence, treatment, and outcomes of lung cancer in northern Thailand, such as demographic characteristics (including hereditary genetic mutations, gender, and geographic location), environmental hazards (such as exposure to indoor radon, smoke, and air pollution), patient health status and behavior, and healthcare providers’ characteristics [8,9,10,11,12,13,14,15,16,17]. Spatial incidence patterns have been used to explore injuries and non-communicable disease incidences as these conditions are the result of interactions between behaviors, lifestyles, and the environment related to residential area and geographical differences [22,23,24,25,26]
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