Lung cancer and urbanization level in a region of Southern Europe influence of socio-economic and environmental factors

• Published in: Journal of public health (Oxford, England) Vol. 38; no. 2; pp. 229 - 236
• Main Authors: Domínguez-Berjón, María Felícitas, Gandarillas, Ana, Soto, María José
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.06.2016
• Subjects: Adult; Aged; Air Pollution - adverse effects; Air Pollution - analysis; Censuses; Cross-Sectional Studies; Environmental Exposure; Europe - epidemiology; Female; Humans; Lung Neoplasms - mortality; Male; Middle Aged; Nitrogen Dioxide - adverse effects; Nitrogen Dioxide - analysis; Regression Analysis; Risk Factors; Rural Population; Sex Distribution; Socioeconomic Factors; Spain - epidemiology; Urban Population - statistics & numerical data; Urbanization; Wider determinants; lung cancer; air pollution; urbanization; Spain; socio-economic factors
• ISSN: 1741-3842; 1741-3850
• DOI: 10.1093/pubmed/fdv047

This study analysed the distribution of lung cancer deaths in areas with different urbanization levels in the Madrid Region and whether such differences persisted when deprivation and air pollution were considered. This was a population-based cross-sectional study covering lung cancer deaths (2001-07). The exposure indicators were: a deprivation index based on 2001 census data; and the daily mean NO2 measurement (2002-07), both at the census tract level. Analysis was stratified by sex and age group and the Poisson regression models were applied to obtain rate ratios (RRs). After adjustment for age, deprivation index and NO2, mortality was similar in the city and Greater Madrid areas and lower in the rural area for the over-64 age group (RR: 0.84 in men and RR: 0.66 in women, with respect to the city of Madrid), and significantly lower in the Greater Madrid area (RR: 0.84 in men and RR: 0.74 in women) and in the rural area (RR: 0.73 in men and RR: 0.51 in women) with respect to the city of Madrid for the under-65 age group. The most urbanized areas of the Madrid Region are characterized by higher lung cancer mortality.