Browsing by Author "Painho, Marco"
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- Colorectal Cancer Incidence And Mortality In Mainland Portugal (2007-2011)Publication . Roquette, Rita; Painho, Marco; Nunes, BaltazarBackground/Objectives: Colorectal cancer is one of most common cancers in the world. That’s also the reality in Portugal where has the second highest cancer incidence rate for both sexes. With this in mind, is important to study colorectal cancer’s incidence and mortality evo-lution and to define measures that diminish the effect of this disease. One relevant issue in this analysis is to identify their spatial patterns and to find explanations to them. Our work’s main goal is to describe and compare spatial patterns of incidence and mortality by colorectal cancer, by sex, at mainland Portugal municipalities in 2007-2011.Methods: Cancer data were collected at Regional Oncologic Regis-tries (ROR). Mortality and Population data were available at Statistics Portugal (INE). All data were aggregated by municipalities and disag-gregated by sex and 17 quinquennial age groups – from 0-4 to 80 and more years old. We used Besag, York and Mollié (BYM) model to com-pute relative risk (RR) and posterior probability (PP). The choice of the geographic unit of analysis and applied model were based on results of our previous published researches.Results: Geographical distribution of incidence and mortality RR present spatial differences around mainland Portugal. Moreover, spatial patterns of incidence RR and PP are more heterogeneous than mortality RR and PP patterns. Colorectal cancer’s incidence RR is higher at Norte and at west coast municipalities. Mortality RR’s maps, in turn, present fewer municipalities classified in extreme classes than incidence’s maps. LVT and Alentejo stand out as the regions with higher mortality’s RR, particularly to men. PP maps strengthen higher heterogeneity of inci-dence comparing to mortality. Incidence maps show high PP values clus-tering in Norte and Centro coast and in LVT. Mortality maps display a wide cluster at LVT and Alentejo, particularly remarkable at men map.Conclusions/Recommendations: We found geographical differ-ences in colorectal cancer’s incidence and mortality rates. It is impor-tant to take into account these patterns when establishing measures to fight cancer. It is relevant to take particularly attention to the mu-nicipalities which register high values of both incidence and mortal-ity RR and PP.
- Epidemiologia espacial do cancro. Incidência e mortalidade por cancro colorretal em Portugal Continental 2007-2011Publication . Roquette, Rita; Painho, Marco; Nunes, BaltazarNeste seminário foi apresentado o trabalho de doutoramento concluído por Rita Roquette. A tese, intitulada “Spatial Epidemiology of Cancer: Data types, spatial aggregation and geographical patterns in mainland Portugal”, teve como principal objetivo contribuir para o conhecimento da epidemiologia espacial do cancro em Portugal continental, com particular ênfase nos padrões de distribuição da incidência e mortalidade por cancro colorrectal.
- Geographical patterns of the incidence and mortality of colorectal cancer in mainland Portugal municipalities (2007-2011)Publication . Roquette, Rita; Painho, Marco; Nunes, BaltazarBackground: Cancer is a leading cause of morbidity and mortality in the world. In Portugal, colorectal cancer is one of the most incident cancers; thus, it is crucial to act to fight it. Knowledge of the geographical distribution of the incidence and mortality of colorectal cancer can facilitate the execution of these actions and make them more effective. Methods: Our paper aims to describe and discuss the geographical patterns of colorectal cancer incidence and mortality in mainland Portugal municipalities (2007–2011). We used the Besag, York and Mollié (BYM) model to compute the relative risk (RR) and posterior probability (PP). We performed a cluster analysis with Global Moran’s Index and Local Moran’s Index (LISA). We ran a geographically weighted regression (GWR) to compare incidence and mortality patterns. Results: Incidence and mortality have different distributions of RR values. The interval of RR concerning incidence was higher than the interval of RR concerning mortality. PP values reinforce the finding of higher heterogeneity of the incidence of colorectal cancer. The comparison of the cluster maps for incidence and mortality shows a few municipalities classified with the same cluster type in both maps. Additionally, the GWR results show that the percentage of RR mortality explained by RR incidence differs throughout mainland Portugal. From the comparison of our results with the prevalence of risk factors (at NUTS II level), the need to be aware of smoking habits, alcohol consumption and the unhealthy diet of the Portuguese population stands out. Conclusions: There are differences in the geographical distribution of the RR incidence and RR mortality of colorectal cancer in mainland Portugal municipalities. Likewise, it is relevant to highlight the cluster of two municipalities with high RR values concerning colorectal cancer’s incidence and mortality. Future research is necessary to explain the geographical differences in the distribution of colorectal cancer in mainland Portugal municipalities. Based on our findings, it may be interesting to examine the influence of smoking, alcohol consumption, diet and screening on colorectal cancer in greater detail. Additionally, it may be relevant to develop an analysis focused on municipalities where the incidence values explain the mortality values poorly (or well).
- A geographically weighted regression approach to investigate air pollution effect on lung cancer: A case study in PortugalPublication . Roquette, Rita; Painho, Marco; Cardoso, DiogoThe risk of developing lung cancer might to a certain extent be attributed to tobacco. Nevertheless, the role of air pollution, both form urban and industrial sources, needs to be addressed. Numerous studies have concluded that long-term exposure to air pollution is an important environmental risk factor for lung cancer mortality. Still, there are only a few studies on air pollution and lung cancer in Portugal and none addressing its spatial dimension. The goal was to determine the influence of air pollution and urbanization rate on lung cancer mortality. A geographically weighted regression (GWR) model was performed to evaluate the relation between particle matter10 (PM10) emissions and lung cancer mortality relative risk (RR) for males and females in Portugal between 2007 and 2011. RR was computed with the BYM model. For a more in-depth analysis, the urbanization rate and the percentage of industrial area in each municipality were added. GWR efforts led to identifying three variables that were statistically significant in explaining lung cancer relative risk mortality, PM10 emissions, urbanization rate and the percentage of industrial area with an adjusted R2 of 0,63 for men and 0,59 for women. A small set of 8 municipalities with high correlation values was also identified (local R2 above 0,70). Stronger relationships were found in the north-western part of mainland Portugal. The local R2 tends to be higher when the emissions of PM10 are joined by urbanization and industrial areas. However, when assessing the industrial areas alone, it was noted that its impact was lower overall. As one of the first communications on this subject in Portugal, we have identified municipalities where possible impacts of air pollution on lung cancer mortality RR are higher thereby highlighting the role of geography and spatial analysis in explaining the associations between a disease and its determinants.
- Spatial epidemiology of cancer: a review of data sources, methods and risk factorsPublication . Roquette, Rita; Painho, Marco; Nunes, BaltazarCancer is a major concern among chronic diseases today. Spatial epidemiology plays a relevant role in this matter and we present here a review of this subject, including a discussion of the literature in terms of the level of geographic data aggregation, risk factors and methods used to analyse the spatial distribution of patterns and spatial clusters. For this purpose, we performed a websearch in the Pubmed and Web of Science databases including studies published between 1979 and 2015. We found 180 papers from 63 journals and noted that spatial epidemiology of cancer has been addressed with more emphasis during the last decade with research based on data mostly extracted from cancer registries and official mortality statistics. In general, the research questions present in the reviewed papers can be classified into three different sets: i) analysis of spatial distribution of cancer and/or its temporal evolution; ii) risk factors; iii) development of data analysis methods and/or evaluation of results obtained from application of existing methods. This review is expected to help promote research in this area through the identification of relevant knowledge gaps. Cancer’s spatial epidemiology represents an important concern, mainly for public health policies design aimed to minimise the impact of chronic disease in specific populations.
- The relevance of spatial aggregation level and of applied methods in the analysis of geographical distribution of cancer mortality in mainland Portugal (2009-2013)Publication . Roquette, Rita; Nunes, Baltazar; Painho, MarcoKnowledge regarding the geographical distribution of diseases is essential in public health in order to define strategies to improve the health of populations and quality of life. The present study aims to establish a methodology to choose a suitable geographic aggregation level of data and an appropriated method which allow us to analyze disease spatial patterns in mainland Portugal, avoiding the "small numbers problem." Malignant cancer mortality data for 2009-2013 was used as a case study.