The striking geographical pattern of gastric cancer mortality in Spain: environmental hypotheses revisited

Aragonés, Núria; Pérez‐Gómez, Beatriz; Pollán, Marina; Ramis, Rebeca; Vidal, Enrique; Lope, Virginia; García‐Pérez, Javier; Boldo, Elena; López‐Abente, Gonzalo

doi:10.1186/1471-2407-9-316

Cited by 41 publications

(27 citation statements)

References 51 publications

(48 reference statements)

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“…The reasons that could make it difficult to establish a relationship between cancer and spatial risk factors include: i) the latency period of the disease (Jarup et al, 2002;Toledano et al, 2001); ii) the situation in which a factor identified in one geographic region may not have the same effect in another region due to the presence or absence of other factors (Aragones et al, 2009); or iii) the fact that most cancers result from a combination of several factors rather a single one (Klassen and Platz, 2006).…”

Section: Methods Appliedmentioning

confidence: 99%

Spatial epidemiology of cancer: a review of data sources, methods and risk factors

Roquette¹,

Paìnho²,

Nunes

2017

Geospat Health

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Cancer 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. IntroductionGiven the relevance of spatial epidemiology in health research and the emphasis of cancer among chronic diseases, as well as the growing amount of studies in this area, it is important to know what the literature says about spatial epidemiology of cancer as well as provide its structured description. According to the World Health Organization (WHO), cancer is a leading cause of death in the world (WHO, 2015). It is also the cause of various morbidities and co-morbidities and can be responsible for loss of years of life years as well as loss of years without disability. Considering the aging population, it is predicted that the number of new cases of cancer will increase by more than 12% over the next decade in the European Union (EU) (DGS, 2013). The fight against cancer is a major challenge in public health. This challenge is due in part to the inequalities in terms of incidence, mortality, and survival. Therefore, a multidisciplinary approach is needed (Bastos et al., 2010). Among the various fields that can contribute to the development of knowledge about this disease, spatial epidemiology plays an important role. It can promote the understanding of spatial and temporal distribution patterns, helping to better identify the risk factors that influence them.Three types of approach can be established in spatial epidemiology: i) mapping; ii) geographic correlation; and iii) clustering (Elliott and Wartenberg, 2004). Mapping or map design regarding health and disease situations is the most often mentioned and used of these three approaches. Further, geographic correlation studies have the goal to spatially compare the health with several types of factors such as e...

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Section: Methods Appliedmentioning

confidence: 99%

Spatial epidemiology of cancer: a review of data sources, methods and risk factors

Roquette¹,

Paìnho²,

Nunes

2017

Geospat Health

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“…No increased incidences of bladder or lung cancer have been noted in the districts of the DB (Lopez-Abente et al, 2006;Aragonés et al, 2009). However, Aragonés et al (2009) found a clear geographic pattern of gastric cancer incidence in Spain, with highest incidence coinciding with the DB. While gastric cancer has not been clearly linked to As exposure, environmental exposure via drinking water was highlighted as one possible cause of the distributions observed.…”

Section: Introductionmentioning

confidence: 99%

Geological factors controlling occurrence and distribution of arsenic in groundwaters from the southern margin of the Duero Basin, Spain

Giménez-Forcada

Smedley

2014

Environ Geochem Health

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Groundwater from springs and boreholes on the southern edge of the Cenozoic Duero Basin (DB) of Spain has concentrations of arsenic (As) which are commonly above the EC drinking-water limit of 10 µg/L, and reach observed values up to 241 µg/L. Groundwater compositions within the sedimentary aquifer vary from Ca-HCO 3 type, variably affected by evaporation and agricultural pollution at shallow levels, to Na-HCO 3 compositions in deeper boreholes of the basin. Groundwater conditions are mainly oxidising but reducing groundwaters exist in sub-basins within the aquifer, localised flow paths likely being influenced by basement structure. Arsenic concentrations are spatially variable, reaching up to 38 µg/L in springs of the Spanish Central System (SCS) basement aquifer and up to 62 µg/L in springs from the DB. Highest As concentrations are associated with the Na-HCO 3 compositions in deep boreholes (200-450 m depth) within the DB. These have high pH values (up to 9.6) can give rise to associated elevated concentrations of V and U (up to 64 µg/L and 30 µg/L respectively). In the deep borehole waters of the DB, oxidising flows derived from the mineralised igneous-metamorphic basement and discharging via major faults, are considered the origin of the higher concentrations. Compositions are consistent with desorption of As and other anionic species from metal oxyhydroxides in an oxic environment. Under locally reducing conditions prevalent in some low-flow parts of the DB, an absence of detectable dissolved As is coincident with low or undetectable SO 4 concentrations, and consistent with loss via formation of authigenic sulphide minerals. Mitigation measures are needed urgently in this semi-arid region where provision of alternative sources of safe drinking water is logistically difficult and expensive.

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“…(5) Geographic variations in gastric cancer incidence and mortality in terms of a north-south gradient have been reported in both the West and the East. (6)(7)(8) These variations may be related to differences in risk factors, such as the prevalence rate of H. pylori infection. Migration studies have shown that first-generation migrants from countries with a high incidence of H. pylori infection relocating to countries of low incidence rates had similar risks as that of the country of origin, but the incidence rate…”

Section: Epidemiological Trends In Gastric Cancermentioning

confidence: 99%

Clinical epidemiology of gastric cancer

Ang

Fock

2014

smedj

308

223

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Gastric cancer is the second leading cause of cancer-related mortality and the fourth most common cancer globally. There are, however, distinct differences in incidence rates in different geographic regions. While the incidence rate of gastric cancer has been falling, that of gastric cardia cancers is reportedly on the rise in some regions. Helicobacter pylori (H. pylori) infection is a major risk factor of non-cardia gastric cancer, and data has emerged concerning the role of H. pylori eradication for primary prevention of gastric cancer. Dietary, lifestyle and metabolic factors have also been implicated. Although addressing these other factors may contribute to health, the actual impact in terms of cancer prevention is unclear. Once irreversible histological changes have occurred, endoscopic surveillance would be necessary. A molecular classification system offers hope for molecularly tailored, personalised therapies for gastric cancer, which may improve the prognosis for patients.

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The striking geographical pattern of gastric cancer mortality in Spain: environmental hypotheses revisited

Cited by 41 publications

References 51 publications

Spatial epidemiology of cancer: a review of data sources, methods and risk factors

Spatial epidemiology of cancer: a review of data sources, methods and risk factors

Geological factors controlling occurrence and distribution of arsenic in groundwaters from the southern margin of the Duero Basin, Spain

Clinical epidemiology of gastric cancer

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