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dc.contributor.authorAragones, Nuria 
dc.contributor.authorPerez-Gomez, Beatriz 
dc.contributor.authorPollan-Santamaria, Marina 
dc.contributor.authorRamis, Rebeca 
dc.contributor.authorVidal, Enric 
dc.contributor.authorLope Carvajal, Virginia 
dc.contributor.authorGarcía-Pérez, Javier 
dc.contributor.authorBoldo, Elena 
dc.contributor.authorLopez-Abente, Gonzalo
dc.identifier.citationBMC Cancer. 2009 Sep 8;9:316.es_ES
dc.description.abstractBACKGROUND: Gastric cancer is decreasing in most countries. While socioeconomic development is the main factor to which this decline has been attributed, enormous differences among countries and within regions are still observed, with the main contributing factors remaining elusive. This study describes the geographic distribution of gastric cancer mortality at a municipal level in Spain, from 1994-2003. METHODS: Smoothed relative risks of stomach cancer mortality were obtained, using the Besag-York-Molliè autoregressive spatial model. Maps depicting relative risk (RR) estimates and posterior probabilities of RR being greater than 1 were plotted. RESULTS: From 1994-2003, 62184 gastric cancer deaths were registered in Spain (7 percent of all deaths due to malignant tumors). The geographic pattern was similar for both sexes. RRs displayed a south-north and coast-inland gradient, with lower risks being observed in Andalusia, the Mediterranean coastline, the Balearic and Canary Islands and the Cantabrian seaboard. The highest risk was concentrated along the west coast of Galicia, broad areas of the Castile & Leon Autonomous community, the province of Cáceres in Extremadura, Lleida and other areas of Catalonia. CONCLUSION: In Spain, risk of gastric cancer mortality displays a striking geographic distribution. With some differences, this persistent and unique pattern is similar across the sexes, suggesting the implication of environmental exposures from sources, such as diet or ground water, which could affect both sexes and delimited geographic areas. Also, the higher sex-ratios found in some areas with high risk of smoking-related cancer mortality in males support the role of tobacco in gastric cancer etiology.es_ES
dc.description.sponsorshipThis study was funded by Grant No. EPY-1176/02 from the Carlos III Institute of Health (Instituto de Salud Carlos III).es_ES
dc.publisherBioMed Central (BMC) es_ES
dc.subject.meshAnimals es_ES
dc.subject.meshFemale es_ES
dc.subject.meshHumans es_ES
dc.subject.meshMale es_ES
dc.subject.meshRisk Factors es_ES
dc.subject.meshSpain es_ES
dc.subject.meshStomach Neoplasms es_ES
dc.subject.meshEnvironmental Exposure es_ES
dc.titleThe striking geographical pattern of gastric cancer mortality in Spain: environmental hypotheses revisitedes_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderInstituto de Salud Carlos III 
dc.identifier.journalBMC canceres_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemiologíaes_ES
dc.rights.accessRightsopen accesses_ES

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