Discrepancies between the Spatial Distribution of Cancer Incidence and Mortality as an Indicator of Unmet Needs in Cancer Prevention and/or Treatment in Hungary
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Data
2.2. Deprivation Index Calculation
2.3. Disease Mapping
2.4. Ecological Regression
2.5. Risk Analysis
2.6. Proportional Model
2.7. Spatial Scan Statistic
3. Results
3.1. Incidence and Mortality of Malignant Neoplasms
3.2. Spatial Variability in Deprivation
3.3. Association between Deprivation and Cancer Mortality and Incidence for People Aged 25–64 Years
3.4. Results of Disease Mapping
4. Discussion
- (i)
- The location of incidence and mortality clusters shows partial or almost complete overlap (e.g., all cancers for both sexes, colorectal cancer for males, lung cancer for both sexes in the country as a whole), but the odds of mortality vary widely compared to the national average mortality.
- (ii)
- Mortality clusters are found in areas of relatively low incidence (in the south-west of the country for all cancers in both sexes and colorectal cancer in men).
- (iii)
- Clusters of high incidence with mortality below the national average (cervical cancer in the western part of the country).
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Global Cancer Observatory: Cancer Today. Available online: https://gco.iarc.fr/today (accessed on 15 March 2024).
- De Angelis, R.; Demuru, E.; Baili, P.; Troussard, X.; Katalinic, A.; Lopez, M.D.C.; Innos, K.; Santaquilani, M.; Blum, M.; Ventura, L.; et al. Complete cancer prevalence in Europe in 2020 by disease duration and country (EUROCARE-6): A population-based study. Lancet Oncol. 2024, 25, 293–307. [Google Scholar] [CrossRef] [PubMed]
- Rosskamp, M.; Verbeeck, J.; Sass, V.; Gadeyne, S.; Verdoodt, F.; De Schutter, H. Social Inequalities in Cancer Survival in Belgium: A Population-Based Cohort Study. Cancer Epidemiol. Biomark. Prev. 2021, 30, 45–52. [Google Scholar] [CrossRef] [PubMed]
- Aarts, M.J.; Kamphuis, C.B.; Louwman, M.J.; Coebergh, J.W.; Mackenbach, J.P.; van Lenthe, F.J. Educational inequalities in cancer survival: A role for comorbidities and health behaviours? J. Epidemiol. Community Health 2013, 67, 365–373. [Google Scholar] [CrossRef]
- Vaccarella, S.; Georges, D.; Bray, F.; Ginsburg, O.; Charvat, H.; Martikainen, P.; Bronnum-Hansen, H.; Deboosere, P.; Bopp, M.; Leinsalu, M.; et al. Socioeconomic inequalities in cancer mortality between and within countries in Europe: A population-based study. Lancet Reg. Health 2023, 25, 100551. [Google Scholar] [CrossRef] [PubMed]
- Woods, L.M.; Belot, A.; Atherton, I.M.; Ellis-Brookes, L.; Baker, M.; Ingleby, F.C. Are deprivation-specific cancer survival patterns similar according to individual-based and area-based measures? A cohort study of patients diagnosed with five malignancies in England and Wales, 2008–2016. BMJ Open 2022, 12, e058411. [Google Scholar] [CrossRef] [PubMed]
- Ellis, L.; Belot, A.; Rachet, B.; Coleman, M.P. The Mortality-to-Incidence Ratio Is Not a Valid Proxy for Cancer Survival. J. Glob. Oncol. 2019, 5, 1–9. [Google Scholar] [CrossRef]
- Kenessey, I.; Szőke, G.; Dobozi, M.; Szatmári, I.; Wéber, A.; Fogarassy, G.; Nagy, P.; Kásler, M.; Polgár, C.; Vathy-Fogarassy, Á. Comparison of Cancer Survival Trends in Hungary in the Periods 2001–2005 and 2011–2015 According to a Population-Based Cancer Registry. Pathol. Oncol. Res. 2022, 28, 1610668. [Google Scholar] [CrossRef]
- OECD. EU Country Cancer Profile: Hungary 2023; OECD: Paris, France, 2023. [Google Scholar]
- Kerpel-Fronius, A.; Megyesfalvi, Z.; Markoczy, Z.; Solymosi, D.; Csanyi, P.; Tisza, J.; Kecskes, A.; Baranyi, B.; Csanky, E.; Doka, A.; et al. HUNCHEST-II contributes to a shift to earlier-stage lung cancer detection: Final results of a nationwide screening program. Eur. Radiol. 2024, 34, 3462–3470. [Google Scholar] [CrossRef]
- OECD. Health at a Glance 2023; OECD: Paris, France, 2023. [Google Scholar]
- Public Health England. Cancer Survival in England for Patients Diagnosed between 2014 and 2018, and Followed up to 2019. Available online: https://www.gov.uk/government/statistics/cancer-survival-in-england-for-patients-diagnosed-between-2014-and-2018-and-followed-up-until-2019/cancer-survival-in-england-for-patients-diagnosed-between-2014-and-2018-and-followed-up-to-2019 (accessed on 24 May 2024).
- Zhang, S.Z.; Xie, L.; Shang, Z.J. Burden of Oral Cancer on the 10 Most Populous Countries from 1990 to 2019: Estimates from the Global Burden of Disease Study 2019. Int. J. Environ. Res. Public Health 2022, 19, 875. [Google Scholar] [CrossRef]
- Juhász, A.; Nagy, C.; Páldy, A.; Beale, L. Development of a Deprivation Index and its relation to premature mortality due to diseases of the circulatory system in Hungary, 1998–2004. Soc. Sci. Med. 2010, 70, 1342–1349. [Google Scholar] [CrossRef]
- Nagy, C.; Juhász, A.; Papp, Z.; Beale, L. Hierarchical spatio-temporal mapping of premature mortality due to alcoholic liver disease in Hungary, 2005–2010. Eur. J. Public Health 2014, 24, 827–833. [Google Scholar] [CrossRef] [PubMed]
- Papp, M.; Korösi, L.; Sándor, J.; Nagy, C.; Juhász, A.; Adány, R. Workforce crisis in primary healthcare worldwide: Hungarian example in a longitudinal follow-up study. BMJ Open 2019, 9, e024957. [Google Scholar] [CrossRef] [PubMed]
- Besag, J.; York, J.; Mollié, A. Bayesian image restoration, with two applications in spatial statistics. Ann. Inst. Stat. Math. 1991, 43, 1–20. [Google Scholar] [CrossRef]
- Beale, L.; Hodgson, S.; Abellan, J.J.; LeFevre, S.; Jarup, L. Evaluation of Spatial Relationships between Health and the Environment: The Rapid Inquiry Facility. Environ. Health Perspect. 2010, 118, 1306–1312. [Google Scholar] [CrossRef]
- Rue, H.; Martino, S.; Chopin, N. Approximate Bayesian inference for latent Gaussian models by using integrated nested Laplace approximations. J. R. Stat. Soc. Ser. B 2009, 71, 319–392. [Google Scholar] [CrossRef]
- Wakefield, J. Disease mapping and spatial regression with count data. Biostatistics 2007, 8, 158–183. [Google Scholar] [CrossRef]
- Dabney, A.R.; Wakefield, J.C. Issues in the mapping of two diseases. Stat. Methods Med. Res. 2005, 14, 83–112. [Google Scholar] [CrossRef]
- Kulldorff, M.; Nagarwalla, N. Spatial Disease Clusters—Detection and Inference. Stat. Med. 1995, 14, 799–810. [Google Scholar] [CrossRef]
- Kulldorff, M. Information Management Services Inc. SaTScan (TM) v7. 0: Software for the Spatial and Space-Time Scan Statistics; Information Management Services, Inc.: Calverton, MD, USA, 2006. [Google Scholar]
- Oroszi, B.; Juhász, A.; Nagy, C.; Horvath, J.K.; McKee, M.; Adány, R. Unequal burden of COVID-19 in Hungary: A geographical and socioeconomic analysis of the second wave of the pandemic. BMJ Glob. Health 2021, 6, e006427. [Google Scholar] [CrossRef]
- Oroszi, B.; Juhász, A.; Nagy, C.; Horváth, J.K.; Komlós, K.E.; Túri, G.; McKee, M.; Adány, R. Characteristics of the Third COVID-19 Pandemic Wave with Special Focus on Socioeconomic Inequalities in Morbidity, Mortality and the Uptake of COVID-19 Vaccination in Hungary. J. Pers. Med. 2022, 12, 388. [Google Scholar] [CrossRef]
- Mihor, A.; Tomsic, S.; Zagar, T.; Lokar, K.; Zadnik, V. Socioeconomic inequalities in cancer incidence in Europe: A comprehensive review of population-based epidemiological studies. Radiol. Oncol. 2020, 54, 1–13. [Google Scholar] [CrossRef] [PubMed]
- Lortet-Tieulent, J.; Georges, D.; Bray, F.; Vaccarella, S. Profiling global cancer incidence and mortality by socioeconomic development. Int. J. Cancer 2020, 147, 3029–3036. [Google Scholar] [CrossRef] [PubMed]
- Tetzlaff, F.; Nowossadeck, E.; Jansen, L.; Michalski, N.; Barnes, B.; Kraywinkel, K.; Hoebel, J. Widening area-based socioeconomic inequalities in cancer mortality in Germany between 2003 and 2019. Sci. Rep. 2023, 13, 17833. [Google Scholar] [CrossRef]
- Palència, L.; Ferrando, J.; Marí-Dell’Olmo, M.; Gotsens, M.; Morrison, J.; Dzurova, D.; Lustigova, M.; Costa, C.; Rodríguez-Sanz, M.; Bosakova, L.; et al. Socio-economic inequalities on cancer mortality in nine European areas: The effect of the last economic recession. Cancer Epidemiol. 2020, 69, 101827. [Google Scholar] [CrossRef]
- Afshar, N.; English, D.R.; Milne, R.L. Factors Explaining Socio-Economic Inequalities in Cancer Survival: A Systematic Review. Cancer Control. 2021, 28, 10732748211011956. [Google Scholar] [CrossRef]
- Arik, A.; Dodd, E.; Streftaris, G. Cancer morbidity trends and regional differences in England-A Bayesian analysis. PLoS ONE 2020, 15, e0232844. [Google Scholar] [CrossRef]
- Abadeh, A.; Ali, A.A.; Bradley, G.; Magalhaes, M.A. Increase in detection of oral cancer and precursor lesions by dentists: Evidence from an oral and maxillofacial pathology service. J. Am. Dent. Assoc. 2019, 150, 531–539. [Google Scholar] [CrossRef]
- Bakouny, Z.; Paciotti, M.; Schmidt, A.L.; Lipsitz, S.R.; Choueiri, T.K.; Trinh, Q.D. Cancer Screening Tests and Cancer Diagnoses during the COVID-19 Pandemic. JAMA Oncol. 2021, 7, 458–460. [Google Scholar] [CrossRef]
Male | Female | |
---|---|---|
RR [95% CI] | ||
Malignant neoplasms | 1.02 [1.02–1.03] | 1.02 [1.01–1.03] |
Malignant neoplasms of lip, oral cavity, and pharynx | 1.10 [1.08–1.13] | 1.08 [1.04–1.12] |
Malignant neoplasm of colon, rectum, and anus | 1.00 [0.99–1.02] | 1.01 [0.99–1.03] |
Malignant neoplasm of pancreas | 1.01 [0.98–1.04] | 1.05 [1.01–1.08] |
Malignant neoplasm of trachea, bronchus, and lung | 1.14 [1.12–1.16] | 1.20 [1.17–1.22] |
Malignant neoplasm of breast | .. | 0.98 [0.96–0.99] |
Malignant neoplasm of cervix uteri | .. | 1.05 [1.02–1.08] |
Male | Female | |
---|---|---|
RR [95% CI] | ||
Malignant neoplasms | 1.11 [1.10–1.13] | 1.13 [1.11–1.14] |
Malignant neoplasms of lip, oral cavity, and pharynx | 1.14 [1.10–1.17] | 1.08 [1.02–1.15] |
Malignant neoplasm of colon, rectum, and anus | 1.05 [1.03–1.08] | 1.04 [1.01–1.07] |
Malignant neoplasm of pancreas | 1.05 [1.02–1.08] | 1.04 [1.01–1.08] |
Malignant neoplasm of trachea, bronchus, and lung | 1.18 [1.16–1.20] | 1.27 [1.24–1.30] |
Malignant neoplasm of breast | .. | 1.04 [1.01–1.07] |
Malignant neoplasm of cervix uteri | .. | 1.16 [1.11–1.21] |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Ádány, R.; Juhász, A.; Nagy, C.; Burkali, B.; Pikó, P.; McKee, M.; Oroszi, B. Discrepancies between the Spatial Distribution of Cancer Incidence and Mortality as an Indicator of Unmet Needs in Cancer Prevention and/or Treatment in Hungary. Cancers 2024, 16, 2917. https://doi.org/10.3390/cancers16162917
Ádány R, Juhász A, Nagy C, Burkali B, Pikó P, McKee M, Oroszi B. Discrepancies between the Spatial Distribution of Cancer Incidence and Mortality as an Indicator of Unmet Needs in Cancer Prevention and/or Treatment in Hungary. Cancers. 2024; 16(16):2917. https://doi.org/10.3390/cancers16162917
Chicago/Turabian StyleÁdány, Róza, Attila Juhász, Csilla Nagy, Bernadett Burkali, Péter Pikó, Martin McKee, and Beatrix Oroszi. 2024. "Discrepancies between the Spatial Distribution of Cancer Incidence and Mortality as an Indicator of Unmet Needs in Cancer Prevention and/or Treatment in Hungary" Cancers 16, no. 16: 2917. https://doi.org/10.3390/cancers16162917
APA StyleÁdány, R., Juhász, A., Nagy, C., Burkali, B., Pikó, P., McKee, M., & Oroszi, B. (2024). Discrepancies between the Spatial Distribution of Cancer Incidence and Mortality as an Indicator of Unmet Needs in Cancer Prevention and/or Treatment in Hungary. Cancers, 16(16), 2917. https://doi.org/10.3390/cancers16162917