B101
Relationship of lung cancer mortality and socio-economic deprivation in the northern moravian region
Ivan Tomasek, Hana Tomaskova, Hana Slachtova, Pavla Polaufova, Anna Splichalova
Institute of Public Health Ostrava, Ostrava, Czech Republic
Background
Lung cancer (ICD-C34) mortality risk was confirmed to be correlated with area socioeconomic deprivation in earlier study. As standardized mortality index (SMR) in geographical areas with a small number of inhabitants isnt stable, Bayesian spatial modelling was used to produce maps of smoothed posterior risks and ecological regression was used to assess covariate effect of each socioeconomic deprivation and social deprivation.
Method
The study region consisted of 22 small geographical units (ORP) located in Northern Moravian region of the Czech Republic with total population 1.2 mil. Three datasets were available for analysis: lung cancer mortality data for the year 2003, census based socioeconomic deprivation index () and social sub-index (SOCSI). Expected counts were calculated based on standardization using distribution data in each ORP and the national mortality rates as the reference. Two models were applied for the datasets: Besag, York and Molli (BYM) model and ecological regression model and WinBugs used for running models.
Results
Maps of SMR values, smoothed relative risk (relative to the reference region of Czech republic), smoothed adjusted relative risk (relative to the study region of Northern Moravia) and estimated relative risks (relative to the reference region) adjusted for covariate SESDI and SOCSI, were provided. SMR values in ORPs varied in range 0.40 and 2.25. Relative risk varied between 0.82 and 1.25 for all models. Regression model performed association between SESDI and the lung cancer mortality risk in 21 ORPs. The map of adjusted risks shows that some SMR variability was explained by accounting of SESDI but there is still the presence of additional spatially-varying unmeasured risk factors
Conclusion
Study confirmed the impact of social economic deprivation on lung cancer mortality. Higher impact was detected for social deprivation comparing to socioeconomic deprivation.
Acknowledgements
This study was supported by EUREKA (E!3751 ISTAHIS)
