Variation of Cancer Incidence between and within GRELL Countries

Paolo Contiero, Giovanna Tagliabue, Gemma Gatta, Jaume Galceran, Jean-Luc Bulliard, Martina Bertoldi, Alessandra Scaburri, Emanuele Crocetti and on behalf of the GRELL Geographic Analysis Working Group
Additional contact information
Paolo Contiero: Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
Giovanna Tagliabue: Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
Gemma Gatta: Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
Jaume Galceran: Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Sant Joan de Reus University Hospital, IISPV, 43204 Reus, Spain
Jean-Luc Bulliard: Vaud Tumour Registry, Centre for Primary Care and Public Health, University of Lausanne, 1010 Lausanne, Switzerland
Martina Bertoldi: Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
Alessandra Scaburri: Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
Emanuele Crocetti: Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo Per Lo Studio dei Tumori (IRST) “Dino Amadori”), 47014 Meldola, Italy
on behalf of the GRELL Geographic Analysis Working Group: Participants are listed in Acknowledgments.

IJERPH, 2021, vol. 18, issue 17, 1-10

Abstract: Variation in cancer incidence between countries and groups of countries has been well studied. However cancer incidence is linked to risk factors that may vary within countries, and may subsist in localized geographic areas. In this study we investigated between- and within-country variation in the incidence of all cancers combined for countries belonging to the Group for Cancer Epidemiology and Registration in Latin Language Countries (GRELL). We hypothesized that investigation at the micro-level (circumscribed regions and local cancer registry areas) would reveal incidence variations not evident at the macro level and allow identification of cancer incidence hotspots for research, public health, and to fight social inequalities. Data for all cancers diagnosed in 2008–2012 were extracted from Cancer Incidence in Five Continents, Vol XI. Incidence variation within a country or region was quantified as r/R, defined as the difference between the highest and lowest incidence rates for cancer registries within a country/region (r), divided by the incidence rate for the entire country/region × 100. We found that the area with the highest male incidence had an ASRw 4.3 times higher than the area with the lowest incidence. The area with the highest female incidence had an ASRw 3.3 times higher than the area with the lowest incidence. Areas with the highest male ASRws were Azores (Portugal), Florianopolis (Brazil), Metropolitan France, north Spain, Belgium, and north-west and north-east Italy. Areas with the highest female ASRws were Florianopolis (Brazil), Belgium, north-west Italy, north-east Italy, central Italy, Switzerland and Metropolitan France. Our analysis has shown that cancer incidence varies markedly across GRELL countries but also within several countries: the presence of several areas with high cancer incidence suggests the presence of area-specific risk factors that deserve further investigation.

Keywords: cancer incidence; geographic analysis; cancer registry; regional analysis; environmental justice; social inequalities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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