ABSTRACT
INTRODUCTION: In the last few decades mortality from cancer among children and adolescents has not decreased homogeneously in industrialized countries. The aim of this study was to determine the epidemiological pattern and temporal trend of mortality from cancer in individuals aged less than 20 years old living in the Autonomous Community of Madrid from 1977 to 2001. MATERIAL AND METHODS: Data on deaths from cancer among children and adolescents were obtained from Spain's National Institute of Statistics and from the Mortality Registry of Madrid. Populations were obtained from official publications of the Institute of Statistics of Madrid. Variables analyzed were sex, 5-year age groups, 5-year death periods and underlying cause of death. The epidemiological pattern was studied and a Poisson's regression model was used to analyze cancer mortality trends in children and adolescents from 1977 to 2001. RESULTS: Cancer mortality among children and adolescents decreased by 41 % from 1977 to 2001. The decrease in mortality differed according to sex (46 % in boys and 33 % in girls) and type of cancer (leukemias: 38 %, non-Hodgkin's lymphomas: 58 %, malignant brain tumors: 45 %, malignant bone tumors: 19 %, ill-defined malignant tumors: 78 %). Moreover, the annual decrease was much greater in the last 5 years (4. 7 %) than during the entire period (2. 2 %). CONCLUSIONS: Cancer mortality among children and adolescents decreased between 1977 and 2001 and our results are similar to those observed in other European and North American regions. To improve knowledge of the epidemiology of cancer among children and adolescents in the Autonomous Community of Madrid, future assessments including mortality, incidence, and survival indicators are required.
Subject(s)
Neoplasms/mortality , Adolescent , Catchment Area, Health , Child , Female , Humans , Incidence , Male , Neoplasms/classification , Prevalence , Spain/epidemiologyABSTRACT
Introducción: La mortalidad por cáncer en niños y adolescentes ha disminuido de modo desigual en los diferentes países desarrollados en las últimas décadas. El objetivo del estudio es conocer el patrón y la tendencia de la mortalidad por cáncer en menores de 20 años residentes en la Comunidad de Madrid entre 1977 y 2001. Material y métodos: Las defunciones fueron cedidas por el Instituto Nacional de Estadística y por el Registro de Mortalidad de la Comunidad de Madrid y las poblaciones se tomaron a partir de publicaciones oficiales del Instituto de Estadística de la Comunidad de Madrid. Las variables estudiadas fueron: sexo, grupo quinquenal de edad, período quinquenal de defunción y causa básica de defunción. Se describe el patrón epidemiológico y se analiza la evolución temporal de la mortalidad por cáncer infantil entre 1977 y 2001 mediante el ajuste de un modelo de Poisson log-lineal. Resultados: La mortalidad por cáncer infantil ha disminuido un 41 % a lo largo del período de estudio. El descenso ha sido desigual para los distintos sexos (varones: 46%; mujeres: 33%) y tipos tumorales (leucemias: 38 %; linfomas no hodgkinianos: 58 %; tumores malignos encefálicos: 45 %; tumores malignos osteoarticulares: 19 %; tumores malignos mal definidos: 78 %). El porcentaje de disminución anual de la mortalidad ha sido mucho mayor para el último quinquenio (4,7 %) que para el período completo (2,2 %). Conclusiones: La mortalidad infantil por cáncer ha descendido entre 1977 y 2001, acercando la situación de nuestra región a la de otras regiones europeas y norteamericanas. Serán necesarias futuras evaluaciones que integren indicadores de mortalidad, incidencia y supervivencia para un mejor conocimiento de la epidemiología del cáncer infantil en la Comunidad de Madrid
Introduction: In the last few decades mortality from cancer among children and adolescents has not decreased homogeneously in industrialized countries. The aim of this study was to determine the epidemiological pattern and temporal trend of mortality from cancer in individuals aged less than 20 years old living in the Autonomous Community of Madrid from 1977 to 2001. Material and methods: Data on deaths from cancer among children and adolescents were obtained from Spains National Institute of Statistics and from the Mortality Registry of Madrid. Populations were obtained from official publications of the Institute of Statistics of Madrid. Variables analyzed were sex, 5-year age groups, 5-year death periods and underlying cause of death. The epidemiological pattern was studied and a Poissons regression model was used to analyze cancer mortality trends in children and adolescents from 1977 to 2001. Results: Cancer mortality among children and adolescents decreased by 41% from 1977 to 2001. The decrease in mortality differed according to sex (46 % in boys and 33 % in girls) and type of cancer (leukemias: 38 %, non-Hodgkins lymphomas: 58 %, malignant brain tumors: 45 %, malignant bone tumors: 19 %, ill-defined malignant tumors: 78 %). Moreover, the annual decrease was much greater in the last 5 years (4. 7 %) than during the entire period (2. 2 %). Conclusions: Cancer mortality among children and adolescents decreased between 1977 and 2001 and our results are similar to those observed in other European and North American regions. To improve knowledge of the epidemiology of cancer among children and adolescents in the Autonomous Community of Madrid, future assessments including mortality, incidence, and survival indicators are required
Subject(s)
Child , Adolescent , Humans , Neoplasms/mortality , Incidence , Prevalence , Catchment Area, Health , Neoplasms/classificationABSTRACT
BACKGROUND: Despite the changes which have taken place in the sources of emissions, the levels of particles, SO2 and CO continue to be high in the municipality of Madrid. Apart from this, photochemical pollutants, such as NO2 and O3 are taking on growing importance due to the increased number of cars and trucks on the road and the major degrees of sunlight in this city. The objective of this article is to set out the short-term relationship between the major pollutants and the daily death rate in the city of Madrid for the 1992-1995 period, using the standardized procedure of the EMECAM Projects (Spanish Multicenter Study of Air Pollution and Death Rate). METHODS: The daily fluctuations in the death rate for all causes except external ones for all ages and for those individuals over age 69, in addition to those of the circulatory system and respiratory apparatus are related to the daily fluctuations in particles (PM10), SO2, NO2, CO and O3, by means of autoregressive Poisson regression models. The seasonality, tendency, temperature, relative humidity, flu, day of the week, holidays and events out of the ordinary are controlled. RESULTS: Statistically significant positive relationships were found to exist between SO2 and all of the death rate series analyzed, between CO and the death rate of individuals over age 69, as well as with cardiovascular and respiratory deaths and of the particles to the death rate as the result of cardiovascular disease. A statistically significant relationship was also found to exist between NO2 and the cardiovascular death rate. These impact are immediate, that is to say, they occur with the pollutants of the same day. No significant positive relationships were found to exist for O3. CONCLUSIONS: These findings suggest that, for a broad spectrum of major pollutants, the current levels of air pollution in Madrid are related to a rise in the death rate.
