[Evolution of mortality due to lung cancer in Andalusia between 1975 and 1977]. / Evolución de la mortalidad por cáncer de pulmón en Andalucía desde 1975 a 1997.

OBJECTIVE: To describe mortality due to lung cancer in those over 24 by sex, age, birth cohort and year of death in Andalusia between 1975 and 1997. DESIGN: A descriptive population-based study. SETTING: Andalusia between 1975 and 1997. PARTICIPANTS: All those residing in Andalusia during the study period. MEASUREMENTS AND MAIN RESULTS: The following indicators were calculated: gross rates, rates adjusted by age of death and rates of potential years of life lost. The European population was used as reference, with specific rates for age-groups and year of birth. Poisson models were used to quantify trends and annual percentages of change both for the entire period and for the 23 years studied. Death from lung cancer in men during these years increased markedly. Age-adjusted rates went up from 77.37 deaths per 100,000 persons per year in 1975 to 121.92 in 1997. However, in women, there was a small drop from 10.19 to 8.22 deaths per 100,000 persons per year over the same period. Men suffered 7.59 times more mortality than women in 1975, reaching 17.25 times more in 1994. Age had a clear relationship to lung cancer mortality: the older the population, the greater the death-rate. In men there was an ascendant cohort effect until the generation born between 1950 and 1959, from which time the effect is unclear. Women had a descending cohort effect, with high variability between one generation and another. CONCLUSIONS: Death from lung cancer in Andalusia between 1975 and 1997 increased in men in transversal terms, whereas in women it went down. However, the analyses of birth cohorts show signs of changes in the most recent generations, although age, in both men and women, is the variable most closely related to mortality.

[Trend in mortality due to diabetes mellitus. Andalusia, 1975-1994]. / Tendencia de la mortalidad por diabetes mellitus. Andalucía, 1975-1994.

BACKGROUND: Relevant differences regarding the temporal evolution of mortality attributed to diabetes mellitus in developed countries have been observed. This work focuses on mortality due to diabetes mellitus in Andalusia during the 1975-1994 period and causes that can explain this evolution are analyzed. METHODS: Deaths caused by diabetes mellitus occurred during the period 1975-1994 were obtained. For each gender the following parameters were calculated: crude mortality rates, age-adjusted rates by means of the direct method using the European population as standard, adjusted rates by age of the potential years of life lost and specific rates by 5-year period groups, for the twenty years studied. Standardized rates were adjusted to a regression straight line regarding the death year and theoretical rates were calculated. With these calculations the percentages in changes of mortality rates were estimated and a projection has been calculated until the year 2000. RESULTS: From 1975 to 1994 the crude mortality rates due to diabetes mellitus had increased slightly both in men and women. The adjusted rates by age have decreased by 19.35% in men and 28.38% in women. The remaining elaborated indicators have decreased more markedly; to note PYLL, with a decrease from 115.2 to 51.25 in men and from 132.98 to 31.94 in women for 100,000 persons/year. CONCLUSIONS: The mortality rates due to diabetes mellitus in Andalusia have decreased both in men and in women, mainly because of the marked decrease in premature mortality, which may indicate an improvement in health care to the diabetic patient.

[Mortality among young people and its impact on life expectancy in Andalusia during 1980-1992]. / La mortalidad en jóvenes y su impacto sobre la evolución de la esperanza de vida en Andalucía durante el período 1980-1992.

BACKGROUND: From the middle eighties, mortality in the age group 15 to 39 years in Andalusia has experienced an important increase; the object of this work is to analyse mortality in this age group, in order to discover the causes which have brought about this increase in mortality and to assess its impact on life expectancy in the eighties. METHODS: Using the mortality data and the population of Andalusia from 1980 to 1992, specific rates have been calculated, both for mortality by age and cause as well as those adjusted for age. To quantify the impact of the causes of death with respect to life expectancy development, the Pollard method was used. RESULTS: There was a relative increase in the mortality of Andalusian young people between the three-yearly periods 1980-1982 and 1990-1992. The causes contributing to this increase, amongst the male population, were: Aids with an excess of 825 deaths, 575 in traffic accidents, 155 suicides and 147 deaths from drug overdoses. These same causes of death led to total losses of 0.46% years in the gain of life expectancy. Amongst women, on the other hand, the causes of death maintained relatively stable rates, with an almost imperceptible effect on life expectancy at birth. CONCLUSIONS: The increase in mortality in the 15-40 age group for causes mentioned previously, is an almost exclusive phenomenon amongst young Andalusian men. This produced a slow-down in any gain in life expectancy during the eighties.

[The trends and geographical distribution of breast cancer mortality in Andalusia (1976-1995)]. / Tendencia y distribución geográfica de la mortalidad por cáncer de mama en Andalucía (1976-1995).

OBJECTIVE: To describe trends and geographical distribution of breast cancer mortality in Andalusian women between 1976 and 1995. DESIGN: Descriptive study. SETTING: Andalusia. PATIENTS AND OTHER PARTICIPANTS: Deaths from breast cancer during the period 1976 to 1995 were obtained. MEASUREMENTS AND MAIN RESULTS: The following were calculated: crude mortality rates; age-adjusted rates by the direct method, using the European population as standard; rates broken down for 15-44, 45-64 and over 65 age-groups; accumulated rates for 0 to 74 years; age-adjusted rates of potential years of life lost (PYLL); specific rates for five-year age groups for each of the five-year periods studied. Between 1976 and 1995 breast cancer mortality in Andalusian women almost doubled in absolute terms. Age-adjusted rates went up by 40.31%; the rates broken down increased, especially those for over-65s, while the 15 to 44 and 45 to 64 groups also went up, as did the PYLL rates. CONCLUSIONS: Breast cancer in Andalusia is a growing health problem, concentrated in very concrete geographical areas. It needs a determined health intervention in order to detect it early and avoid the deaths it is causing.

[Epidemiological analysis of the role of fertility in the decrease of maternal mortality in the Spanish autonomic communities in the XX century]. / Análisis epidemiológico del papel de la fecundidad en el descenso de la mortalidad materna en las comunidades autónomas Españolas a lo largo del siglo XX.

The study which has been carried out has meant to show from an epidemiological perspective the relationships which exist between fecundity and maternal mortality, and has underscored the need to take into account the changes which have taken place in the reproductive conduct of women when one studies the decrease in direct maternal mortality. For the analysis of the tendencies and periods selected, we have used the regressive linear rate and the rate of determination. It is worth pointing out the appearance of decreasing rates of maternal mortality in the pre-chemotherapeutic period which are equal to or higher than those found in the chemotherapeutic period in selected Autonomous Communities. We must also point out that the negative tendency which was shown by maternal mortality in Cataluña and the Basque region since 1919 shows an inversion between the mid-50s and the mid-60s, which were years of a great increase in fecundity in the mentioned areas.