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Estudios originales
Medwave 2020;20(1):e7766 doi: 10.5867/medwave.2020.01.7766
Autocorrelación espacial de mortalidad por cáncer de mama en la Región Metropolitana, Chile: estudio ecológico
Spatial autocorrelation of breast cancer mortality in the Metropolitan Region, Chile: an ecological study
Doris Durán, María José Monsalves
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Palabras clave: breast neoplasms, breast cancer, mortality statistics, spatial analysis

Abstract

Introduction
Breast cancer is the most common malignancy in women worldwide and Chile, being the leading cause of female cancer death. A wide variation in mortality has been reported, with geographic clusters of higher risk.

Objective
To spatially analyze mortality from breast cancer in women in the Metropolitan Region in 2015.

Methods
Ecological study of location. We used death records in 2015 (C50 according to ICD10) and population projections of the Statistics Institute to estimate mortality rates. We calculated crude breast cancer mortality rates and standardized mortality ratios and performed a spatial epidemiological analysis of breast cancer mortality in women, estimating the global and local Moran I index to assess spatial autocorrelation. We present the results in maps according to the 2016 pre-census cartography.

Results
There were 622 deaths from breast cancer in the Metropolitan Region in 2015. The mean age was 66 years (SD: 15.5). 92.4% of deaths were registered in urban or central areas. However, the highest mortality rates were observed in peripherical districts. No global spatial autocorrelation was observed in the region (Moran’s I 0.007 p = 0.134). However, at the local level, four districts differ significantly from their neighbors.

Conclusions
The risk of dying from breast cancer in the Metropolitan Region of Chile is concentrated in women from peripherical communes. Four districts in the region present different risks from their neighboring districts. It is necessary to investigate local realities to prevent deaths from this pathology.


 

Only Spanish version is available.

Licencia Creative Commons Esta obra de Medwave está bajo una licencia Creative Commons Atribución-NoComercial 3.0 Unported. Esta licencia permite el uso, distribución y reproducción del artículo en cualquier medio, siempre y cuando se otorgue el crédito correspondiente al autor del artículo y al medio en que se publica, en este caso, Medwave.

 

Introduction
Breast cancer is the most common malignancy in women worldwide and Chile, being the leading cause of female cancer death. A wide variation in mortality has been reported, with geographic clusters of higher risk.

Objective
To spatially analyze mortality from breast cancer in women in the Metropolitan Region in 2015.

Methods
Ecological study of location. We used death records in 2015 (C50 according to ICD10) and population projections of the Statistics Institute to estimate mortality rates. We calculated crude breast cancer mortality rates and standardized mortality ratios and performed a spatial epidemiological analysis of breast cancer mortality in women, estimating the global and local Moran I index to assess spatial autocorrelation. We present the results in maps according to the 2016 pre-census cartography.

Results
There were 622 deaths from breast cancer in the Metropolitan Region in 2015. The mean age was 66 years (SD: 15.5). 92.4% of deaths were registered in urban or central areas. However, the highest mortality rates were observed in peripherical districts. No global spatial autocorrelation was observed in the region (Moran’s I 0.007 p = 0.134). However, at the local level, four districts differ significantly from their neighbors.

Conclusions
The risk of dying from breast cancer in the Metropolitan Region of Chile is concentrated in women from peripherical communes. Four districts in the region present different risks from their neighboring districts. It is necessary to investigate local realities to prevent deaths from this pathology.

Autores: Doris Durán[1,2], María José Monsalves[2]

Filiación:
[1] Programa de Doctorado en Salud Pública, Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
[2] Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile

E-mail: doris.duran@uss.cl

Correspondencia a:
[1] Facultad de Medicina y Ciencia
Universidad San Sebastián
Lota 2465
Santiago 7510157
Chile

Citación: Durán D, Monsalves M. Spatial autocorrelation of breast cancer mortality in the Metropolitan Region, Chile: an ecological study. Medwave 2020;20(1):e7766 doi: 10.5867/medwave.2020.01.7766

Fecha de envío: 28/8/2019

Fecha de aceptación: 26/12/2019

Fecha de publicación: 27/1/2020

Origen: No solicitado

Tipo de revisión: Con revisión por pares externa, por dos árbitros, a doble ciego

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  2. International Agency for Research on Cancer, World Health Organization. GLOBOCAN 2012: Estimates Cancer Incidence, Mortality and Prevalence Worldwide in 2012. [On line]. | Link |
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  11. Organización Panamericana de la Salud. Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud. Décima Revisión. Washington D.C.: 2008. [On line]. | Link |
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  13. Celemín JP. Autocorrelación espacial e indicadores locales de asociación espacial. Importancia, estructura y aplicación. Rev Univ Geogr 2009;18:11–31. [On line]. | Link |
  14. Kondo K. Testing for global spatial autocorrelation in Stata*. 2018;2018:1–9. [On line]. | Link |
  15. Mansori K, Solaymani-Dodaran M, Mosavi-Jarrahi A, Motlagh AG, Salehi M, Delavari A, et al. Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models. J Prev Med Public Health. 2018 Jan;51(1):33-40. | CrossRef | PubMed |
  16. Anselin L. Local Indicators of Spatial Association—LISA. Geogr Anal 1995;27:93–115. | CrossRef |
  17. Gonzaga CM, Freitas-Junior R, Curado MP, Sousa AL, Souza-Neto JA, Souza MR. Temporal trends in female breast cancer mortality in Brazil and correlations with social inequalities: ecological time-series study. BMC Public Health. 2015 Feb 7;15:96. | CrossRef | PubMed |
  18. Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Ann Oncol. 2005 Mar;16(3):481-8. | PubMed |
  19. Instituto Nacional de Estadísticas. Web Diseminación Censo 2017. Result. Censo 2017. 2019. [On line]. | Link |
  20. Fasching PA. Breast cancer in young women: do BRCA1 or BRCA2 mutations matter? Lancet Oncol. 2018 Feb;19(2):150-151. | CrossRef | PubMed |
  21. Herrera Riquelme CA, Kuhn-Barrientos L, Rosso Astorga R, Jiménez de la Jara J. [Trends in mortality from cancer in Chile according to differences in educational level, 2000-2010]. Rev Panam Salud Publica. 2015 Jan;37(1):44-51. | PubMed |
  22. Merino G. Caracterización de los Casos Incidentes de Cáncer de Mama de las Usuarias de los Establecimientos de Salud del Servicio Metropolitano Sur Oriente, durante los años 2006-2015 (datos no publicados). 2017. [On line]. | Link |
  23. Mathers CD, Fat DM, Inoue M, Rao C, Lopez AD. Counting the dead and what they died from: an assessment of the global status of cause of death data. Bull World Health Organ. 2005 Mar;83(3):171-7. | PubMed |
  24. Núñez F ML, Icaza N MG. [Quality of Mortality statistics in Chile, 1997-2003]. Rev Med Chil. 2006 Sep;134(9):1191-6. | PubMed |
International Agency for Research on Cancer. World Cancer Report 2014. Geneva: International Agency for Research on Cancer 2014. [On line]. | Link |

International Agency for Research on Cancer, World Health Organization. GLOBOCAN 2012: Estimates Cancer Incidence, Mortality and Prevalence Worldwide in 2012. [On line]. | Link |

Hall SA, Kaufman JS, Millikan RC, Ricketts TC, Herman D, Savitz DA. Urbanization and breast cancer incidence in North Carolina, 1995-1999. Ann Epidemiol. 2005 Nov;15(10):796-803. | PubMed |

Gonzaga CM, Freitas-Junior R, Souza MR, Curado MP, Freitas NM. Disparities in female breast cancer mortality rates between urban centers and rural areas of Brazil: ecological time-series study. Breast. 2014 Apr;23(2):180-7. | CrossRef | PubMed |

Tumas N, Pou SA, Díaz MDP. [Inequities in health: socio-demographic and spatial analysis of breast cancer in women from Córdoba, Argentina]. Gac Sanit. 2017 Sep - Oct;31(5):396-403. | CrossRef | PubMed |

Vallebuona C, Diaz N, Galaz JC, et al. Estimación de incidencia de cáncer para Chile 2003-2007. Santiago, Chile: 2012. [On line]. | Link |

Departamento de Estadísticas e Información de salud. Serie defunciones y mortalidad observada por tumores malignos edad y sexo. Dep. Estadísticas e Inf. Salud. Minist. Salud. 2017. [On line]. | Link |

Peralta M O. Cancer de mama en Chile: datos epidemiologicos. Rev Chil Obstet Ginecol 2002;67(6):439–45. | CrossRef |

Icaza, G.,Nuñez,L.,Torres-Avilés F. Atlas de mortalidad en Chile, 2001-2008. 2009. [On line]. | Link |

Icaza G, Núñez L, Bugueño H. [Epidemiological analysis of breast cancer mortality in women in Chile]. Rev Med Chil. 2017 Jan;145(1):106-114. | CrossRef | PubMed |

Organización Panamericana de la Salud. Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud. Décima Revisión. Washington D.C.: 2008. [On line]. | Link |

Gobierno Regional Metropolitano de Santiago. Datos Geográficos Chile. 2019. [On line]. | Link |

Celemín JP. Autocorrelación espacial e indicadores locales de asociación espacial. Importancia, estructura y aplicación. Rev Univ Geogr 2009;18:11–31. [On line]. | Link |

Kondo K. Testing for global spatial autocorrelation in Stata*. 2018;2018:1–9. [On line]. | Link |

Mansori K, Solaymani-Dodaran M, Mosavi-Jarrahi A, Motlagh AG, Salehi M, Delavari A, et al. Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models. J Prev Med Public Health. 2018 Jan;51(1):33-40. | CrossRef | PubMed |

Anselin L. Local Indicators of Spatial Association—LISA. Geogr Anal 1995;27:93–115. | CrossRef |

Gonzaga CM, Freitas-Junior R, Curado MP, Sousa AL, Souza-Neto JA, Souza MR. Temporal trends in female breast cancer mortality in Brazil and correlations with social inequalities: ecological time-series study. BMC Public Health. 2015 Feb 7;15:96. | CrossRef | PubMed |

Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Ann Oncol. 2005 Mar;16(3):481-8. | PubMed |

Instituto Nacional de Estadísticas. Web Diseminación Censo 2017. Result. Censo 2017. 2019. [On line]. | Link |

Fasching PA. Breast cancer in young women: do BRCA1 or BRCA2 mutations matter? Lancet Oncol. 2018 Feb;19(2):150-151. | CrossRef | PubMed |

Herrera Riquelme CA, Kuhn-Barrientos L, Rosso Astorga R, Jiménez de la Jara J. [Trends in mortality from cancer in Chile according to differences in educational level, 2000-2010]. Rev Panam Salud Publica. 2015 Jan;37(1):44-51. | PubMed |

Merino G. Caracterización de los Casos Incidentes de Cáncer de Mama de las Usuarias de los Establecimientos de Salud del Servicio Metropolitano Sur Oriente, durante los años 2006-2015 (datos no publicados). 2017. [On line]. | Link |

Mathers CD, Fat DM, Inoue M, Rao C, Lopez AD. Counting the dead and what they died from: an assessment of the global status of cause of death data. Bull World Health Organ. 2005 Mar;83(3):171-7. | PubMed |

Núñez F ML, Icaza N MG. [Quality of Mortality statistics in Chile, 1997-2003]. Rev Med Chil. 2006 Sep;134(9):1191-6. | PubMed |