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- Colorectal cancer incidence: a spatio-temporal analysis in Southern Portugal 1998-2006Publication . São João, Ricardo; Papoila, Ana Luisa; Amaral Turkman, Antónia; Ribeiro, Conceição; Geraldes, Carlos; Miranda, AnaInvestigate the influence of geographical environment in colorectal cancer (CRC) incidence in Southern Portugal. Due to the important role of socioeconomic status in the risk of CRC, this variable has also been taken into account.
- Stomach cancer incidence in Southern Portugal 1998-2006:a spatio-temporal analysisPublication . Papoila, Ana Luisa; Ribeiro, Conceição; São João, Ricardo; Geraldes, Carlos; Amaral Turkman, Antónia; Miranda, AnaUnderstanding geographical differences in health, particularly in small areas, became a major concern of epidemiologists. Geographical association studies and, more recently, several spatial disease mapping studies have emerged due to the development of new spatial statistical tools. Among other diseases, these methods are being applied to analyze cancer data. However, in this kind of studies, it is of utmost importance to also investigate the influence of temporal variability and that is why spatio-temporal studies became so popular. The aim of this study is to investigate spatial and temporal trends for the incidence of this type of cancer. This retrospective population-based study is based on data on all stomach cancers registered by the Southern Portuguese Cancer Registry (ROR Sul) between 1998 and 2006. Because several studies have underlined the important role of socioeconomic status in cancer risk, information on this variable has also been taken into account. Bayesian hierarchical models were applied to model stomach incidence at a county level and resulting relative risks were used to build risk maps for cancer incidence. Age-Period-Cohort models were also applied.
- Stomach cancer incidence in Southern Portugal 1998-2006: A spatio-temporal analysisPublication . Papoila, Ana Luisa; Riebler, Andrea; Amaral-Turkman, Antónia; São João, Ricardo; Ribeiro, Conceição; Geraldes, Carlos; Miranda, AnaStomach cancer belongs to the most common malignant tumors in Portugal. Main causal factors are age, dietary habits, smoking, and Helicobacter pylori infections. As these factors do not only operate on different time dimensions, such as age, period, or birth cohort, but may also vary along space, it is of utmost interest to model temporal and spatial trends jointly. In this paper, we analyze incidence of stomach cancer in Southern Portugal between 1998 and 2006 for females and males jointly using a spatial multivariate age-period-cohort model. Thus, we avoid age aggregation and allow the exploration of heterogeneous time trends between males and females across age, period, birth cohort, and space. Model estimation is performed within a Bayesian setting assuming (gender specific) smoothing priors. Our results show that the posterior expected rate of stomach cancer is decreasing for all counties in Southern Portugal and that males around 70 have a two times higher risk of getting stomach cancer compared with their female counterparts. We further found that, except for some few counties, the spatial influence is almost constant over time and negligible in the southern counties of Southern Portugal.