Your browser doesn't support javascript.
loading
Geographic variations in cervical cancer risk in San Luis Potosí state, Mexico: A spatial statistical approach.
Terán-Hernández, Mónica; Ramis-Prieto, Rebeca; Calderón-Hernández, Jaqueline; Garrocho-Rangel, Carlos Félix; Campos-Alanís, Juan; Ávalos-Lozano, José Antonio; Aguilar-Robledo, Miguel.
Afiliação
  • Terán-Hernández M; Geography Graduate Programme, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, México. mteran@uaslp.mx.
  • Ramis-Prieto R; Universidad Autónoma de San Luis Potosí (UASLP), Campus Poniente, 130 Av. Niño Artillero, Zona Universitaria, San Luis Potosí, S. L. P., 78210, Mexico. mteran@uaslp.mx.
  • Calderón-Hernández J; Department of Environmental Epidemiology and Cancer, National Centre for Epidemiology, Carlos III Institute of Health (ISCIII), C/Monforte de Lemos 5, Pab. 12, 28029, Madrid, Spain.
  • Garrocho-Rangel CF; Centre of Applied Research in Environmental and Health, Coordination of Innovation and Application in Science and Technology, Universidad Autónoma de San Luis Potosí (UASLP), Unidad de Posgrado 550 Av. Sierra Leona, Lomas 2ª sección, San Luis Potosí, S.L.P., 78210, Mexico.
  • Campos-Alanís J; El Colegio Mexiquense, A.C. Ex-Hacienda Santa Cruz de los Patos, Zinacantepec, CP 51350, Mexico.
  • Ávalos-Lozano JA; Faculty of Geography, Universidad Autónoma del Estado de México (UAEM), Cerro de Coatepec s/n Ciudad Universitaria, CP 50110, Toluca, Mexico.
  • Aguilar-Robledo M; Regional Laboratory of Variability, Climate Change and Environmental Risk Assessment, Universidad Autónoma de San Luis Potosí (UASLP), Unidad de Posgrado 550 Av. Sierra Leona, Lomas 2ª sección, San Luis Potosí, S.L.P. 78210, Mexico.
Int J Equity Health ; 15(1): 161, 2016 Sep 29.
Article em En | MEDLINE | ID: mdl-27681081
BACKGROUND: Worldwide, Cervical Cancer (CC) is the fourth most common type of cancer and cause of death in women. It is a significant public health problem, especially in low and middle-income/Gross Domestic Product (GDP) countries. In the past decade, several studies of CC have been published, that identify the main modifiable and non-modifiable CC risk factors for Mexican women. However, there are no studies that attempt to explain the residual spatial variation in CC incidence In Mexico, i.e. spatial variation that cannot be ascribed to known, spatially varying risk factors. METHODS: This paper uses a spatial statistical methodology that takes into account spatial variation in socio-economic factors and accessibility to health services, whilst allowing for residual, unexplained spatial variation in risk. To describe residual spatial variations in CC risk, we used generalised linear mixed models (GLMM) with both spatially structured and unstructured random effects, using a Bayesian approach to inference. RESULTS: The highest risk is concentrated in the southeast, where the Matlapa and Aquismón municipalities register excessive risk, with posterior probabilities greater than 0.8. The lack of coverage of Cervical Cancer-Screening Programme (CCSP) (RR 1.17, 95 % CI 1.12-1.22), Marginalisation Index (RR 1.05, 95 % CI 1.03-1.08), and lack of accessibility to health services (RR 1.01, 95 % CI 1.00-1.03) were significant covariates. CONCLUSIONS: There are substantial differences between municipalities, with high-risk areas mainly in low-resource areas lacking accessibility to health services for CC. Our results clearly indicate the presence of spatial patterns, and the relevance of the spatial analysis for public health intervention. Ignoring the spatial variability means to continue a public policy that does not tackle deficiencies in its national CCSP and to keep disadvantaging and disempowering Mexican women in regard to their health care.
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies País/Região como assunto: Mexico Idioma: En Revista: Int J Equity Health Ano de publicação: 2016 Tipo de documento: Article País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies País/Região como assunto: Mexico Idioma: En Revista: Int J Equity Health Ano de publicação: 2016 Tipo de documento: Article País de publicação: Reino Unido