Spatio-temporal evolution of female lung cancer mortality in a region of Spain, is it worth taking migration into account?

A novel methodology, consisting of a Bayesian hierarchical model, is used in this paper. Such a model allows the handling of data with a very high disaggregation, while at the same time taking advantage of its spatial and temporal structure.The spatio-temporal pattern which was found points to geographical differences in the time trends of risk. In fact, the southern coastal side of the CV has had a higher increase in risk, coinciding with the settlement of a large foreign community in that area, mainly comprised of elderly people from the European Union.Migration has frequently been ignored as a risk factor in the description of the geographical risk of lung cancer and it is suggested that this factor should be considered, especially in tourist regions. The temporal component in disease mapping provides a more accurate depiction of risk factors acting on the population.Lung cancer is the most common cause of death from cancer among males in the European Union (EU), and the second most common among females [1]. Lung cancer mortality in women has increased sharply in almost all EU countries in recent decades [2] with an annual growth of 1.7 percent [3], and Spain is not an exception to this trend [4]. However, although the Spanish female adjusted mortality rate for lung cancer is relatively low, the observed mortality increase in the last decade of the twentieth century for women between ages 35 and 64 is the highest in Europe [5], and an increase in incidence has been noted as well [6].Lung cancer is a long latency disease [7] mainly reflecting past smoking habits. In fact tobacco smoking is well-established as the main cause of lung cancer and about 90 percent of cases are thought to be tobacco related [8]. In Spain, a lung cancer risk increase related to smoking patterns has been described [9] for female generations born after 1940. However, smoking prevalence in women is not the same in every European country. In northern Europe, more women smoke than in the sout