Municipal distribution of ovarian cancer mortality in Spain

Smoothed relative risks of ovarian cancer mortality were obtained, using the Besag, York and Molliè autoregressive spatial model. Standardised mortality ratios, smoothed relative risks, and distribution of the posterior probability of relative risks being greater than 1 were depicted on municipal maps.During the study period (1989–1998), 13,869 ovarian cancer deaths were registered in 2,718 Spanish towns, accounting for 4% of all cancer-related deaths among women. The highest relative risks were mainly concentrated in three areas, i.e., the interior of Barcelona and Gerona (north-east Spain), the north of Lugo and Asturias (north-west Spain) and along the Seville-Huelva boundary (in the south-west). Eivissa (Balearic Islands) and El Hierro (Canary Islands) also registered increased risks.Well established ovarian cancer risk factors might not contribute significantly to the municipal distribution of ovarian cancer mortality. Environmental and occupational exposures possibly linked to this pattern and prevalent in specific regions, are discussed in this paper. Small-area geographical studies are effective instruments for detecting risk areas that may otherwise remain concealed on a more reduced scale.In 2002, ovarian cancer was the sixth leading tumour and the seventh leading cause of cancer-related death in women world-wide [1]. In Spain, a total of 1760 ovarian cancer deaths were registered in 2006, accounting for 4.6% of all cancer-related deaths in women [2]. Insofar as incidence is concerned, is highest in developed countries. Within Europe, the lowest rates correspond to Mediterranean countries whereas the highest are found in Northern Europe. In 2002, the Spanish incidence rate, adjusted for the standard world population, was estimated at 9.9 cases per 100,000 person-years [3]. However, data of cancer incidence obtained from the provincial registers available in Spain differ from 11 cases per 100,000 person-years in Asturias (in the period 1996–2000) to 6 cases