Spatio-Temporal Variation of Lung Cancer in Crete, 1992–2013. Economic or Health Crisis?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting and Study Population
2.2. Incidence and Mortality Rates and Other Indexes
2.3. Statistical Analysis
2.4. Ethical Approval
3. Results
3.1. Changing Trends of LC and Associated Factors before and after the Economic Crisis
3.2. LC Hot Spots before and after the Economic Crisis
3.3. Predictors and Overall Risk of LC Mortality
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Lung Cancer Cases | Variation Rate from 1992 to 2013 | p Value | |
---|---|---|---|---|
Period A (1992–2008) | Period B (2009–2013) | |||
ASIR/100,000/year | 37.9 | 47.8 | +9.8 | 0.01 |
ASMR/100,000/year | 30.5 | 43.8 | +13.3 | <0.001 |
5 year Net-Survival (%) | 14.6 | 12.1 | −2.5 | 0.04 |
Gender (%) | 0.01 | |||
Males | 91.8 | 82.4 | −9.3 | |
Females | 8.2 | 17.6 | +9.4 | |
Age at year of diagnosis (Median) | 68 | 77 | +9 | <0.001 |
Stage at year of diagnosis (%) | <0.001 | |||
I | 17.1 | 6.1 | −11 | |
II | 12.2 | 8.2 | −7.9 | |
III | 13 | 17.2 | +8.2 | |
IV | 39.7 | 44.8 | +10.2 | |
Not known | 18 | 18.1 | +0.2 | |
Adjusted Charlson Comorbidity Index-CCI% (Median) | 3 | 4 | +1 | 0.04 |
Family medical history of LC or other lung disease | 0.62 | |||
No | 15.1 | 15.0 | −0.1 | |
Yes | 67.6 | 67.5 | −0.1 | |
Not known | 17.3 | 17.5 | +0.2 | |
Smoking status (%) | 0.02 | |||
Never smoker | 19.9 | 12.8 | −7.1 | |
Ever smoker | 71.8 | 79.2 | +7.4 | |
Not known | 8.3 | 8 | −0.3 | |
Alcohol consumption (%) | 0.02 | |||
No | 29.9 | 21.1 | −8.8 | |
Yes | 32 | 41.4 | +9.4 | |
Not known | 38.1 | 37.5 | −0.6 | |
Exposure to OAP (% of LC patients potentially exposed) | 25.1 | 34.9 | +9.8 | <0.001 |
Deprivation Index (Median) | 17.5 | 29.2 | +11.7 | <0.001 |
Covariates | Period A (1992–2008) | Period B (2009–2013) | ||
---|---|---|---|---|
Relative Risk * of LC Death (95%CI) | p Value | Relative Risk * of LC Death (95%CI) | p Value | |
Adjusted Charlson’s Comorbidity Index-CCI% | 4.1 (3.8–4.4) | 0.02 | 4.9 (4.4–5.5) | 0.04 |
Family medical history of LC or other lung disease | 4.0 (3.5–4.6) | 0.03 | 4.0 (3.3–4.8) | 0.04 |
Ever smokers | 4.8 (4.6–5.1) | 0.01 | 5.7 (5.2–6.3) | 0.03 |
Alcohol consumers | 1.8 (1.2–2.4) | 0.02 | 2.1 (1.3–3.0) | 0.04 |
Exposure to OAP | 1.9 (1.6–2.1) | 0.02 | 2.3 (1.9–2.8) | 0.03 |
Deprivation Index | 1.5 (1.1–2.0) | 0.03 | 5.4 (5.1–5.8) | 0.03 |
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Sifaki-Pistolla, D.; Chatzea, V.E.; Mechili, E.A.; Koinis, F.; Georgoulias, V.; Lionis, C.; Tzanakis, N. Spatio-Temporal Variation of Lung Cancer in Crete, 1992–2013. Economic or Health Crisis? Int. J. Environ. Res. Public Health 2022, 19, 12161. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912161
Sifaki-Pistolla D, Chatzea VE, Mechili EA, Koinis F, Georgoulias V, Lionis C, Tzanakis N. Spatio-Temporal Variation of Lung Cancer in Crete, 1992–2013. Economic or Health Crisis? International Journal of Environmental Research and Public Health. 2022; 19(19):12161. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912161
Chicago/Turabian StyleSifaki-Pistolla, Dimitra, Vasiliki Eirini Chatzea, Enkeleint A. Mechili, Filippos Koinis, Vassilis Georgoulias, Christos Lionis, and Nikos Tzanakis. 2022. "Spatio-Temporal Variation of Lung Cancer in Crete, 1992–2013. Economic or Health Crisis?" International Journal of Environmental Research and Public Health 19, no. 19: 12161. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912161