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El 'Atlas of Cancer Mortality in Portugal and Spain 2003–2012', muestra la distribución espacial de la mortalidad municipal por distintos tipos cáncer para el periodo 2003-2012. Ha sido desarrollado por la Unidad de Epidemiología del Cáncer y Ambiental del Centro Nacional de Epidemiología del ISCIII, que forma parte del CIBERESP, y por el Departamento de Epidemiología del Instituto Nacional De Saúde Doutor Ricardo Jorge de Portugal. El estudio de la distribución geográfica del riesgo de fallecer por cáncer es una de las herramientas que se usan en epidemiología para generar hipótesis sobre la posible implicación de factores ambientales en el origen de los tumores. This project is partially supported by research grant from the Spanish Health Research Fund (FIS) of the National Institute of Health Carlos III (ISCIII), Spain (Project PI17CIII/00040: “Spatial distribution of municipal cancer mortality in Spain (SICAMSA)” (“Distribución Espacial de la Mortalidad municipal por CÁncer en ESpaña (DEMOCAES)”). Introduction. Methods. Results: Oesophagus (ICD-10 C15) Stomach (ICD-10 C16) Colorectal (ICD-10 C18–C21) Pancreas (ICD-10 C25) Larynx (ICD-10 C32) Lung (ICD-10 C33–C34) Female Breast (ICD-10 C50) Prostate (ICD-10 C61) Bladder (ICD-10 C67) Leukaemia (ICD-10 C91–C95) References. Annexes: Annex I and Annex II No

Objectives To characterize asymptomatic SARS-CoV-2 infections and develop a symptom-based risk score useful in primary healthcare. Study design and setting 61,092 community-dwelling participants in a nationwide population-based serosurvey completed a questionnaire on COVID-19 symptoms and received an immunoassay for SARS-CoV-2 IgG antibodies between April 27-June 22, 2020. Standardized prevalence ratios for asymptomatic infection were estimated across participant characteristics. We constructed a symptom-based risk score and evaluated its ability to predict SARS-CoV-2 infection. Results 28.7% of infections were asymptomatic (95% CI 26.1-31.4%). Standardized asymptomatic prevalence ratios were 1.19 (1.02-1.40) for men versus women, 1.82 (1.33-2.50) and 1.45 (0.96-2.18) for individuals, Graphical Abstract Image, graphical abstract

Background: The analysis of the evolution of the COVID-19 epidemic can provide evidence of the impact of measures implemented to reduce its progression. Our aim was to describe the evolution of the pandemic in the different Spanish regions and to examine the effect of the non-pharmaceutical public health interventions during the first epidemic wave on these trends. Methods: Daily incidence rates of cases were calculated at national and regional level between 31th of January and 10th of May 2020. Epidemic curves, important dates of interventions and effective reproduction number (Rt) were plotted and transmissibility parameters were calculated. To summarize the geographical heterogeneity in the evolution, regional epidemic curves have been classified into homogeneous groups using a clustering procedure. Findings: The incidence rate reached 5 cases per 100,000 on March 1 and peaked at March 20. The Rt gradually decreased after the national lockdown falling below 1 on March 24. Two homogeneous groups of epidemic curves were identified among regions, mainly differentiated by the magnitude of the daily incidence rate and the evolution of the Rt in the period prior to lockdown. However, irrespectively of the previous trend, the lockdown was followed by a steep decrease in the number of cases starting 6 days after its implementation. Interpretation: Our results confirm that the restrictive national lockdown efficiently reduced the progression of the epidemic in Spain during the first wave. This effect was similar in the two regional clusters, independent of the previous dynamics of the epidemic. Funding Statement: The study was supported by Instituto de Salud Carlos III, Spain (ISCIII) grant number COV20-008 Declaration of Interests: All authors declare no competing interests.

Prostate cancer (PCa) is the second most common cancer among men worldwide. Its etiology remains largely unknown compared to other common cancers. We have developed a risk stratification model combining environmental factors with family history and genetic susceptibility. 818 PCa cases and 1,006 healthy controls were compared. Subjects were interviewed on major lifestyle factors and family history. Fifty-six PCa susceptibility SNPs were genotyped. Risk models based on logistic regression were developed to combine environmental factors, family history and a genetic risk score. In the whole model, compared with subjects with low risk (reference category, decile 1), those carrying an intermediate risk (decile 5) had a 265% increase in PCa risk (OR = 3.65, 95% CI 2.26 to 5.91). The genetic risk score had an area under the ROC curve (AUROC) of 0.66 (95% CI 0.63 to 0.68). When adding the environmental score and family history to the genetic risk score, the AUROC increased by 0.05, reaching 0.71 (95% CI 0.69 to 0.74). Genetic susceptibility has a stronger risk value of the prediction that modifiable risk factors. While the added value of each SNP is small, the combination of 56 SNPs adds to the predictive ability of the risk model. Biological samples were stored at the biobanks supported by Instituto de Salud Carlos III- FEDER: Parc de Salut MAR Biobank (MARBiobanc) (), ‘Biobanco La Fe’ () and FISABIO Biobank (), as well as at the Public Health Laboratory of Gipuzkoa, the Basque Biobank, the ICOBIOBANC (sponsored by the Catalan Institute of Oncology), the IUOPA Biobank of the University of Oviedo, and the ISCIII Biobank. SNP genotyping services were provided by the Spanish ‘Centro Nacional de Genotipado’ (CEGEN-ISCIII). We thank all the subjects who participated in the study and all MCC-Spain collaborators. This work was supported by the ‘Acción Transversal del Cancer’, approved by the Spanish Ministry Council on the 11th October 2007, by the Instituto de Salud Carlos III, co-founded by FEDER funds –‘a way to build Europe’ (grants , , , , , , , , , , ,, , , , , , , , , and ). Support was also provided by the Fundación Marqués de Valdecilla (grant ); the Junta de Castilla y León (grant ); the Consejería de Salud of the Junta de Andalucía (); the Conselleria de Sanitat of the Generalitat Valenciana (grant ); the Recercaixa (grant ); the Regional Government of the Basque Country; the Consejería de Sanidad de la Región de Murcia; European Commission grants ; the Spanish Association Against Cancer (AECC) Scientific Foundation; the Catalan Government DURSI (grant ); the Fundación Caja de Ahorros de Asturias; the University of Oviedo; Societat Catalana de Digestologia; and COST action Eucolongene. The authors thank the “Bioinformatics and Research Group in Genetic and Environmental Epidemiology” (BRG-GEE) of the Cancer and Environmental Epidemiology Unit in III Institute of Health (ISCIII), Spain, for their technical scientific support (Group consisting of Pablo Fernández-Navarro (group leader), Mario González-Sánchez (bioinformatic), Javier González-Palacios (bioinformatic)). Sí

Title and summary, also in English. El cáncer de mama es el tumor más frecuente en Europa. Según la Agencia Internacional de Investigación del Cáncer, en 2006 se diagnosticaron unos 429.900 casos nuevos de cáncer de mama en Europa, con una tasa estandarizada de incidencia de 110 casos por 100.000 mujeres. También es la localización más frecuente en mujeres españolas: supone casi la cuarta parte de los casos de cáncer femeninos, y su incidencia está aumentando entre un 2-3% anual. Entre las posibles causas de este incremento están los cambios en los patrones reproductivos y en los hábitos de vida y la introducción de la terapia hormonal sustitutiva. Nuestro país, con una tasa de incidencia estandarizada estimada de 93,6 casos por 100.000 mujeres-año para 2006, ocupa una posición intermedia entre los países de Europa occidental y los del este. Es también una importante causa de mortalidad femenina. En 2005 causó la muerte de 5.703 mujeres españolas, con una tasa de mortalidad estandarizada de 18,6 por 100.000 mujeres-año. Desde los años 90 la mortalidad por cáncer de mama está descendiendo debido al diagnóstico precoz por programas de cribado y a los avances terapéuticos. En España esta tendencia decreciente se observa a partir de 1993, con un descenso de un 2,4% anual.La supervivencia global en Europa a los 5 años es cercana al 79%, inferior a la observada en EEUU (90%), y ha aumentado en los últimos años. En España, se sitúa en un 83%, significativamente más alta que la media europea. Breast cancer is the most frequent neoplasm in Europe. According to the International Agency for Research on Cancer, there were an estimated 429,900 cases diagnosed in Europe in 2006, with an age-standardised incidence rate of 110 cases per 100,000 women.It is also the most frequent cancer in Spanish women, accounting for one forth of female cancer cases, and its incidence is increasing around 2-3% per year. Changes in reproductive behaviour and life style along with the introduction of hormone replacement therapy are partially responsible of this trend. Our country, with an estimated age-standardised incidence rate of 93.6 cases per 100,000 women-year in 2006, occupies an intermediate position between Western and Eastern European countries.This tumour also represents an important cause of female mortality. In 2005, it caused 5,703 deaths in Spanish women, with an age-standardised mortality rate of 18.6 per 100,000 women-year. However, since the 90’s, breast cancer mortality is declining thanks to earlier diagnosis derived from population screening programs and to therapeutical advances. In Spain this downward trend has started in 1993, declining a 2.4% per year.In Europe, 5-year global survival is close to 79%, lower than EEUU survival estimates (90%). Breast cancer survival has risen in recent years. In Spain, 5-year survival is around 83%, significantly higher than European average. Sí

Pleural cancer mortality is an acknowledged indicator of exposure to asbestos and mesothelioma mortality but in 15%-20% of cases no exposure can be recalled. In the past, asbestos was used in many industries and it is still found in many installations. Our objective was to ascertain whether there might be excess pleural cancer mortality among populations residing in the vicinity of Spanish industrial installations that are governed by the Integrated Pollution Prevention and Control (IPPC) Directive and the European Pollutant Release and Transfer Register Regulation and report their emissions to air. An ecological study was designed to examine pleural cancer mortality at a municipal level (8098 Spanish towns) over the period 1997-2006, during which 2146 deaths were registered. We conducted an exploratory "near vs. far" analysis to estimate the relative risks (RRs) of towns situated at a distance of

Resumen Objetivo: Describir los patrones de distribución geográfica de la incidencia municipal de los tumores más frecuentes en la provincia de Huelva y compararla con la estimada para el conjunto de España. Método: Se calcularon los riesgos relativos (RR) usando el modelo condicional autorregresivo propuesto por Besag, York y Mollié mediante la herramienta INLA, para los años 2007-2011, de las siguientes localizaciones: colon, recto y ano en hombres y en mujeres; tráquea, bronquios y pulmón, próstata y vejiga en hombres; y mama en mujeres. Estos RR se representaron en mapas de coropletas y de isopletas (mediante interpolación por kriging). Resultados: Los RR para cáncer de vejiga en hombres fueron superiores a 1 en todos los municipios, siendo sus intervalos de credibilidad superiores a la unidad en cuatro municipios, destacando la capital con 1,56 (intervalo de credibilidad al 95%:1,30-1,67). Para el cáncer de próstata, las probabilidades a posteriori en 68 de los 79 municipios quedaron por debajo de 0,1. Para el cáncer de pulmón, nueve municipios mostraron intervalos de credibilidad por debajo de la unidad, casi todos en la zona oriental. En las mujeres, los RR para cáncer de mama fueron significativamente superiores en la zona de la capital. Finalmente, las tasas de incidencia provincial de Huelva muestran en general valores próximos a las estimadas para el conjunto de España, destacando las diferencias en cáncer de vejiga en hombres (35% superior) y en cáncer de próstata (30% inferior). Conclusiones: En la provincia de Huelva existe una distribución espacial municipal de la incidencia de cáncer con unos patrones bien definidos para algunas localizaciones tumorales concretas, presentando en general unas tasas de incidencia cercanas a las del territorio nacional. Abstract Objective: To describe the geographic distribution patterns of the municipal incidence of the most common tumours in the Huelva province (Spain) as compared to the estimated incidence for all of Spain. Methods: Relative risk (RR) was computed based on the conditional autoregressive model proposed by Besag, York and Mollié by applying the INLA tool to the cancer data for 2007-2011 for the following tumour locations: colon, rectum and anus (men and women); trachea, bronchia, and lungs, prostate and bladder in men; and breasts in women. The RR was presented in in choropleth and isopleth (with kriging interpolation) risk maps. Results: RR for bladder cancer in men was greater than 1.0 in all municipalities, with confidence intervals over 1.0 in four municipalities; Madrid having a 1.56 RR (95%CI 1.30-1.67). For prostate cancer, a posteriori probabilities were below 0.1 in 68 of the 79 municipalities. For lung cancer, nine municipalities had confidence limits below 1.0, almost all of them in western Spain. For women, the RR for breast cancer was significantly higher in the capital of province area. The cancer incidence rates for the Huelva province were, in general, similar to those estimated for Spain, standing out bladder cancer in men (35% higher) and prostate cancer (30% lower). Conclusions: In the Huelva province, there is a geographical municipal distribution of cancer incidence with well-defined patterns for some specific tumour locations, with overall incidence rates very similar to those in the rest of Spain.