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Geographic variations in cervical cancer risk in San Luis Potosí state, Mexico: A spatial statistical approach.
- Source :
- International Journal for Equity in Health; 9/29/2016, Vol. 15, p1-16, 16p, 4 Charts, 7 Maps
- Publication Year :
- 2016
-
Abstract
- 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 socioeconomic 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- CONFIDENCE intervals
HEALTH services accessibility
POPULATION geography
RISK assessment
SELF-efficacy
WOMEN'S health
CERVIX uteri tumors
RESIDENTIAL patterns
SOCIOECONOMIC factors
STATISTICAL models
DESCRIPTIVE statistics
MIDDLE-income countries
LOW-income countries
INFERENTIAL statistics
EARLY detection of cancer
TUMOR risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 14759276
- Volume :
- 15
- Database :
- Complementary Index
- Journal :
- International Journal for Equity in Health
- Publication Type :
- Academic Journal
- Accession number :
- 118521101
- Full Text :
- https://doi.org/10.1186/s12939-016-0448-z