Geographical patterns of cancer mortality in Spain

This report discusses the methodology and main findings of the Atlas of Cancer Mortality in Spain with special reference to some major forms of cancer. The mortality for all cancers and specifically lung cancer, for both sexes, is highest in the peripheral regions of Spain. This agrees basically with the level of urbanization and industrialization which has developed during the past several decades. Madrid is the outstanding exception to these relationships. The mortality pattern for stomach cancer is directly opposite to that of lung cancer, the more rural inland provinces having higher mortalities and most Mediterranean provinces showing lower mortalities. For breast cancer areas of higher mortality are some northern and some Mediterranean provinces. A similar pattern is shown by other uterus cancer with areas of higher mortality in the Mediterranean provinces. Considered individually, the province of Cádiz shows the greatest risk of death from cancer, being ranked first for the following cancers: lung, oral cavity and pharynx, esophagus, larynx, and prostate for males and esophagus, other uterus, and bone for females. All these findings definitely produce more questions than answers. Future research on analytical epidemiology of cancer in Spain is strongly recommended.