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Bladder cancer mortality trends and patterns in Córdoba, Argentina (1986–2006)

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Abstract

Background

Bladder cancer is common worldwide and the fourth most commonly diagnosed malignancy in men in Argentina.

Objective

To describe bladder cancer mortality trends in Córdoba (1986–2006), considering the effect of age, period, and cohort, and to estimate the effect of arsenic exposure on bladder cancer, and its interaction with sex, while controlling by smoking habits and space and time variation of the rates.

Methods

A joinpoint regression was performed to compute the estimated annual percentage changes (EAPC) of the age-standardized mortality rates (ASMR) in an adult population from Córdoba, Argentina. A Poisson model was fitted to estimate the effect of age, period, and cohort. The influence of gender, tobacco smoking (using lung cancer ASMR as surrogate), and arsenic in drinking water was examined using a hierarchical model.

Results

A favorable trend (1986–2006) in bladder cancer ASMR in both sexes was found: EAPC of −2.54 in men and −1.69 in women. There was a decreasing trend in relative risk (RR) for cohorts born in 1931 or after. The multilevel model showed an increasing risk for each increase in lung cancer ASMR unit (RR = 1.001) and a biological interaction between sex and arsenic exposure. RR was higher among men exposed to increasing As-exposure categories (RR male low exposure 3.14, RR male intermediate exposure 4.03, RR male high exposure 4.71 versus female low exposure). A non-random space–time distribution of the rates was observed.

Conclusions

There has been a decreasing trend in ASMR for bladder cancer in Córdoba. This study confirms that bladder cancer is associated with age, gender, smoking habit, and exposure to arsenic. Moreover, an effect measure modification between exposure to arsenic and sex was found.

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Acknowledgments

We are especially grateful to the Department of Statistics, Ministry of Health of Córdoba Province, for kindly allowing us to use the 1986–2006 mortality database, and for their assistance with all the data management steps used in this study. Sonia A. Pou’s research was supported by fellowships provided by the National Scientific and Technical Research Council (CONICET).

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Authors and Affiliations

  1. Celular Biology Institute, Faculty of Medical Sciences, University of Córdoba, Córdoba, Argentina

    Sonia Alejandra Pou, Alberto Ruben Osella & Maria del Pilar Diaz

  2. National Scientific and Technical Research Council (CONICET). Statistics Unit, School of Nutrition, Faculty of Medical Sciences, University of Córdoba, Córdoba, Argentina

    Sonia Alejandra Pou

  3. Laboratory of Epidemiology and Biostatistics, IRCCS Saverio de Bellis, Castellana Grotte, Bari, Italy

    Alberto Ruben Osella

  4. Statistics Unit, School of Nutrition, Faculty of Medical Sciences, University of Córdoba, Córdoba, Argentina

    Maria del Pilar Diaz

  5. Ciudad Universitaria, Enrique Barros s/n, CP 5000, Córdoba, Argentina

    Maria del Pilar Diaz

Authors
  1. Sonia Alejandra Pou
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  2. Alberto Ruben Osella
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  3. Maria del Pilar Diaz
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Correspondence to Maria del Pilar Diaz.

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Pou, S.A., Osella, A.R. & Diaz, M.d.P. Bladder cancer mortality trends and patterns in Córdoba, Argentina (1986–2006). Cancer Causes Control 22, 407–415 (2011). https://doi.org/10.1007/s10552-010-9711-6

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  • DOI: https://doi.org/10.1007/s10552-010-9711-6

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