There is a rich body of literature on the distribution of cancer incidence and mortality in socioeconomically different world regions, but none of the studies has compared the spatial distribution of mortality and incidence to see if they are consistent with each other. All malignant neoplasms combined and cervical, colorectal, breast, pancreatic, lung, and oral cancers separately were studied in the Hungarian population aged 25–64 years for 2007–2018 at the municipality level by sex. In each case, the spatial distribution of incidence and mortality were compared with each other and with the level of deprivation using disease mapping, spatial regression, risk analysis, and spatial scan statistics. A positive association between deprivation and mortality was found for each type of cancer, but there was no significant association for male colorectal cancer (relative risk (RR) 1.00; 95% credible interval (CI) 0.99–1.02), pancreatic cancer (RR: 1.01; 95%CI 0.98–1.04), and female colorectal cancer incidence (RR: 1.01; 95%CI 0.99–1.03), whereas a negative association for breast cancer (RR: 0.98; 95%CI 0.96–0.99) was found. Disease mapping analyses showed only partial overlap between areas of high incidence and mortality, often independent of deprivation. Our results highlight not only the diverse relationship between cancer burden and deprivation, but also the inconsistent relationship between cancer incidence and mortality, pointing to areas with populations that require special public health attention.
关于不同社会经济水平地区癌症发病率和死亡率分布的文献颇为丰富，但尚无研究比较死亡率与发病率的空间分布以验证二者是否一致。本研究以匈牙利25-64岁人群为对象，在市级行政单位层面按性别分析了2007-2018年间所有恶性肿瘤合并数据及宫颈癌、结直肠癌、乳腺癌、胰腺癌、肺癌和口腔癌的独立数据。通过疾病地图绘制、空间回归、风险分析和空间扫描统计等方法，分别比较了各类癌症发病率与死亡率的空间分布及其与贫困水平的关系。结果显示：各类癌症死亡率均与贫困程度呈正相关，但男性结直肠癌（相对风险RR 1.00；95%可信区间CI 0.99–1.02）、胰腺癌（RR 1.01；95%CI 0.98–1.04）及女性结直肠癌发病率（RR 1.01；95%CI 0.99–1.03）与贫困水平无显著关联，而乳腺癌发病率则呈负相关（RR 0.98；95%CI 0.96–0.99）。疾病地图分析表明高发病率与高死亡率区域仅部分重叠，且常独立于贫困水平。本研究不仅揭示了癌症负担与贫困关系的多样性，更凸显了癌症发病率与死亡率间的不一致性，为需要特殊公共卫生关注的区域人群提供了科学依据。
肿瘤(癌症)患者之家