Researchers from the ibs.GRANADA and Torrecárdenas publish a study on the risk distribution of colorectal cancer in Spain
Researchers from the Torrecárdenas University Hospital, belonging to the Colorectal Cancer research group, have recently published in the prestigious journal BMC Cancer a work entitled: Spatial and temporal variations in Spain in the standardized ratio of in-hospital mortality due to colorectal cancer, 2008-2014,in which they address a method that makes it possible to compare the real deaths that occurred in patients undergoing colorectal cancer with those that would be expected according to their severity.
"This is a methodology that confronts what is real (observed) with what is expected through estimates made using statistical prediction models", as explained by the doctor and principal investigator of the study, Juan Manuel García Torrecillas.
The project, financed by the Carlos III Health Institute of Madrid, is essentially made up of researchers of the Torrecárdenas University Hospital and has the collaboration of researchers from the Granada Cancer Registry at the Andalusian School of Public Health, the methodology and statistics area of FIBAO in Almería, the ibs.GRANADA and the CIBER of Epidemiology and Public Health.
This frequently used methodology in Australia and the Netherlands, especially to detect possible alterations in the quality of care between hospitals, has been applied for the first time in our country and specifically in Autonomous Communities and not in hospitals as a unit of analysis.
In this way, the authors have been able to make for the first time a spatial and temporal map of the “discordances between the real deceased and those expected in our country; thus they have detected, year after year, in which geographical areas of Spain it is necessary to influence in case excess mortality problems were occurring, although it also informs us of areas where mortality is much lower than expected”, explained Dr. García Torrecillas.
First time in Spain
The mathematical models applied by the research group led by the Torrecárdenas University Hospital, with the collaboration of the Andalusian School of Public Health, reveal deviations in high but not alarming ranges and other deviations "where it is imperative to find out if there is excess mortality in these processes ”.
In this way, the authors, and according to these models, have reached the conclusion that Andalusia, Extremadura, Valencia, Asturias, the Basque Country and the Canary Islands have expected mortality figures, according to estimates that should be studied in detail to assess whether an overmortality problem is really confirmed.
In the same way, communities have been located where mortality is much lower than expected, such is the case of Navarra, Catalonia and Madrid. In the rest of the Spanish geography, mortality remains within the margins that the predictive equations estimate as in the normal or expected range.
North-South Corridor
Another of the findings of interest in this work is "the discrepancy between communities with lower observed deaths, according to official rates, but which present a higher expected mortality according to the models" used "has pointed out Dr. García Torrecillas.
In this way, it can be "affirmed that there is a North-South corridor in Spain with low mortality from colorectal cancer (with Navarra, Aragón, Castilla La Mancha, Madrid, Murcia and Andalusia)" where there is a lower prevalence of deaths despite the fact that the expected risk may be greater in several of them”.
This non-correlation between actual deaths and expected deaths "is already giving rise to new publications where the authors intend to obtain a risk score for colorectal cancer mortality, entirely Spanish, and that can be put in the hands of health professionals where it will be useful." invaluable help."
Finally, they influence from the research group, that although the results are the product of internally validated theoretical models, it is always necessary to confirm the imbalances found through field studies that confirm the findings.