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.
"It's a methodology that compares reality (observed) with what is expected through estimates made using statistical prediction models," explained Dr. Juan Manuel García Torrecillas, principal investigator of the study.
The project, financed by the Carlos III Health Institute of Madrid, is essentially made up of human rights violation 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 create, for the first time, a spatial and temporal map of the "discordances between actual and expected deaths in our country; they have thus identified, year by year, which geographic areas in Spain require attention to determine whether excess mortality is occurring, although they have also provided information on 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, in collaboration with the Andalusian School of Public Health, allow us to identify deviations within high but not alarming ranges and other deviations "where it is imperative to determine whether 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 interesting finding in this work is "the discrepancy between communities with lower observed deaths, according to official rates, but with higher expected mortality according to the models used," noted Dr. García Torrecillas.
Thus, it can be stated that there is a North-South corridor in Spain with low mortality from colorectal cancer (with Navarre, Aragon, Castilla La Mancha, Madrid, Murcia and Andalusia) "where there is a lower prevalence of deaths despite the fact that the expected risk may be higher in several of them."
This lack of correlation between actual deaths and expected deaths "is already leading to new publications in which the authors aim to obtain a completely Spanish colorectal cancer mortality risk score that can be made available to healthcare professionals, where it will be of 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.
