IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i19p12161-d925045.html
   My bibliography  Save this article

Spatio-Temporal Variation of Lung Cancer in Crete, 1992–2013. Economic or Health Crisis?

Author

Listed:
  • Dimitra Sifaki-Pistolla

    (Cancer Registry of Crete, School of Medicine, University of Crete, 700 13 Heraklion, Greece)

  • Vasiliki Eirini Chatzea

    (Cancer Registry of Crete, School of Medicine, University of Crete, 700 13 Heraklion, Greece)

  • Enkeleint A. Mechili

    (Cancer Registry of Crete, School of Medicine, University of Crete, 700 13 Heraklion, Greece)

  • Filippos Koinis

    (Cancer Registry of Crete, School of Medicine, University of Crete, 700 13 Heraklion, Greece)

  • Vassilis Georgoulias

    (Cancer Registry of Crete, School of Medicine, University of Crete, 700 13 Heraklion, Greece)

  • Christos Lionis

    (Cancer Registry of Crete, School of Medicine, University of Crete, 700 13 Heraklion, Greece)

  • Nikos Tzanakis

    (Cancer Registry of Crete, School of Medicine, University of Crete, 700 13 Heraklion, Greece)

Abstract

(1) Background: This is the first population-based study in Greece, with the aim to measure the changing trends of lung cancer (LC) and the associated risk factors before and after the economic crisis. Among the main objectives were the identification of LC hot spots and high-risk areas; (2) Methods: The study was conducted in Crete, the biggest island in Greece. Data (5057 LC cases) were collected from the Cancer Registry of Crete (CRC). The age-standardized incidence and mortality rates (ASIR, ASMR/100,000/year) were estimated, while additional indexes were used, including the adjusted Charlson’s comorbidity index (CCI%), the deprivation index (HPI-2), and the exposure to outdoor air pollution (OAP). The analysis was performed for two time periods (Period A: 1992–2008; Period B: 2009–2013); (3) Results: ASIR presented a significant increase during the economic crisis, while an even higher increase was observed in ASMR (Period A: ASMR = 30.5/100,000/year; Period B: ASMR = 43.8/100,000/year; p < 0.001). After 2009, a significant increase in the observed LC hot spots was identified in several sub-regions in Crete ( p = 0.04). The risk of LC mortality increased even more for smokers (RR = 5.7; 95%CI = 5.2–6.3) and those living in highly deprived geographical regions (RR = 5.4; 95%CI = 5.1–5.8) during the austerity period. The multiple effect of LC predictors resulted in adjusted RRs ranging from 0.7 to 5.7 within the island ( p < 0.05); (4) Conclusions: The increased LC burden after the onset of the economic crisis, along with a changing pattern of LC predictors stressed the urgent need of geographically oriented interventions and cancer control programs focusing on the most deprived or vulnerable population groups.

Suggested Citation

  • Dimitra Sifaki-Pistolla & Vasiliki Eirini Chatzea & Enkeleint A. Mechili & Filippos Koinis & Vassilis Georgoulias & Christos Lionis & Nikos Tzanakis, 2022. "Spatio-Temporal Variation of Lung Cancer in Crete, 1992–2013. Economic or Health Crisis?," IJERPH, MDPI, vol. 19(19), pages 1-10, September.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12161-:d:925045
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/19/12161/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/19/12161/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Iasmina Petrovici & Mihaela Ionica & Octavian C. Neagoe, 2021. "Economic Crisis: A Factor for the Delayed Diagnosis of Breast Cancer," IJERPH, MDPI, vol. 18(8), pages 1-10, April.
    2. Ifanti, Amalia A. & Argyriou, Andreas A. & Kalofonou, Foteini H. & Kalofonos, Haralabos P., 2013. "Financial crisis and austerity measures in Greece: Their impact on health promotion policies and public health care," Health Policy, Elsevier, vol. 113(1), pages 8-12.
    3. Martin Ravallion, 2011. "On multidimensional indices of poverty," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 9(2), pages 235-248, June.
    4. Tapia Granados, José A. & Rodriguez, Javier M., 2015. "Health, economic crisis, and austerity: A comparison of Greece, Finland and Iceland," Health Policy, Elsevier, vol. 119(7), pages 941-953.
    5. Melinda C Aldrich & Heather M Munro & Michael Mumma & Eric L Grogan & Pierre P Massion & Timothy S Blackwell & William J Blot, 2015. "Chronic Obstructive Pulmonary Disease and Subsequent Overall and Lung Cancer Mortality in Low-Income Adults," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-14, March.
    6. Simou, Effie & Koutsogeorgou, Eleni, 2014. "Effects of the economic crisis on health and healthcare in Greece in the literature from 2009 to 2013: A systematic review," Health Policy, Elsevier, vol. 115(2), pages 111-119.
    7. Antonakakis, Nikolaos & Collins, Alan, 2014. "The impact of fiscal austerity on suicide: On the empirics of a modern Greek tragedy," Social Science & Medicine, Elsevier, vol. 112(C), pages 39-50.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Robert J. Kolesar & Rok Spruk, 2024. "Effect of Austerity Measures on Infant Mortality: Evidence from Greece," Papers 2407.17084, arXiv.org.
    2. Toshiki Hasegawa & Kouji Fukuyama & Motohiro Okada, 2021. "Relationships between Expenditure of Regional Governments and Suicide Mortalities Caused by Six Major Motives in Japan," IJERPH, MDPI, vol. 19(1), pages 1-18, December.
    3. Vogler, Sabine & Zimmermann, Nina & de Joncheere, Kees, 2016. "Policy interventions related to medicines: Survey of measures taken in European countries during 2010–2015," Health Policy, Elsevier, vol. 120(12), pages 1363-1377.
    4. Grigorakis, Nikolaos & Floros, Christos & Tsangari, Haritini & Tsoukatos, Evangelos, 2016. "Out of pocket payments and social health insurance for private hospital care: Evidence from Greece," Health Policy, Elsevier, vol. 120(8), pages 948-959.
    5. Toffolutti, Veronica & Suhrcke, Marc, 2019. "Does austerity really kill?," Economics & Human Biology, Elsevier, vol. 33(C), pages 211-223.
    6. George Loukopoulos & Theodoros Roupas, 2014. "Financial Analysis of the Greek Private Health Sector over the Last Decade (2002-2012)," European Research Studies Journal, European Research Studies Journal, vol. 0(2), pages 3-19.
    7. José A. Tapia Granados & Edward L. Ionides, 2017. "Population health and the economy: Mortality and the Great Recession in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 219-235, December.
    8. Jofre-Bonet, Mireia & Serra-Sastre, Victoria & Vandoros, Sotiris, 2018. "The impact of the Great Recession on health-related risk factors, behaviour and outcomes in England," Social Science & Medicine, Elsevier, vol. 197(C), pages 213-225.
    9. Luca Salvati, 2020. "Demographic Dynamics, Urban Cycles and Economic Downturns: A Long-term Investigation of a Metropolitan Region in Europe, 1956–2016," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 39(3), pages 549-575, June.
    10. Konstantinos N. Zafeiris & Georgios Kontogiannis & Byron Kotzamanis, 2024. "The evolution of fertility in Greece since the 1960s: a joinpoint regression analysis," Journal of Population Research, Springer, vol. 41(4), pages 1-20, December.
    11. Konstantinos N. Zafeiris, 2020. "Gender differences in life expectancy at birth in Greece 1994–2017," Journal of Population Research, Springer, vol. 37(1), pages 73-89, March.
    12. Apostolos Kamekis & George Rachiotis & Adelais Markaki & Vasiliki Samara & Emmanouil K. Symvoulakis, 2021. "Employment and suicidal rates during economic recession: A country-targeted integrative review," International Journal of Social Psychiatry, , vol. 67(6), pages 801-815, September.
    13. Janina Isabel Steinert & Lucie Dale Cluver & G. J. Melendez-Torres & Sebastian Vollmer, 2018. "One Size Fits All? The Validity of a Composite Poverty Index Across Urban and Rural Households in South Africa," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 136(1), pages 51-72, February.
    14. Brum, Matias & De Rosa, Mauricio, 2021. "Too little but not too late: nowcasting poverty and cash transfers’ incidence during COVID-19’s crisis," World Development, Elsevier, vol. 140(C).
    15. Vu, Trung V., 2020. "Economic complexity and health outcomes: A global perspective," Social Science & Medicine, Elsevier, vol. 265(C).
    16. Matías Brum & Mauricio de Rosa, 2020. "Too little but not too late. Nowcasting poverty and cash transfers' incidence in Uruguay during COVID-19's crisis," Documentos de Trabajo (working papers) 20-09, Instituto de Economía - IECON.
    17. Alkire, Sabina & Santos, Maria Emma, 2014. "Measuring Acute Poverty in the Developing World: Robustness and Scope of the Multidimensional Poverty Index," World Development, Elsevier, vol. 59(C), pages 251-274.
    18. Tomasz Rokicki & Aleksandra Perkowska & Marcin Ratajczak, 2020. "Differentiation in Healthcare Financing in EU Countries," Sustainability, MDPI, vol. 13(1), pages 1-17, December.
    19. Chris De Neubourg & Jingqing Chai & Marlous de Milliano & Ilze Plavgo, 2013. "Step-by-Step Guidelines to the Multiple Overlapping Deprivation Analysis (MODA)," Papers inwopa695, Innocenti Working Papers.
    20. M. Azhar Hussain & Nikolaj Siersbæk & Lars Peter Østerdal, 2020. "Multidimensional welfare comparisons of EU member states before, during, and after the financial crisis: a dominance approach," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 55(4), pages 645-686, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12161-:d:925045. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.