Search

Summary: Objective: To estimate national and provincial prevalence of obesity and excess weight in the child and adolescent population in Spain by sex and sociodemographic characteristics, and to explore sources of inequalities in their distribution, and their geographical patterns. Methods: ENE‐COVID is a nationwide representative seroepidemiological survey (68 287 participants) stratified by province and municipality size (April–June 2020). Participants answered a questionnaire which collected self‐reported weight and height, that allowed estimating crude and model‐based standardized prevalences of obesity and excess weight in the 10 543 child and adolescent participants aged 2–17 years. Results: Crude prevalences (WHO growth reference) were higher in boys than in girls (obesity: 13.4% vs. 7.9%; excess weight: 33.7% vs. 26.0%; severe obesity: 2.9% vs. 1.2%). These prevalences varied with age, increased with the presence of any adult with excess weight in the household, while they decreased with higher adult educational and census tract average income levels. Obesity by province ranged 1.8%–30.5% in boys and 0%–17.6% in girls; excess weight ranged 15.2%–49.9% in boys and 10.8%–40.8% in girls. The lowest prevalences of obesity and excess weight were found in provinces in the northern half of Spain. Sociodemographic characteristics only partially explained the observed geographical variability (33.6% obesity; 44.2% excess weight). Conclusions: Childhood and adolescent obesity and excess weight are highly prevalent in Spain, with relevant sex, sociodemographic and geographical differences. The geographic variability explained by sociodemographic variables indicates that there are other potentially modifiable factors on which to focus interventions at different geographic levels to fight this problem. [ABSTRACT FROM AUTHOR]

INTRODUCTION The role of cigarette smoking on breast cancer risk remains controversial, due to its dual carcinogenic-antiestrogenic action. METHODS In the population-based multi-case-control study (MCC-Spain), we collected epidemiological and clinical information for 1733 breast cancer cases and 1903 controls, including smoking exposure. The association with breast cancer, overall, by pathological subtype and menopausal status, was assessed using logistic and multinomial regression models. RESULTS Smokers had higher risk of premenopausal breast cancer, particularly if they had smoked ≥30 years (AOR=1.75; 95% CI: 1.04-2.94), although most estimates did not achieve statistical significance. In contrast, among postmenopausal women, smoking was associated with lower risk of breast cancer, mainly in overweight and obese women. The strongest risk reductions were observed among postmenopausal women who had stopped smoking ≥10 years before cancer diagnosis, particularly for HER2+ tumors (AOR=0.28; 95% CI: 0.11-0.68); p for heterogeneity = 0.040). Also, those who had smoked <10 pack-years (AOR=0.68; 95% CI: 0.47-0.98) or 10-25 pack-years (AOR=0.62; 95% CI: 0.42-0.92) during their lifetime were at a reduced risk of all breast cancer subtypes (p for heterogeneity: 0.405 and 0.475, respectively); however, women who had smoked more than 25 pack-years showed no reduced risk. CONCLUSIONS Menopausal status plays a key role in the relationship between tobacco and breast cancer for all cancer subtypes. While smoking seems to increase the risk in premenopausal woman, it might be associated to lower risk of breast cancer among postmenopausal women with excess weight. [ABSTRACT FROM AUTHOR]

Objective: The prevalence of depressive symptoms immediately after the diagnosis of colorectal cancer (CRC) is high and has important implications both psychologically and on the course of the disease. The aim of this study is to analyse the association between depressive symptoms and CRC survival at 5 years after diagnosis.Methods: This multicentre, prospective, observational cohort study was conducted on a sample of 2602 patients with CRC who completed the Hospital Anxiety and Depression Scale (HADS-D) at 5 years of follow-up. Survival was analysed using the Kaplan-Meier method and Cox regression models.Results: According to our analysis, the prevalence of depressive symptoms after a CRC diagnosis was 23.8%. The Cox regression analysis identified depression as an independent risk factor for survival (HR = 1.47; 95% CI: 1.21-1.8), a finding which persisted after adjusting for sex (female: HR = 0.63; 95% CI: 0.51-0.76), age (>70 years: HR = 3.78; 95% CI: 1.94-7.36), need for help (yes: HR = 1.43; 95% CI: 1.17-1.74), provision of social assistance (yes: HR = 1.46; 95% CI: 1.16-1.82), tumour size (T3-T4: HR = 1.56; 95% CI: 1.22-1.99), nodule staging (N1-N2: HR = 2.46; 95% CI: 2.04-2.96), and diagnosis during a screening test (yes: HR = 0.71; 95% CI: 0.55-0.91).Conclusions: There is a high prevalence of depressive symptoms in patients diagnosed with CRC. These symptoms were negatively associated with the survival rate independently of other clinical variables. Therefore, patients diagnosed with CRC should be screened for depressive symptoms to ensure appropriate treatment can be provided. [ABSTRACT FROM AUTHOR]

Abstract Background Burden of disease is a joint measure of mortality and morbidity which makes it easier to compare health problems in which these two components enjoy different degrees of relative importance. The objective of this study is ascertaining the burden of disease due to cancer in Spain via the calculation of disability-adjusted life years (DALYs). Methods DALYs are the sum of years of life lost due to premature mortality and years lost due to disability. World Health Organization methodology and the following sources of data were used: the Mortality Register and Princeton Model Life Table for Years of life lost due to premature mortality and population, incidence estimates (Spanish tumour registries and fitting of generalized linear mixed models), duration (from data of survival in Spain from the EUROCARE-3 study and fitting of Weibull distribution function) and disability (weights published in the literature) for Years lost due to disability. Results There were 828,997 DALYs due to cancer (20.5 DALYs/1,000 population), 61% in men. Of the total, 51% corresponded to lung, colorectal, breast, stomach and prostate cancers. Mortality (84% of DALYs) predominated over disability. Subjects aged under 20 years accounted for 1.6% and those aged over 70 years accounted for 30.1% of DALYs. Conclusion Lung, colorectal and breast cancers are responsible for the highest number of DALYs in Spain. Even if the burden of disease due to cancer is predominantly caused by mortality, some cancers have a significant weight of disability. Information on 2000 burden of disease due to cancer can be useful to assess how it has evolved over time and the impact of medical advances on it in terms of mortality and disability.

Cadmium is a ubiquitous and persistent metal, associated with different harmful health effects and with increased morbidity and mortality. Understanding the main sources of exposure is essential to identify at risk populations and to design public health interventions. To evaluate cadmium exposure in a random-sample of general adult population from three regions of Spain, assessed by the urinary cadmium (U–Cd) concentration, and to identify its potential determinants and sex-specific differences, including sociodemographic, lifestyle and dietary factors. We measured U–Cd (μg/g creatinine) in single urine spot samples from 1282 controls enrolled in the multicase-control study in common tumors in Spain (MCC-Spain) with inductively coupling plasma-mass spectrometry equipped with an octopole reaction systems (ICP-ORS-MS). The association between sociodemographic, lifestyle, and dietary characteristics and U–Cd concentrations was evaluated using geometric mean ratios (GMR) estimated by multiple log-linear regression models. Overall, geometric mean U–Cd concentration was 0.40 (95%CI: 0.38, 0.41) μg/g creatinine. Levels were higher in women than in men (GMR]: 1.19; 95%CI: 1.07, 1.32), and increased with age in males (p trend < 0.001). Cigarette smoking was clearly associated to U–Cd levels (GMR former vs non-smokers : 1.16; 95%CI: 1.05, 1.29; GMR current vs non-smokers : 1.42; 95%CI: 1.26, 1.60); the relationship with secondhand tobacco exposure in non-smokers, was restricted to women (p interaction = 0.02). Sampling season and region also seemed to influence U–Cd concentrations, with lower levels in summer (GMR summer vs average : 0.79; 95%CI: 0.71, 0.88), and higher levels in North-Spain Asturias (GMR Asturias vs average : 1.13; 95%CI: 1.04, 1.23). Regarding diet, higher U–Cd concentration was associated with eggs consumption only in men (p interaction = 0.04), just as rice intake was associated in women (p interaction = 0.03). Conclusion : These results confirmed that tobacco exposure is the main modifiable predictor of U–Cd concentrations, and remark that the role of dietary/sociodemographic factors on U–Cd levels may differ by sex. • Smoking status is the main modifiable predictor of U-Cd concentrations. • Secondhand smoke exposure could be an important source of cadmium exposure in women. • Dietary variables explain a small proportion of total variation in U-Cd levels. • Regional/seasonal differences in U-Cd levels suggest environmental factors involved. [ABSTRACT FROM AUTHOR]

Background: In Spain, differences in the prevalence of obesity and excess weight according to sex and sociodemographic factors have been described at the national level, although current data do not allow to delve into geographical differences for these conditions. The aim was to estimate national and regional prevalences of adult obesity and excess weight in Spain by sex and sociodemographic characteristics, and to explore difference sources of inequalities in its distribution, as well as its geographical pattern., Method: ENE-COVID study was a nationwide representative seroepidemiological survey with 57,131 participants. Residents in 35,893 households were selected from municipal rolls using a two-stage random sampling stratified by province and municipality size (April-June 2020). Participants (77.0% of contacted individuals) answered a questionnaire which collected self-reported weight and height, as well as different socioeconomic variables, that allowed estimating crude and standardized prevalences of adult obesity and excess weight., Results: Crude prevalences of obesity and excess weight were higher in men (obesity: 19.3% vs. 18.0%; excess weight: 63.7% vs. 48.4%), while severe obesity was more prevalent in women (4.5% vs. 5.3%). These prevalences increased with age and disability, and decreased with education, census tract income and municipality size. Differences by educational level, relative census income, nationality or disability were clearly higher among women. Obesity by province ranged 13.3-27.4% in men and 11.4-28.1% in women; excess weight ranged 57.2-76.0% in men and 38.9-59.5% in women. The highest prevalences were located in the southern half of the country and some north-western provinces. Sociodemographic characteristics only explained a small part of the observed geographical variability (25.2% obesity)., Conclusion: Obesity and overweight have a high prevalence in Spain, with notable geographical and sex differences. Socioeconomic inequalities are stronger among women. The observed geographical variability suggests the need to implement regional and local interventions to effectively address this public health problem., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gutiérrez-González, García-Solano, Pastor-Barriuso, Fernández de Larrea-Baz, Rollán-Gordo, Peñalver-Argüeso, Peña-Rey, Pollán, Pérez-Gómez and the ENE-COVID Study Group.)

Introduction: The protection of children is a major driver of behavior among those in charge of their care. We evaluated whether compliance with preventive measures against SARS-CoV-2 infection among adults living with children was different from that of those not living with them, in 2020., Methods: We used the COSMO-SPAIN ( N = 867) and the nationally representative ENE-COVID ( N = 29,926) surveys to estimate prevalence of compliance (95% confidence interval). Logistic model based standardization methods were applied to estimate standardized prevalence differences (SPrD) to the overall distribution of age, sex, education, history of COVID-19, and residence of other >60 yrs in the household., Results: We observed that adults living with children more frequently avoided bars (SPrD ENE-COVID : 4.2%; 95% CI: 2.3-6.1), crowded places (SPrD COSMO : 8.0%; 95% CI: 0.6-15.1) and did not use public transportation (SPrD ENE-COVID : 4.9%; 95% CI: 3.0-6.7). They were also more worried about work and family conciliation (SPrD COSMO : 12.2%; 95% CI: 4.8-19.5) and about closure of education centers (SPrD COSMO : 26.5%; 95% CI: 19.4-33.6)., Discussion: In general, adults living with children adopted slightly more frequently social distancing measures., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Jroundi, Fernández de Larrea-Baz, Rodríguez-Blázquez, Pastor-Barriuso, Pollán-Santamaría, Forjaz, Pérez-Gómez and the ENE-COVID Study Group.)

Objective: We analyzed the burden of disease in the elderly population in Spain in 2008., Methods: A population-based cross-sectional study was performed to calculate the disability-adjusted life years (DALYs) of the Spanish population aged ≥ 60 years old. DALYs are the sum of the number of years of life lost (YLLs) and the number of years lived with disability (YLDs). Data sources included the national mortality register for YLLs, and inference of Euro-A subregion (including Spain) estimates for YLDs., Results: In the elderly population, DALYs lost due to all diseases were estimated at 2.1 million. The main causes of DALYs were malignancies (21.3%), neuropsychiatric disorders (21.1%) and cardiovascular diseases (20.4%). The main specific subcategories were dementias, ischemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, lung cancer, hearing loss and osteoarthritis., Conclusions: Burden of disease analysis allows distinct health problems to be reassessed in relation to classical mortality analysis., (Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.)