Optimal locations of establishing smoking cessation services for cancer patients in Crete, Greece

Abstract

Introduction To identify the optimum geographic locations of establishing smoking cessation services for cancer patients in Crete. Material and Methods Data (1992-2013) for selected tobacco induced cancers (lung, oral cavity and pharynx, nasal cavity and paranasal sinus, larynx, esophagus, stomach, pancreas, kidney, liver, bladder, uterus, cervix, colon/rectum, ovary and leukemia) were obtained from the Cancer Registry of Crete (CRC). Age-Adjusted Incidence Rates (AAIR) and Smoking Attributable Fraction (SAF%) were estimated. Smoking rates were estimated by age group and other selected socio-economic and clinical variables. All rates were mapped and analyzed in the ArcGIS 10.3.1. The Getis ord statistic, K-Means (a=0.05) and multi-criteria model builder were performed. Results The AAIR for tobacco-related cancers was 160 new cases/100,000/year (AAIRmales=222.1/100,000/year; AAIRfemales=98.7/100,000/year). Larynx (SAF=71.4%), esophagus (SAF=42.4%), lung (SAF=41.9%), oral cavity (SAF=38.7%) and bladder (SAF=36.5%) presented the highest SAFs in all the municipalities of Crete. Significant variations were observed in the geographical distribution of all estimated rates (Pvalue<0.05). Higher smoking rates among the cancer patients were observed in two urban centers, as well as in several rural municipalities with lower income rates (mean income/year<9,000euro). Ten different locations were identified as optimal areas for smoking cessation services; alternative locations are also provided. Conclusions The proposed optimum locations for establishing smoking cessation services are expected to contribute to the enhancement of cancer control in Crete. Furthermore, this study will guide a smoking cessation program in the region of Crete aiming to minimize the burden of tobacco-induced cancers.

Keywords

• smoking cessation
• cancer
• geographical information systems