Similarity of Slovak regions in neoplastic mortality in the context of risk factors and access to health care

Abstract

Aim: Access to primary health care is highly connected to the prevention of cancer mortality, since the risk factors threatening health can be early identified. The aim of this paper is, firstly, to explore similarity within and between the regions of the Slovak Republic and cancer mortality patterns, and secondly, to reveal if similar regions are characterised by the similar access to health care or risk factors occurrence. Methods: Data on deaths by sex, type of cancer death and region from 1996 to 2014 is provided by the National Health Information Centre of Slovakia. The relationships between 8 regions and 16 cancer types are described by correspondence analysis for both sexes. Results: The most similar cancer mortality patterns among Slovak regions are between the Nitra and Trnava regions for both sexes, and the Košice region for males. The Prešov region is showed as an outlier from other regions for females, likely due to the highest concentration of Roma marginalised communities. As for access to health care, the Trnava region as well as Nitra region report the lowest densities of physicians, 2.4 and 2.6 per 1,000 inhabitants, respectively. The most serious cancer types mortality is attributed to the digestive organs (C15-C26) in each Slovak region for both sexes with the average proportion of 35.56%. Observed high association between the Nitra region and respiratory cancer (C30-C39) in males may be confirmed by the increased incidence of radon in this region. Similarly, a tight relationship between the Bratislava region and cancer of male genital organs (C60-C63) can relate to the highest proportion of drug users in the Bratislava region. Conclusions: Based on the findings of similar regions in cancer mortality patterns, we recommend to set the same prevention programs in the Trnava and Nitra regions, on the other hand, different preventive interventions should be introduced in the Prešov region.