Material Deprivation and Incidence of Lung Cancer: a Census Block Analysis

We study the relationship between incidence for lung cancer in males in the Tuscan Region and material deprivation defined at census block level. We developed a bi-variate hierarchical Bayesian model to assess completeness of registration of incidence data and we proposed a series of random effect hierarchical Bayesian models to estimate the degree of association with material deprivation. Model comparison is addressed by a modified Deviance Information Criterion. We estimated a percent increase in risk of lung cancer for an increase of one standard deviation of material deprivation at census block level of 3.36% vs 5.87% at municipality level. The random slope models reported a paradoxically negative effect of material deprivation at census block level in some areas. Spatially structured random intercept models behaved better and random slope models were penalized by their extra complexity. To our knowledge this is the first Italian study which analyzed cancer incidence at regional level.