Physical exercise, use of Plantago ovata and aspirin, and reduced risk of colon cancer.

To evaluate certain risk and protective factors for colon cancer in our population, we conducted a paired case-control study where cases were all people diagnosed with colon cancer who were registered at the Cancer Data Exchange Systems of the Community of Madrid between January 1995 and December 1996, and controls were randomly taken from electoral lists. The study population consisted of 424 persons. Using SPSS for Windows, variables were adjusted by multiple logistic regression. The results indicate that lack of physical exercise is associated with an increased risk of colon cancer, with an odds ratio (OR) of 2.8 (95% confidence interval (CI) 1.28-6.21) as compared with moderate activity 1-2 days a week. The risk decreases linearly with increasing physical exercise, and this association remains after stratifying the analysis for the existence of constipation. The consumption of is associated with a reduced risk of colon cancer in constipated patients, with an OR of 0.094 (0.014-0.639), as is aspirin use, with an OR of 0.980 (0.898-0.999). These results were obtained after adjusting all the ORs for diet, smoking, alcohol consumption, family history and socio-demographic factors such as marital status and educational level.

[Proposed method to estimate underreporting of induced abortion in Spain]. / Propuesta de un método para estimar la subnotificación del aborto inducido practicado en España.

In Spain, from 1987 to 1990 the rate of legal abortion reported to the health authorities has doubled; nevertheless, the observed geographical differences suggest to an underreporting of the number of voluntary pregnancy terminations. Based on information on several sociodemographic, economic and cultural characteristics, contraceptive use, availability of abortion services, fertility indices, and maternal and child health status, five homogenEous groups of autonomous region were identified applying factor and cluster analysis techniques. To estimate the level of underreporting, we assumed that all the regions which shape a cluster ought to have the same abortion rate that the region with the highest rate in each group. We estimate that about 18,463 abortions (33.2%) were not reported during 1990. The proposed method can be used for assessing the notification since it allows to identify geographical areas where very similar rates of legal abortion are expected.

[The association between regular alcohol consumption and accidents]. / Asociación entre el consumo habitual de alcohol y accidentes.

The traffic accidents prevention in the direction of attempting to limit drinking-driving behaviour is difficult to implement. However, if there was a relationship between these accidents and the regular consumption of alcohol, the reduction of alcohol use should be promoted. Likely, this strategy would be useful to other accidents. This study evaluates the association between regular consumption of alcohol and the occurrence of any type of accidents, a traffic accident, a home accident and an occupational accident. The information source has been interviews carried out to persons 16 years and older in National Health Interview Survey. In occupational accidents only interviews of men between 16 and 64 years of age have been used. The odds ratio (OR) calculated by logistic regression was the measure of association used. Except for home accidents, the results show statistically significant OR for the 16 to 24 and 25 to 44 age groups. For the occurrence of any type of accident, the ORs for the 16 to 24 years age group were: 1.37 for moderate drinkers, 1.87 for great drinkers and 2.55 for heavy drinkers, and the ORs for the 25 to 44 years age group were 1.28, 1.65 and 2.11 for the same levels of consumption. Similar magnitude of association showed the traffic and occupational accidents. In all cases interaction between regular consumption of alcohol and age was found. Our results suggest that a new direction in the health policy of accidents should be developed.

[Life expectancy free of disability: global indicator of health status]. / Esperanza de vida libre de incapacidad: un indicador global del estado de salud.

BACKGROUND: Due to the limitations of mortality and morbidity as measures of the health status in developed countries, the elaboration of health indexes which include quality of life in addition to life duration has been proposed. The aim of the present article is to report the results of the calculation for Spain in 1986 of one of these indexes, the expectancy of life free from disability (ELFD). METHODS: The life expectancy (LE) and the ELFD were calculated on the basis of data from health surveys by interview and mortality data from routine statistics. This method was proposed by Sullivan in 1971 on the basis of the procedure of life tables. RESULTS: The results showed that the difference in LE between sexes was reduced when the years lived in disability were taken into account. Thus, while LE at birth was 79.6 years in females and 73.2 in males, the ELFD was 62.6 and 60.8, respectively. CONCLUSIONS: The important reduction in the difference between sexes regarding LE when ELFD is accounted for shows that the gain in years of life in females is obtained at the expense of years lived in disability. ELFD appears as a useful index for the evaluation of needs and the planning of social health services.

[Social inequality and mortality in Spain]. / Desigualdad social y mortalidad en España.

The routine information sources published by the National Statistics Institute have been used to show the mortality rate with regard to the socioeconomic situation. Occupation has been used as an indicator for the socioeconomic position. The deaths of males between the ages of 16 and 65 years have been considered. The population chosen was that which figured in the 1981 Census. The measurements which have been studied are the Standardized Mortality Rate, the Standardized Mortality Ratio (SMR) and Potential Life Years Lost (PLYL). Differences in mortality according to occupational group have been found; group VII always displayed the worst results. The Mortality Rate of this group is 1.65 times higher than that group I, the SMR is 149 (100 in group I) and the PLYL rate is 43.59 per 1000 (per 28.48 in group I). The best results in group V have been attributed to the lack of homogeneity among its components, thus limiting its use in this type of study.

PIP: Data from official Spanish sources are used to explore the relationship between social inequality and mortality. The focus is on mortality differentials by occupation for males aged 16 to 65 between 1980 and 1982. The results confirm that the lowest socioeconomic groups experience the highest rates of mortality. (SUMMARY IN ENG)