Projections of cancer mortality risks using spatio-temporal P-spline models.

Cancer mortality risk estimates are essential for planning resource allocation and designing and evaluating cancer prevention and management strategies. However, mortality figures generally become available after a few years, making necessary to develop reliable procedures to provide current and near future mortality risks. In this work, a spatio-temporal P-spline model is used to provide predictions of mortality/incidence counts. The model is appropriate to capture smooth temporal trends and to predict cancer mortality/incidence counts in different regions for future years. The prediction mean squared error of the forecast values as well as an appropriate estimator are derived. Spanish prostate cancer mortality data in the period 1975-2008 will be used to illustrate results with a focus on cancer mortality forecasting in 2009-2011.