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Klaus CA, Henry KA, Il'yasova D. Capturing emergency dispatch address points as geocoding candidates to quantify delimited confidence in residential geolocation. Int J Health Geogr 2023; 22:25. [PMID: 37752482 PMCID: PMC10523746 DOI: 10.1186/s12942-023-00347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND In response to citizens' concerns about elevated cancer incidence in their locales, US CDC proposed publishing cancer incidence at sub-county scales. At these scales, confidence in patients' residential geolocation becomes a key constraint of geospatial analysis. To support monitoring cancer incidence in sub-county areas, we presented summary metrics to numerically delimit confidence in residential geolocation. RESULTS We defined a concept of Residential Address Discriminant Power (RADP) as theoretically perfect within all residential addresses and its practical application, i.e., using Emergency Dispatch (ED) Address Point Candidates of Equivalent Likelihood (CEL) to quantify Residential Geolocation Discriminant Power (RGDP) to approximate RADP. Leveraging different productivity of probabilistic, deterministic, and interactive geocoding record linkage, we simultaneously detected CEL for 5,807 cancer cases reported to North Carolina Central Cancer Registry (NC CCR)- in January 2022. Batch-match probabilistic and deterministic algorithms matched 86.0% cases to their unique ED address point candidates or a CEL, 4.4% to parcel site address, and 1.4% to street centerline. Interactively geocoded cases were 8.2%. To demonstrate differences in residential geolocation confidence between enumeration areas, we calculated sRGDP for cancer cases by county and assessed the existing uncertainty within the ED data, i.e., identified duplicate addresses (as CEL) for each ED address point in the 2014 version of the NC ED data and calculated ED_sRGDP by county. Both summary RGDP (sRGDP) (0.62-1.00) and ED_sRGDP (0.36-1.00) varied across counties and were lower in rural counties (p < 0.05); sRGDP correlated with ED_sRGDP (r = 0.42, p < 0.001). The discussion covered multiple conceptual and economic issues attendant to quantifying confidence in residential geolocation and presented a set of organizing principles for future work. CONCLUSIONS Our methodology produces simple metrics - sRGDP - to capture confidence in residential geolocation via leveraging ED address points as CEL. Two facts demonstrate the usefulness of sRGDP as area-based summary metrics: sRGDP variability between counties and the overall lower quality of residential geolocation in rural vs. urban counties. Low sRGDP for the cancer cases within the area of interest helps manage expectations for the uncertainty in cancer incidence data. By supplementing cancer incidence data with sRGDP and ED_sRGDP, CCRs can demonstrate transparency in geocoding success, which may help win citizen trust.
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Affiliation(s)
| | - Kevin A Henry
- Department of Geography, Environment and Urban Studies, Temple University, Philadelphia, PA, USA
- Division of Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Dora Il'yasova
- Center for Social and Clinical Research, National Minority Quality Forum, Washington, DC, USA
- Department of Community and Family Health, Duke University School of Medicine, Durham, NC, USA
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Nguyen CT, Song I, Jung I, Choi Y, Kim S. Changes in spatial clusters of cancer incidence and mortality over 15 years in South Korea: Implication to cancer control. Cancer Med 2023; 12:17418-17427. [PMID: 37489117 PMCID: PMC10501259 DOI: 10.1002/cam4.6365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND The temporal investigation of high-risk areas of cancer incidence and mortality can provide practical implications in cancer control. We aimed to investigate the changes in spatial clusters of incidence and mortality from 1999 through 2013 by major cancer types in South Korea. METHODS We applied flexible scan statistics to identify spatial clusters of cancer incidence and mortality by three 5-year periods and seven major cancer types using the counts of new cases and deaths and population in 244 districts during 1999-2013. Then, we compared the changes across three periods in the locations of primary clusters of incidence and mortality by cancer types. To explore the determinants that possibly affect cancer cluster areas, we compared geographic characteristics between clustered and non-clustered areas. RESULTS While incidence clusters for lung, stomach, and liver cancer remained in the same areas over 15 years, mortality clusters were relocated to the areas similar to those of incidence clusters. In contrast, colorectal, breast, cervical, and prostate cancer displayed consistently different locations of clusters over time, indicating the disappearance of existing clusters and the appearance of new clusters. Cluster areas tended to show higher portions of older population, unemployment, smoking, and cancer screening compared to non-cluster areas particularly for mortality. CONCLUSIONS Our findings of diverse patterns of changes in cancer incidence and mortality clusters over 15 years can indicate the degree of effectiveness in cancer prevention and treatment depending on the area and suggest the need for area-specific applications of different cancer control programs.
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Affiliation(s)
- Cham Thi Nguyen
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and PolicyNational Cancer CenterGoyang‐siRepublic of Korea
| | - Insang Song
- Department of GeographyUniversity of OregonEugeneOregonUSA
| | - Inkyung Jung
- Department of Biomedical Systems InformaticsYonsei UniversitySeoulRepublic of Korea
| | - Yoon‐Jung Choi
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and PolicyNational Cancer CenterGoyang‐siRepublic of Korea
| | - Sun‐Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and PolicyNational Cancer CenterGoyang‐siRepublic of Korea
- Department of Cancer AI and Digital Health, Graduate School of Cancer Science and PolicyNational Cancer CenterGoyang‐siRepublic of Korea
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Slavik CE, Yiannakoulias N. Investigating reports of cancer clusters in Canada: a qualitative study of public health communication practices and investigation procedures. Health Promot Chronic Dis Prev Can 2022; 42:490-502. [PMID: 36383159 PMCID: PMC9903850 DOI: 10.24095/hpcdp.42.11/12.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION: Public health officials provide an important public service responding to community concerns around cancer and often receive requests to investigate patterns of cancer incidence and communicate findings with citizens. In this study, we identified procedures Canadian public health officials followed when investigating reports of cancer clusters, and explored the challenges officials faced conducting risk communication with communities. METHODS: Thirteen interviews were administered by telephone with 15 officials across Canadian jurisdictions and analyzed using thematic analysis. A content analysis of procedural documents received from five provinces was also undertaken. RESULTS: A third of provinces/territories in this study did not use any consistent guidelines to investigate reports of cancer clusters, a third used their own guidelines and a third used guidelines from other countries. Each Canadian jurisdiction identified a different agency or individual responsible for investigating cluster inquiries. Officials in most interviews considered public education to be the primary objective of risk communication during an investigation. Officials in only 4 of 13 interviews cited an overall positive response from the public after investigating reports of a cancer cluster. CONCLUSION: Differences in practices used to investigate suspected cancer clusters by public health officials were revealed in this work. Establishing pan-Canadian cancer cluster guidelines could improve procedural consistency across jurisdictions and offer enhanced opportunities to compare cluster responses for evaluation. A reporting system to track reported clusters may improve information sharing between federal, provincial/territorial and local investigators. During formal investigations, face-to-face participatory communication approaches should be explored to improve citizen engagement and manage community concerns.
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Affiliation(s)
- Catherine E Slavik
- School of Earth, Environment & Society, McMaster University, Hamilton, Ontario, Canada
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Niko Yiannakoulias
- School of Earth, Environment & Society, McMaster University, Hamilton, Ontario, Canada
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Sadler RC, Larsen K. Mapping the Way to Good Health: The Interdisciplinary Challenges of Geographers in Medical Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12419. [PMID: 36231725 PMCID: PMC9564750 DOI: 10.3390/ijerph191912419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
Geography has an important role to play in shaping the direction of medical research. In particular, its tools and theory provide essential understanding to the impacts of place on health behaviors and outcomes. Understanding some of its evolution-particularly into the subfield of medical geography-is therefore useful both for geographers and medical researchers. In this paper, we present some of the debates that geographers have grappled with, the growth of GIS (particularly in the context of medical research), some important methodological considerations that geographers help center, and some recommendations for future work at this nexus. Throughout, we speak from the perspective of geographers who have worked nearly exclusively in the health sciences since obtaining our PhDs.
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Affiliation(s)
- Richard Casey Sadler
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI 48502, USA
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Kristian Larsen
- CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Department of Geography and Planning, University of Toronto, Toronto, ON M5G 1G6, Canada
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
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A Flexible Method for Identifying Spatial Clusters of Breast Cancer Using Individual-Level Data. Ann Epidemiol 2022; 73:9-16. [PMID: 35772615 DOI: 10.1016/j.annepidem.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/16/2022] [Accepted: 06/10/2022] [Indexed: 11/22/2022]
Abstract
Prior research has shown that cancer risk varies by geography, but scan statistics methods for identifying cancer clusters in case-control studies have been limited in their ability to identify multiple clusters and adjust for participant-level risk factors. We develop a method to identify geographic patterns of breast cancer odds using the Wisconsin Women's Health Study, a series of 5 population-based case-control studies of female Wisconsin residents aged 20-79 enrolled in 1988-2004 (cases=16,076, controls=16,795). We create sets of potential clusters by overlaying a 1 km grid over each county-neighborhood and enumerating a series of overlapping circles. Using a two-step approach, we fit a penalized binomial regression model to the number of cases and trials in each grid cell, penalizing all potential clusters by the least absolute shrinkage and selection operator (Lasso). We use BIC to select the number of clusters, which are included in a participant-level logistic regression model. We identify 15 geographic clusters, resulting in 23 areas of unique geographic odds ratios. After adjustment for known risk factors, confidence intervals narrowed but breast cancer odds ratios did not meaningfully change; one additional hotspot was identified. By considering multiple overlapping spatial clusters simultaneously, we discern gradients of spatial odds across Wisconsin.
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Palmer AL, Wong-Francq K, Setton E. Cancer and the Environment projects with four First Nations organizations: working together to address concerns about carcinogens in the environment. Canadian Journal of Public Health 2021; 113:227-238. [PMID: 34669182 PMCID: PMC8975920 DOI: 10.17269/s41997-021-00571-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/20/2021] [Indexed: 11/17/2022]
Abstract
Setting For First Nations people, human health and well-being are interconnected with a healthy environment. First Nations organizations commonly raise concerns regarding carcinogens in the environment; however, few case studies are available as guidance for working in a participatory and respectful way to help assess and address these concerns. Intervention Through four community-led pilot projects executed over two years, we collaborated with 15 participants from four First Nations organizations across four provinces to identify concerns related to environmental carcinogens and to address those concerns through an integrated knowledge translation (KT) approach. We co-developed and implemented strategic KT plans for each pilot project, and conducted evaluation surveys and interviews with participants at multiple time points to assess process, progress, barriers and facilitators, and impact. Outcomes The activities and outputs of the pilot projects are available at www.carexcanada.ca. Participants identified 18 concerns, and we co-developed 24 knowledge products. Tailored fact sheets for communities and briefing notes for leadership were deemed most useful; interactive maps were deemed less useful. Evaluation indicated that the collaborative projects were effective in addressing the concerns raised regarding exposures to carcinogens. Implications The participant-led approach and multi-year funding to support capacity enhancement and face-to-face engagement were facilitators to project success. However, participants did face important barriers to collaborate which should be considered in future projects of this kind: the most important being a lack of resources (people and time), given competing and often more urgent priorities.
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Affiliation(s)
- Alison L Palmer
- CAREX Canada, Faculty of Health Sciences, Simon Fraser University, Harbour Centre Campus, Suite 2602, 515 West Hastings St, Vancouver, BC, V6B 5K3, Canada.
| | - Katy Wong-Francq
- Office of the Vice President, Research and International, University of Waterloo, Waterloo, ON, Canada
| | - Eleanor Setton
- Department of Geography, University of Victoria, Victoria, BC, Canada
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Schündeln MM, Lange T, Knoll M, Spix C, Brenner H, Bozorgmehr K, Stock C. Statistical methods for spatial cluster detection in childhood cancer incidence: A simulation study. Cancer Epidemiol 2020; 70:101873. [PMID: 33360605 DOI: 10.1016/j.canep.2020.101873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/15/2020] [Accepted: 11/29/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVE The potential existence of spatial clusters in childhood cancer incidence is a debated topic. Identification of such clusters may help to better understand etiology and develop preventive strategies. We evaluated widely used statistical approaches to cluster detection in this context. METHODS Incidence of newly diagnosed childhood cancer (140/1,000,000 children under 15 years) and nephroblastoma (7/1,000,000) was simulated. Clusters of defined size (1-50) were randomly assembled on the district level in Germany. Each cluster was simulated with different relative risk levels (1-100). For each combination 2000 iterations were done. Simulated data was then analyzed by three local clustering tests: Besag-Newell method, spatial scan statistic and Bayesian Besag-York-Mollié with Integrated Nested Laplace Approximation approach. The operating characteristics (sensitivity, specificity, predictive values, power and correct classification) of all three methods were systematically described. RESULTS Performance varied considerably within and between methods, depending on the simulated setting. Sensitivity of all methods was positively associated with increasing size, incidence and RR of the high-risk area. Besag-York-Mollié showed highest specificity for minimally increased RR in most scenarios. The performance of all methods was lower in the nephroblastoma scenario compared with the scenario including all cancer cases. CONCLUSION This study illustrates the challenge to make reliable inferences on the existence of spatial clusters based on single statistical approaches in childhood cancer. Application of multiple methods, ideally with known operating characteristics, and a critical discussion of the joint evidence seems recommendable when aiming to identify high-risk clusters.
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Affiliation(s)
- Michael M Schündeln
- Pediatric Hematology and Oncology, Department of Pediatrics III, University Hospital Essen and the University of Duisburg-Essen, Essen, Germany.
| | - Toni Lange
- Center for Evidence-based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Germany
| | - Maximilian Knoll
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Claudia Spix
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kayvan Bozorgmehr
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Christian Stock
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Heidelberg, Germany
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Nethery RC, Yang Y, Brown AJ, Dominici F. A causal inference framework for cancer cluster investigations using publicly available data. JOURNAL OF THE ROYAL STATISTICAL SOCIETY. SERIES A, (STATISTICS IN SOCIETY) 2020; 183:1253-1272. [PMID: 34262243 PMCID: PMC8276584 DOI: 10.1111/rssa.12567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Often, a community becomes alarmed when high rates of cancer are noticed, and residents suspect that the cancer cases could be caused by a known source of hazard. In response, the US Centers for Disease Control and Prevention recommend that departments of health perform a standardized incidence ratio (SIR) analysis to determine whether the observed cancer incidence is higher than expected. This approach has several limitations that are well documented in the existing literature. In this paper we propose a novel causal inference framework for cancer cluster investigations, rooted in the potential outcomes framework. Assuming that a source of hazard representing a potential cause of increased cancer rates in the community is identified a priori, we focus our approach on a causal inference estimand which we call the causal SIR (cSIR). The cSIR is a ratio defined as the expected cancer incidence in the exposed population divided by the expected cancer incidence for the same population under the (counterfactual) scenario of no exposure. To estimate the cSIR we need to overcome two main challenges: 1) identify unexposed populations that are as similar as possible to the exposed one to inform estimation of the expected cancer incidence under the counterfactual scenario of no exposure, and 2) publicly available data on cancer incidence for these unexposed populations are often available at a much higher level of spatial aggregation (e.g. county) than what is desired (e.g. census block group). We overcome the first challenge by relying on matching. We overcome the second challenge by building a Bayesian hierarchical model that borrows information from other sources to impute cancer incidence at the desired level of spatial aggregation. In simulations, our statistical approach was shown to provide dramatically improved results, i.e., less bias and better coverage, than the current approach to SIR analyses. We apply our proposed approach to investigate whether trichloroethylene vapor exposure has caused increased cancer incidence in Endicott, New York.
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Affiliation(s)
| | - Yue Yang
- Harvard T.H. Chan School of Public Health, Boston MA, USA
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Horzmann KA, Portales AM, Batcho KG, Freeman JL. Developmental toxicity of trichloroethylene in zebrafish (Danio rerio). ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2020; 22:728-739. [PMID: 31989135 DOI: 10.1039/c9em00565j] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Trichloroethylene (TCE), an industrial solvent and degreaser, is an environmental toxicant that contaminates over half of Superfund sites, is a known carcinogen, and is linked to congenital defects and neurodegenerative disease. The developmental toxicity of TCE near ecologically relevant levels needs further characterization in order to better assess health risks of exposure. In this study, the toxicodynamics of TCE in the zebrafish (Danio rerio) model was investigated through the establishment of a LC50 concentration and by monitoring the acute developmental toxicity of ecologically relevant concentrations (0, 5, 50, and 500 parts per billion; ppb) of TCE during two different exposure lengths (1-72 hours post fertilization (hpf) and 1-120 hpf). Acute developmental toxicity was assessed by monitoring survival and hatching, larval morphology, larval heart rate, and behavioral responses during an embryonic photomotor response test and a larval visual motor response test. Embryonic exposure to TCE was associated with decreased percent hatch at 48 hpf, altered larval morphology, increased heart rate, and altered behavioral responses during the photomotor response test and visual motor response test. Larval morphology and behavioral alterations were more pronounced in the 1-120 hpf exposure length trials. The observed alterations suggest developmental TCE toxicity is still a concern at regulatory concentrations and that timing of exposure influences developmental toxicity.
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Affiliation(s)
- Katharine A Horzmann
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA.
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Francis SS, Enders C, Hyde R, Gao X, Wang R, Ma X, Wiemels JL, Selvin S, Metayer C. Spatial-Temporal Cluster Analysis of Childhood Cancer in California. Epidemiology 2020; 31:214-223. [PMID: 31596791 PMCID: PMC9005107 DOI: 10.1097/ede.0000000000001121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The observance of nonrandom space-time groupings of childhood cancer has been a concern of health professionals and the general public for decades. Many childhood cancers are suspected to have initiated in utero; therefore, we examined the spatial-temporal randomness of the birthplace of children who later developed cancer. METHODS We performed a space-time cluster analysis using birth addresses of 5,896 cases and 23,369 population-based, age-, sex-, and race/ethnicity-matched controls in California from 1997 to 2007, evaluating 20 types of childhood cancer and three a priori designated subgroups of childhood acute lymphoblastic leukemia (ALL). We analyzed data using a newly designed semiparametric analysis program, ClustR, and a common algorithm, SaTScan. RESULTS We observed evidence for nonrandom space-time clustering for ALL diagnosed at 2-6 years of age in the South San Francisco Bay Area (ClustR P = 0.04, SaTScan P = 0.07), and malignant gonadal germ cell tumors in a region of Los Angeles (ClustR P = 0.03, SaTScan P = 0.06). ClustR did not identify evidence of clustering for other childhood cancers, although SaTScan suggested some clustering for Hodgkin lymphoma (P = 0.09), astrocytoma (P = 0.06), and retinoblastoma (P = 0.06). CONCLUSIONS Our study provides evidence that childhood ALL diagnosed at 2-6 years and malignant gonadal germ cell tumors sporadically occurs in nonrandom space-time clusters. Further research is warranted to identify epidemiologic features that may inform the underlying etiology.
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Affiliation(s)
- Stephen Starko Francis
- Department of Neurological Surgery, University of California, San Francisco, USA
- Division of Epidemiology, University of Nevada, Reno, USA
| | - Catherine Enders
- Division of Epidemiology, University of California, Berkeley, USA
| | - Rebecca Hyde
- Division of Epidemiology, University of California, Berkeley, USA
| | - Xing Gao
- Division of Epidemiology, University of California, Berkeley, USA
| | - Rong Wang
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, USA
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, USA
| | - Joseph L. Wiemels
- Department of Genetic Epidemiology, University of Southern California, USA
| | - Steve Selvin
- Division of Epidemiology, University of California, Berkeley, USA
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Protecting Children from Toxic Waste: Data-Usability Evaluation Can Deter Flawed Cleanup. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020424. [PMID: 31936349 PMCID: PMC7014154 DOI: 10.3390/ijerph17020424] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/20/2019] [Accepted: 12/26/2019] [Indexed: 01/04/2023]
Abstract
Nearly 25 percent of US children live within 2 km of toxic-waste sites, most of which are in urban areas. They face higher rates of cancer than adults, partly because the dominant contaminants at most US hazardous-waste sites include genotoxic carcinogens, like trichloroethylene, that are much more harmful to children. The purpose of this article is to help protect the public, especially children, from these threats and to improve toxics-remediation by beginning to test our hypothesis: If site-remediation assessments fail data-usability evaluation (DUE), they likely compromise later cleanups and public health, especially children’s health. To begin hypothesis-testing, we perform a focused DUE for an unremediated, Pasadena, California toxic site. Our DUE methods are (a) comparing project-specific, remediation-assessment data with the remediation-assessment conceptual site model (CSM), in order to identify data gaps, and (b) using data-gap directionality to assess possible determinate bias (whether reported toxics risks are lower/higher than true values). Our results reveal (1) major CSM data gaps, particularly regarding Pasadena-toxic-site risks to children; (2) determinate bias, namely, risk underestimation; thus (3) likely inadequate remediation. Our discussion shows that if these results are generalizable, requiring routine, independent, DUEs might deter flawed toxic-site assessment/cleanup and resulting health threats, especially to children.
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Garvin MC, Schijf J, Kaufman SR, Konow C, Liang D, Nigra AE, Stracker NH, Whelan RJ, Wiles GC. A survey of trace metal burdens in increment cores from eastern cottonwood (Populus deltoides) across a childhood cancer cluster, Sandusky County, OH, USA. CHEMOSPHERE 2020; 238:124528. [PMID: 31425869 DOI: 10.1016/j.chemosphere.2019.124528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/04/2019] [Accepted: 08/05/2019] [Indexed: 06/10/2023]
Abstract
A dendrochemical study of cottonwood trees (Populus deltoides) was conducted across a childhood cancer cluster in eastern Sandusky County (Ohio, USA). The justification for this study was that no satisfactory explanation has yet been put forward, despite extensive local surveys of aerosols, groundwater, and soil. Concentrations of eight trace metals were measured by ICP-MS in microwave-digested 5-year sections of increment cores, collected during 2012 and 2013. To determine whether the onset of the first cancer cases could be connected to an emergence of any of these contaminants, cores spanning the period 1970-2009 were taken from 51 trees of similar age, inside the cluster and in a control area to the west. The abundance of metals in cottonwood tree annual rings served as a proxy for their long-term, low-level accumulation from the same sources whereby exposure of the children may have occurred. A spatial analysis of cumulative metal burdens (lifetime accumulation in the tree) was performed to search for significant 'hotspots', employing a scan statistic with a mask of variable radius and center. For Cd, Cr, and Ni, circular hotspots were found that nearly coincide with the cancer cluster and are similar in size. No hotspots were found for Co, Cu, and Pb, while As and V were largely below method detection limits. Whereas our results do not implicate exposure to metals as a causative factor, we conclude that, after 1970, cottonwood trees have accumulated more Cd, Cr, and Ni, inside the childhood cancer cluster than elsewhere in Sandusky County.
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Affiliation(s)
- Mary C Garvin
- Oberlin College, Department of Biology, 119 Woodland St., Oberlin, OH, 44074, USA
| | - Johan Schijf
- University of Maryland Center for Environmental Science, Chesapeake Biological Laboratory, P.O. Box 38, Solomons, MD, 20688, USA.
| | - Sonya R Kaufman
- Oberlin College, Department of Biology, 119 Woodland St., Oberlin, OH, 44074, USA
| | - Courtney Konow
- Oberlin College, Department of Biology, 119 Woodland St., Oberlin, OH, 44074, USA
| | - Dong Liang
- University of Maryland Center for Environmental Science, Chesapeake Biological Laboratory, P.O. Box 38, Solomons, MD, 20688, USA
| | - Anne E Nigra
- Columbia University Mailman School of Public Health, Department of Environmental Health Sciences, 722 West 168th St., New York, NY, 10032, USA
| | - Norberth H Stracker
- Johns Hopkins University School of Medicine, Division of Infectious Diseases, 1830 East Monument St., Room 442, Baltimore, MD, 21287, USA
| | - Rebecca J Whelan
- University of Notre Dame, Department of Chemistry and Biochemistry, 140D McCourtney Hall, Notre Dame, IN, 46556, USA
| | - Gregory C Wiles
- The College of Wooster, Department of Earth Sciences, 944 College Hall, Wooster, OH, 44691, USA
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Abstract
BACKGROUND Until recently, large individual-level longitudinal data were unavailable to investigate clusters of disease, driving a need for suitable statistical tools. We introduce a robust, efficient, intuitive R package, ClustR, for space-time cluster analysis of individual-level data. METHODS We developed ClustR and evaluated the tool using a simulated dataset mirroring the population of California with constructed clusters. We assessed Cluster's performance under various conditions and compared it with another space-time clustering algorithm: SaTScan. RESULTS ClustR mostly exhibited high sensitivity for urban clusters and low sensitivity for rural clusters. Specificity was generally high. Compared with SaTScan, ClustR ran faster and demonstrated similar sensitivity, but had lower specificity. Select cluster types were detected better by ClustR than SaTScan and vice versa. CONCLUSION ClustR is a user-friendly, publicly available tool designed to perform efficient cluster analysis on individual-level data, filling a gap among current tools. ClustR and SaTScan exhibited different strengths and may be useful in conjunction.
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Yang B, Liu JB, So SK, Han SS, Wang SS, Hertz A, Shariff-Marco S, Gomez SL, Rosenberg PS, Nguyen MH, Hsing AW. Disparities in hepatocellular carcinoma incidence by race/ethnicity and geographic area in California: Implications for prevention. Cancer 2018; 124:3551-3559. [PMID: 30113700 PMCID: PMC6436543 DOI: 10.1002/cncr.31598] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND The incidence of hepatocellular carcinoma (HCC) has been rising rapidly in the United States. California is an ethnically diverse state with the largest number of incident HCC cases in the country. Characterizing HCC disparities in California may inform priorities for HCC prevention. METHODS By using data from the Surveillance, Epidemiology, and End Results 18-Registry Database and the California Cancer Registry, age-adjusted HCC incidence in California from 2009 through 2013 was calculated by race/ethnicity and neighborhood ethnic enclave status. A geographic analysis was conducted using Medical Service Study Areas (MSSAs) as the geographic unit, and race/ethnicity-specific standardized incidence ratios (SIRs) were calculated to identify MSSAs with higher-than-expected HCC incidence compared with the statewide average. RESULTS During 2009 through 2013, the age-adjusted incidence of HCC in California was the highest in Asians/Pacific Islanders (APIs) and Hispanics (>100% higher than whites), especially those living in more ethnic neighborhoods (20%-30% higher than less ethnic neighborhoods). Of the 542 MSSAs statewide, 42 had elevated HCC incidence (SIR ≥ 1.5; lower bound of 95% confidence interval > 1) for whites, 14 for blacks, 24 for APIs, and 36 for Hispanics. These MSSAs have 24% to 52% higher proportions of individuals below the 100% federal poverty line than other MSSAs. CONCLUSIONS APIs and Hispanics residing in more ethnic neighborhoods and individuals residing in lower income neighborhoods require more extensive preventive efforts tailored toward their unique risk factor profiles. The current race/ethnicity-specific geographic analysis can be extended to other states to inform priorities for HCC targeted prevention at the subcounty level, eventually reducing HCC burden in the country.
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Affiliation(s)
- Baiyu Yang
- Stanford Cancer Institute, Stanford University School of Medicine, Palo Alto, California
| | - Jessica B. Liu
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California
| | - Samuel K. So
- Stanford Cancer Institute, Stanford University School of Medicine, Palo Alto, California
- Asian Liver Center, Stanford University School of Medicine, Palo Alto, California
| | - Summer S. Han
- Stanford Cancer Institute, Stanford University School of Medicine, Palo Alto, California
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California
| | - Sophia S. Wang
- Department of Population Sciences, City of Hope, Duarte, California
| | - Andrew Hertz
- Cancer Prevention Institute of California, Fremont, California
| | - Salma Shariff-Marco
- Stanford Cancer Institute, Stanford University School of Medicine, Palo Alto, California
- Cancer Prevention Institute of California, Fremont, California
| | - Scarlett Lin Gomez
- Cancer Prevention Institute of California, Fremont, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Philip S. Rosenberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Mindie H. Nguyen
- Stanford Cancer Institute, Stanford University School of Medicine, Palo Alto, California
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Ann W. Hsing
- Stanford Cancer Institute, Stanford University School of Medicine, Palo Alto, California
- Department of Medicine, Stanford University School of Medicine, Stanford, California
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
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15
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Press DJ, McKinley M, Deapen D, Clarke CA, Gomez SL. Residential cancer cluster investigation nearby a Superfund Study Area with trichloroethylene contamination. Cancer Causes Control 2016; 27:607-13. [PMID: 26983615 PMCID: PMC5759954 DOI: 10.1007/s10552-016-0734-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/29/2016] [Indexed: 01/07/2023]
Abstract
PURPOSE Trichloroethylene (TCE) is an industrial solvent associated with liver cancer, kidney cancer, and non-Hodgkin's lymphoma (NHL). It is unclear whether an excess of TCE-associated cancers have occurred surrounding the Middlefield-Ellis-Whisman Superfund site in Mountain View, California. We conducted a population-based cancer cluster investigation comparing the incidence of NHL, liver, and kidney cancers in the neighborhood of interest to the incidence among residents in the surrounding four-county region. METHODS Case counts and address information were obtained using routinely collected data from the Greater Bay Area Cancer Registry, part of the Surveillance, Epidemiology, and End Results program. Population denominators were obtained from the 1990, 2000, and 2010 US censuses. Standardized incidence ratios (SIRs) with two-sided 99 % confidence intervals (CIs) were calculated for time intervals surrounding the US Censuses. RESULTS There were no statistically significant differences between the neighborhood of interest and the larger region for cancers of the liver or kidney. A statistically significant elevation was observed for NHL during one of the three time periods evaluated (1996-2005: SIR = 1.8, 99 % CI 1.1-2.8). No statistically significant NHL elevation existed in the earlier 1988-1995 (SIR = 1.3, 99 % CI 0.5-2.6) or later 2006-2011 (SIR = 1.3, 99 % CI 0.6-2.4) periods. CONCLUSION There is no evidence of an increased incidence of liver or kidney cancer, and there is a lack of evidence of a consistent, sustained, or more recent elevation in NHL occurrence in this neighborhood. This evaluation included existing cancer registry data, which cannot speak to specific exposures incurred by past or current residents of this neighborhood.
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Affiliation(s)
- David J Press
- Cancer Prevention Institute of California, 2201 Walnut Ave, Suite 300, Fremont, CA, 94538, USA.
- University of Southern California, 2001 N Soto St, Suite 305, Los Angeles, CA, 90032, USA.
- Department of Public Health Sciences, University of Chicago, 5841 South Maryland Ave, Rm. R-214, MC2000, Chicago, IL, 60637, USA.
| | - Meg McKinley
- Cancer Prevention Institute of California, 2201 Walnut Ave, Suite 300, Fremont, CA, 94538, USA
| | - Dennis Deapen
- University of Southern California, 2001 N Soto St, Suite 305, Los Angeles, CA, 90032, USA
| | - Christina A Clarke
- Cancer Prevention Institute of California, 2201 Walnut Ave, Suite 300, Fremont, CA, 94538, USA
- Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, 94305-5405, USA
| | - Scarlett Lin Gomez
- Cancer Prevention Institute of California, 2201 Walnut Ave, Suite 300, Fremont, CA, 94538, USA
- Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, 94305-5405, USA
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Pérez S, Laperrière V, Borderon M, Padilla C, Maignant G, Oliveau S. Evolution of research in health geographics through the International Journal of Health Geographics (2002-2015). Int J Health Geogr 2016; 15:3. [PMID: 26790403 PMCID: PMC4719657 DOI: 10.1186/s12942-016-0032-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/07/2016] [Indexed: 01/04/2023] Open
Abstract
Health geographics is a fast-developing research area. Subjects broached in scientific literature are most varied, ranging from vectorial diseases to access to healthcare, with a recent revival of themes such as the implication of health in the Smart City, or a predominantly individual-centered approach. Far beyond standard meta-analyses, the present study deliberately adopts the standpoint of questioning space in its foundations, through various authors of the International Journal of Health Geographics, a highly influential journal in that field. The idea is to find space as the common denominator in this specialized literature, as well as its relation to spatial analysis, without for all that trying to tend towards exhaustive approaches. 660 articles have being published in the journal since launch, but 359 articles were selected based on the presence of the word “Space” in either the title, or the abstract or the text over 13 years of the journal’s existence. From that database, a lexical analysis (tag cloud) reveals the perception of space in literature, and shows how approaches are evolving, thus underlining that the scope of health geographics is far from narrowing.
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Affiliation(s)
- Sandra Pérez
- UMR ESPACE 7300, University of Nice Sophia, Nice, France.
| | | | - Marion Borderon
- UMR ESPACE 7300, University of Aix-Marseille, Aix-en-Provence, France.
| | | | | | - Sébastien Oliveau
- UMR ESPACE 7300, University of Aix-Marseille, Aix-en-Provence, France.
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17
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Rosenthal M, Johnson CJ, Scoppa S, Carter K. Two Suspected Worksite or Occupational Cancer Clusters Investigated Using the Cancer Data Registry and Multiple Primary Standardized Incidence Ratios in SEER *Stat-Idaho, 2013-2014. JOURNAL OF REGISTRY MANAGEMENT 2016; 41:128-133. [PMID: 28121313 PMCID: PMC7147979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Investigations of suspected cancer clusters are resource intensive and rarely identify true clusters: among 428 publicly reported US investigations during 1990-2011, only 1 etiologic cluster was identified. In 2013, the Cancer Data Registry of Idaho (CDRI) was contacted regarding a suspected cancer cluster at a worksite (Cluster A) and among an occupational cohort (Cluster B). We investigated to determine whether these were true clusters. METHODS We derived investigation cohorts for Cluster A from facility-provided employee records and for Cluster B from professional licensing records. We used Registry PlusTM Link Plus to conduct probabilistic linkage of cohort members to the CDRI registry and completed matching through manual review by using LexisNexis®, Accurint®, and the Social Security Death Index. We calculated standardized incidence ratios (SIR) using the MP-SIR session type in SEER*Stat and Idaho and US referent populations. RESULTS For Cluster A, we identified 34 cancer cases during 9,689 person-years; compared with Idaho and US rates, 95 percent CIs for SIRs included 1.0 for 24 of 24 primary site categories. For Cluster B, we identified 78 cancer cases during 15,154 person-years; compared with Idaho rates, 95 percent CI for SIRs included 1.0 for 23 of 24 primary site categories and was less than 1.0 for lung and bronchus cancers, and compared with US rates, 95 percent CI for SIRs included 1.0 for 22 of 24 primary site categories and was less than 1.0 for lung and bronchus and colorectal cancers. CONCLUSION We identified no statistically significant excess in cancer incidence in either cohort. SEER*Stat's MP-SIR is an efficient tool for performing SIR assessments, a Centers for Disease Control and Prevention/Council of State and Territorial Epidemiologists-recommended step when investigating suspected cancer clusters.
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Affiliation(s)
- Mariana Rosenthal
- Epidemic Intelligence Service Officer assigned to the Idaho Department of Health and Welfare, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Steve Scoppa
- Information Management Services Inc, Calverton, Maryland
| | - Kris Carter
- Career Epidemiology Field Officer assigned to the Idaho Department of Health and Welfare, Centers for Disease Control and Prevention, Atlanta, Georgia
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18
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Sub-chronic exposure to EOMABRS leachate induces germinal epithelial cell lesions, sperm abnormalities and oxidative damage in rats. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2015. [DOI: 10.1016/j.apjr.2015.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Brotherton L, Welton M, Robb SW. Racial disparities of pancreatic cancer in Georgia: a county-wide comparison of incidence and mortality across the state, 2000-2011. Cancer Med 2015; 5:100-10. [PMID: 26590010 PMCID: PMC4708903 DOI: 10.1002/cam4.552] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 08/31/2015] [Accepted: 09/02/2015] [Indexed: 12/20/2022] Open
Abstract
Understanding the geographic distribution of pancreatic cancer is important in assessing disease burden and identifying high‐risk populations. This study examined the geographic trends of pancreatic cancer incidence, mortality, and mortality‐to‐incidence ratios (MIRs) in Georgia, with a special focus on racial disparities of disease. Directly age‐adjusted pancreatic cancer incidence and mortality rates for Georgia counties (N = 159) were obtained for 2000–2011. Maps of county age‐adjusted disease rates and MIRs were generated separately for African Americans and Caucasians. Cluster analyses were conducted to identify unusual geographic aggregations of cancer cases or deaths. Pearson correlation coefficients were calculated to examine associations between county health factors (e.g., health behaviors, clinical care, and physical environment) and pancreatic cancer incidence or mortality rates. African Americans displayed a significantly higher age‐adjusted incidence (14.6/100,000) and mortality rate (13.3/100,000), compared to Caucasians. Cluster analyses identified five significant incidence clusters and four significant mortality clusters among Caucasians; one significant incidence cluster and two significant mortality clusters were identified among African Americans. Weak but significant correlations were noted between physical environment and pancreatic cancer incidence (ρ = 0.16, P = 0.04) and mortality (ρ = 0.18, P = 0.02) among African Americans. A disproportion burden of pancreatic cancer incidence and mortality was exhibited among African Americans in Georgia. Disease intervention efforts should be implemented in high‐risk areas, such as the southwest and central region of the state. Future studies should assess health behaviors and physical environment in relationship with the spatial distribution of pancreatic cancer.
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Affiliation(s)
- Lindsay Brotherton
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - Michael Welton
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - Sara W Robb
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
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20
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Langie SAS, Koppen G, Desaulniers D, Al-Mulla F, Al-Temaimi R, Amedei A, Azqueta A, Bisson WH, Brown DG, Brunborg G, Charles AK, Chen T, Colacci A, Darroudi F, Forte S, Gonzalez L, Hamid RA, Knudsen LE, Leyns L, Lopez de Cerain Salsamendi A, Memeo L, Mondello C, Mothersill C, Olsen AK, Pavanello S, Raju J, Rojas E, Roy R, Ryan EP, Ostrosky-Wegman P, Salem HK, Scovassi AI, Singh N, Vaccari M, Van Schooten FJ, Valverde M, Woodrick J, Zhang L, van Larebeke N, Kirsch-Volders M, Collins AR. Causes of genome instability: the effect of low dose chemical exposures in modern society. Carcinogenesis 2015; 36 Suppl 1:S61-88. [PMID: 26106144 DOI: 10.1093/carcin/bgv031] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Genome instability is a prerequisite for the development of cancer. It occurs when genome maintenance systems fail to safeguard the genome's integrity, whether as a consequence of inherited defects or induced via exposure to environmental agents (chemicals, biological agents and radiation). Thus, genome instability can be defined as an enhanced tendency for the genome to acquire mutations; ranging from changes to the nucleotide sequence to chromosomal gain, rearrangements or loss. This review raises the hypothesis that in addition to known human carcinogens, exposure to low dose of other chemicals present in our modern society could contribute to carcinogenesis by indirectly affecting genome stability. The selected chemicals with their mechanisms of action proposed to indirectly contribute to genome instability are: heavy metals (DNA repair, epigenetic modification, DNA damage signaling, telomere length), acrylamide (DNA repair, chromosome segregation), bisphenol A (epigenetic modification, DNA damage signaling, mitochondrial function, chromosome segregation), benomyl (chromosome segregation), quinones (epigenetic modification) and nano-sized particles (epigenetic pathways, mitochondrial function, chromosome segregation, telomere length). The purpose of this review is to describe the crucial aspects of genome instability, to outline the ways in which environmental chemicals can affect this cancer hallmark and to identify candidate chemicals for further study. The overall aim is to make scientists aware of the increasing need to unravel the underlying mechanisms via which chemicals at low doses can induce genome instability and thus promote carcinogenesis.
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Affiliation(s)
- Sabine A S Langie
- Environmental Risk and Health Unit, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium, Health Canada, Environmental Health Sciences and Research Bureau, Environmental Health Centre, Ottawa, Ontario K1A0K9, Canada, Department of Pathology, Kuwait University, Safat 13110, Kuwait, Department of Experimental and Clinical Medicine, University of Firenze, Florence 50134, Italy, Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Navarra, Pamplona 31009, Spain, Environmental and Molecular Toxicology, Environmental Health Sciences Center, Oregon State University, Corvallis, OR 97331, USA, Department of Environmental and Radiological Health Sciences/Food Science and Human Nutrition, College of Veterinary Medicine and Biomedical Sciences, Colorado State University/Colorado School of Public Health, Fort Collins, CO 80523-1680, USA, Department of Chemicals and Radiation, Division of Environmental Medicine, Norwegian Institute of Public Health, PO Box 4404, N-0403 Oslo, Norway, Hopkins Building, School of Biological Sciences, University of Reading, Reading, Berkshire RG6 6UB, UK, Division of Genetic and Molecular Toxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR 72079, USA, Center for Environmental Carcinogenesis and Risk Assessment, Environmental Protection and Health Prevention Agency, Bologna 40126, Italy, Human and Environmental Safety Research, Department of Health Sciences, College of North Atlantic, Doha, State of Qatar, Mediterranean Institute of Oncology, 95029 Viagrande, Italy, Laboratory for Cell Genetics, Vrije Universiteit Brussel, Brussels 1050, Belgium, Department of Biomedical Science, Faculty of Medicine and Health Sciences, University Putra, Serdang 43400, Selangor, Malaysia, University of Copenhagen, Department of Public Health, Copenhagen 1353, Denmark, Institute of Molecular Genetics, National Research Council, Pavia 27100, Italy, Medical Phys
| | - Gudrun Koppen
- Environmental Risk and Health Unit, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium, Health Canada, Environmental Health Sciences and Research Bureau, Environmental Health Centre, Ottawa, Ontario K1A0K9, Canada, Department of Pathology, Kuwait University, Safat 13110, Kuwait, Department of Experimental and Clinical Medicine, University of Firenze, Florence 50134, Italy, Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Navarra, Pamplona 31009, Spain, Environmental and Molecular Toxicology, Environmental Health Sciences Center, Oregon State University, Corvallis, OR 97331, USA, Department of Environmental and Radiological Health Sciences/Food Science and Human Nutrition, College of Veterinary Medicine and Biomedical Sciences, Colorado State University/Colorado School of Public Health, Fort Collins, CO 80523-1680, USA, Department of Chemicals and Radiation, Division of Environmental Medicine, Norwegian Institute of Public Health, PO Box 4404, N-0403 Oslo, Norway, Hopkins Building, School of Biological Sciences, University of Reading, Reading, Berkshire RG6 6UB, UK, Division of Genetic and Molecular Toxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR 72079, USA, Center for Environmental Carcinogenesis and Risk Assessment, Environmental Protection and Health Prevention Agency, Bologna 40126, Italy, Human and Environmental Safety Research, Department of Health Sciences, College of North Atlantic, Doha, State of Qatar, Mediterranean Institute of Oncology, 95029 Viagrande, Italy, Laboratory for Cell Genetics, Vrije Universiteit Brussel, Brussels 1050, Belgium, Department of Biomedical Science, Faculty of Medicine and Health Sciences, University Putra, Serdang 43400, Selangor, Malaysia, University of Copenhagen, Department of Public Health, Copenhagen 1353, Denmark, Institute of Molecular Genetics, National Research Council, Pavia 27100, Italy, Medical Phys
| | - Daniel Desaulniers
- Health Canada, Environmental Health Sciences and Research Bureau, Environmental Health Centre, Ottawa, Ontario K1A0K9, Canada
| | - Fahd Al-Mulla
- Department of Pathology, Kuwait University, Safat 13110, Kuwait
| | | | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Firenze, Florence 50134, Italy
| | - Amaya Azqueta
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Navarra, Pamplona 31009, Spain
| | - William H Bisson
- Environmental and Molecular Toxicology, Environmental Health Sciences Center, Oregon State University, Corvallis, OR 97331, USA
| | - Dustin G Brown
- Department of Environmental and Radiological Health Sciences/Food Science and Human Nutrition, College of Veterinary Medicine and Biomedical Sciences, Colorado State University/Colorado School of Public Health, Fort Collins, CO 80523-1680, USA
| | - Gunnar Brunborg
- Department of Chemicals and Radiation, Division of Environmental Medicine, Norwegian Institute of Public Health, PO Box 4404, N-0403 Oslo, Norway
| | - Amelia K Charles
- Hopkins Building, School of Biological Sciences, University of Reading, Reading, Berkshire RG6 6UB, UK
| | - Tao Chen
- Division of Genetic and Molecular Toxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR 72079, USA
| | - Annamaria Colacci
- Center for Environmental Carcinogenesis and Risk Assessment, Environmental Protection and Health Prevention Agency, Bologna 40126, Italy
| | - Firouz Darroudi
- Human and Environmental Safety Research, Department of Health Sciences, College of North Atlantic, Doha, State of Qatar
| | - Stefano Forte
- Mediterranean Institute of Oncology, 95029 Viagrande, Italy
| | - Laetitia Gonzalez
- Laboratory for Cell Genetics, Vrije Universiteit Brussel, Brussels 1050, Belgium
| | - Roslida A Hamid
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, University Putra, Serdang 43400, Selangor, Malaysia
| | - Lisbeth E Knudsen
- University of Copenhagen, Department of Public Health, Copenhagen 1353, Denmark
| | - Luc Leyns
- Laboratory for Cell Genetics, Vrije Universiteit Brussel, Brussels 1050, Belgium
| | | | - Lorenzo Memeo
- Mediterranean Institute of Oncology, 95029 Viagrande, Italy
| | - Chiara Mondello
- Institute of Molecular Genetics, National Research Council, Pavia 27100, Italy
| | - Carmel Mothersill
- Medical Physics & Applied Radiation Sciences, McMaster University, Hamilton, Ontario L8S4L8, Canada
| | - Ann-Karin Olsen
- Department of Chemicals and Radiation, Division of Environmental Medicine, Norwegian Institute of Public Health, PO Box 4404, N-0403 Oslo, Norway
| | - Sofia Pavanello
- Department of Cardiac, Thoracic and Vascular Sciences, Unit of Occupational Medicine, University of Padova, Padova 35128, Italy
| | - Jayadev Raju
- Toxicology Research Division, Bureau of Chemical Safety Food Directorate, Health Products and Food Branch Health Canada, Ottawa, Ontario K1A0K9, Canada
| | - Emilio Rojas
- Departamento de Medicina Genomica y Toxicologia Ambiental, Instituto de Investigaciones Biomedicas, Universidad Nacional Autonoma de México, México CP 04510, México
| | - Rabindra Roy
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Elizabeth P Ryan
- Department of Environmental and Radiological Health Sciences/Food Science and Human Nutrition, College of Veterinary Medicine and Biomedical Sciences, Colorado State University/Colorado School of Public Health, Fort Collins, CO 80523-1680, USA
| | - Patricia Ostrosky-Wegman
- Departamento de Medicina Genomica y Toxicologia Ambiental, Instituto de Investigaciones Biomedicas, Universidad Nacional Autonoma de México, México CP 04510, México
| | - Hosni K Salem
- Urology Department, kasr Al-Ainy School of Medicine, Cairo University, El Manial, Cairo 12515, Egypt
| | - A Ivana Scovassi
- Institute of Molecular Genetics, National Research Council, Pavia 27100, Italy
| | - Neetu Singh
- Centre for Advanced Research, King George's Medical University, Chowk, Lucknow 226003, Uttar Pradesh, India
| | - Monica Vaccari
- Center for Environmental Carcinogenesis and Risk Assessment, Environmental Protection and Health Prevention Agency, Bologna 40126, Italy
| | - Frederik J Van Schooten
- Department of Toxicology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, 6200MD, PO Box 61, Maastricht, The Netherlands
| | - Mahara Valverde
- Departamento de Medicina Genomica y Toxicologia Ambiental, Instituto de Investigaciones Biomedicas, Universidad Nacional Autonoma de México, México CP 04510, México
| | - Jordan Woodrick
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Luoping Zhang
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720-7360, USA
| | - Nik van Larebeke
- Laboratory for Analytical and Environmental Chemistry, Vrije Universiteit Brussel, Brussels 1050, Belgium, Study Centre for Carcinogenesis and Primary Prevention of Cancer, Ghent University, Ghent 9000, Belgium
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Lu Y, Song S, Wang R, Liu Z, Meng J, Sweetman AJ, Jenkins A, Ferrier RC, Li H, Luo W, Wang T. Impacts of soil and water pollution on food safety and health risks in China. ENVIRONMENT INTERNATIONAL 2015; 77:5-15. [PMID: 25603422 DOI: 10.1016/j.envint.2014.12.010] [Citation(s) in RCA: 407] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 12/25/2014] [Accepted: 12/31/2014] [Indexed: 05/21/2023]
Abstract
Environmental pollution and food safety are two of the most important issues of our time. Soil and water pollution, in particular, have historically impacted on food safety which represents an important threat to human health. Nowhere has that situation been more complex and challenging than in China, where a combination of pollution and an increasing food safety risk have affected a large part of the population. Water scarcity, pesticide over-application, and chemical pollutants are considered to be the most important factors impacting on food safety in China. Inadequate quantity and quality of surface water resources in China have led to the long-term use of waste-water irrigation to fulfill the water requirements for agricultural production. In some regions this has caused serious agricultural land and food pollution, especially for heavy metals. It is important, therefore, that issues threatening food safety such as combined pesticide residues and heavy metal pollution are addressed to reduce risks to human health. The increasing negative effects on food safety from water and soil pollution have put more people at risk of carcinogenic diseases, potentially contributing to 'cancer villages' which appear to correlate strongly with the main food producing areas. Currently in China, food safety policies are not integrated with soil and water pollution management policies. Here, a comprehensive map of both soil and water pollution threats to food safety in China is presented and integrated policies addressing soil and water pollution for achieving food safety are suggested to provide a holistic approach.
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Affiliation(s)
- Yonglong Lu
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China.
| | - Shuai Song
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Ruoshi Wang
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhaoyang Liu
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jing Meng
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Andrew J Sweetman
- Lancaster Environment Centre, Lancaster University, Lancaster LA1 4YQ, UK; Centre for Ecology & Hydrology, Wallingford, OX10 8BB, UK
| | - Alan Jenkins
- Centre for Ecology & Hydrology, Wallingford, OX10 8BB, UK
| | | | - Hong Li
- Lancaster Environment Centre, Lancaster University, Lancaster LA1 4YQ, UK; Centre for Ecology & Hydrology, Wallingford, OX10 8BB, UK
| | - Wei Luo
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Tieyu Wang
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
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22
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Collins JJ, Bender TJ, Bonner EM, Bodner KM, Kreft AM. Brain Cancer in Workers Employed at a Laboratory Research Facility. PLoS One 2014; 9:e113997. [PMID: 25493437 PMCID: PMC4262372 DOI: 10.1371/journal.pone.0113997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 11/02/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND An earlier study of research facility workers found more brain cancer deaths than expected, but no workplace exposures were implicated. METHODS Adding four additional years of vital-status follow-up, we reassessed the risk of death from brain cancer in the same workforce, including 5,284 workers employed between 1963, when the facility opened, and 2007. We compared the work histories of the brain cancer decedents in relationship to when they died and their ages at death. RESULTS As in most other studies of laboratory and research workers, we found low rates of total mortality, total cancers, accidents, suicides, and chronic conditions such as heart disease and diabetes. We found no new brain cancer deaths in the four years of additional follow-up. Our best estimate of the brain cancer standardized mortality ratio (SMR) was 1.32 (95% confidence interval [95% CI] 0.66-2.37), but the SMR might have been as high as 1.69. Deaths from benign brain tumors and other non-malignant diseases of the nervous system were at or below expected levels. CONCLUSION With the addition of four more years of follow-up and in the absence of any new brain cancers, the updated estimate of the risk of brain cancer death is smaller than in the original study. There was no consistent pattern among the work histories of decedents that indicated a common causative exposure.
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Affiliation(s)
- James J. Collins
- Health and Human Services, Saginaw Valley State University, University Center, Michigan, United States of America
| | - Thomas John Bender
- Health Services/Epidemiology, The Dow Chemical Company, Midland, Michigan, United States of America
| | - Eileen M. Bonner
- Health Services, The Dow Chemical Company, Collegeville, Pennsylvania, United States of America
| | - Kenneth M. Bodner
- Epidemiology, Kelly Services, South Lake Tahoe, California, United States of America
| | - Alisa M. Kreft
- EH&S Delivery Expertise, The Dow Chemical Company, Bristol, Pennsylvania, United States of America
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Levine PH, Hashmi S, Minaei AA, Veneroso C. Inflammatory breast cancer clusters: A hypothesis. World J Clin Oncol 2014; 5:539-545. [PMID: 25114867 PMCID: PMC4127623 DOI: 10.5306/wjco.v5.i3.539] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 03/18/2014] [Accepted: 04/29/2014] [Indexed: 02/06/2023] Open
Abstract
Cancer clusters have long been a focus of interest because of the possibility of identifying etiologic agents. Only on rare occasions, however, have such cluster investigations been successful. One major difficulty in cluster investigations, particularly in the area of breast cancer, is the long latent period. There have been a number of publications providing a discouraging picture regarding cancer cluster investigations. The possibility of learning from a cluster investigation, however, is greatly increased if the cancer involved is relatively rare and if it has a short latent period. Inflammatory breast cancer (IBC) fits these criteria and is worth pursuing because of the strong evidence that environmental factors play a major role. In this report we describe our experience with several clusters and the lessons learned which are now being utilized to improve investigation of future IBC clusters. The first IBC cluster that we evaluated was in 2000, when we were asked to investigate an apparent cluster of IBC in Castro Valley, California where three women in an office setting of 24 people were diagnosed with IBC in a ten month period from May 1999 to March 2000. Our investigation of this striking cluster did not yield a specific trigger for this cluster but it did indicate that the women involved all had at least two IBC risk factors that may well have made them susceptible to getting IBC. We are now investigating another apparent cluster in Texas and are aware of several others requiring careful consideration. We see a need for a consistent protocol for the evaluation of IBC clusters focusing on the laboratory investigation of environmental triggers, primarily infectious agents and chemical carcinogens.
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Thompson JA, Bissett WT, Sweeney AM. Evaluating geostatistical modeling of exceedance probability as the first step in disease cluster investigations: very low birth weights near toxic Texas sites. Environ Health 2014; 13:47. [PMID: 24906417 PMCID: PMC4063235 DOI: 10.1186/1476-069x-13-47] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 06/04/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND The first step in evaluating potential geographic clusters of disease calls for an evaluation of the disease risk comparing the risk in a defined location to the risk in neighboring locations. Environmental exposures, however, represent continuous exposure levels across space not an exposure with a distinct boundary. The objectives of the current study were to adapt, apply and evaluate a geostatistical approach for identifying disease clusters. METHODS The exceedance probability for very low birth weight (VLBW; < 1.5 kg) infants was mapped using an Intrinsic Conditional Autoregressive model. The data were applied to a 20 by 20 grid of 1 km2 pixels centered on each of the 13 National Priority List Superfund Sites in Harris County, Texas. RESULTS Large clusters of VLBW were identified in close proximity to four of the 13 Superfund Sites. Three of the Superfund Sites, associated with disease clusters, were located close together in central Houston and these sites may have been surrounded by a single, confluent disease cluster. CONCLUSIONS Geostatistical modeling of the exceedance probability for very low birth weights identified disease clusters of varying size, shape and statistical certainty near Superfund Sites in Harris County, Texas. The approach offers considerable potential as the first step for investigating potential disease clusters.
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Affiliation(s)
- James A Thompson
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4475, USA
| | - Wesley T Bissett
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4475, USA
| | - Anne M Sweeney
- Department of Epidemiology and Biostatistics, School of Rural Public Health, Texas A&M Health Science Center, College Station, College Station, TX 77843-1266, USA
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Simpson BW, Truant P, Resnick BA. Stop and listen to the people: an enhanced approach to cancer cluster investigations. Am J Public Health 2014; 104:1204-8. [PMID: 24832152 DOI: 10.2105/ajph.2013.301836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Cancer cluster investigations need to address the disconnect between traditional public health approaches and human needs. Cancer cluster investigations often magnify fear and uncertainty because they rarely find a definitive environmental cause. Traditional approaches emphasize population-level data analysis and undervalue active listening. Because few studies have explored active listening in cancer cluster investigations, we conducted a descriptive oral history case study of a Frederick, Maryland, investigation. We interviewed 12 community members and 9 public health professionals about the investigation of a perceived cancer cluster. Many believed it was linked to environmental contamination at Fort Detrick, a local US Army base. We propose enhanced active listening that seeks out peoples' perspectives, validates their concerns, and engages them in the investigative process.
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Affiliation(s)
- Brian W Simpson
- Brian W. Simpson is with the Office of Communications, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Patti Truant and Beth A. Resnick are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health
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Goodman M, LaKind JS, Fagliano JA, Lash TL, Wiemels JL, Winn DM, Patel C, Van Eenwyk J, Kohler BA, Schisterman EF, Albert P, Mattison DR. Cancer cluster investigations: review of the past and proposals for the future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:1479-99. [PMID: 24477211 PMCID: PMC3945549 DOI: 10.3390/ijerph110201479] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 01/13/2014] [Accepted: 01/20/2014] [Indexed: 12/18/2022]
Abstract
Residential clusters of non-communicable diseases are a source of enduring public concern, and at times, controversy. Many clusters reported to public health agencies by concerned citizens are accompanied by expectations that investigations will uncover a cause of disease. While goals, methods and conclusions of cluster studies are debated in the scientific literature and popular press, investigations of reported residential clusters rarely provide definitive answers about disease etiology. Further, it is inherently difficult to study a cluster for diseases with complex etiology and long latency (e.g., most cancers). Regardless, cluster investigations remain an important function of local, state and federal public health agencies. Challenges limiting the ability of cluster investigations to uncover causes for disease include the need to consider long latency, low statistical power of most analyses, uncertain definitions of cluster boundaries and population of interest, and in- and out-migration. A multi-disciplinary Workshop was held to discuss innovative and/or under-explored approaches to investigate cancer clusters. Several potentially fruitful paths forward are described, including modern methods of reconstructing residential history, improved approaches to analyzing spatial data, improved utilization of electronic data sources, advances using biomarkers of carcinogenesis, novel concepts for grouping cases, investigations of infectious etiology of cancer, and "omics" approaches.
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Affiliation(s)
- Michael Goodman
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA.
| | - Judy S LaKind
- LaKind Associates, LLC, 106 Oakdale Avenue, Catonsville, MD 21228, USA.
| | - Jerald A Fagliano
- Division of Epidemiology, Environmental and Occupational Health, New Jersey Department of Health, P.O. Box 369, Trenton, NJ 08625, USA.
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA.
| | - Joseph L Wiemels
- Division of Cancer Epidemiology, Department of Epidemiology & Biostatistics, School of Medicine, University of California, Helen Diller Family Cancer Research Building, HD 274 1450 3rd Street, San Francisco, MC 0520, San Francisco, CA 94158, USA.
| | - Deborah M Winn
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD 20892, USA.
| | - Chirag Patel
- School of Medicine, Stanford University, 1265 Welch Road, Stanford, CA 94305, USA.
| | - Juliet Van Eenwyk
- Washington State Department of Health, P.O. Box 47812, Olympia, WA 98504, USA.
| | - Betsy A Kohler
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA.
| | - Enrique F Schisterman
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA.
| | - Paul Albert
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA.
| | - Donald R Mattison
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA.
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Lemke D, Mattauch V, Heidinger O, Pebesma E, Hense HW. Detecting cancer clusters in a regional population with local cluster tests and Bayesian smoothing methods: a simulation study. Int J Health Geogr 2013; 12:54. [PMID: 24314148 PMCID: PMC3878948 DOI: 10.1186/1476-072x-12-54] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 12/01/2013] [Indexed: 01/04/2023] Open
Abstract
Background There is a rising public and political demand for prospective cancer cluster monitoring. But there is little empirical evidence on the performance of established cluster detection tests under conditions of small and heterogeneous sample sizes and varying spatial scales, such as are the case for most existing population-based cancer registries. Therefore this simulation study aims to evaluate different cluster detection methods, implemented in the open soure environment R, in their ability to identify clusters of lung cancer using real-life data from an epidemiological cancer registry in Germany. Methods Risk surfaces were constructed with two different spatial cluster types, representing a relative risk of RR = 2.0 or of RR = 4.0, in relation to the overall background incidence of lung cancer, separately for men and women. Lung cancer cases were sampled from this risk surface as geocodes using an inhomogeneous Poisson process. The realisations of the cancer cases were analysed within small spatial (census tracts, N = 1983) and within aggregated large spatial scales (communities, N = 78). Subsequently, they were submitted to the cluster detection methods. The test accuracy for cluster location was determined in terms of detection rates (DR), false-positive (FP) rates and positive predictive values. The Bayesian smoothing models were evaluated using ROC curves. Results With moderate risk increase (RR = 2.0), local cluster tests showed better DR (for both spatial aggregation scales > 0.90) and lower FP rates (both < 0.05) than the Bayesian smoothing methods. When the cluster RR was raised four-fold, the local cluster tests showed better DR with lower FPs only for the small spatial scale. At a large spatial scale, the Bayesian smoothing methods, especially those implementing a spatial neighbourhood, showed a substantially lower FP rate than the cluster tests. However, the risk increases at this scale were mostly diluted by data aggregation. Conclusion High resolution spatial scales seem more appropriate as data base for cancer cluster testing and monitoring than the commonly used aggregated scales. We suggest the development of a two-stage approach that combines methods with high detection rates as a first-line screening with methods of higher predictive ability at the second stage.
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Affiliation(s)
- Dorothea Lemke
- Institute of Epidemiology and Social Medicine, Medical Faculty, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1 D3, D 48149, Münster, Germany.
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Assunção R. Commentary: Statistical assessment of cancer cluster evidence--in search of a middle ground. Int J Epidemiol 2013; 42:453-5; discussion 455-6. [PMID: 23569186 DOI: 10.1093/ije/dys240] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Renato Assunção
- Departamento de Ciência da Computação, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, 6627 Belo Horizonte MG, Brazil.
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Stewart BW. Cancer clusters: what have we learned? Intern Med J 2013; 43:5-6. [PMID: 23324087 DOI: 10.1111/imj.12024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 11/12/2012] [Indexed: 11/28/2022]
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Condon SK, Sullivan J, Netreba B. Cancer clusters in the USA: what do the last twenty years of state and federal investigations tell us? Crit Rev Toxicol 2012. [PMID: 23190217 DOI: 10.3109/10408444.2012.743504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Goodman M, Naiman JS, Goodman D, LaKind JS. Response to Condon et al. comments on "Cancer clusters in the USA: what do the last twenty years of state and federal investigations tell us?". Crit Rev Toxicol 2012; 43:75-6. [PMID: 23151122 PMCID: PMC3541670 DOI: 10.3109/10408444.2012.743505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Michael Goodman
- Emory University, Rollins School of Public Health, Atlanta, GA, USA
| | - Joshua S. Naiman
- School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Dina Goodman
- Emory College of Arts and Sciences, Atlanta, GA, USA
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