期刊名称：Environmental Health - a Global Access Science Source
印刷版ISSN：1476-069X
电子版ISSN：1476-069X
出版年度：2009
卷号：8
期号：1
页码：3
DOI：10.1186/1476-069X-8-3
语种：English
出版社：BioMed Central
摘要：In 1988, elevated cancer incidence in upper Cape Cod, Massachusetts prompted a large epidemiological study of nine cancers to investigate possible environmental risk factors. Positive associations were observed, but explained only a portion of the excess cancer incidence. This case-control study provided detailed information on individual-level covariates and residential history that can be spatially analyzed using generalized additive models (GAMs) and geographical information systems (GIS). We investigated the association between residence and bladder, kidney, and pancreatic cancer on upper Cape Cod. We estimated adjusted odds ratios using GAMs, smoothing on location. A 40-year residential history allowed for latency restrictions. We mapped spatially continuous odds ratios using GIS and identified statistically significant clusters using permutation tests. Maps of bladder cancer are essentially flat ignoring latency, but show a statistically significant hot spot near known Massachusetts Military Reservation (MMR) groundwater plumes when 15 years latency is assumed. The kidney cancer map shows significantly increased ORs in the south of the study area and decreased ORs in the north. Spatial epidemiology using individual level data from population-based studies addresses many methodological criticisms of cluster studies and generates new exposure hypotheses. Our results provide evidence for spatial clustering of bladder cancer near MMR plumes that suggest further investigation using detailed exposure modeling.
关键词：Pancreatic Cancer ; Bladder Cancer ; Geographical Information System ; Kidney Cancer ; Generalize Additive Model
