Spatial Analysis of Bladder, Kidney, and Pancreatic Cancer on Upper Cape Cod: An Application of Generalized Additive Models to Case-Control Data

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dc.contributor.author Vieira, Verónica en_US
dc.contributor.author Webster, Thomas en_US
dc.contributor.author Weinberg, Janice en_US
dc.contributor.author Aschengrau, Ann en_US
dc.date.accessioned 2011-12-29T22:21:56Z
dc.date.available 2011-12-29T22:21:56Z
dc.date.copyright 2009 en_US
dc.date.issued 2009-2-10 en_US
dc.identifier.citation Vieira, Verónica, Thomas Webster, Janice Weinberg, Ann Aschengrau. "Spatial analysis of bladder, kidney, and pancreatic cancer on upper Cape Cod: an application of generalized additive models to case-control data" 8:3. (2009) en_US
dc.identifier.issn 1476-069X en_US
dc.identifier.uri http://hdl.handle.net/2144/2581
dc.description.abstract BACKGROUND: 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). METHODS: 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. RESULTS: 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. CONCLUSION: 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. en_US
dc.description.sponsorship National Institute of Environmental Health (5 P42 ES007381); National Institutes of Health en_US
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.rights Copyright 2009 Vieira et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. en_US
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_US
dc.title Spatial Analysis of Bladder, Kidney, and Pancreatic Cancer on Upper Cape Cod: An Application of Generalized Additive Models to Case-Control Data en_US
dc.type article en_US
dc.identifier.doi 10.1186/1476-069X-8-3 en_US
dc.identifier.pubmedid 19208254 en_US
dc.identifier.pmcid 2652449 en_US

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