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Small-area spatio-temporal analyses of bladder and kidney cancer risk in Nova Scotia, Canada

BACKGROUND: Bladder and kidney cancers are the ninth and twelfth most common type of cancer worldwide, respectively. Internationally, rates vary ten-fold, with several countries showing rising incidence. This study describes the spatial and spatio-temporal variations in the incidence risk of these d...

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Autores principales: Saint-Jacques, Nathalie, Lee, Jonathan S. W., Brown, Patrick, Stafford, Jamie, Parker, Louise, Dummer, Trevor J. B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761137/
https://www.ncbi.nlm.nih.gov/pubmed/26895703
http://dx.doi.org/10.1186/s12889-016-2767-9
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author Saint-Jacques, Nathalie
Lee, Jonathan S. W.
Brown, Patrick
Stafford, Jamie
Parker, Louise
Dummer, Trevor J. B.
author_facet Saint-Jacques, Nathalie
Lee, Jonathan S. W.
Brown, Patrick
Stafford, Jamie
Parker, Louise
Dummer, Trevor J. B.
author_sort Saint-Jacques, Nathalie
collection PubMed
description BACKGROUND: Bladder and kidney cancers are the ninth and twelfth most common type of cancer worldwide, respectively. Internationally, rates vary ten-fold, with several countries showing rising incidence. This study describes the spatial and spatio-temporal variations in the incidence risk of these diseases for Nova Scotia, a province located in Atlantic Canada, where rates for bladder and kidney cancer exceed those of the national average by about 25 % and 35 %, respectively. METHODS: Cancer incidence in the 311 Communities of Nova-Scotia was analyzed with a spatial autoregressive model for the case counts of bladder and kidney cancers (3,232 and 2,143 total cases, respectively), accounting for each Community's population and including variables known to influence risk. A spatially-continuous analysis, using a geostatistical Local Expectation-Maximization smoothing algorithm, modeled finer-scale spatial variation in risk for south-western Nova Scotia (1,810 bladder and 957 kidney cases) and Cape Breton (1,101 bladder, 703 kidney). RESULTS: Evidence of spatial variations in the risk of bladder and kidney cancer was demonstrated using both aggregated Community-level mapping and continuous-grid based localized mapping; and these were generally stable over time. The Community-level analysis suggested that much of this heterogeneity was not accounted for by known explanatory variables. There appears to be a north-east to south-west increasing gradient with a number of south-western Communities have risk of bladder or kidney cancer more than 10 % above the provincial average. Kidney cancer risk was also elevated in various northeastern communities. Over a 12 year period this exceedance translated in an excess of 200 cases. Patterns of variations in risk obtained from the spatially continuous smoothing analysis generally mirrored those from the Community-level autoregressive model, although these more localized risk estimates resulted in a larger spatial extent for which risk is likely to be elevated. CONCLUSIONS: Modelling the spatio-temporal distribution of disease risk enabled the quantification of risk relative to expected background levels and the identification of high risk areas. It also permitted the determination of the relative stability of the observed patterns over time and in this study, pointed to excess risk potentially driven by exposure to risk factors that act in a sustained manner over time. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-016-2767-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-47611372016-02-21 Small-area spatio-temporal analyses of bladder and kidney cancer risk in Nova Scotia, Canada Saint-Jacques, Nathalie Lee, Jonathan S. W. Brown, Patrick Stafford, Jamie Parker, Louise Dummer, Trevor J. B. BMC Public Health Research Article BACKGROUND: Bladder and kidney cancers are the ninth and twelfth most common type of cancer worldwide, respectively. Internationally, rates vary ten-fold, with several countries showing rising incidence. This study describes the spatial and spatio-temporal variations in the incidence risk of these diseases for Nova Scotia, a province located in Atlantic Canada, where rates for bladder and kidney cancer exceed those of the national average by about 25 % and 35 %, respectively. METHODS: Cancer incidence in the 311 Communities of Nova-Scotia was analyzed with a spatial autoregressive model for the case counts of bladder and kidney cancers (3,232 and 2,143 total cases, respectively), accounting for each Community's population and including variables known to influence risk. A spatially-continuous analysis, using a geostatistical Local Expectation-Maximization smoothing algorithm, modeled finer-scale spatial variation in risk for south-western Nova Scotia (1,810 bladder and 957 kidney cases) and Cape Breton (1,101 bladder, 703 kidney). RESULTS: Evidence of spatial variations in the risk of bladder and kidney cancer was demonstrated using both aggregated Community-level mapping and continuous-grid based localized mapping; and these were generally stable over time. The Community-level analysis suggested that much of this heterogeneity was not accounted for by known explanatory variables. There appears to be a north-east to south-west increasing gradient with a number of south-western Communities have risk of bladder or kidney cancer more than 10 % above the provincial average. Kidney cancer risk was also elevated in various northeastern communities. Over a 12 year period this exceedance translated in an excess of 200 cases. Patterns of variations in risk obtained from the spatially continuous smoothing analysis generally mirrored those from the Community-level autoregressive model, although these more localized risk estimates resulted in a larger spatial extent for which risk is likely to be elevated. CONCLUSIONS: Modelling the spatio-temporal distribution of disease risk enabled the quantification of risk relative to expected background levels and the identification of high risk areas. It also permitted the determination of the relative stability of the observed patterns over time and in this study, pointed to excess risk potentially driven by exposure to risk factors that act in a sustained manner over time. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-016-2767-9) contains supplementary material, which is available to authorized users. BioMed Central 2016-02-19 /pmc/articles/PMC4761137/ /pubmed/26895703 http://dx.doi.org/10.1186/s12889-016-2767-9 Text en © Saint-Jacques et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Saint-Jacques, Nathalie
Lee, Jonathan S. W.
Brown, Patrick
Stafford, Jamie
Parker, Louise
Dummer, Trevor J. B.
Small-area spatio-temporal analyses of bladder and kidney cancer risk in Nova Scotia, Canada
title Small-area spatio-temporal analyses of bladder and kidney cancer risk in Nova Scotia, Canada
title_full Small-area spatio-temporal analyses of bladder and kidney cancer risk in Nova Scotia, Canada
title_fullStr Small-area spatio-temporal analyses of bladder and kidney cancer risk in Nova Scotia, Canada
title_full_unstemmed Small-area spatio-temporal analyses of bladder and kidney cancer risk in Nova Scotia, Canada
title_short Small-area spatio-temporal analyses of bladder and kidney cancer risk in Nova Scotia, Canada
title_sort small-area spatio-temporal analyses of bladder and kidney cancer risk in nova scotia, canada
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761137/
https://www.ncbi.nlm.nih.gov/pubmed/26895703
http://dx.doi.org/10.1186/s12889-016-2767-9
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