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dc.contributor.authorVieira, Verónicaen_US
dc.contributor.authorWebster, Thomasen_US
dc.contributor.authorWeinberg, Janiceen_US
dc.contributor.authorAschengrau, Annen_US
dc.date.accessioned2011-12-29T22:21:56Z
dc.date.available2011-12-29T22:21:56Z
dc.date.copyright2009en_US
dc.date.issued2009-2-10en_US
dc.identifier.citationVieira, 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.issn1476-069Xen_US
dc.identifier.urihttp://hdl.handle.net/2144/2581
dc.description.abstractBACKGROUND: 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.sponsorshipNational Institute of Environmental Health (5 P42 ES007381); National Institutes of Healthen_US
dc.language.isoenen_US
dc.publisherBioMed Centralen_US
dc.rightsCopyright 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.urihttp://creativecommons.org/licenses/by/2.0en_US
dc.titleSpatial Analysis of Bladder, Kidney, and Pancreatic Cancer on Upper Cape Cod: An Application of Generalized Additive Models to Case-Control Dataen_US
dc.typearticleen_US
dc.identifier.doi10.1186/1476-069X-8-3en_US
dc.identifier.pubmedid19208254en_US
dc.identifier.pmcid2652449en_US


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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.
Except where otherwise noted, this item's license is described as 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.