Detecting interaction between random region and fixed age effects in disease mapping

The purpose of this article is to draw attention to the possible need for inclusion of interaction effects between regions and age groups in mapping studies. We propose a simple model for including such an interaction in order to develop a test for its significance. The assumption of an absence of such interaction effects is a helpful simplifying one. The measure of relative risk related to a particular region becomes easily and neatly summarized. Indeed, such a test seems warranted because it is anticipated that the simple model, which ignores such interaction, as is in common use, may at times be adequate. The test proposed is a score test and hence only requires fitting the simpler model. We illustrate our approaches using mortality data from British Columbia, Canada, over the 5-year period 1985-1989. For this data, the interaction effect between age groups and regions is quite large and significant.