Evaluating spatial methods for investigating global clustering and cluster detection of cancer cases

There have been articles on comparing methods for global clustering evaluation and cluster detection in disease surveillance, but power and sample size (SS) requirements have not been explored for spatially correlated data in this area. We are developing such requirements for tests of spatial clustering and cluster detection for regional cancer cases. We compared global clustering methods including Moran's I, Tango's and Besag-Newell's R statistics, and cluster detection methods including circular and elliptic spatial scan statistics (SaTScan), flexibly shaped spatial scan statistics, Turnbull's cluster evaluation permutation procedure, local indicators of spatial association, and upper-level set scan statistics. We identified eight geographic patterns that are representative of patterns of mortality due to various types of cancer in the U.S. from 1998 to 2002. We then evaluated the selected spatial methods based on state- and county-level data simulated from these different spatial patterns in terms of geographic locations and relative risks, and varying SSs using the 2000 population in each county. The comparison provides insight into the performance of the spatial methods when applied to varying cancer count data in terms of power and precision of cluster detection.