Bladder cancer clusters in Florida: identifying populations at risk

Area of Science:

• Environmental Epidemiology
• Spatial Analysis
• Public Health

Background:

• Modifiable risk factors for bladder cancer include tobacco and chemical exposure.
• Identifying high-risk areas and associated factors is crucial for targeted interventions.

Purpose of the Study:

• To identify high-risk bladder cancer areas in Florida.
• To determine risk factors associated with bladder cancer clusters using individual and area-based data.

Main Methods:

• Spatial modeling of 23,266 bladder cancer cases (1998-2002) to detect areas of excess risk.
• Multivariable regression to assess associations with sociodemographic indicators, smoking history, and proximity to arsenic-contaminated wells.

Main Results:

• Twenty-five bladder cancer clusters were identified, with 13 early-stage and 12 advanced-stage.
• Urban white patients were more likely to reside in advanced bladder cancer clusters.
• Proximity to known arsenic-contaminated drinking water wells was associated with advanced bladder cancer cluster membership.

Conclusions:

• Multiple early and late-stage bladder cancer clusters exist in Florida.
• Living near arsenic-contaminated wells is a significant risk factor for advanced bladder cancer.
• Increased well water evaluation, public awareness, smoking cessation support, and targeted screening are warranted in high-risk areas.