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Spatial-Temporal Cluster Analysis of Childhood Cancer in California.

Stephen Starko Francis1,2, Catherine Enders3, Rebecca Hyde3

  • 1From the Department of Neurological Surgery, University of California, San Francisco, CA.

Epidemiology (Cambridge, Mass.)
|October 10, 2019
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Summary

Childhood cancers, including acute lymphoblastic leukemia (ALL) and germ cell tumors, show nonrandom space-time clustering in California. This suggests potential environmental or genetic factors warranting further investigation into cancer origins.

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Area of Science:

  • Epidemiology
  • Environmental Health
  • Pediatric Oncology

Background:

  • Childhood cancer clusters have long been a public health concern.
  • Many childhood cancers are suspected to originate in utero, prompting investigation into birth locations.
  • Understanding spatial-temporal patterns is crucial for identifying potential etiologies.

Purpose of the Study:

  • To investigate the spatial-temporal randomness of birthplaces for children diagnosed with cancer.
  • To identify potential geographic clusters of specific childhood cancer types.

Main Methods:

  • Space-time cluster analysis of 5,896 childhood cancer cases and matched controls in California (1997-2007).
  • Evaluation of 20 childhood cancer types and three acute lymphoblastic leukemia (ALL) subgroups.
  • Utilized ClustR and SaTScan analysis programs.

Main Results:

  • Evidence of nonrandom space-time clustering for ALL (ages 2-6) in the South San Francisco Bay Area.
  • Detected clustering for malignant gonadal germ cell tumors in a Los Angeles region.
  • SaTScan suggested potential clustering for Hodgkin lymphoma, astrocytoma, and retinoblastoma.

Conclusions:

  • Childhood ALL (ages 2-6) and malignant gonadal germ cell tumors exhibit sporadic nonrandom space-time clustering.
  • Findings highlight the need for further research into epidemiologic features and underlying causes.
  • Identified specific cancer types and locations for targeted public health surveillance.