The Geography of Cancer: Regional Disparities in the Incidence of Prostate Cancer in Puerto Rico, 2016-2022

Prostate cancer remains the most prevalent malignancy and a leading cause of cancer-related mortality among men in Puerto Rico. This study evaluates regional disparities in prostate cancer incidence across 76 contiguous municipalities on the main island and characterizes areas exhibiting statistically significant spatial clustering. Using spatial analytical techniques-including Moran's I and Getis-Ord Gi*-within Geographic Information Systems (GIS), we analyze data from the Puerto Rico Central Cancer Registry (RCCPR) spanning 2016 to 2022. The findings reveal a non-random spatial distribution of prostate cancer incidence, with consistent clustering patterns observed throughout most of the study period, except in 2019. Notably, cold-spot regions were persistently identified in the northwest and western municipalities, while elevated incidence rates were concentrated in clusters located in the southern and eastern regions. These results underscore the presence of enduring geographic disparities in the prostate cancer burden across Puerto Rico.