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Spatial-temporal analysis of bladder cancer risk in the New England Bladder Cancer Study

机译：新英格兰膀胱癌研究中膀胱癌风险的时空分析

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Background: Exploring spatial-temporal patterns of disease incidence can identify areas of significantly elevated or decreased risk, providing potential clues about disease risk factors and timing of exposure. Aims: We sought to explore the spatial-temporal risk of bladder cancer in three New England states in the United States. Methods: We examined bladder cancer risk in relation to residential location based on interview data from a large, population-based case-control study conducted in Maine, New Hampshire, and Vermont from 2001 to 2004 (N = 500 urothelial carcinoma case patients and 602 control subjects). Subjects in the analysis data set resided within the study area for the 25-year period before study enrollment. We used crude and adjusted generalized additive models to spatially model the probability of being a case. We adjusted for several important risk factors, including smoking history, occupational history, and exposure to drinking water contaminants (arsenic, disinfection by-product exposure). We evaluated models at several different time periods independently to explore the presence of significant risk areas in a time frame of etiologic relevance. We also modeled cumulative spatial risk over 25 years before diagnosis of disease. Results: Risk of bladder cancer varied over space and the pattern of unexplained risk was consistent in time windows of 5,10,15, 20 years before diagnosis and at time of diagnosis. Analyses stratified by French Canadian status revealed a distinct spatial pattern of unexplained risk among French Canadians. Conclusions: We found a significant association between spatial location and bladder cancer risk after adjusting for several important risk factors. Additional analyses of etiologic factors to determine the reason for this association will be presented.
机译：背景：探索疾病发生的时空格局可以确定风险显着升高或降低的区域，从而提供有关疾病风险因素和暴露时间的潜在线索。目的：我们试图探索美国三个新英格兰州的膀胱癌的时空风险。方法：我们根据2001年至2004年在缅因州，新罕布什尔州和佛蒙特州进行的一项基于人群的大型病例对照研究的访谈数据，调查了与居住地点相关的膀胱癌风险（N = 500例尿路上皮癌病例和602例对照对象）。在研究入组之前的25年中，分析数据集中的受试者居住在研究区域内。我们使用粗略的和经过调整的广义加性模型在空间上对作为案例的可能性进行建模。我们对几个重要的风险因素进行了调整，包括吸烟史，职业史和饮用水污染物的暴露（砷，消毒副产物的暴露）。我们在几个不同的时间段独立评估了模型，以探究病因相关时间范围内重大风险区域的存在。我们还对疾病诊断前25年的累积空间风险进行了建模。结果：膀胱癌的风险随空间而异，无法解释的风险模式在诊断前和诊断时的20、5、10、15、20年的时间窗内保持一致。根据加拿大裔加拿大人身份进行的分层分析显示，加拿大裔法国人存在无法解释的风险的独特空间格局。结论：在调整了几个重要的危险因素后，我们发现空间位置与膀胱癌风险之间存在显着相关性。将提供病因因素的其他分析，以确定这种关联的原因。

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