ABSTRACT: Exploring Associations between Residential Location
and Breast Cancer Incidence in a Case-Control Study
Locating geographic hot spots of cancer may lead to new
causal hypotheses and ultimately to new knowledge of cancer-causing
The Cape Cod region of Massachusetts has experienced
elevated incidence of breast cancer compared with statewide averages.
The origins of the excess remain largely unexplained, even after
the Upper Cape Cod Cancer Incidence Study investigated numerous
potential environmental exposures.
Using case-control data from
this study (258 cases and 686 controls), we developed an exploratory
approach for measuring associations between residential location
and breast cancer incidence, adjusting for individual-level risk
We measured crude and adjusted odds ratios over the
study region using fixed-scale grids and a smoothing algorithm
of overlapping circular units. Polycircular hot spot regions,
derived from the peak values of the smoothed odds ratios, delineated
geographic areas wherein residence was associated with 60% [odds
ratio (OR), 1.6; 95% confidence interval (CI), 0.8-3.2] to 210%
(OR, 3.1; 95% CI, 1.3-7.2) increased incidence relative to the
remainder of the study population.
The findings suggest several
directions for further research, including the identification
of potential environmental exposures that may be assessed in
forthcoming case-control studies.
[05/17/2002; Environmental Health Perspectives]
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