A STUDY OF THE BREAST-CANCER DYNAMICS IN NORTH-CAROLINA

This work is concerned with the study of breast cancer incidence in th e State of North Carolina. Methodologically, the current analysis illu strates the importance of spatiotemporal random field modelling and in troduces a mode of reasoning that is based on a combination of inducti ve and deductive processes. The composite space/time analysis utilizes thr variability characteristics of incidence and the mathematical fea tures of the random field model to fit it to the data. The analysis is significantly general and can efficiently represent non-homogeneous a nd non-stationary characteristics of breast cancer variation. Incidenc e predictions are produced using data at the same time period as well as data from other time periods and disease registries. The random fie ld provides a rigorous and systematic method for generating detailed m aps, which offer a quantitative description of the incidence variation from place to place and from time to time together with a measure of the accuracy of the incidence maps. Spatiotemporal mapping accounts fo r the geographical locations and the rime instants of the incidence ob servations, which is not usually the case with most empirical Bayes me thods. it is also more accurate than purely spatial statistics methods , and can offer valuable information about the breast cancer risk and dynamics in North Carolina. Field studies could be initialized in high -rate areas identified by the maps in an effort to uncover environment al or life-style factors that might be responsible for the high risk r ates. Also, the incidence maps can help elucidate causal mechanisms, e xplain disease occurrences at a certain scale, and offer guidance in h ealth management and administration. (C) 1997 Elsevier Science Ltd.