CANCER CLUSTERS - THE IMPORTANCE OF MONITORING MULTIPLE GEOGRAPHIC SCALES

Analysis of cancer incidence data at a variety of geographic scales pr ovides surveillance information that can allay fears of the general pu blic, prevent costly and unwarranted epidemiologic studies driven by p olitical pressures, and target appropriate cases for further investiga tion. We systematically examined New Jersey Cancer Registry data (1979 -1985) for childhood and young adult (0-24 years) cancers at multiple geographic scales-at the state level, then by degree of urbanization, county boundaries, and minor civil divisions. The state had increased rates for some cancers when compared to four other SEER (Surveillance, Epidemiology and End Results) states. No meaningful patterns at eithe r the most urban/suburban/most rural scales or at the county level of analysis were found. At the minor civil division level, the Ederer, My ers and Mantel method found evidence of clustering of pediatric and yo ung adult cases statewide. Stratification of cases by race yielded eve n stronger findings and indicated that whites had clustering of cases for several cancer types. In-depth analysis of individual cases yielde d hypotheses for investigating identified clusters.