High breast cancer mortality rates have been reported in the northeastern part of the United States, with recent attention focused on Long Island, New York.
In this study, the authors investigate whether the high breast cancer mortality is evenly spread over the Northeast, in the sense that any observed clusters of deaths can be explained by chance alone, or whether there are clusters of statistical significance.
Demographic data and age-specific breast cancer mortality rates for women were obtained for all 244 counties in 11 northeastern states and for the District of Columbia for 1988-1992.
A recently developed spatial scan statistic is used, which searches for clusters of cases without specifying their size or location ahead of time, and which tests for their statistical significance while adjusting for the multiple testing inherent in such a procedure.
The basic analysis is adjusted for age, with further analyses examining how the results are affected by incorporating race, urbanicity, and parity as confounding variables.
There is a statistically significant and geographically broad cluster of breast cancer deaths in the New York City-Philadelphia, Pennsylvania, metropolitan area (p=0.0001), which has a 7.4% higher mortality rate than the rest of the Northeast.
The cluster remains significant when race, urbanicity, and/or parity are included as confounding variables. (...)
Mots-clés Pascal : Tumeur maligne, Glande mammaire, Epidémiologie, Analyse amas, Etats Unis, Amérique du Nord, Amérique, Nord est, Homme, Variation géographique, Mortalité, Méthodologie, Analyse statistique, Facteur risque, Age, Race, Parité, Glande mammaire pathologie, Milieu urbain
Mots-clés Pascal anglais : Malignant tumor, Mammary gland, Epidemiology, Cluster analysis, United States, North America, America, Northeast, Human, Geographical variation, Mortality, Methodology, Statistical analysis, Risk factor, Age, Race, Parity, Mammary gland diseases, Urban environment
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0428070
Code Inist : 002B20E02. Création : 19/12/1997.