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Cancer Cluster Investigations: Review of the Past and Proposals for the Future

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  • Michael Goodman

    (Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA
    These authors contributed equally to this work.)

  • Judy S. LaKind

    (LaKind Associates, LLC, 106 Oakdale Avenue, Catonsville, MD 21228, USA
    Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Howard Hall Suite 200, 660 W. Redwood Street, Baltimore, MD 21201, USA
    Department of Pediatrics, College of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, 500 University Drive, Hershey, PA 17033, USA
    These authors contributed equally to this work.)

  • Jerald A. Fagliano

    (Division of Epidemiology, Environmental and Occupational Health, New Jersey Department of Health, P.O. Box 369, Trenton, NJ 08625, USA
    These authors contributed equally to this work.)

  • Timothy L. Lash

    (Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA
    These authors contributed equally to this work.)

  • Joseph L. Wiemels

    (Division of Cancer Epidemiology, Department of Epidemiology & Biostatistics, School of Medicine, University of California, Helen Diller Family Cancer Research Building, HD 274 1450 3rd Street, San Francisco, MC 0520, San Francisco, CA 94158, USA
    These authors contributed equally to this work.)

  • Deborah M. Winn

    (Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD 20892, USA
    These authors contributed equally to this work.)

  • Chirag Patel

    (School of Medicine, Stanford University, 1265 Welch Road, Stanford, CA 94305, USA
    These authors contributed equally to this work.)

  • Juliet Van Eenwyk

    (Washington State Department of Health, P.O. Box 47812, Olympia, WA 98504, USA
    These authors contributed equally to this work.)

  • Betsy A. Kohler

    (North American Association of Central Cancer Registries, Inc., 2121 W. White Oaks Drive, Suite B, Springfield, IL 62704, USA
    These authors contributed equally to this work.)

  • Enrique F. Schisterman

    (Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd., Bethesda, MD 20892, USA
    These authors contributed equally to this work.)

  • Paul Albert

    (Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd., Bethesda, MD 20892, USA
    These authors contributed equally to this work.)

  • Donald R. Mattison

    (Risk Sciences International, 325 Dalhousie Street, Ottawa, ON K1N 7G2, Canada
    McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, 325 Dalhousie Street, Ottawa, ON K1N 7G2, Canada
    These authors contributed equally to this work.)

Abstract

Residential clusters of non-communicable diseases are a source of enduring public concern, and at times, controversy. Many clusters reported to public health agencies by concerned citizens are accompanied by expectations that investigations will uncover a cause of disease. While goals, methods and conclusions of cluster studies are debated in the scientific literature and popular press, investigations of reported residential clusters rarely provide definitive answers about disease etiology. Further, it is inherently difficult to study a cluster for diseases with complex etiology and long latency (e.g., most cancers). Regardless, cluster investigations remain an important function of local, state and federal public health agencies. Challenges limiting the ability of cluster investigations to uncover causes for disease include the need to consider long latency, low statistical power of most analyses, uncertain definitions of cluster boundaries and population of interest, and in- and out-migration. A multi-disciplinary Workshop was held to discuss innovative and/or under-explored approaches to investigate cancer clusters. Several potentially fruitful paths forward are described, including modern methods of reconstructing residential history, improved approaches to analyzing spatial data, improved utilization of electronic data sources, advances using biomarkers of carcinogenesis, novel concepts for grouping cases, investigations of infectious etiology of cancer, and “omics” approaches.

Suggested Citation

  • Michael Goodman & Judy S. LaKind & Jerald A. Fagliano & Timothy L. Lash & Joseph L. Wiemels & Deborah M. Winn & Chirag Patel & Juliet Van Eenwyk & Betsy A. Kohler & Enrique F. Schisterman & Paul Alber, 2014. "Cancer Cluster Investigations: Review of the Past and Proposals for the Future," IJERPH, MDPI, vol. 11(2), pages 1-21, January.
    • Handle: RePEc:gam:jijerp:v:11:y:2014:i:2:p:1479-1499:d:32586
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    References listed on IDEAS

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    1. Rothman, K.J., 1987. "Clustering of disease," American Journal of Public Health, American Public Health Association, vol. 77(1), pages 13-15.
    2. Trumbo, C.W., 2000. "Public requests for cancer cluster investigations: A survey of state health departments," American Journal of Public Health, American Public Health Association, vol. 90(8), pages 1300-1302.
    3. Julian Besag & James Newell, 1991. "The Detection of Clusters in Rare Diseases," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 154(1), pages 143-155, January.
    4. Pearce, Jamie & Boyle, Paul, 2005. "Is the urban excess in lung cancer in Scotland explained by patterns of smoking?," Social Science & Medicine, Elsevier, vol. 60(12), pages 2833-2843, June.
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    Cited by:

    1. Barbara A. Cohn & Mary Beth Terry, 2019. "Environmental Influences on Mammographic Breast Density in California: A Strategy to Reduce Breast Cancer Risk," IJERPH, MDPI, vol. 16(23), pages 1-9, November.

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