Geographic differences in invasive and in situ breast cancer incidence according to precise geographic coordinates, Connecticut, 1991-95.
To evaluate geographical variation of invasive and in situ breast cancer incidence rates using precise geographical coordinates for place of residence at diagnosis, latitude-longitude coordinates pertaining to 10,601 invasive and 1,814 in situ breast cancers for Connecticut women, 1991-95, were linked to US Census information on the 2,905 State census block groups. A spatial scan statistic was used to detect geographic excess or deficits in incidence and test the statistical significance of results, without prior assumptions about the size or location of such areas. The age adjusted invasive cancer incidence rate was 165.3/100,000 women/year. The spatial scan statistic identified 3 places with significantly low incidence rates and 4 places where rates were significantly high. The most probable location of low incidence was rural northeastern Connecticut where risk of disease, relative to elsewhere around the state, was 0.70 (p = 0.0001); the most probable place of elevated incidence was north central Connecticut where a relative risk of 1.34 (p = 0.002) was observed. Incidence of in situ disease was estimated to be significantly high for north central Connecticut (RR = 1.84; p = 0.0001). Geographic differences of invasive and in situ breast cancer incidence were observed. Examining cancer events at the lowest available level of data aggregation is beneficial in highlighting localized rate variations. Such information may enable public health officials to target additional resources for promoting breast cancer screening to specific locations.
Gregorio
David I
DI
Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT 06030-6205, USA. gregorio@nso.uchc.edu
Kulldorff
Martin
M
Barry
Leah
L
Samociuk
Holly
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D002278:Carcinoma in Situ / Q000453:epidemiology* / Q000473:pathology; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D005843:Geography; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D011159:Population Surveillance; D012042:Registries; D012307:Risk Factors; D013997:Time Factors