title: Epidemiologic mapping of Florida childhood cancer clusters.
abstract: BACKGROUND
  Childhood cancer remains the leading cause of disease-related mortality for children. Whereas, improvement in care has dramatically increased survival, the risk factors remain to be fully understood. The increasing incidence of childhood cancer in Florida may be associated with possible cancer clusters. We aimed, in this study, to identify and confirm possible childhood cancer clusters and their subtypes in the state of Florida.
  
  
  METHODS
  We conducted purely spatial and space-time analyzes to assess any evidence of childhood malignancy clusters in the state of Florida using SaTScan. Data from the Florida Association of Pediatric Tumor Programs (FAPTP) for the period 2000-2007 were used in this analysis.
  
  
  RESULTS
  In the purely spatial analysis, the relative risks (RR) of overall childhood cancer persisted after controlling for confounding factors in south Florida (SF) (RR = 1.36, P = 0.001) and northeastern Florida (NEF) (RR = 1.30, P = 0.01). Likewise, in the space-time analysis, there was a statistically significant increase in cancer rates in SF (RR = 1.52, P = 0.001) between 2006 and 2007. The purely spatial analysis of the cancer subtypes indicated a statistically significant increase in the rate of leukemia and brain/CNS cancers in both SF and NEF, P < 0.05. The space-time analysis indicated a statistically significant sizable increase in brain/CNS tumors (RR = 2.25, P = 0.02) for 2006-2007.
  
  
  CONCLUSIONS
  There is evidence of spatial and space-time childhood cancer clustering in SF and NEF. This evidence is suggestive of the presence of possible predisposing factors in these cluster regions. Therefore, further study is needed to investigate these potential risk factors.
authors.affiliation: Department of Mathematics and Statistics, University of West Florida, Pensacola, Florida 32514, USA. ramin@uwf.edu
authors.forename: Raid
authors.initials: R
authors.lastname: Amin
authors.forename: Alexander
authors.initials: A
authors.lastname: Bohnert
authors.forename: Laurens
authors.initials: L
authors.lastname: Holmes
authors.forename: Ayyappan
authors.initials: A
authors.lastname: Rajasekaran
authors.forename: Chatchawin
authors.initials: C
authors.lastname: Assanasen
mesh_terms: D002648:Child; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000453:epidemiology*; D013029:Space-Time Clustering