title: Spatial clustering of myelodysplastic syndromes (MDS) in the Seattle-Puget Sound region of Washington State.
abstract: OBJECTIVE
  Incidence of myelodysplastic syndromes (MDS) has been described in the United States since its inclusion in the Surveillance, Epidemiology, and End Results program in 2001, and the Seattle-Puget Sound region of Washington State has among the highest rates of the registries. In this investigation, we described small-scale incidence patterns of MDS within the Seattle-Puget Sound region from 2002 to 2006 and identified potential spatial clusters to inform planning of future studies of MDS etiology.
  
  
  METHODS
  We used a spatial disease mapping model to estimate smoothed relative risks for each census tract and to describe the spatial component of variability in the incidence rates. We also used two methods to describe the location of potential MDS clusters: the approach of Besag and Newell and the Kulldorff spatial scan statistic.
  
  
  RESULTS
  Our findings from all three approaches indicated the most likely areas of increased MDS incidence were located on Whidbey Island in Island County.
  
  
  CONCLUSIONS
  Interpretation is limited because our data are based on the residential location of the MDS case only at the time of diagnosis. Nevertheless, inclusion of identified cluster regions in future population-based research and investigation of individual-level exposures could shed light on environmental risk factors for MDS.
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA, USA.
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Ross
authors.forename: Jon
authors.initials: J
authors.lastname: Wakefield
authors.forename: Scott
authors.initials: S
authors.lastname: Davis
authors.forename: Anneclaire J
authors.initials: AJ
authors.lastname: De Roos
mesh_terms: D016000:Cluster Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009190:Myelodysplastic Syndromes / Q000453:epidemiology*; D012042:Registries; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014861:Washington