title: [Active monitoring of cancer clusters: comments from an epidemiological perspective].
abstract: Epidemiological cancer registries are responsible for the description of the occurrence of cancers in time and space in the respective Federal State(s). Their work also involves the work-up of suspected or obvious regional clusters of cancer cases. The current sequence of action - (a) to confirm the cluster by a statistical test, (b) to identify specific exposures as potential causes, (c) to potentially conduct etiologic-epidemiological studies to confirm a suspected association - fails because of methodological difficulties. This article outlines a different approach that focuses on (a) the explanation of these methodological limitations and (b) on the current epidemiological knowledge on cancer etiology in order to rule out misunderstandings on potential causes of cancer clusters. Collaboration with professional cancer registries is advised.
authors.affiliation: Epidemiologisches Krebsregister Baden-Württemberg, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 581, 69120, Heidelberg, Deutschland, n.becker@dkfz.de.
authors.forename: N
authors.initials: N
authors.lastname: Becker
mesh_terms: D016000:Cluster Analysis; D003627:Data Interpretation, Statistical; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D011159:Population Surveillance / Q000379:methods*; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D062211:Spatio-Temporal Analysis