title: Evaluating for a geospatial relationship between radon levels and thyroid cancer in Pennsylvania.
abstract: OBJECTIVE
  To determine whether there is an association between radon levels and the rise in incidence of thyroid cancer in Pennsylvania.
  
  
  METHODS
  Epidemiological study of the state of Pennsylvania.
  
  
  METHODS
  We used information from the Pennsylvania Cancer Registry and the Pennsylvania Department of Energy. From the registry, information regarding thyroid incidence by county and zip code was recorded. Information regarding radon levels per county was recorded from the state. Poisson regression models were fit predicting county-level thyroid incidence and change as a function of radon/lagged radon levels. To account for measurement error in the radon levels, a Bayesian Model extending the Poisson models was fit. Geospatial clustering analysis was also performed.
  
  
  RESULTS
  No association was noted between cumulative radon levels and thyroid incidence. In the Poisson modeling, no significant association was noted between county radon level and thyroid cancer incidence (P = .23). Looking for a lag between the radon level and its effect, no significant effect was seen with a lag of 0 to 6 years between exposure and effect (P = .063 to P = .59). The Bayesian models also failed to show a statistically significant association. A cluster of high thyroid cancer incidence was found in western Pennsylvania.
  
  
  CONCLUSIONS
  Through a variety of models, no association was elicited between annual radon levels recorded in Pennsylvania and the rising incidence of thyroid cancer. However, a cluster of thyroid cancer incidence was found in western Pennsylvania. Further studies may be helpful in looking for other exposures or associations.
authors.affiliation: Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, U.S.A.; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Hershey, Pennsylvania, U.S.A.
authors.forename: Neerav
authors.initials: N
authors.lastname: Goyal
authors.forename: Fabian
authors.initials: F
authors.lastname: Camacho
authors.forename: Joseph
authors.initials: J
authors.lastname: Mangano
authors.forename: David
authors.initials: D
authors.lastname: Goldenberg
mesh_terms: D001499:Bayes Theorem; D015984:Causality; D016000:Cluster Analysis; D006801:Humans; D015994:Incidence; D009381:Neoplasms, Radiation-Induced / Q000191:economics* / Q000209:etiology*; D010414:Pennsylvania; D016012:Poisson Distribution; D011886:Radon / Q000009:adverse effects* / Q000032:analysis*; D012042:Registries; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D019371:Topography, Medical
chemical_list: D011886:Radon
keywords: Ecological study; Pennsylvania; geospatial clustering; radon; thyroid cancer