title: Geographical variation in the incidence of childhood leukaemia in Manitoba.
abstract: BACKGROUND
  Identification of geographical areas and ecological factors associated with higher incidence of childhood leukaemias can direct further study for preventable factors and location of health services to manage such individuals.
  
  
  OBJECTIVE
  The aim of this study was to describe the geographical variation and the socio-demographic factors associated with childhood leukaemia in Manitoba.
  
  
  METHODS
  Information on childhood leukaemia incidence between 1992 and 2008 was obtained from the Canadian Cancer Registry and the socio-demographic characteristics for the area of residence from the 2006 Canadian Census. Bayesian spatial Poisson mixed models were used to describe the geographical variation of childhood leukaemia and to determine the association between childhood leukaemia and socio-demographic factors.
  
  
  RESULTS
  The south-eastern part of the province had a higher incidence of childhood leukaemia than other parts of the province. In the age and sex-adjusted Poisson regression models, areas with higher proportions of visible minorities and immigrant residents had higher childhood leukaemia incidence rate ratios. In the saturated Poisson regression model, the childhood leukaemia rates were higher in areas with higher proportions of immigrant residents. Unemployment rates were not a significant factor in leukaemia incidence.
  
  
  CONCLUSIONS
  In Manitoba, areas with higher proportions of immigrants experience higher incidence rates of childhood leukaemia. We have identified geographical areas with higher incidence, which require further study and attention.
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Torabi
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.|Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Harminder
authors.initials: H
authors.lastname: Singh
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Katie
authors.initials: K
authors.lastname: Galloway
authors.affiliation: Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Israels
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D005843:Geography; D006801:Humans; D015994:Incidence; D007223:Infant; D007938:Leukemia / Q000453:epidemiology*; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors
keywords: childhood leukaemia; geographical epidemiology; spatial patterns