title: [Analysis of small areas of pediatric cancer in the municipality of Murcia (Spain)].
abstract: BACKGROUND
  Occasionally, primary care pediatricians notice the presence of small clusters of pediatric cancer (PC), but are often frustrated by the findings after statistical analysis. The study of small areas in spatial epidemiology has led to advances in identifying clusters and the environmental risk factors involved. The purpose of this study was to describe the PC incidence and the spatial distribution at the minimum level of disaggregation possible in Murcia, presenting the first urban municipality map of PC in Spain.
  
  
  METHODS
  A population-based descriptive study was conducted on the PC cases diagnosed in children younger than 15 years, between 1998 and 2013 in the municipality of Murcia. Cases were classified by sex, age group, and tumor type. Coordinates of home addresses at the time of diagnosis were assigned to each case, and spatial and spatio-temporal analyses were carried out at the level of census tracts, using FleXScan and SatScan.
  
  
  RESULTS
  A total of 155 cases of PC were diagnosed during this period. The overall incidence of PC (138/10(6) of children under the age of 15) and the incidence for individual tumor types were within the expected ranges for Europe. A spatio-temporal cluster of Hodgkin lymphoma was identified.
  
  
  CONCLUSIONS
  Small area analysis of PC cases may be a useful tool for the identification of PC clusters, which would allow for the generation of hypotheses regarding disease etiology, as well as developing urban models for environmental surveillance of PC.
authors.affiliation: Unidad de Salud Medioambiental Pediátrica, Servicio de Pediatría, Laboratorio de Entorno y Salud Humana, Instituto de Investigación Biosanitaria de la Región de Murcia (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España. Electronic address: ortega@pehsu.org.
authors.forename: J A
authors.initials: JA
authors.lastname: Ortega-García
authors.affiliation: Departamento de Métodos Cuantitativos e Informáticos, Universidad Politécnica de Cartagena, Murcia, España.
authors.forename: F A
authors.initials: FA
authors.lastname: López-Hernández
authors.affiliation: Unidad de Salud Medioambiental Pediátrica, Servicio de Pediatría, Laboratorio de Entorno y Salud Humana, Instituto de Investigación Biosanitaria de la Región de Murcia (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: A
authors.initials: A
authors.lastname: Cárceles-Álvarez
authors.affiliation: Unidad de Salud Medioambiental Pediátrica, Servicio de Pediatría, Laboratorio de Entorno y Salud Humana, Instituto de Investigación Biosanitaria de la Región de Murcia (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: E J
authors.initials: EJ
authors.lastname: Santiago-Rodríguez
authors.affiliation: Unidad de Salud Medioambiental Pediátrica, Servicio de Pediatría, Laboratorio de Entorno y Salud Humana, Instituto de Investigación Biosanitaria de la Región de Murcia (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: A C
authors.initials: AC
authors.lastname: Sánchez
authors.affiliation: Sección de Oncología y Hematología Pediátricas, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: M
authors.initials: M
authors.lastname: Bermúdez-Cortes
authors.affiliation: Sección de Oncología y Hematología Pediátricas, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: J L
authors.initials: JL
authors.lastname: Fuster-Soler
mesh_terms: D002648:Child; D005060:Europe; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000453:epidemiology*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
keywords: Aetiology; Agrupamiento; Análisis de áreas pequeñas; Childhood cancer; Cluster; Cáncer infantil; Enfermedad de Hodgkin; Etiología; Hodgkin disease; Small-area analysis