title: Analysis of spatial-temporal clusters of childhood cancer incidence in the province of Córdoba, Argentina (2004-2013).
abstract: BACKGROUND
  In spite of its low incidence, childhood cancer is becoming increasingly more relevant in Argentina. More advances have been made in cancer treatment than in the study of its etiology or determining factors. There are no investigations that analyze its spatial and temporal distribution or potential clustering.
  
  
  OBJECTIVE
  To perform exploratory spatial and temporal analyses based on the database of the Registry of Tumors of the Province of Córdoba (2004-2013) to determine the clustering of childhood cancer incidence in Córdoba (Argentina).
  
  
  METHODS
  Epidemiological, retrospective, ecological study. Data from 1098 patients with malignancies aged 0-14 years old from the Registry of Tumors of the Province of Córdoba (2004-2013) were used. A geographic information system model was developed. The presence of spatial, temporal, and spatial-temporal clusters was analyzed in the districts of Córdoba using the SaTScan software.
  
  
  RESULTS
  Spatial clusters were detected, with a high number of cases, for total tumors (p= 0.01), leukemias (p= 0.02), malignant neoplasms of lymphoid, hematopoietic and related tissue (p= 0.03), central nervous system tumors (p= 0.03), and a high level of indicators of risk for renal tumors (p= 0.01). In addition, a temporal cluster (p= 0.01) and a spatial-temporal cluster (p= 0.02) for neuroblastoma and other peripheral nervous cell tumors were also observed.
  
  
  CONCLUSIONS
  Significant clusters were determined, with important associated indicators observed in several districts of Córdoba. This is the first methodological step towards the development of new investigations on the risk factors for childhood cancer and its etiology.
authors.affiliation: Cátedra de Antropología, Facultad de Ciencias Exactas, Físicas y Naturales, Universidad Nacional de Córdoba. Córdoba, Argentina. lisandroagost@gmail.com.
authors.forename: Lisandro
authors.initials: L
authors.lastname: Agost
mesh_terms: D000293:Adolescent; D001118:Argentina / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000453:epidemiology*; D012189:Retrospective Studies; D062211:Spatio-Temporal Analysis; D013997:Time Factors
keywords: Cancer; Children; Cluster analysis; Geographic information systems; Incidence