title: Female Breast Cancer Mortality Clusters in Shandong Province, China: A Spatial Analysis.
abstract: This study aimed to detect the spatial distribution and high-risk clusters of female breast cancer mortality for the years 2011 to 2013 in Shandong Province, China. The urban-rural difference in the spatial distribution and clusters of disease mortality were also examined. Breast cancer mortality data were obtained from the Shandong Death Registration System (SDRS) during 2011 to 2013 and were adjusted for the underreporting rate. The purely spatial scan Statistics method was performed using Discrete Poisson model. Seven significant spatial clusters for high mortality of female breast cancer were detected in Shandong Province at the county level; these clusters were mainly located in the eastern, southern, southwestern, central and northern regions. The spatial distributions differed significantly between urban and rural populations. Population ageing influenced the distribution of breast cancer clusters for the urban eastern residents. This study provided evidence for the presence of clusters of breast cancer mortality in Shandong, China and found urban-rural difference in the clusters, which is helpful for developing effective strategies to control breast cancer in different areas.
authors.affiliation: The Department for Chronic and Non-communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chu
authors.affiliation: School of Public Health, Shandong University, Jinan, 250012, China.
authors.forename: Chengchao
authors.initials: C
authors.lastname: Zhou
authors.affiliation: The Department for Chronic and Non-communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Guo
authors.affiliation: Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Queensland, Australia.|School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Jiandong
authors.initials: J
authors.lastname: Sun
authors.affiliation: School of Public Health, Shandong University, Jinan, 250012, China.
authors.forename: Fuzhong
authors.initials: F
authors.lastname: Xue
authors.affiliation: The Department for Chronic and Non-communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
authors.forename: Jiyu
authors.initials: J
authors.lastname: Zhang
authors.affiliation: The Department for Chronic and Non-communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
authors.forename: Zilong
authors.initials: Z
authors.lastname: Lu
authors.affiliation: The Department for Chronic and Non-communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
authors.forename: Zhentao
authors.initials: Z
authors.lastname: Fu
authors.affiliation: The Department for Chronic and Non-communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China. aqxuepi@163.com.
authors.forename: Aiqiang
authors.initials: A
authors.lastname: Xu
mesh_terms: D000367:Age Factors; D001943:Breast Neoplasms / Q000401:mortality*; D002681:China / Q000453:epidemiology; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D015233:Models, Statistical; D012042:Registries; D012424:Rural Population; D062206:Spatial Analysis; D014505:Urban Population