Epidemiologic mapping of Florida childhood cancer clusters

Background. Childhood cancer remains the leading cause of disease-related mortality for children. Whereas, improvement in care has dramatically increased survival, the risk factors remain to be fully understood. The increasing incidence of childhood cancer in Florida may be associated with possible cancer clusters. We aimed, in this study, to identify and confirm possible childhood cancer clusters and their subtypes in the state of Florida. Methods. We conducted purely spatial and space-time analyzes to assess any evidence of childhood malignancy clusters in the state of Florida using SaTScan™. Data from the Florida Association of Pediatric Tumor Programs (FAPTP) for the period 2000-2007 were used in this analysis. Results. In the purely spatial analysis, the relative risks (RR) of overall childhood cancer persisted after controlling for confounding factors in south Florida (SF) (RR=1.36, P=0.001) and northeastern Florida (NEF) (RR=1.30, P=0.01). Likewise, in the space-time analysis, there was a statistically significant increase in cancer rates in SF (RR=1.52, P=0.001) between 2006 and 2007. The purely spatial analysis of the cancer subtypes indicated a statistically significant increase in the rate of leukemia and brain/CNS cancers in both SF and NEF, P<0.05. The space-time analysis indicated a statistically significant sizable increase in brain/CNS tumors (RR=2.25, P=0.02) for 2006-2007. Conclusions. There is evidence of spatial and space-time childhood cancer clustering in SF and NEF. This evidence is suggestive of the presence of possible predisposing factors in these cluster regions. Therefore, further study is needed to investigate these potential risk factors.