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Brain Cancer Mortality in the United States. Joint work with: Zixing Fang, UCLA David Gregorio, Univ Connecticut. U.S. Brain Cancer Mortality 1986-1995. deaths rate* (95% CI) Children (age <20): 5,062 0.75 (0.66-0.83) Adults (age 20+): 106,710 6.0 (5.8-6.2)

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brain cancer mortality in the united states

Brain Cancer Mortalityin the United States

Joint work with:

Zixing Fang, UCLA

David Gregorio, Univ Connecticut

u s brain cancer mortality 1986 1995
U.S. Brain Cancer Mortality1986-1995

deaths rate* (95% CI)

Children (age <20): 5,062 0.75 (0.66-0.83)

Adults (age 20+): 106,710 6.0 (5.8-6.2)

Adult Women: 48,650 4.9 (4.7-5.0)

Adult Men: 58,060 7.2 (7.0-7.5)

* annual deaths / 100,000

brain cancer
Brain Cancer
  • Known risk factors:
  • High dose ionizing radiation
  • Selected congenital and genetic disorders
  • Explains only a small percent of cases.
  • Potential risk factors:
  • N-nitroso compounds?, phenols?, pesticides?, polycyclic aromatic hydrocarbons?, organic solvents?
adjustments
Adjustments

All subsequent analyses where adjusted for:

  • Age
  • Gender
  • Ethnicity (African-American, White, Other)
cuzick edward s test children
Cuzick-Edward’s Test: Children

k p-value

200 0.04

500 0.13

tango s excess events test children
Tango’s Excess Events Test:Children

l p-value

1000 0.005

2000 0.06

5000 0.21

10000 0.29

children seven most likely clusters
Children: Seven Most Likely Clusters

Cluster Obs Exp RR p=

1. Carolinas 86 51 1.7 0.24

2. California 16 4.9 3.3 0.74

3. Michigan 318 250 1.3 0.74

4. S Carolina 24 10 2.5 0.79

5. Kentucky-Tenn 127 88 1.4 0.79

6. Wisconsin 10 2.4 4.1 0.98

7. Nebraska 12 3.6 3.3 0.99

conclusions children
Conclusions: Children

Some evidence of global spatial clustering, but

rather weak.

No statistically significant clusters detected.

Any part of the pattern seen on the original map may be due to chance.

cuzick edward s k nn all adults
Cuzick-Edward’s k-NN: All Adults

k p-value

4000 0.0001

10000 0.0001

tango s eet all adults
Tango’s EET: All Adults

l p-value

1000 0.0001

2000 0.0001

5000 0.0001

10000 0.0001

cuzick edward s women
Cuzick-Edward’s: Women

k p-value

1500 0.0001

3000 0.0001

tango s eet women
Tango’s EET: Women

l p-value

1000 0.0001

2000 0.0001

5000 0.0001

10000 0.0001

women most likely clusters
Women: Most Likely Clusters

Cluster Obs Exp RR p=

1. Arkansas et al. 2830 2328 1.22 0.0001

2. Carolinas 1783 1518 1.17 0.0001

3. Oklahoma et al. 1709 1496 1.14 0.003

4. Minnesota et al. 2616 2369 1.10 0.01

10. N.J. / N.Y. 1809 2300 0.79 0.0001

11. S Texas 127 214 0.59 0.0001

12. New Mexico et al. 849 1049 0.81 0.0001

cuzick edward s men
Cuzick-Edward’s: Men

k p-value

2000 0.0001

4000 0.0001

tango s eet men
Tango’s EET: Men

l p-value

1000 0.0001

2000 0.0001

5000 0.0001

10000 0.0001

men most likely clusters
Men: Most Likely Clusters

Cluster Obs Exp RR p=

1. Kentucky et al. 3295 2860 1.15 0.0001

2. Carolinas 1925 1658 1.16 0.0001

3. Arkansas et al. 1143 964 1.19 0.001

4. Washington et al. 1664 1455 1.14 0.003

5. Michigan 1251 1074 1.17 0.005

11. N.J. / N.Y. 2084 2615 0.80 0.0001

12. S Texas 157 262 0.60 0.0001

13. New Mexico et al. 1418 1680 0.84 0.0001

14. Upstate N.Y. et al. 1642 1895 0.87 0.0001

conclusions adults
Conclusions: Adults

Strong evidence of global spatial clustering.

It is possible to pinpoint specific areas with higher and lower rates that are statistically significant, and unlikely to be due to chance.

The exact borders of detected clusters are uncertain.

Similar patterns for men and women.

conclusion general
Conclusion: General

Tests for spatial randomness are very useful additions to cancer maps, in order to determine if the observed patterns are likely due to chance or not.

Different tests provide complementary information.

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