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. 1999 Mar-Apr;90(2):104-8.
doi: 10.1007/BF03404111.

An analysis of the geographic variation in cancer incidence and its determinants in Ontario

S D Walter  1 , L D Marrett, S M Taylor, D King
Affiliations

An analysis of the geographic variation in cancer incidence and its determinants in Ontario

S D Walter et al. Can J Public Health. 1999 Mar-Apr.

Abstract
in English, French

Cancer incidence data for the Ontario Public Health Units in 1980-91 were examined to investigate regional patterns and the existence of outlier values after adjustment for known risk factors. Candidate risk factors were derived from the Ontario Health Survey and the census. Weighted regressions were fit to the data, and the spatial pattern of the residuals was analyzed. The number of outlier data points with significant elevations or reductions in risk was close to that expected by chance. They were dispersed geographically, and occurred in a variety of cancer types. We conclude that, in general, most of the geographic variation in cancer risk can be associated with variation in known risk factors, and that there appear to be no broad regional effects remaining after adjustment for these factors. A few cancer sites provide limited evidence of regional effects that may warrant further investigation.

Nous avons revu les données statistiques des unités de santé publique de l’Ontario (1980‐91) concernant l’incidence du cancer dans le but d’identifier les déterminants potentiels des variations régionales des risques à travers la province. L’information relative aux facteurs de risque provenait de l’Enquête sur la santé de l’Ontario de 1990 et du recensement. Une régression des carrés minimisés a été effectuée, ainsi qu’une analyse des corrélations spatiales des erreurs.

Le nombre de points extrêmes résultant en une augmentation ou une réduction significative du risque se rapprochait de celui anticipé par l’effet du hazard. Géographiquement, ces extrêmes étaient distribués à travers la province et étaient observés dans plusieurs types de cancer. Ces données démontrent qu’il n’y a pas d’unités où l’on retrouve un risque de cancer anormalement élevé ou anormalement bas, comparativement à l’ensemble de la province, après ajustement pour les facteurs de risque connus. Les données concernant quelques sites suggèrent cependant la possibilité d’effets régionaux qui méritent d’être analysés davantage.

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References

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