Space-Time Clustering of Testicular Cancer Using Residential Histories

摘要本研究项目的主要目的是通过在丹麦开展一项大规模的、全人群的病例对照研究，利用居住历史调查病例和对照的时空聚类，从而产生有关睾丸癌病因学的见解。睾丸癌是15-34岁男性最常见的癌症原因，但对其病因知之甚少。已确定的和推定的风险因素，作为一个整体，只占睾丸癌总病例的一小部分，需要新的技术来解决这个公共卫生之谜。我们研究组最近开发了能够进行时空聚类分析的q统计和时空信息系统（STIS）技术。其他分析癌症集群的方法通常忽略居住流动性，并且几乎完全使用诊断或死亡时间居住地的静态空间点分布。此外，很少有空间技术能够充分考虑已知的风险因素和协变量。我们的方法通过利用代表生活线的参与者的居住历史来解决这些需求，从而评估相对于控制组的居住历史的病例的居住历史的生命过程中任何时刻的时空聚类。此外，代替广泛使用的（但往往不恰当的）空间随机性零假设，q统计可以根据每个人的风险因素和协变量纳入每个人成为病例的概率。本项目将应用创新的Q-statistics和sti技术，通过比较病例与对照组的居住史来识别睾丸癌的空间聚类。拟议的研究将从全国范围内的丹麦癌症登记处（1994-2003年诊断）中选择睾丸癌病例（3100例），并从普通人群中选择对照组（3100例，年龄匹配）。病例和控制将与丹麦中央人口登记处提供的居住历史信息联系起来，并将实施q统计来检查聚类。将要求地方当局和丹麦环境保护局的登记处确定最重要的群集周围可能的环境污染模式，以产生关于睾丸癌的环境原因的假设。未来的研究将通过收集生物标志物和在流行病学框架内模拟环境污染物来解决这些环境假设。这项研究将有史以来第一次允许流行病学家使用详细的居住历史来评估睾丸癌的时空集群，其预期目的是产生与睾丸癌相关的潜在病因因素的新假设，以便在未来的研究中进行调查。睾丸癌是15-34岁男性中最常见的癌症类型，这项研究的科学创新有望极大地提高我们对睾丸癌的认识。这项研究将使环境和空间流行病学家能够通过比较病例的居住史与对照组的居住史来调查睾丸癌的空间集群，其预期目的是产生关于睾丸癌病因的新假设。

DESCRIPTION (provided by applicant): Space-Time Clustering of Testicular Cancer Using Residential Histories Abstract The primary objective of the proposed research project is to generate insights concerning the etiology of testicular cancer by conducting a large, population-wide case-control study in Denmark investigating space- time clustering of cases and controls using residential histories. Testicular cancer is the most common cause of cancer in men aged 15-34 yet relatively little is known about its etiology. The established and presumptive risk factors, taken as a whole, account for only a small proportion of the total cases of testicular cancer, and novel techniques are needed to solve this public health enigma. Our research team has recently developed Q-statistics and Space-Time Information System (STIS) technology that enable space-time cluster analyses. Other methods for analyzing cancer clusters typically ignore residential mobility, and almost exclusively work with static spatial point distributions of place-of-residence at time of diagnosis or time of death. In addition, few spatial techniques adequately account for known risk factors and covariates. Our approach addresses each of these needs by utilizing the residential history of the participants represented as a life-line, and thus evaluates space-time clustering at any moment in the life-course of the residential histories of the cases relative to the residential histories of the controls. In addition, in place of the widely used (but often inappropriate) null hypothesis of spatial randomness, Q-statistics can incorporate each individual's probability of being a case based on his/her risk factors and covariates. This project will apply the innovative Q-statistics and STIS technology to identify spatial clustering of testicular cancer by comparing the residential histories of the cases with those of the controls. The proposed research will select testicular cancer cases (3100) from the nation-wide Danish Cancer Registry (diagnosed in 1994-2003) and controls (3100, matched on age) from the general population. The cases and controls will be linked with residential history information available in the Danish Central Population Registry and Q-statistics will be implemented to examine clustering. Local authorities and registers at the Danish Environmental Protection Agency will be asked to identify possible patterns of environmental contamination surrounding the most significant clusters to generate hypotheses about environmental causes of testicular cancer. Future research will address such environmental hypotheses by collecting biomarkers and modeling environmental contaminants within an epidemiologic framework. This research will, for the first time ever, allow epidemiologists to assess space-time clusters of testicular cancer using detailed residential histories, with the intended purpose of generating fresh hypotheses about potential etiologic factors associated with testicular cancer to be investigated in future studies. Space-Time Clustering of Testicular Cancer Using Residential Histories Relevance The scientific innovations from this research are expected to dramatically improve our understanding of testicular cancer, the most common type of cancer in men aged 15-34. This research will enable environmental and spatial epidemiologists to investigate spatial clusters of testicular cancer by comparing residential histories of cases with residential histories of controls, with the intended purpose of generating fresh hypotheses concerning the etiology of testicular cancer.