Περίληψη:
The interpretation of reports of clusters of childhood leukaemia is
difficult, first because little is known about the causes of the
disease, and second because there is insufficient information on whether
cases show a generalized tendency to cluster geographically. The
EUROCLUS project is a European collaborative study whose primary
objective is to determine whether the residence locations of cases at
diagnosis show a general tendency towards spatial clustering. The second
objective is to interpret any patterns observed and, in particular, to
see if clustering can be explained in terms of either infectious agents
or environmental hazards as aetiological agents. The spatial
distribution of 13351 cases of childhood leukaemia diagnosed in 17
countries between 1980 and 1989 has been analysed using the
Pothoff-Whittinghill method. The overall results show statistically
significant evidence of clustering of total childhood leukaemia within
small census areas (P = 0.03) but the magnitude of the clustering is
small (extra-Poisson component of variance (%) = 1.7 with 90%
confidence interval 0.2-3.1). The clustering is most marked in areas
that have intermediate population density (150-499 persons km(-2)). It
cannot be attributed to any specific age group at diagnosis or cell type
and involves spatial aggregation of cases of different ages and cell
types. The results indicate that intense clusters are a rare phenomenon
that merit careful investigation, although aetiological insights are
more likely to come from investigation of large numbers of cases. We
present a method for detecting clustering that is simple and readily
available to cancer registries and similar groups.
Συγγραφείς:
Alexander, FE
Boyle, P
Carli, PM
Coebergh, JW
Draper, GJ
and Ekbom, A
Levi, F
McKinney, PA
McWhirter, W and
Michaelis, J
Peris-Bonet, R
Petridou, E
Pompe-Kirn, V and
Plisko, I
Pukkala, E
Rahu, M
Storm, H
Terracini, B and
Vatten, L
Wray, N
