Abstract
Residential clusters of non-communicable diseases are a source of enduring public concern, and at times, controversy. Many clusters reported to public health agencies by concerned citizens are accompanied by expectations that investigations will uncover a cause of disease. While goals, methods and conclusions of cluster studies are debated in the scientific literature and popular press, investigations of reported residential clusters rarely provide definitive answers about disease etiology. Further, it is inherently difficult to study a cluster for diseases with complex etiology and long latency (e.g., most cancers). Regardless, cluster investigations remain an important function of local, state and federal public health agencies. Challenges limiting the ability of cluster investigations to uncover causes for disease include the need to consider long latency, low statistical power of most analyses, uncertain definitions of cluster boundaries and population of interest, and in- and out-migration. A multi-disciplinary Workshop was held to discuss innovative and/or under-explored approaches to investigate cancer clusters. Several potentially fruitful paths forward are described, including modern methods of reconstructing residential history, improved approaches to analyzing spatial data, improved utilization of electronic data sources, advances using biomarkers of carcinogenesis, novel concepts for grouping cases, investigations of infectious etiology of cancer, and "omics" approaches.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1479-1499 |
| Number of pages | 21 |
| Journal | International Journal of Environmental Research and Public Health |
| Volume | 11 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jan 28 2014 |
| Externally published | Yes |
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Keywords
- Cancer
- Cancer biomarkers
- Case grouping
- Cluster investigations
- Exposome
- Infection
- Leukemia
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Health, Toxicology and Mutagenesis
- Medicine(all)
Cite this
Cancer cluster investigations : Review of the past and proposals for the future. / Goodman, Michael; Lakind, Judy S.; Fagliano, Jerald A.; Lash, Timothy L.; Wiemels, Joseph L.; Winn, Deborah M.; Patel, Chirag; Van Eenwyk, Juliet; Kohler, Betsy A.; Schisterman, Enrique F.; Albert, Paul; Mattison, Donald R.
In: International Journal of Environmental Research and Public Health, Vol. 11, No. 2, 28.01.2014, p. 1479-1499.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cancer cluster investigations
T2 - Review of the past and proposals for the future
AU - Goodman, Michael
AU - Lakind, Judy S.
AU - Fagliano, Jerald A.
AU - Lash, Timothy L.
AU - Wiemels, Joseph L.
AU - Winn, Deborah M.
AU - Patel, Chirag
AU - Van Eenwyk, Juliet
AU - Kohler, Betsy A.
AU - Schisterman, Enrique F.
AU - Albert, Paul
AU - Mattison, Donald R.
PY - 2014/1/28
Y1 - 2014/1/28
N2 - Residential clusters of non-communicable diseases are a source of enduring public concern, and at times, controversy. Many clusters reported to public health agencies by concerned citizens are accompanied by expectations that investigations will uncover a cause of disease. While goals, methods and conclusions of cluster studies are debated in the scientific literature and popular press, investigations of reported residential clusters rarely provide definitive answers about disease etiology. Further, it is inherently difficult to study a cluster for diseases with complex etiology and long latency (e.g., most cancers). Regardless, cluster investigations remain an important function of local, state and federal public health agencies. Challenges limiting the ability of cluster investigations to uncover causes for disease include the need to consider long latency, low statistical power of most analyses, uncertain definitions of cluster boundaries and population of interest, and in- and out-migration. A multi-disciplinary Workshop was held to discuss innovative and/or under-explored approaches to investigate cancer clusters. Several potentially fruitful paths forward are described, including modern methods of reconstructing residential history, improved approaches to analyzing spatial data, improved utilization of electronic data sources, advances using biomarkers of carcinogenesis, novel concepts for grouping cases, investigations of infectious etiology of cancer, and "omics" approaches.
AB - Residential clusters of non-communicable diseases are a source of enduring public concern, and at times, controversy. Many clusters reported to public health agencies by concerned citizens are accompanied by expectations that investigations will uncover a cause of disease. While goals, methods and conclusions of cluster studies are debated in the scientific literature and popular press, investigations of reported residential clusters rarely provide definitive answers about disease etiology. Further, it is inherently difficult to study a cluster for diseases with complex etiology and long latency (e.g., most cancers). Regardless, cluster investigations remain an important function of local, state and federal public health agencies. Challenges limiting the ability of cluster investigations to uncover causes for disease include the need to consider long latency, low statistical power of most analyses, uncertain definitions of cluster boundaries and population of interest, and in- and out-migration. A multi-disciplinary Workshop was held to discuss innovative and/or under-explored approaches to investigate cancer clusters. Several potentially fruitful paths forward are described, including modern methods of reconstructing residential history, improved approaches to analyzing spatial data, improved utilization of electronic data sources, advances using biomarkers of carcinogenesis, novel concepts for grouping cases, investigations of infectious etiology of cancer, and "omics" approaches.
KW - Cancer
KW - Cancer biomarkers
KW - Case grouping
KW - Cluster investigations
KW - Exposome
KW - Infection
KW - Leukemia
UR - http://www.scopus.com/inward/record.url?scp=84893587290&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84893587290&partnerID=8YFLogxK
U2 - 10.3390/ijerph110201479
DO - 10.3390/ijerph110201479
M3 - Article
C2 - 24477211
AN - SCOPUS:84893587290
VL - 11
SP - 1479
EP - 1499
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
SN - 1661-7827
IS - 2
ER -