Devier J R, Brownson R C, Bagby J R, Carlson G M, Crellin J R
Division of Chronic Disease Prevention and Health Promotion, Missouri Department of Health, Columbia 65203.
Am J Epidemiol. 1990 Jul;132(1 Suppl):S23-31. doi: 10.1093/oxfordjournals.aje.a115784.
A protocol was developed in 1984 by the Missouri Department of Health to provide a systematic method for responding to citizen reports of cancer clusters. This protocol integrates public health and environmental expertise and includes two stages: the preliminary review and the investigation. The preliminary review is focused on problem definition and hypothesis generation. Cancer mortality and incidence data are reviewed. Information is gathered and verified through the efforts of citizens, local health officials, environmental staff, and the cancer program staff. Epidemiologic factors evaluated include type of cancer, temporal and spatial relations, population at risk, community profile, and possible environmental and occupational factors. The investigation is an expanded analytic study. Resources are focused on cancer inquiries that appear most likely to involve manageable common exposures. Program experience and protocol development highlights, including surveillance system improvement and educational programming, are described.
1984年，密苏里州卫生部制定了一项协议，以提供一种系统的方法来回应公民关于癌症聚集的报告。该协议整合了公共卫生和环境方面的专业知识，包括两个阶段：初步审查和调查。初步审查侧重于问题定义和假设生成。对癌症死亡率和发病率数据进行审查。通过公民、当地卫生官员、环境工作人员和癌症项目工作人员的努力收集并核实信息。评估的流行病学因素包括癌症类型、时间和空间关系、高危人群、社区概况以及可能的环境和职业因素。调查是一项扩展的分析研究。资源集中在那些看起来最有可能涉及可控常见暴露的癌症询问上。描述了项目经验和协议制定的亮点，包括监测系统的改进和教育规划。
