Ortega-García J A, López-Hernández F A, Cárceles-Álvarez A, Santiago-Rodríguez E J, Sánchez A C, Bermúdez-Cortes M, Fuster-Soler J L
Unidad de Salud Medioambiental Pediátrica, Servicio de Pediatría, Laboratorio de Entorno y Salud Humana, Instituto de Investigación Biosanitaria de la Región de Murcia (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
Departamento de Métodos Cuantitativos e Informáticos, Universidad Politécnica de Cartagena, Murcia, España.
An Pediatr (Barc). 2016 Mar;84(3):154-62. doi: 10.1016/j.anpedi.2015.04.021. Epub 2015 Jul 8.
Occasionally, primary care pediatricians notice the presence of small clusters of pediatric cancer (PC), but are often frustrated by the findings after statistical analysis. The study of small areas in spatial epidemiology has led to advances in identifying clusters and the environmental risk factors involved. The purpose of this study was to describe the PC incidence and the spatial distribution at the minimum level of disaggregation possible in Murcia, presenting the first urban municipality map of PC in Spain.
A population-based descriptive study was conducted on the PC cases diagnosed in children younger than 15 years, between 1998 and 2013 in the municipality of Murcia. Cases were classified by sex, age group, and tumor type. Coordinates of home addresses at the time of diagnosis were assigned to each case, and spatial and spatio-temporal analyses were carried out at the level of census tracts, using FleXScan and SatScan.
A total of 155 cases of PC were diagnosed during this period. The overall incidence of PC (138/10(6) of children under the age of 15) and the incidence for individual tumor types were within the expected ranges for Europe. A spatio-temporal cluster of Hodgkin lymphoma was identified.
Small area analysis of PC cases may be a useful tool for the identification of PC clusters, which would allow for the generation of hypotheses regarding disease etiology, as well as developing urban models for environmental surveillance of PC.
初级保健儿科医生偶尔会注意到小儿癌症(PC)的小聚集情况,但在统计分析后的结果往往令人沮丧。空间流行病学中对小区域的研究已推动了在识别聚集情况及相关环境风险因素方面取得进展。本研究的目的是描述穆尔西亚地区在尽可能最小的细分层面上的PC发病率和空间分布,呈现西班牙首张PC城市市政地图。
对1998年至2013年期间在穆尔西亚市诊断出的15岁以下儿童的PC病例进行了一项基于人群的描述性研究。病例按性别、年龄组和肿瘤类型分类。为每个病例分配诊断时家庭住址的坐标,并使用FleXScan和SatScan在普查区层面进行空间和时空分析。
在此期间共诊断出155例PC病例。PC的总体发病率(15岁以下儿童中为138/10⁶)以及各肿瘤类型的发病率均在欧洲预期范围内。识别出了霍奇金淋巴瘤的一个时空聚集区。
对PC病例进行小区域分析可能是识别PC聚集情况的有用工具,这将有助于生成关于疾病病因的假设,并开发用于PC环境监测的城市模型。