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Use of the Spatial Scan Statistic to Identify Geographic Variations in Late Stage Colorectal Cancer in California (United States)

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Abstract

Objectives

To identify geographic variations in colorectal cancer by stage at diagnosis in California using a descriptive analysis coupled with a spatial analysis and to discuss methodological considerations concerning the spatial statistical method.

Methods

We analyzed 59,076 colorectal cancer cases diagnosed in California from 1996 to 2000 by logistic regression and by a spatial scan statistic to identify areas with a higher and lower relative risk of late-stage colorectal cancer.

Results

In California, 57% of overall cases of colorectal cancer were diagnosed at a late stage. Californians diagnosed with late-stage colorectal cancer were more likely to be Hispanic and living in areas of lower socioeconomic status. The spatial scan identified two areas where the observed number of late-stage cancer was different than the number expected from the distribution in the rest of the state.

Conclusions

Spatial scan analyses can complement descriptive statistics, but results must be interpreted with consideration of factors that affect the ability to detect meaningful differences such as the number of events observed, accuracy in geocoding rural versus urban addresses, and the difficulty of adjusting for covariates.

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Acknowledgements

We acknowledge the contribution of Dr. William E. Wright, Chief of the Cancer Surveillance Section of the California Department of Health Service for his support and input into this project, Mark Allen for his assistance preparing the California Cancer Registry data, and Robert Schwartz (NCCDPHP, CDC) for his expertise in optimizing our information system capacity in order to undertake the analysis.

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Authors and Affiliations

  1. Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K55, Atlanta, GA, 30341-3717, USA

    Lori A. Pollack, Carol A. Gotway, Thomas B. Richards, Laura C. Seeff & Sidibe Kassim

  2. California Cancer Registry, Public Health Institute, Sacramento, CA, USA

    Janet H. Bates, Arti Parikh-Patel & Holly Hodges

Authors
  1. Lori A. Pollack
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  2. Carol A. Gotway
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  3. Janet H. Bates
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  4. Arti Parikh-Patel
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  6. Laura C. Seeff
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  7. Holly Hodges
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  8. Sidibe Kassim
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Correspondence to Lori A. Pollack.

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Pollack, L.A., Gotway, C.A., Bates, J.H. et al. Use of the Spatial Scan Statistic to Identify Geographic Variations in Late Stage Colorectal Cancer in California (United States). Cancer Causes Control 17, 449–457 (2006). https://doi.org/10.1007/s10552-005-0505-1

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  • DOI: https://doi.org/10.1007/s10552-005-0505-1

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