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Geographical Clustering of Pancreatic Cancers in the Northeast Nile Delta Region of Egypt

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Abstract

The northeast Nile Delta, Egypt’s most polluted region, appears to have a high incidence of pancreatic cancer. We sought to determine whether there is any geographic clustering of pancreatic cancers there and, if so, whether such clustering might be associated with environmental pollution. Using data from the medical records of the Gastrointestinal Surgical Center of Mansoura University in the Dakahleia Province of Egypt and detailed geographical maps of the northeast Nile Delta region, we plotted the residences of all 373 patients who had pancreatic cancer diagnosed between 1995 and 2000. The study region has 15 administrative districts, whose centroid coordinates, population, and number of pancreatic cancer patients were determined for this study. Monte Carlo simulation identified statistically significant clustering of pancreatic cancer in five subdivisions located near the Nile River and Delta plains. This clustering was independent of population size and formed two larger clusters. When data were analyzed by sex, clustering of pancreatic cancer was observed in the same five subdivisions for men but only two subdivisions showed clustering for women. Together, our data suggest that there is clustering of pancreatic cancer cases in the northeast Nile delta region and that this clustering may be related to water pollution. Our data also warrant future studies of the association between water pollution and pancreatic cancer in the region.

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Acknowledgments

We thank Dr. Ibrahim Seifeldin at Tanta Cancer Center and Dr. Somaia Ezzat at Damietta Cancer Center in Egypt for their help in retrieving patient data. This work was supported in part by a grant from Eli Lilly Research, a grant from the Topfer Fund for Cancer Research at M. D. Anderson Cancer Center, and grants CA K07 090241 and CA 99513 from the National Cancer Institute and by the National Institutes of Health through the University of Michigan’s Cancer Center Support Grant (5 P30 CA46592).

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Authors and Affiliations

  1. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA

    A. S. Soliman

  2. Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA

    X. Wang & K.-Anh. Do

  3. Deltas—Global Change and Coastal Geoarchaeology Programs, U.S. National Museum of Natural History, Smithsonian Institution, Washington, D.C., USA

    J.-D. Stanley

  4. Gastrointestinal Surgical Center, Mansoura University, Mansoura, Egypt

    N. El-Ghawalby, F. Ezzat, A. Soultan, M. Abdel-Wahab, O. Fathy & G. Ebidi

  5. Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA

    M. L. Bondy & N. Abdel-Karim

  6. Division of Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA

    B. Levin

  7. Division of Pathology and Laboratory Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA

    S. R. Hamilton

  8. Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA

    J. L. Abbruzzese

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  1. A. S. Soliman
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  2. X. Wang
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  3. J.-D. Stanley
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  4. N. El-Ghawalby
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  8. M. Abdel-Wahab
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  9. O. Fathy
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  10. G. Ebidi
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  11. N. Abdel-Karim
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  12. K.-Anh. Do
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  13. B. Levin
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  15. J. L. Abbruzzese
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Correspondence to A. S. Soliman.

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Soliman, A.S., Wang, X., Stanley, JD. et al. Geographical Clustering of Pancreatic Cancers in the Northeast Nile Delta Region of Egypt. Arch Environ Contam Toxicol 51, 142–148 (2006). https://doi.org/10.1007/s00244-005-0154-0

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