Spatial clusters of cancer incidence: analyzing 1940 census data linked to 1966–2017 cancer records



A life course perspective to cancer incidence is important for understanding effects of the environment during early life on later cancer risk. We assessed spatial clusters of cancer incidence based on early life location defined as 1940 US Census Enumeration District (ED).


A cohort of 260,585 individuals aged 0–40 years in 1940 was selected. Individuals were followed from 1940 to cancer diagnosis, death, or last residence in Utah. We geocoded ED centroids in Utah for the 1940 Census. Spatial scan statistics with purely spatial elliptic scanning window were used to identify spatial clusters of EDs with excess cancer rates across 26 cancer types, assuming a discrete Poisson model.


Cancer was diagnosed in 66,904 (25.67%) individuals during follow-up across 892 EDs. Average follow-up was 50.9 years. We detected 15 clusters of excess risk for bladder, breast, cervix, colon, lung, melanoma, oral, ovary, prostate, and soft tissue cancers. An urban area had dense overlap of multiple cancer types, including two EDs at increased risk for five cancer types each.


Early environments may contribute to cancer risk later in life. Life course perspectives applied to the study of cancer incidence can provide insights for increasing understanding of cancer etiology.

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This study was supported by the National Institutes of Health (1K12HD085852-01).

Author information




All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by CLL, MT, RH, and HAH. The first draft of the manuscript was written by CL and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Claire L. Leiser.

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Leiser, C.L., Taddie, M., Hemmert, R. et al. Spatial clusters of cancer incidence: analyzing 1940 census data linked to 1966–2017 cancer records. Cancer Causes Control 31, 609–615 (2020).

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  • Life course epidemiology
  • Spatial scan statistic
  • Early life exposures
  • Environment