A spatial study of bladder cancer mortality and incidence in the contiguous US: 2000–2014

• Published in: The Science of the total environment 2019-06, Vol.670, p.806-813
• Main Authors: Amin, Raid W., Stafford, Bunpen, Guttmann, Rodney P.
• Format: Article
• Language: English
• Subjects: Arsenic - analysis; Bladder cancer cluster; Cluster analysis; Drinking Water - chemistry; Environmental Exposure - statistics & numerical data; Epidemiology; Female; Humans; Incidence; Male; Regression Analysis; Risk Factors; Socioeconomic Factors; United States; United States - epidemiology; Urinary Bladder Neoplasms - mortality; Water Wells
• ISSN: 0048-9697; 1879-1026
• DOI: 10.1016/j.scitotenv.2019.03.290

Bladder cancer is a significant health issue across the United States of America (USA). Evidence of unequal distribution of a disease or condition's incidence and mortality would suggest that important geographically-defined variables may play a role. In this study, a spatial cluster analysis of bladder cancer mortality identified significant hot spots in some parts of the USA. Regression analysis modelling estimated the effects of selected covariates or risk factors for bladder cancer mortality and also incidence. Spatial heat maps and cluster identification were done for mortality and incidence. The main result was the significant association between bladder cancer mortality and arsenic intake from well water. A similar result was also obtained for cancer incidence and arsenic. Additionally, there are certain geographic areas that appear to have bladder cancer mortality rates beyond the simple association with the studied covariates. These geographic areas warrant further investigation to better understand why cancer mortality is unusually high in such geographic areas and to potentially identify additional local concerns or needs to further address bladder cancer mortality in those specific sites. [Display omitted] •There are clusters of bladder cancer mortality across the contiguous USA.•There is an association between bladder cancer mortality and demographic factors.•There is an association between bladder cancer incidence and demographic factors.•There are clusters of high arsenic intake levels in the contiguous USA.