The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #73119

David I Gregorio, PhD¹, Lan Huang, MS², Martin Kulldorff, PhD¹, and T. Joseph Sheehan, PhD¹. (1) Division of Epidemiology & Biostatistics, Department of Community Medicine, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-6325, 860-679-5480, gregorio@nso.uchc.edu, (2) Department of Statistics, University of Connecticut, 215 Glenbrook Rd, Storrs, CT 06269-4120

Spatial scan statistics utilizing the number of events for a given place and time are increasingly relevant tools for geographical cluster analysis and disease surveillance. Our on-going work is extending the procedure to assess health states that are measured on continuous scales (e.g., survival time following diagnosis). Here, we describe geographic variation in survival time among 15,259 Connecticut men who were diagnosed with prostate cancer between 1984 and 1995. The analysis, including uncensored and censored data and adjusted for age variability among the population at-risk, revealed 5 locations in Connecticut where average survival time was significantly less than that of cases who resided elsewhere around the State and 4 locations where survival time was significantly longer. The most likely reduced survival time cluster involved 679 men from West-Central Connecticut whose risk of dying at any time with their disease was 1.5-times greater than that of other Connecticut men with the disease. Conversely, the most likely increased survival time cluster involved 1,248 cases from nearby North-Central Connecticut whose risk of dying following diagnosis was 73 percent of the risk of other cases in around the State. Our presentation will examine these results in relation to further adjustments for patient (e.g., race/ethnicity) and disease (e.g. grade, stage) characteristics.

Learning Objectives:

• Demonstration of extension of spatial scan statistic to accomodate continuous outcome data

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.