| Abstract: | Background: The purpose of the present study was to determine geographic clustering of breast cancerincidence in Kanagawa Prefecture, using cancer registry data. The study also aimed at examining the associationbetween socio-economic factors and any identified cluster. Materials and Methods: Incidence data were collectedfor women who were first diagnosed with breast cancer during the period from January to December 2006 inKanagawa. The data consisted of 2,326 incidence cases extracted from the total of 34,323 Kanagawa CancerRegistration data issued in 2011. To adjust for differences in age distribution, the standardized mortality ratio(SMR) and the standardized incidence ratio (SIR) of breast cancer were calculated for each of 56 municipalities(e.g., city, special ward, town, and village) in Kanagawa by an indirect method using Kanagawa female populationdata. Spatial scan statistics were used to detect any area of elevated risk as a cluster for breast cancer deaths and/or incidences. The Student t-test was performed to examine differences in socio-economic variables, viz, personsper household, total fertility rate, age at first marriage for women, and marriage rate, between cluster and otherregions. Results: There was a statistically significant cluster of breast cancer incidence (p=0.001) composed of11 municipalities in southeastern area of Kanagawa Prefecture, whose SIR was 35 percent higher than that ofthe remainder of Kanagawa Prefecture. In this cluster, average value of age at first-marriage for women wassignificantly higher than in the rest of Kanagawa (p=0.017). No statistically significant clusters of breast cancerdeaths were detected (p=0.53). Conclusions: There was a statistically significant cluster of high breast cancerincidence in southeastern area of Kanagawa Prefecture. It was suggested that the cluster region was related tothe tendency to marry later. This study methodology will be helpful in the analysis of geographical disparitiesin cancer deaths and incidence. |
