Methods of Mapping and Identifying Small Clusters of Rare Diseases with Applications to Geographical Epidemiology

Abstract

Geographical variation operates at a variety of scales. Methods of mapping variation in disease incidence between different countries or even counties are relatively well developed. When, however, the question relates to much smaller aggregations (that is, “clustering”), attention has mainly been restricted to areas near putative point hazards; the majority of cases are excluded from such an investigation. In this study we show how clustering may be investigated and displayed in such a way that it becomes a powerful tool in epidemiological research. As examples we use incidence data from the Yorkshire health region for selected childhood cancers and adult haematopoietic malignancies. The methods would readily extend to any small clusters of rare events.