Abstract
Incidence rate of oral cancer in Changhua County is the highest among the 23 counties of Taiwan during 2001. However, in health data analysis, crude or adjusted incidence rates of a rare event (e.g., cancer) for small populations often exhibit high variances and are, thus, less reliable. We proposed a generalized Bayesian Maximum Entropy (GBME) analysis of spatiotemporal disease mapping under conditions of considerable data uncertainty. GBME was used to study the oral cancer population incidence in Changhua County (Taiwan). Methodologically, GBME is based on an epistematics principles framework and generates spatiotemporal estimates of oral cancer incidence rates. In a way, it accounts for the multi-sourced uncertainty of rates, including small population effects, and the composite space-time dependence of rare events in terms of an extended Poisson-based semivariogram. The results showed that GBME analysis alleviates the noises of oral cancer data from population size effect. Comparing to the raw incidence data, the maps of GBME-estimated results can identify high risk oral cancer regions in Changhua County, where the prevalence of betel quid chewing and cigarette smoking is relatively higher than the rest of the areas. GBME method is a valuable tool for spatiotemporal disease mapping under conditions of uncertainty.
Highlights
Heavy metals are extremely persistent in the environment and can cause adverse effects on human health
A total of 231 townships have information on oral cancer (OC) mortality rates in males and soil heavy metal content was used in the spatial regression analysis
A positive (STL > 0) timetrend exists in spatial dependence of OC mortality. These results show that the temporal changes in spatial clusters of OC mortality may relate to environmental pollution
Summary
Heavy metals are extremely persistent in the environment and can cause adverse effects on human health. Research has classified many heavy metals, including arsenic (As), chromium (Cr[VI]) and nickel (Ni[II]), as human carcinogens [1,2]. Soil and the human body intake environmental heavy metals absorbed in various ways. Heavy metal content in soil is an index of possible environmental exposure to heavy metal, and reflects somewhat the level of exposure of the human body. Some studies indicate that long-term exposure to heavy metals may promote cancer development in local residents [3,4,5]. Consulting the Taiwan Cancer Registry Database (TCRD) shows that oral cancer (OC) is more frequent in males, ranking as the fourth leading cause of cancer-related deaths in Taiwan since 2003. Several areas in the central and eastern parts of Taiwan, e.g.,
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