The impact of socio-economic and environmental factors on the spatial patterns of cancer incidence in Israel: A registry-based cohort study

Abstract

BACKGROUND AND AIM: Spatial methods usually used to identify geographical health risk differences. Only a few studies used semi-individual latent multi exposure approach, to investigate the socioeconomic and environmental factors that explain cancer risk spatial patterns. Our aim is to evaluate spatial clusters of cancer and to determine the impact of both socioeconomic and environmental factors on the spatial patterns of cancer incidence in Israel by applying generalized additive models (GAMs). METHODS: The current study is a registry-based cohort study. The data include the 1995 Israeli Central Bureau of statistics census (N=1,066,714) linked to the Israeli Cancer Registry data. In addition, ambient exposures were determined including: particulate matter with a diameter size that is equal to or smaller than 2.5µm, normalized difference vegetation index derived from satellite data, nitrogen oxides. We first used the global and local Morans’ I in order to identify cancer incidence clusters. RESULTS:During 17 years of follow-up (1998-2015) there were 62,049 new cancer cases among 1,022,637 participants in the 1995 census. Cancer incidence were clustered by geographical area (global Moran’s I Index =0.054, p-value0.000). Cancer clusters were located mainly in the northern district of Israel (surrounding Haifa region) and in the center part of Israel (surrounding Tel-Aviv region). CONCLUSIONS:The spatial clusters of cancer incidence in Israel can be attributed to socioeconomic and environmental risk factors. Further analysis will be conducted to evaluate the spatial associations with the socioeconomic and environmental factors using spatial modeling. KEYWORDS: socio-economic factors, environmental epidemiology, spatial statistics, particulate matter, cancer incidence, green space