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Space–time
clustering patterns of gliomas in the Netherlands suggest an
infectious aetiology
M.P.W.A. Houben,
J.W.W. Coebergh, J.M. Birch,
C.C. Tijssen, C.M. van
Duijn, R.J.Q. McNally
Department
of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands [MPWAH,
CCT]. Department of Epidemiology and Biostatistics, Erasmus MC,
Rotterdam, The Netherlands [MPWAH, JWWC, CMvD]. Cancer Research UK
Paediatric and Familial Cancer Research Group, Royal Manchester
Children’s Hospital, Manchester, United Kingdom [JMB, RJQM].
Comprehensive Cancer Centre South, Eindhoven, The Netherlands [JWWC].
School of Clinical Medical Sciences (Child Health) and School of
Population and Health Sciences, University of Newcastle Upon Tyne,
Newcastle Upon Tyne, United Kingdom [RJQM]. Corresponding
author. Present address: Sir James Spence Institute, Level 4, Royal
Victoria Infirmary, Queen Victoria Road, Newcastle NE1 4LP, United
Kingdom. Tel.: +44 191 202 3029; fax: +44 191 202 3060. Received
18 May 2005; accepted 23 June 2005.
To test the hypothesis that infectious
exposures may be involved in glioma aetiology, we have analysed
space–time clustering and seasonal variation using population-based
data from the South of the Netherlands between 1983 and 2001.
Knox tests for space–time interactions
between cases were applied, with spatial coordinates of the addresses
at time of diagnosis, and with distance to the Nth nearest
neighbour.
Data were also analysed by a second order
procedure based on K-functions.
Tests for heterogeneity and Edwards’
test for sinusoidal variation were applied to examine seasonal
variation of incidence.
There was statistically significant
space–time clustering in the Eastern, but not in the Western part of
the region.
Clustering was only present in adults,
particularly in less densely populated areas.
There was no evidence for seasonal
variation.
The results support a role for infectious
exposures in glioma aetiology that may act preferentially in certain
geographical areas.
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