Clustering of childhood cancer in the inner city of Tehran metropolitan area: A GIS-based analysis

The aim of this study was both to map the childhood cancer incidence in the districts of Tehran metropolitan area and to explore possible clustering of cancer cases in the diverse environments of this area. All incidence cases of childhood cancers (age group under 15 years) belonging to the 22 districts of Tehran metropolis and occurring during the period of 1998 till 2002 were ascertained from three sources. Each case's place of residency was geo-referenced. The scan statistics cluster detecting technique was used to evaluate clustering of cases throughout Tehran. The overall incidence rate (IR) of childhood cancer was 176.3/1,000,000 children under 15 years of age. The lowest IR among both boys and girls was observed in district 22 (69.4/1,000,000) and the highest was observed in district 6 (242.09/1,000,000). The detection of clusters was performed for all cancer sites. All the cancer sites combined category showed clustering in the districts 7, 13, 8, 6, 3, 14, 12, 11, and 4. For this category, the clustering likelihood was marginally statistically significant (p-value=0.056), with an overall relative risk of 1.30. No statistically significant patterns of clustering were detected for other categories.