皮肤癌是最常见的,然而通常是可以预防的,美国的癌症类型。暴露于阳光的紫外线辐射是皮肤癌最突出的环境危险因素。除了环境暴露,人口统计学特征,如种族,年龄,和社会经济地位可能使一些群体更脆弱。描述了一种探索性空间聚类方法,用于基于综合指数识别皮肤癌发病率和死亡率的脆弱性聚类,结合了环境和人口风险因素的数据。
基于县级紫外线数据和人口危险因素,使用加性百分位数排名方法生成了两个皮肤癌脆弱性指数。有了这些指数,单变量局部Moran\I的空间自相关识别出显著的簇,或热点,整体脆弱性指数较高的邻近县。分别确定了皮肤癌发病率和死亡率的集群。
脆弱性高的县在空间上分布在美国各地,其格局通常向南部和西部增加。在犹他州和科罗拉多州主要观察到皮肤癌发病率高的县集群,即使具有高度保守的意义。同时,在阿拉巴马州南部和佛罗里达州西部以及阿拉巴马州北部观察到皮肤癌死亡率脆弱性的集群,佐治亚州北部,穿过田纳西州-北卡罗来纳州地区。
未来的皮肤癌研究和筛查计划可能会使用这些创新的综合脆弱性指数和确定的集群,以根据潜在的人口和环境因素的预期风险更好地定位资源。
Skin cancer is the most common, yet oftentimes preventable, cancer type in the United States. Exposure to ultraviolet radiation from sunlight is the most prominent environmental risk factor for skin cancer. Besides environmental exposure, demographic characteristics such as race, age, and socioeconomic status may make some groups more vulnerable. An exploratory spatial clustering method is described for identifying clusters of vulnerability to skin cancer incidence and mortality based on composite indices, which combine data from environmental and demographic risk factors.
Based on county-level ultraviolet data and demographic risk factors, two vulnerability indices for skin cancer were generated using an additive percentile rank approach. With these indices, univariate local Moran\'s I spatial autocorrelation identified significant clusters, or hotspots, of neighboring counties with high overall vulnerability indices. Clusters were identified separately for skin cancer incidence and mortality.
Counties with high vulnerabilities were spatially distributed across the United States in a pattern that generally increased to the South and West. Clusters of counties with high skin cancer incidence vulnerability were mostly observed in Utah and Colorado, even with highly conservative levels of significance. Meanwhile, clusters for skin cancer mortality vulnerability were observed in southern
Alabama and west Florida as well as across north
Alabama, north Georgia and up through the Tennessee-North Carolina area.
Future skin cancer research and screening initiatives may use these innovative composite vulnerability indices and identified clusters to better target resources based on anticipated risk from underlying demographic and environmental factors.