Nationwide analysis on the impact of socioeconomic land use factors and incidence of urothelial carcinoma. (February 2018)

• Record Type: Journal Article
• Authors: Brandt, Maximilian P.; Gust, Kilian M.; Mani, Jens; Vallo, Stefan; Höfner, Thomas; Borgmann, Hendrik; Tsaur, Igor; Thomas, Christian; Haferkamp, Axel; Herrmann, Eva; Bartsch, Georg
• Is Part Of: Cancer epidemiology. Volume 52(2018:Feb.)
• Page Start: 63
• Page End: 69
• Publication Date: 2018-02
• Subjects: Environmental exposure -- Socioeconomic factor -- Smoking -- Incidence rates -- Urothelial carcinoma; Cancer -- Epidemiology -- Periodicals; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Carcinogenesis -- Periodicals; 616.994005
• DOI: 10.1016/j.canep.2017.12.001
• Languages: English
• ISSNs: 1877-7821

Abstract

Highlights: Nationwide data of cancer registries in Germany was analyzed and showed regional "hot-spots" of high incidence rates of urothelial carcinoma Results on incidence rates revealed clusters with high incidence rates of up to 151% and 126% for men and women in Germany, respectively. Socioeconomic land use factors (agricultural, industrial and residential) have an unequal association with tumor incidence. These land use factors may be associated with a relative risk increase for urothelial carcinoma. Abstract: Background: Incidence rates for urothelial carcinoma (UC) have been reported to differ between countries within the European Union (EU). Besides occupational exposure to chemicals, other substances such as tobacco and nitrite in groundwater have been identified as risk factors for UC. We investigated if regional differences in UC incidence rates are associated with agricultural, industrial and residential land use. Methods: Newly diagnosed cases of UC between 2003 and 2010 were included. Information within 364 administrative districts of Germany from 2004 for land use factors were obtained and calculated as a proportion of the total area of the respective administrative district and as a smoothed proportion. Furthermore, information on smoking habits was included in our analysis. Kulldorff spatial clustering was used to detect different clusters. A negative binomial model was used to test the spatial association between UC incidence as a ratio of observed versus expected incidence rates, land use and smoking habits. Results: We identified 437, 847, 834 person years with 171, 086 cases of UC. Cluster analysis revealed areas with higher incidence of UC than others (p = 0.0002). Multivariate analysis including significant pairwise interactions showed that the environmental factors were independently associated with UC (p < 0.001). The RR was 1.066 (95% CI 1.052–1.080), 1.066 (95% CI 1.042–1.089) and 1.067 (95% CI 1.045–1.093) for agricultural, industrial and residential areas, respectively, and 0.996 (95% CI 0.869–0.999) for the proportion of never smokers. Conclusion: This study displays regional differences in incidence of UC in Germany. Additionally, results suggest that socioeconomic factors based on agricultural, industrial and residential land use may be associated with UC incidence rates.