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Abstract:
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We develop the first detailed illustration of the use of a cluster detection method utilizing a spatial scan statistic based on an exponential survival model, applying it to study the spatial patterns of survival of cancer patients with stage III, and stage IV colorectal cancer and stage I/II, stage III, and stage IV lung cancer in the state of California and the county of Los Angeles diagnosed during 1988-2002. We compute nonparametric estimates of survival inside and outside of those detected clusters, which confirms the survival pattern detected by the spatial scan statistic in both areas. In LA County, we investigate the possible relationship between the detected clusters and demographic factors, such as race, gender and histology, and socioeconomic factors, such as education, employment, income and health insurance using nonparametric methods and logistic regression models.
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