Performance of cancer cluster Q-statistics for case-control residential histories

Spat Spatiotemporal Epidemiol. 2012 Dec;3(4):297-310. doi: 10.1016/j.sste.2012.09.002. Epub 2012 Sep 24.


Few investigations of health event clustering have evaluated residential mobility, though causative exposures for chronic diseases such as cancer often occur long before diagnosis. Recently developed Q-statistics incorporate human mobility into disease cluster investigations by quantifying space- and time-dependent nearest neighbor relationships. Using residential histories from two cancer case-control studies, we created simulated clusters to examine Q-statistic performance. Results suggest the intersection of cases with significant clustering over their life course, Q(i), with cases who are constituents of significant local clusters at given times, Q(it), yielded the best performance, which improved with increasing cluster size. Upon comparison, a larger proportion of true positives were detected with Kulldorf's spatial scan method if the time of clustering was provided. We recommend using Q-statistics to identify when and where clustering may have occurred, followed by the scan method to localize the candidate clusters. Future work should investigate the generalizability of these findings.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Case-Control Studies*
  • Cluster Analysis*
  • Denmark / epidemiology
  • Geographic Information Systems
  • Humans
  • Models, Statistical
  • Neoplasms / epidemiology*
  • Population Dynamics* / statistics & numerical data
  • Spatial Analysis*
  • Time Factors
  • United States / epidemiology