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Joint Spatio-Temporal Modeling of Low Incidence Cancers Sharing Common Risk Factors

並列摘要


In this article, we present a joint modeling approach that combines information from multiple diseases. Our model can be used to obtain more reliable estimates in rare diseases by incorporating information from more common diseases for which there exists a shared set of important risk factors. Information is shared through both a latent spatial process and a latent temporal process. We develop a fully Bayesian hierarchical implementation of our spatio-temporal model in order to estimate relative risk, adjusted for age and gender, at the county level in Iowa in five-year intervals for the period 1973-2002. Our analysis includes lung, oral, and esophageal cancers which are related to excessive tobacco and alcohol use risk factors. Lung cancer risk estimates tend to be stable due to the large number of occurrences in small regions, i.e. counties. The lower risk cancers (oral and esophageal) have fewer occurrences in small regions and thus have estimates that are highly variable and unreliable. Estimates from individual and joint modeling of these diseases are examined and compared. The joint modeling approach has a profound impact on estimates regarding the low risk oral and esophageal cancers while the higher risk lung cancer is minutely impacted. Clearer spatial and temporal patterns are obtained and the standard errors of the estimates are reduced leading to more reliable estimates.

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