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Using residential histories to examine risk for non-Hodgkin’s lymphoma in Kentucky

Authors: Jay Christian*, University of Kentucky, Bin Huang, University of Kentucky, Courtney Walker, University of Kentucky, Eric Durbin, Kentucky Cancer Registry, Jeff Levy, University of Kentucky
Topics: Medical and Health Geography, Spatial Analysis & Modeling, Geographic Information Science and Systems
Keywords: residential history, cancer, exposure assessment, Kentucky, spatio-temporal analysis
Session Type: Paper
Presentation File: No File Uploaded

Kentucky has the highest overall incidence rate of cancer in the U.S., likely related to the high prevalence of behavioral risk factors such as tobacco use and obesity. Within the state, the Appalachian region generally has higher rates of most cancers. One notable exception is non-Hodgkin’s Lymphoma (NHL), a hematopoietic cancer known or suspected to be associated with exposure to a variety of chemical agents. Incidence rates of NHL in Kentucky are highest in western and north-central parts of the state, rather than the Appalachian region. We are currently conducting a population-based case-control study of NHL and potential contextual and environmental exposures. Because latency for NHL is up to 20 years, we are using data on individuals’ previous residences to characterize exposures over a decade or more, based on their locations relative to environmental hazards. We are primarily examining residential proximity to sites appearing in EPA’s Toxic Release Inventory and Superfund programs, and focusing on specific classes of contaminants potentially linked to risk of NHL. The Kentucky Cancer Registry is contributing data on 5000 NHL cases, and the Kentucky Department for Public Health is providing information from death certificates for 5000 age-, gender-, and race/ethnicity-matched controls who did not have cancer when they died. LexisNexis, Inc. is supplying up to ten previous addresses for cases and controls. In this presentation, we will further explore regional disparities in NHL, share results of the exposure assessment and final analysis, and discuss limitations and challenges of using residential histories for environmental epidemiologic research.

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