Spatial and Temporal Distribution of Pediatric Cancers in Southern Ghana: A Retrospective Observational Study

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports Pub Date : 2025-04-29 DOI:10.1002/hsr2.70797

Efiba Vidda Senkyire Kwarteng, Amma Aboagyewa Larbi, Nanatte Veronica Anderson, Sheriff Wahab, Yaa Gyamfua Oppong-Mensah, Samuel Ato Andam-Akorful, Alexander Kwarteng, Lawrence Osei-Tutu, Gladys Acquah, Comfort Asoogo, Bernice Eklu, Paul Obeng, Barnabas Manlokiya, Ben Gyan, Vivian Paintsil

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Abstract

Background

More than 80% of children living with cancer reside in developing countries like Ghana, with over 1000 new cases projected each year. Spatial analysis of pediatric cancers provides insights into possible environmental risk factors, potential genetic associations, and the identification of clusters or hotspots, which can guide further investigation into causal factors and inform population-level interventions.

Aim

This retrospective observational study aimed to investigate the spatial distribution dynamics of pediatric cancer cases diagnosed at the Komfo Anokye Teaching Hospital, Ghana.

Methods

Poisson regression and spatial statistical tools, including Kernel Density Estimation (KDE) and Kulldorff's spatial scan statistics, were used to analyze 652 pediatric cancer cases recorded from 2018 to 2022 in Southern Ghana.

Results

The results revealed increasing pediatric cancer cases over the 5 years. Burkitt Lymphoma, Leukemia, Nephroblastoma, Other Non-Hodgkins Lymphoma, and Retinoblastoma had higher incidence among children, with males having a 24% higher incidence rate compared to females (Incident Rate Ratios [IRR] estimated at 1.24 at p < 0.01, 95% confidence interval [CI): 1.06, 1.45). Further, the KDE plot consistently revealed a high density of reported cases in the central part of the study area, with a noticeable directional diffusion of pediatric cancer cases toward the northwest from 2018 to 2022. Three significant clusters of relative risk between 1.65 and 2.17, p < 0.01, were identified, covering parts of the Bono East and Ashanti Regions of Ghana.

Conclusion

Clustering cancer cases could suggest a possible environmental influence on the occurrence of the disease. Although this study offers relevant baseline information, comprehensive epidemiological investigations are necessary to establish specific environmental risk factors and potential gene-environment interactions contributing to this pediatric cancer clustering.

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加纳南部儿童癌症的时空分布：一项回顾性观察研究

80%以上的儿童癌症患者生活在加纳等发展中国家，预计每年将有1000多例新病例。儿童癌症的空间分析提供了对可能的环境风险因素、潜在遗传关联以及集群或热点识别的见解，可以指导进一步调查病因并为人群层面的干预提供信息。目的：本回顾性观察性研究旨在调查加纳Komfo Anokye教学医院诊断的儿童癌症病例的空间分布动态。方法采用泊松回归和空间统计工具，包括核密度估计（KDE）和Kulldorff空间扫描统计，对加纳南部2018年至2022年记录的652例儿童癌症病例进行分析。结果5年来儿童癌症病例呈上升趋势。伯基特淋巴瘤、白血病、肾母细胞瘤、其他非霍奇金淋巴瘤和视网膜母细胞瘤在儿童中的发病率较高，男性的发病率比女性高24%（发病率比[IRR]估计为1.24,p < 0.01, 95%可信区间[CI]: 1.06, 1.45）。此外，KDE图一致显示研究区域中部报告病例密度高，2018年至2022年儿童癌症病例向西北方向明显扩散。确定了三个相对风险在1.65和2.17 （p < 0.01）之间的显著集群，覆盖了加纳波诺东部和阿散蒂地区的部分地区。结论聚类性肿瘤病例可能提示环境因素对肿瘤发生的影响。虽然这项研究提供了相关的基线信息，但全面的流行病学调查是必要的，以确定具体的环境危险因素和潜在的基因-环境相互作用，有助于这种儿童癌症聚类。

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