Medical-based Geographical Information System (mGIS)

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Medical-based Geographical Information System
(mGIS)

• Diagnosis versus Healing

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Case Study Breast Cancer
GIS
Health
Environment
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Study objectives

• To determine the association (if any) between
  selected spatial environmental factors and breast
  cancer rates in the US.
• To investigate the possible (if any) cause(s)
  contributed by those factors.
• To define new, modular prototype Geographic
  Information System

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Facts/Spatial-based patterns

• Estimated 211,300 new cases of invasive breast
  cancer expected to occur in US
• All locations are not equal for breast cancer
  risk geography plays a role
• High mortality rates in the northeastern US,
  while in the far East (China Japan) it is very
  much rare

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Fig 1
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Methods analysis

• Regression analysis revealed that two
  environmental factors mainly average temperature
  mean elevation accounted for 48.6 of the
  variance in the mortality rates (F21.71
  p0.000)

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Stepwise regression analysis

• All the relevant finding related to the
  explanatory power of the independent variables,
  in the goodness of fit of all possible models can
  be enhanced by looking at the best-fit models
  with the significant (at the 5 level, p ? 0.05)
  explanatory underlying variables, for each of the
  mortality/incidence pattern groups according to
  the spatial environmental factors

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Effect of average temperature on breast cancer

• Melatonin rhythm

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Temperature vs Melatonin vs breast cancer

• Temperature cause a variety of physiological
  changes, e.g. of blood composition, blood
  pressure and circadian rhythms
• Melatonin exert potent inhibition on cancer
  growth (anti-angiogenic molecule)
• Temperature is a major regulator of melatonin
  rhythms

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Latitude vs Altitude vs Temperature

• The principle controls of temperature variation
  are latitude and altitude (elevation)
• latitude for a given point on the earth has an
  effect on temperature, the farther from the
  Equator a point is the cooler average temperature
  that point is likely to have

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• The existence of negative relationship between
  latitude and mortality rates
• Variation in latitude lead to variations in
  temperature and sunlight intensity and hence
  disturbance of melatonin rhythms
• Positive relationships between mortality data and
  longitude as we move toward East mortality rates
  are approx. 25 higher for women in the
  northeastern US than for women in the South or
  West.

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Jet Lag and Circadian Rhythm

• Jet Lag is caused from air travel through
  changing time zones. Usually going East is worse
  than going West
• It caused due to disturbance of melatonin rhythms

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Hypothesis

• The exposure to some spatial environmental
  factors seems likely to have a major impact on
  the overall trends in breast cancer rates. The
  possibility to develop cancer is existing
  naturally through the environment factors.
  Unbalanced in these nature factors and/or other
  existing risk factors, e.g. socioeconomic
  conditions will increase the chance for cancer
  development.

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Geographic Information System

• Is a computer-based tool for mapping and
  analyzing things that exist and events that
  happen on earth. GIS technology integrates common
  database operations such as query and statistical
  analysis with the unique visualization and
  geographic analysis benefits offered by maps
  ESRI
• Is an integrated system of computer hardware,
  software, and trained personnel linking
  topographic, demographic, utility, facility,
  image and other resource data that is
  geographically referenced. NASA

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GIS vs Health

• As far as the time of Hippocrates (c. 3rd century
  BC), physician have observed that certain
  diseases seems to occur in some places and not
  others

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• Geographical mapping of disease events date
  back to the first maps used by Dr. John Snow in
  1859 to trace the origin of cholera outbreak in
  London, England

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Examples GIS in Health

• 1970s, National Cancer Institute (NCI) mapped
  cancer data
• The Long Island Breast Cancer Study Project
• GIS-H (AverStar, Inc., of Vienna, Virginia)
• Epi Map 2000 to public health (CDC, Centers of
  Disease Control Prevention)
• Late-Stage Breast Cancer Program (Baystate
  Medical Center in Springfield, Massachusetts)
• The WHO Health Mapper

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Uses of GIS in public health

• Determining geographic distribution of diseases
• Analyzing spatial and temporal trends
• Mapping populations at risk
• Stratifying risk factors
• Assessing resource allocation
• Planning and targeting interventions
• Monitoring diseases and interventions over time

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• Why not apply GIS technology for prevention and
  healing
• The role of ecology

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Proposed mGIS for breast cancer
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Conclusion

• Spatial factors can induce changes in melatonin
  rhythms, which can lead to increase in breast
  cancer rates
• Environmental temperatures can modulate cancer
  via changes induced in melatonin rhythms.
• Map-based exploration of georeferenced health
  statistics will lead to a better understanding of
  health/environment interaction.

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Refrences

• 1 Kulldorff M, Feuer EJ, Miller BA, Freedman
  LS. Breast cancer clusters in the northeast
  United States a geographic analysis. Am J
  Epidemiol 1997 146(2)161-70.
• 2 Laden F, Spiegelman D, Neas LM, Colditz GA,
  Hankinson SE, Byrne C, Rosner BA, Speizer FE,
  Hunter DJ. Geographic variation in breast cancer
  incidence rates in a cohort of US women. J Natl
  Cancer Instit 1997 89(18)1373-8.
• 3 American Cancer Society. Breast cancer facts
  figures 2003. Available http//seer.cancer.gov.
• 4 Roche LM, Koltz J, Abe T, Koher BA. Breast
  cancer in New Jersey 1979-1995. New Jersey Dept
  of Health and Senior Services. Available
  http//www.state.nj.us/health.

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• 11 Kliukiene J, Tynes T, Andersen A. Risk of
  breast cancer among Norwegian women with visual
  impairment. British J Cancer 2001 84(3) 397-9.
• 12 Coleman MP. Reiter RJ. Breast cancer,
  blindness and melatonin. Eur J Cancer 1992
  28(2-3) 501-3.
• 13 Reiter RJ, Richardson BA. Magnetic field
  effects on pineal indolemine metabolism and
  possible biological consequences. FASEB J 1992
  6 2283-7.
• 14 Indira N, Granger M. Part I Biological
  effects, concern focuses on cancer and endocrine
  and nervous system disorders. IEEE Spectrum 1990
  23-27.
• 15 Lissoni P, Rovelli F, Malugani F, Bucovec R,
  Conti A, Maestroni GJ. Anti-angiogenic activity
  of melatonin in advanced cancer patients.
  Neuroendocrinol Lett 2001 22(1) 45-7.

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• 23 Wang RJ. Lethal effect of daylight fluorescent
  light on human cells in tissue culture medium.
  Photochem Photobiol 1975 B(21) 373-5.
• 24 James SG, Jean LF, Jonathan DM, Daniel HF, Ann
  BN. Geographic variations in breast cancer
  survival among older women. J Gerontol Series A
  Biol Sci Med Sci 2002 57 M401-M406.
• 25 Goodwin JS, Freeman JL, Freeman D, Nattinger
  AB. Geographic variations in breast cancer
  mortality do higher rates imply elevated
  incidence or poorer survival?. Am J Public Health
  1998 88(3) 458-60.
• 26 Samel A, Wegmann HM. Bright light a
  countermeasure for Jet Lag. Chronobiol Int 1997
  14 173-83.
• 27 Delagrange P, Guardiola-Lemaitre B. Melatonin
  its receptors and relationships with biological
  rhythm disorders. Clin Neuropharm 1997 20
  482-510.

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Akram
Nanna