Bayesian Space-Time Analysis of Brain Cancer Incidence in Southern Ontario, Canada: 2010-2013.

Canada has one of the highest incidence rates of brain cancer in the world. This study investigates the space-time variation of brain cancer risk across Southern Ontario, Canada. A Bayesian spatio-temporal regression model is used to estimate the relative risk of brain cancer in the 12 spatial health units of Southern Ontario over a four-year period (2010-2013). This work also explores the association between brain cancer and two potential risk factors: traumatic head injury (THI) and excess body fat (EBF). Across all areal units from 2010-2013, results show that the relative risk of brain cancer ranged from 0.83 (95% credible interval (CI) 0.74-0.91) to 1.26 (95% CI 1.13-1.41). Over the years, the eastern and western health units had persistently higher risk levels compared to those in the central areas. Results suggest that areas with elevated THI rates and EBF levels were also potentially associated with higher brain cancer relative risk. Findings revealed that the mean temporal trend for cancer risk progression in the region smoothly decreased over time. Overall, 50% of the health units displayed area-specific trends which were higher than the region's average, thus indicating a slower decrease in cancer rates for these areas in comparison to the mean trend.