A shared component model for detecting joint and selective clustering of two diseases

The study of spatial variations in disease rates is a common epidemiological approach used to describe the geographical clustering of diseases and to generate hypotheses about the possible 'causes' which could explain apparent differences in risk. Recent statistical and computational developments have led to the use of realistically complex models to account for overdispersion and spatial correlation. However, these developments have focused almost exclusively on spatial modelling of a single disease. Many diseases share common risk factors (smoking being an obvious example) and, if similar patterns of geographical variation of related diseases can be identified, this may provide more convincing evidence of real clustering in the underlying risk surface. We propose a shared component model for the joint spatial analysis of two diseases. The key idea is to separate the underlying risk surface for each disease into a shared and a disease-specific component. The various components of this formulation are modelled simultaneously by using spatial cluster models implemented via reversible jump Markov chain Monte Carlo methods. We illustrate the methodology through an analysis of oral and oesophageal cancer mortality in the 544 districts of Germany, 1986–1990.