Amr S Soliman, MD, PhD, Epidemiology, University of Michigan, 109 S. Observatory, Ann Arbor, MI 48109, 734-764-5469, asoliman@umich.edu and Jean-Daniel Stanley, PhD, Geology, U.S. National Museum of Natural History, Smithsonian Institution Washington, D.C., USA, Museum of Natural History, Smithsonian Institution Washington, D.C., USA, Washington, DC, DC 20006.

The northeast Nile Delta, Egypt’s most polluted region, appears to have a high incidence of pancreatic cancer. We sought to determine whether there is any geographic clustering of pancreatic cancers there and, if so, whether such clustering might be associated with environmental pollution. Using data from the medical records of the Gastrointestinal Surgical Center of Mansoura University in the Dakahleia Province of Egypt and detailed geographical maps of the northeast Nile Delta region, we plotted the residences of all 373 patients who had pancreatic cancer diagnosed between 1995 and 2000. The study region has 15 administrative districts, whose centroid coordinates, population, and number of pancreatic cancer patients were determined for this study. Monte Carlo simulation identified statistically significant clustering of pancreatic cancer in 5 subdivisions located near the Nile River and Delta plains. This clustering was independent of population size and formed 2 larger clusters. When data were analyzed by sex, clustering of pancreatic cancer was observed in the same 5 subdivisions for men but only 2 subdivisions showed clustering for women. Together, our data suggest that there is clustering of pancreatic cancer cases in the northeast Nile Delta region and that this clustering may be related to water pollution. Our data also warrant future studies of the association between water pollution and pancreatic cancer in the region.

Learning Objectives:

• 1. To learn about the unusually high incidence of pancreatic cancer in the Northeast Nile Delta region of Egypt.
• 2. To review the possible hypotheses linking pancreatic cancer distribution to pollution caused by agriculture in this region.
• 3. To discuss possible research methods for future testing of this epidemiologic investigation.

Keywords: Cancer, Environmental Exposures

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.