Next Article in Journal
Injury-Related Behavioral Variables in Alpine Skiers, Snowboarders, and Ski Tourers—A Matched and Enlarged Re-Analysis
Previous Article in Journal
The Importance of Self-Monitoring for Behavior Change in Youth: Findings from the SWITCH® School Wellness Feasibility Study
Open AccessArticle

Thyroid Cancer Incidence Rates in North Dakota are Associated with Land and Water Use

Department of Population Health, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND 58202-9037, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(20), 3805; https://doi.org/10.3390/ijerph16203805
Received: 10 September 2019 / Revised: 29 September 2019 / Accepted: 7 October 2019 / Published: 10 October 2019
Objective: The increasing rate of thyroid cancer diagnoses in the U.S. reflects the increasing use of ultrasonography and of specialist medical care. North Dakota is a rural state with limited access to specialist care, yet its incidence of thyroid cancer is significantly greater than that of the U.S. overall. We sought to identify factors responsible for the high incidence of thyroid cancer in North Dakota. Methods: We examined county-specific incidence rates for thyroid cancer in North Dakota in relation to demographic and geographic factors, including median household income, percent of land fertilized, cattle density per capita, and source of drinking water (city or well water), using structural equation modeling. We included county level data on residential radon levels and estimates of radioactive iodine in milk following nuclear weapons testing in the 1950s. Results: Thyroid cancer incidence rates were significantly associated with median income (p < 0.05); percent of land fertilized (p < 0.05); the use of city water (p < 0.01), and cattle density per capita (p < 0.001). Conclusions: The risk of thyroid cancer in North Dakota is positively associated with income and with factors related to land and water use. Our finding that thyroid cancer incidence rates are associated with the use of city water was unexpected and merits examination in other locations with a mix of city and well water use. View Full-Text
Keywords: thyroid cancer; structural equation models; epidemiology; radiation; water thyroid cancer; structural equation models; epidemiology; radiation; water
Show Figures

Figure 1

MDPI and ACS Style

Schwartz, G.G.; Klug, M.G. Thyroid Cancer Incidence Rates in North Dakota are Associated with Land and Water Use. Int. J. Environ. Res. Public Health 2019, 16, 3805.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop