Exploratory analysis of potential risk factors of a rare disease: Spatial distribution of adrenocortical carcinoma in Israel as a case study

The underlying assumption of the proposed exploratory approach is that, if the geographic patterns of different diseases are compared, the cases of a 'subject' disease should occur closer to cases of a disease with similar environmental risk factors (etiology) and farther away from cases of a disease with different etiology. In the present study, the performance of proposed approach is investigated by cross-examination of the spatial patterns of three widespread cancers - lung, larynx and colorectal (CRC) - with that of a rare malignant disease - Adrenocortical Carcinoma (ACC). As the analysis indicates, the spatial distribution of ACC is more likely to be related to hereditary factors than to environmental causes, in accordance with current knowledge about this rare disease.