Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S14-13

(P)

INCIDENCE OF HYPOSPADIAS: SPATIAL ANALYSIS BY CLUSTER DETECTION.

Arthur LAURIOT DIT PREVOST

, Florent OCCELLI

, Caroline LANIER

, Sharma DYUTI

, Estelle AUBRY

, Eric NECTOUX

Rene-Hilaire PRISO

, Damien CUNY

and Remi BESSON

1) Hôpital Jeanne de Flandre, Université de Lille, CHRU de Lille, Clinique de chirurgie de l'enfant, Urologie pédiatrique,

Lille, FRANCE - 2) Université de Lille, Lille, FRANCE - 3) Hopital Jeanne de Flandre, Université de Lille, CHRU de Lille,

Clinique de chirurgie de l'enfant, Urologie pédiatrique, Lille, FRANCE - 4) Hopital Jeanne de Flandre, Université de Lille,

CHRU de Lille, Clinique de chirurgie de l'enfant, Orthopedie pédiatrique, Lille, FRANCE

PURPOSE

The incidence of hypospadias seems to be in progression (actual prevalence =1/250 boys). Genetic or endocrine factors

have been described. Actual hypothesis involve environmental factors in endocrine disorder. Geographical distribution of

hypospadias' incidence in our region was analyzed in order to highlight high-incidence areas.

MATERIAL AND METHODS

A retrospective analysis (1992-2012) including all cases of hypospadias collected in our Department was led in a highly

populated area of 4.10^6 inhabitants. We calculated a Standardized Incidence Rate (SIR: observed/expected) for each

of the 170 counties. Areas with atypical incidence, named clusters, were revealed with the scan statistic. The Relative

Risk (RR) for each cluster was calculated using SIR inside-cluster compared to SIR outside-cluster.

RESULTS

Of the 390341 boys born on the period, 1003 cases of hypospadias were identified in our reference center. Regional

incidence for hypospadias was 2.5/1000 male newborn. Two high-incidence clusters (C+), and two low-incidence

clusters (C-) presented a significant RR (respectively 1.79, 2.09, 0.21, 0.19; p<0.001). Both C+ were found in rural and

semi-rural area, especially close to major highways, whereas both C- were situated at the borders of our region. C-

could be the consequence of patients consulting outside the region.

CONCLUSIONS

This innovative approach regarding the geographical distribution of incidence could show areas with abnormal high-

incidence for hypospadias. This kind of analysis seems suitable for comprehensive registry (no subclinical form, no

missed diagnosis). Further research will compare those clusters to the rest of the region on specific parameters such as

environmental exposure.