This chapter discusses disease clusters, such as cancer, and how they appear in the same indiscriminate pattern. The cause of a disease cluster can be occasionally identified, although it is more common for clusters to be the result of the random and uneven distribution of disease spread across the population. A number of clusters disappear upon closer examination because they have been artificially created based on spurious data. To validate a disease cluster, it must first be defined and its scope determined. Disease clusters may occur in time as well as space; a previous unremarkable rate of disease in an area may suddenly appear to increase. The most common strategy for studying a cluster is to follow the disease rate over time, a period of “watchful waiting,” to see if the disease rate declines to background levels.
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