The spatial scan statistic is commonly used for geographical disease cluster detection, cluster evaluation and disease surveillance. The most commonly used shape of the scanning window is circular. In this paper we explore an elliptic version of the spatial scan statistic, using a scanning window of variable location, shape (eccentricity), angle and size, and with and without an eccentricity penalty. The method is applied to breast cancer mortality data from Northeastern United States and female oral cancer mortality in the United States. Power comparisons are made with the circular scan statistic. Copyright (c) 2006 John Wiley & Sons, Ltd.