The role of area‐level socioeconomic disadvantage in racial disparities in cancer incidence in metropolitan Detroit

Author:

Purrington Kristen S.12ORCID,Hastert Theresa A.12ORCID,Madhav K. C.3,Nair Mrudula1,Snider Natalie1,Ruterbusch Julie J.12,Schwartz Ann G.12,Stoffel Elena M.4,Peters Edward S.5,Rozek Laura S.6

Affiliation:

1. Department of Oncology Wayne State University School of Medicine Michigan Detroit USA

2. Population Studies and Disparities Research Program Barbara Ann Karmanos Cancer Institute Michigan Detroit USA

3. Department of Internal Medicine Yale School of Medicine, Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center Connecticut New Haven USA

4. Division of Gastroenterology, Department of Internal Medicine University of Michigan Health System Michigan Ann Arbor USA

5. Department of Epidemiology, College of Public Health University of Nebraska Medical Center Omaha Nebraska USA

6. Department of Oncology Georgetown University School of Medicine District of Columbia Washington USA

Abstract

AbstractBackgroundNeighborhood deprivation is associated with both race and cancer incidence, but there is a need to better understand the effect of structural inequities on racial cancer disparities. The goal of this analysis was to evaluate the relationship between a comprehensive measure of neighborhood‐level social disadvantage and cancer incidence within the racially diverse population of metropolitan Detroit.MethodsWe estimated breast, colorectal, lung, and prostate cancer incidence rates using Metropolitan Detroit Cancer Surveillance System and US decennial census data. Neighborhood socioeconomic disadvantage was measured by the Area Deprivation Index (ADI) using Census Bureau's American Community Survey data at the Public Use Microdata Areas (PUMA) level. Associations between ADI at time of diagnosis and cancer incidence were estimated using Poisson mixed‐effects models adjusting for age and sex. Attenuation of race‐incidence associations by ADI was quantified using the “mediation” package in R.ResultsADI was inversely associated with incidence of breast cancer for both non‐Hispanic White (NHW) and non‐Hispanic Black (NHB) women (NHW: per‐quartile RR = 0.92, 95% CI 0.88–0.96; NHB: per‐quartile RR = 0.94, 95% CI 0.91–0.98) and with prostate cancer incidence only for NHW men (per‐quartile RR = 0.94, 95% CI 0.90–0.97). ADI was positively associated with incidence of lung cancer for NHWs and NHBs (NHW: per‐quartile RR = 1.12, 95% CI 1.04–1.21; NHB: per‐quartile RR = 1.37, 95% CI 1.25–1.51) and incidence of colorectal cancer (CRC) only among NHBs (per‐quartile RR = 1.11, 95% CI 1.02–1.21). ADI significantly attenuated the relationship between race and hormone receptor positive, HER2‐negative breast cancer (proportion attenuated = 8.5%, 95% CI 4.1–16.6%) and CRC cancer (proportion attenuated = 7.3%, 95% CI 3.7 to 12.8%), and there was a significant interaction between race and ADI for lung (interaction RR = 1.22, p < 0.0001) and prostate cancer (interaction RR = 1.09, p = 0.00092).ConclusionsArea‐level socioeconomic disadvantage is associated with risk of common cancers in a racially diverse population and plays a role in racial differences in cancer incidence.

Funder

Foundation for the National Institutes of Health

National Cancer Institute

Publisher

Wiley

Subject

Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3