Area-level Socioeconomic Disadvantage and Cancer Survival in Metropolitan Detroit.
Cancer Epidemiol Biomarkers Prev
; 32(3): 387-397, 2023 03 06.
Article
en En
| MEDLINE
| ID: mdl-36723416
ABSTRACT
BACKGROUND:
Racial segregation is linked to poorer neighborhood quality and adverse health conditions among minorities, including worse cancer outcomes. We evaluated relationships between race, neighborhood social disadvantage, and cancer survival.METHODS:
We calculated overall and cancer-specific survival for 11,367 non-Hispanic Black (NHB) and 29,481 non-Hispanic White (NHW) individuals with breast, colorectal, lung, or prostate cancer using data from the Metropolitan Detroit Cancer Surveillance System. The area deprivation index (ADI) was used to measure social disadvantage at the census block group level, where higher ADI is associated with poorer neighborhood factors. Associations between ADI and survival were estimated using Cox proportional hazards mixed-effects models accounting for geographic grouping and adjusting for demographic and clinical factors.RESULTS:
Increasing ADI quintile was associated with increased overall mortality for all four cancer sites in multivariable-adjusted models. Stratified by race, these associations remained among breast (NHW HR = 1.16, P < 0.0001; NHB HR = 1.20, P < 0.0001), colorectal (NHW HR = 1.11, P < 0.0001; NHB HR = 1.09, P = 0.00378), prostate (NHW HR = 1.18, P < 0.0001; NHB HR = 1.18, P < 0.0001), and lung cancers (NHW HR = 1.06, P < 0.0001; NHB HR = 1.07, P = 0.00177). Cancer-specific mortality estimates were similar to overall mortality. Adjustment for ADI substantially attenuated the effects of race on mortality for breast [overall proportion attenuated (OPA) = 47%, P < 0.0001; cancer-specific proportion attenuated (CSPA) = 37%, P < 0.0001] prostate cancer (OPA = 51%, P < 0.0001; CSPA = 56%, P < 0.0001), and colorectal cancer (OPA = 69%, P = 0.032; CSPA = 36%, P = 0.018).CONCLUSIONS:
Area-level socioeconomic disadvantage is related to cancer mortality in a racially diverse population, impacting racial differences in cancer mortality. IMPACT Understanding the role of neighborhood quality in cancer survivorship could improve community-based intervention practices.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Disparidades Socioeconómicas en Salud
/
Neoplasias
Tipo de estudio:
Prognostic_studies
Idioma:
En
Revista:
Cancer Epidemiol Biomarkers Prev
Asunto de la revista:
BIOQUIMICA
/
EPIDEMIOLOGIA
/
NEOPLASIAS
Año:
2023
Tipo del documento:
Article