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. 2018 May;28(5):316-321.e2.
doi: 10.1016/j.annepidem.2018.02.004. Epub 2018 Mar 22.

Neighborhood disadvantage and racial disparities in colorectal cancer incidence: a population-based study in Louisiana

Denise M Danos  1 , Tekeda F Ferguson  2 , Neal R Simonsen  1 , Claudia Leonardi  3 , Qingzhao Yu  4 , Xiao-Cheng Wu  5 , Richard A Scribner  6
Affiliations

Neighborhood disadvantage and racial disparities in colorectal cancer incidence: a population-based study in Louisiana

Denise M Danos et al. Ann Epidemiol. 2018 May.

Abstract

Purpose: Colorectal cancer (CRC) continues to demonstrate racial disparities in incidence and survival in the United States. This study investigates the role of neighborhood concentrated disadvantage in racial disparities in CRC incidence in Louisiana.

Methods: Louisiana Tumor Registry and U.S. Census data were used to assess the incidence of CRC diagnosed in individuals 35 years and older between 2008 and 2012. Neighborhood concentrated disadvantage index (CDI) was calculated based on the PhenX Toolkit protocol. The incidence of CRC was modeled using multilevel binomial regression with individuals nested within neighborhoods.

Results: Our study included 10,198 cases of CRC. Adjusting for age and sex, CRC risk was 28% higher for blacks than whites (risk ratio [RR] = 1.28; 95% confidence interval [CI] = 1.22-1.33). One SD increase in CDI was associated with 14% increase in risk for whites (RR = 1.14; 95% CI = 1.10-1.18) and 5% increase for blacks (RR = 1.05; 95% CI = 1.02-1.09). After controlling for differential effects of CDI by race, racial disparities were not observed in disadvantaged areas.

Conclusion: CRC incidence increased with neighborhood disadvantage and racial disparities diminished with mounting disadvantage. Our results suggest additional dimensions to racial disparities in CRC outside of neighborhood disadvantage that warrants further research.

Keywords: Colorectal cancer; Concentrated disadvantage; Disparities; Multilevel modeling; Social epidemiology.

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Conflict of interest statement

The authors do not have any conflicts of interest to disclose.

Figures

Fig. 1.
Fig. 1.
Distribution of concentrated disadvantage index scores by race.
Fig. 2.
Fig. 2.
Results from the final multilevel model: (A) predicted annual incidence for black and white residents in a hypothetical age- and sex-balanced population aged over 35 years and (B) adjusted black/white risk ratio as a function of concentrated disadvantage.
See this image and copyright information in PMC

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References

    1. Maniscalco L, Lefante C, Hsieh M, Andrews P, Pareti L, Mumphrey B, et al. Cancer in Louisiana, 2009–2013 New Orleans: Louisiana Tumor Registry; 2015. (Cancer in Louisiana; Vol. 31).
    1. American Cancer Society. Cancer Facts & Figures for African Americans 2013–2014 Atlanta: American Cancer Society; 2013.
    1. World Health Organization. Commission on Social Determinants of Health–Final Report Copenhagen: WHO; 2008.
    1. Diez Roux A, Merkin S, Arnett D, Chambless L, Massing M, Nieto F, et al. Neighborhood of residence and incidence of coronary heart disease. N Engl J Med 2001;345(2):99–106. - PubMed
    1. King K, Morenoff J, House J. Neighborhood context and social disparities in cumulative biological risk factors. Psychosom Med 2011;73(7):572–9. - PMC - PubMed

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