Breast cancer screening needs assessment in 19 Northern California counties: geography, poverty, and racial/ethnic identity composition.

IF 2.2 4区医学 Q3 ONCOLOGY

Cancer Causes & Control Pub Date : 2024-12-01 DOI:10.1007/s10552-024-01943-8

Brittany L Morgan Bustamante, Diana Miglioretti, Theresa Keegan, Eric Stewart, Anshu Shrestha, Nuen Tsang Yang, Rosemary D Cress, Luis Carvajal-Carmona, Julie Dang, Laura Fejerman

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引用次数: 0

Abstract

Purpose: To describe the area-level rate of breast cancers, the percentage of early-stage diagnoses (stage I-IIa), and associations between area-level measures of poverty, racial/ethnic composition, primary care shortage, and urban/rural/frontier status for the UC Davis Comprehensive Cancer Center (UCDCCC) catchment area.

Methods: Using data from the SEER Cancer Registry of Greater California (2014-2018) and the California Department of Health Care Access and Information Medical Service Study Area, we conducted an ecological study in the UCDCCC catchment area to identify geographies that need screening interventions and their demographic characteristics.

Results: The higher the percentage of the population identifying as Hispanic/Latino/Latinx, and the higher the percentage of the population below the 100% poverty level, the lower the odds of being diagnosed at an early-stage (OR = 0.98, 95% CI 0.96-0.99 and OR = 0.96, 95% CI 0.93-0.99, respectively). The association with poverty level was attenuated in the multivariable model when the Hispanic/Latino/Latinx population percentage was added. Several California counties had high poverty levels and differences in cancer stage distribution between racial/ethnic category groups. For all individuals combined, 65% was the lowest proportion of early-stage diagnoses for any geography. However, when stratified by racial/ethnic category, 11 geographies were below 65% for Hispanic/Latino/Latinx individuals, six for non-Hispanic Asian and Pacific Islander individuals, and seven for non-Hispanic African American/Black individuals, in contrast to one for non-Hispanic White individuals.

Conclusions: Areas with lower percentages of breast cancers diagnosed at an early-stage were characterized by high levels of poverty. Variation in the proportion of early-stage diagnosis was also observed by race/ethnicity where the proportion of Hispanic/Latino/Latinx individuals was associated with fewer early-stage diagnoses.

Impact: Results will inform the implementation of the UCDCCC mobile cancer prevention and early detection program, providing specific locations and populations to prioritize for tailored outreach, education, and screening.

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北加州19个县的乳腺癌筛查需求评估：地理、贫困和种族/民族身份构成

目的：描述加州大学戴维斯分校综合癌症中心（UCDCCC）集水区乳腺癌的区域发病率、早期诊断（I-IIa期）的百分比，以及区域贫困、种族/民族构成、初级保健短缺和城市/农村/边境状况之间的关系。方法：利用大加利福尼亚州SEER癌症登记处（2014-2018）和加利福尼亚州卫生保健获取和信息医疗服务研究区的数据，我们在UCDCCC集水区进行了一项生态研究，以确定需要筛查干预的地理区域及其人口统计学特征。结果：西班牙裔/拉丁裔/拉丁裔人口比例越高，低于100%贫困水平的人口比例越高，早期诊断的几率越低（OR = 0.98, 95% CI 0.96-0.99, OR = 0.96, 95% CI 0.93-0.99）。在多变量模型中，当加入西班牙裔/拉丁裔/拉丁裔人口百分比时，与贫困水平的关联减弱。加州几个县的贫困率很高，不同种族/民族的癌症分期分布也存在差异。所有个体加起来，65%是所有地区早期诊断比例最低的。然而，当按种族/民族类别分层时，11个地区的西班牙裔/拉丁裔/拉丁裔个体的比例低于65%，6个地区的非西班牙裔亚裔和太平洋岛民个体的比例低于65%，7个地区的非西班牙裔美国人/黑人个体的比例低于65%，而非西班牙裔白人个体的比例为1个。结论：早期乳腺癌确诊率较低的地区，其特点是贫困程度较高。早期诊断比例的差异还观察到种族/民族的差异，其中西班牙裔/拉丁裔/拉丁裔个体的比例与早期诊断较少相关。影响：结果将为UCDCCC移动癌症预防和早期检测项目的实施提供信息，提供具体地点和人群，优先进行量身定制的推广、教育和筛查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Causes & Control 医学-公共卫生、环境卫生与职业卫生

CiteScore

3.90

自引率

4.30%

发文量

130

审稿时长

6.6 months

期刊介绍： Cancer Causes & Control is an international refereed journal that both reports and stimulates new avenues of investigation into the causes, control, and subsequent prevention of cancer. By drawing together related information published currently in a diverse range of biological and medical journals, it has a multidisciplinary and multinational approach. The scope of the journal includes: variation in cancer distribution within and between populations; factors associated with cancer risk; preventive and therapeutic interventions on a population scale; economic, demographic, and health-policy implications of cancer; and related methodological issues. The emphasis is on speed of publication. The journal will normally publish within 30 to 60 days of acceptance of manuscripts. Cancer Causes & Control publishes Original Articles, Reviews, Commentaries, Opinions, Short Communications and Letters to the Editor which will have direct relevance to researchers and practitioners working in epidemiology, medical statistics, cancer biology, health education, medical economics and related fields. The journal also contains significant information for government agencies concerned with cancer research, control and policy.