Racial/ethnic and socioeconomic disparities in cancer mortality hotspots: A multi-state geospatial analysis

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-06-24 DOI:10.1016/j.amjsurg.2025.116492

Azza Sarfraz, Mujtaba Khalil, Zayed Rashid, Abdullah Altaf, Jun Kawashima, Shahzaib Zindani, Timothy M. Pawlik

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引用次数: 0

Abstract

Introduction

We sought to identify county-level cancer mortality hotspots for breast, colorectal, lung, and prostate cancers, as well as evaluate contributions of structural factors underlying racial/ethnic disparities, and social vulnerability index (SVI).

Methods

This ecological analysis included states selected to represent high (i.e., Massachusetts), medium (i.e., Ohio), and low (i.e., Mississippi) GDP categories. A cancer hotspot was defined as a county with elevated cancer mortality rates.

Results

Cancer hotspots in Mississippi consisted of higher SVI (breast: 95.9 vs. 82.8), lower median household income ($34,808 vs. $43,766), and predominantly Black populations (63.7 % vs. 35.1 %) (all p < 0.05). Ohio hotspots had higher rates of food insecurity (17 % vs. 13 %), smoking (lung: 29 vs. 23 %), and obesity (colorectal: 41 % vs. 38 %) (all p < 0.05). In Mississippi, disparities rooted in structural racism were more prominent, whereas socioeconomic disadvantage was more prominent in Ohio.

Conclusion

Cancer mortality hotspots are disproportionately concentrated in low-GDP states, driven by social vulnerability and economic disparities.

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癌症死亡率热点的种族/民族和社会经济差异：多州地理空间分析

我们试图确定乳腺癌、结直肠癌、肺癌和前列腺癌的县级癌症死亡率热点，并评估种族/民族差异背后的结构性因素和社会脆弱性指数（SVI）的贡献。方法本生态分析包括了代表高（如马萨诸塞州）、中等（如俄亥俄州）和低（如密西西比州）GDP类别的州。癌症热点被定义为癌症死亡率高的县。结果密西西比州的癌症热点地区SVI较高（乳房：95.9对82.8），家庭收入中位数较低（34,808美元对43,766美元），主要是黑人（63.7%对35.1%）(所有p <；0.05)。俄亥俄州热点地区的食品不安全（17%对13%）、吸烟（肺部：29%对23%）和肥胖（结肠直肠：41%对38%）的比例更高(所有p <；0.05)。在密西西比州，结构性种族主义的差异更为突出，而在俄亥俄州，社会经济劣势更为突出。结论受社会脆弱性和经济差距的影响，癌症死亡热点地区不成比例地集中在低gdp国家。

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

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.