ASPO Abstracts
Mapping Colorectal Cancer in Texas: Associations between Socioeconomic Factors and Late Stage Diagnosis, Stratified by Age at Diagnosis
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Background:Colorectal cancer deaths, 2nd highest among U.S. cancer deaths, are preventable through mass screening. In the US, several colorectal cancer screening methods are available and recommended for people aged 50 or older at average risk of colorectal cancer. Demographic disparities in colorectal cancer screening, incidence, and mortality are well described in the literature; however, demographic disparities for emerging age-based trends in colorectal cancer incidence and mortality are not well understood. The aim of this study is to explore the relationship between socioeconomic determinants of health and stage at diagnosis with colorectal cancer, stratified by age, among Texans diagnosed with colorectal cancer between 2005 and 2014.Methods:The Texas Cancer Registry, a department of the Texas Department of State Health Services, collected data through surveillance. Associations between socioeconomic variables and stage at diagnosis with colorectal cancer, stratified by age at diagnosis, were tested with multivariable logistic regression in univariable and multivariable models. Results were used to map of Texas counties with populations at increased risk of late stage colorectal cancer diagnosis using ArcGIS raster math.Results:Between younger and older strata of Texans, relationships differed between stage at colorectal cancer diagnosis and: race, insurance status, and census tract poverty level. Among older participants, those at risk of increased odds of late stage colorectal cancer diagnosis were non-Hispanic Black participants (OR=1.25) compared to White, participants with Medicaid (OR=1.38) or no insurance (OR=1.39) compared to privately insured, and participants who lived in census tracts with greater than 5% poverty levels compared to census tracts with 0-4% poverty. Among participants aged 18-49, those with Medicaid had higher odds of late stage colorectal cancer diagnosis as compared to privately insured participants.Conclusion: Associations between socioeconomic factors and late stage colorectal cancer differed between age-based strata. Information on socioeconomic factors associated with increased odds of late stage diagnosis was mapped to identify niche county populations at elevated odds of late stage colorectal diagnosis.
Keywords: colorectal neoplasms, mass screening, epidemiology, social determinants of health