ASPO Abstracts
Understanding Geographic and Racial Disparities in Mortality from Four Major Cancers in the State of Georgia: A Spatial Epidemiologic Analysis, 1999 - 2019
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Purpose of the study: Progress in cancer outcomes in the general population are not equitable among all populations, leaving some, such as rural and non-Hispanic Blacks (NH-Black) behind. We examined geographic and racial variation in cancer mortality in the state of Georgia, and investigated the correlation between the observed spatial differences and county-level characteristics.Methods: We analyzed data on breast, colorectal, lung, and prostate cancer mortality among adults (aged >18 years) in 159 Georgia counties from years 1999 through 2019. Geospatial methods were applied, and we identified hot spot counties based on cancer mortality rates overall and stratified by non-Hispanic White (NH-White) and NH-Black races. We assessed differences in county-level characteristics between hot spot and non-hot spot counties using Wilcoxon rank-sum test and Spearman correlation and stratified all analyses by race/ethnicity. Results: Among all adults, 5.0% (8 of 159), 8.2% (13 of 159), 5.0% (8 of 159), and 6.9% (11 of 159) of Georgia counties were estimated hot spots for breast cancer, colorectal, lung, and prostate cancer mortality, respectively. Among NH-Whites, 5.7% (9 of 159), 4.4% (7 of 159), 4.4% (7 of 159) counties, and 5.0% (8 of 159) of counties were identified as hot spots for breast, colorectal, lung, and prostate cancer mortality, respectively. Among NH-Blacks, 5.7% (9 of 159), 3.8% (6 of 159), 7.4% (11 of 159), and 5.7% (9 of 159) counties were identified as hot spots for breast, colorectal, lung, prostate cancer mortality, respectively. Cancer mortality hot spots were heavily concentrated in three major areas: 1) eastern Piedmont to Coastal Plain regions, 2) southwestern rural Georgia area, or 3) northern-most rural Georgia. Overall, hot spot counties generally had higher proportion of NH-Blacks, older adult population, greater poverty, and more rurality.Conclusions: We observed distinct geographic and racial/ethnic disparities in mortality from breast, colorectal, lung, and prostate cancer in Georgia. Targeted cancer prevention strategies and allocation of health resources are needed in counties with elevated cancer mortality rates, focusing on interventions suitable for NH-Black, low-income, and rural residents.
Keywords: Cancer, Mortality, Health Disparities, Rural, Hot Spots, Georgia