From the Department of Geography and Urban Studies, Temple University, Philadelphia, PA.
New Jersey State Cancer Registry, Trenton, NJ.
Epidemiology. 2020 Sep;31(5):728-735. doi: 10.1097/EDE.0000000000001216.
Residential histories linked to cancer registry data provide new opportunities to examine cancer outcomes by neighborhood socioeconomic status (SES). We examined differences in regional stage colon cancer survival estimates comparing models using a single neighborhood SES at diagnosis to models using neighborhood SES from residential histories.
We linked regional stage colon cancers from the New Jersey State Cancer Registry diagnosed from 2006 to 2011 to LexisNexis administrative data to obtain residential histories. We defined neighborhood SES as census tract poverty based on location at diagnosis and across the follow-up period through 31 December 2016 based on residential histories (average, time-weighted average, time-varying). Using Cox proportional hazards regression, we estimated associations between colon cancer and census tract poverty measurements (continuous and categorical), adjusted for age, sex, race/ethnicity, regional substage, and mover status.
Sixty-five percent of the sample was nonmovers (one census tract); 35% (movers) changed tract at least once. Cases from tracts with >20% poverty changed residential tracts more often (42%) than cases from tracts with <5% poverty (32%). Hazard ratios (HRs) were generally similar in strength and direction across census tract poverty measurements. In time-varying models, cases in the highest poverty category (>20%) had a 30% higher risk of regional stage colon cancer death than cases in the lowest category (<5%) (95% confidence interval [CI] = 1.04, 1.63).
Residential changes after regional stage colon cancer diagnosis may be associated with a higher risk of colon cancer death among cases in high-poverty areas. This has important implications for postdiagnostic access to care for treatment and follow-up surveillance. See video abstract: http://links.lww.com/EDE/B705.
与癌症登记数据相关的居住史为通过邻里社会经济地位（SES）来检查癌症结果提供了新的机会。我们比较了使用诊断时单一邻里 SES 与使用居住史中的邻里 SES 的模型，以检验区域阶段结肠癌生存估计值的差异。
我们将新泽西州癌症登记处诊断的 2006 年至 2011 年期间的区域阶段结肠癌与 LexisNexis 行政数据相关联，以获取居住史。我们将邻里 SES 定义为根据诊断时的位置和截至 2016 年 12 月 31 日的随访期间的位置（平均、时间加权平均、时变）的普查区贫困情况。使用 Cox 比例风险回归，我们根据年龄、性别、种族/族裔、区域亚分期和移居者状态，调整了结肠癌与普查区贫困衡量标准（连续和分类）之间的关联。
样本的 65%为非移居者（一个普查区）；35%（移居者）至少改变了一个普查区。来自贫困率>20%的普查区的病例改变居住地的频率（42%）高于贫困率<5%的普查区（32%）。在时变模型中，最高贫困类别（>20%）的病例死于区域阶段结肠癌的风险比最低类别（<5%）的病例高 30%（95%置信区间[CI] = 1.04, 1.63）。
区域阶段结肠癌诊断后发生的居住地变化可能与高贫困地区病例的结肠癌死亡风险增加有关。这对诊断后获得治疗和随访监测的机会具有重要意义。观看视频摘要：http://links.lww.com/EDE/B705。
