Hall Jaclyn M, Szurek Sarah M, Cho Heedeok, Guo Yi, Gutter Michael S, Khalil Georges E, Licht Jonathan D, Shenkman Elizabeth A
Department of Health Outcomes and Biomedical Informatics, University of Florida, United States.
Department of Family, Youth and Community Sciences, University of Florida, United States.
Prev Med Rep. 2022 Jul 22;29:101922. doi: 10.1016/j.pmedr.2022.101922. eCollection 2022 Oct.
We aimed to examine poverty and rurality as potential predictors of cancer health disparities. This cross-sectional study used data from the Florida Cancer Data System on all cancer diagnoses in the years 2014-2018 to determine age-adjusted incidence and mortality (per 100,000 population) for the 22 most common cancer sites within rural and urban counties, and high poverty and low poverty communities. Rural/urban and high/low poverty related cancer disparities were tested for statistical significance using the Rate Ratio statistical test. Overall cancer incidence was significantly lower in rural areas than in urban, but significantly higher in high poverty communities. Rurality and poverty were both associated with disparity in cancer incidence risk for tobacco-related cancers. The overall mortality was 22% higher in high poverty areas compared to low poverty areas. Ten cancer sites had mortality disparity from 83% to 17% higher in high poverty areas. Only three cancer sites, all tobacco-related, had higher mortality in rural areas than urban areas, demonstrating the intersectional nature of inhaled and smokeless tobacco use in rural low-income communities. Cancer and mortality rates in rural and urban areas may be largely driven by poverty. The high disparities related to high poverty areas reflects poor access to preventative care and treatment. Low income communities, rural or urban, will require focused efforts to address challenges specific to each population.
我们旨在研究贫困和农村地区状况作为癌症健康差距潜在预测因素的情况。这项横断面研究使用了佛罗里达癌症数据系统中2014 - 2018年所有癌症诊断的数据,以确定农村和城市县以及高贫困和低贫困社区内22个最常见癌症部位的年龄调整发病率和死亡率(每10万人)。使用率比统计检验对农村/城市以及高/低贫困相关的癌症差距进行统计学显著性检验。总体而言,农村地区的癌症发病率显著低于城市地区,但在高贫困社区显著更高。农村地区状况和贫困都与烟草相关癌症的发病风险差距有关。高贫困地区的总体死亡率比低贫困地区高22%。十个癌症部位在高贫困地区的死亡率差距高出83%至17%。只有三个癌症部位(均与烟草相关)在农村地区的死亡率高于城市地区,这表明农村低收入社区吸入性和无烟烟草使用的交叉性特征。农村和城市地区的癌症及死亡率可能在很大程度上由贫困驱动。与高贫困地区相关的高差距反映了获得预防保健和治疗的机会不足。低收入社区,无论农村还是城市,都需要集中精力应对各人群特有的挑战。