McIntire Russell K, Juon Hee-Soon, Keith Scott W, Simone Nicole L, Waters Dexter, Lewis Eleanor, Zeigler-Johnson Charnita
Jefferson College of Population Health, Thomas Jefferson University, 901 Walnut St., 10 Floor, Philadelphia, PA 19107, United States.
Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, 834 Chestnut St., Benjamin Franklin House, Suite 320, Philadelphia, PA 19107, United States.
Prev Med Rep. 2023 Apr 26;33:102218. doi: 10.1016/j.pmedr.2023.102218. eCollection 2023 Jun.
Community-based breast cancer prevention efforts often focus on women who live in the same neighborhoods, as they tend to have similar demographic characteristics, health behaviors, and environmental exposures; yet little research describes methods of selecting neighborhoods of focus for community-based cancer prevention interventions. Studies frequently use demographics from census data, or single breast cancer outcomes (e.g., mortality, morbidity) in order to choose neighborhoods of focus for breast cancer interventions, which may not be optimal. This study presents a novel method for measuring the burden of breast cancer among neighborhoods that could be used for selecting neighborhoods of focus. In this study, we 1) calculate a metric composed of multiple breast cancer outcomes to describe the burden of breast cancer in census tracts Philadelphia, PA, USA; 2) map the neighborhoods with the greatest breast cancer burden; and 3) compare census tracts with the highest burden of breast cancer to those with demographics sometimes used for geo-based prioritization, i.e., race and income. The results of our study showed that race or income may not be appropriate proxies for neighborhood breast cancer burden; comparing the breast cancer burden with demographics at the census tract level, we found few overlaps with the highest percentage African American or the lowest median incomes. Agencies implementing community-based breast cancer interventions should consider this method to inform the selection of neighborhoods for breast cancer prevention interventions, including education, screening, and treatment.
基于社区的乳腺癌预防工作通常聚焦于居住在同一社区的女性,因为她们往往具有相似的人口统计学特征、健康行为和环境暴露情况;然而,很少有研究描述为基于社区的癌症预防干预措施选择重点社区的方法。研究通常使用人口普查数据中的人口统计学信息,或单一的乳腺癌结果(如死亡率、发病率)来选择乳腺癌干预措施的重点社区,而这可能并非最佳方法。本研究提出了一种衡量社区乳腺癌负担的新方法,可用于选择重点社区。在本研究中,我们:1)计算一个由多个乳腺癌结果组成的指标,以描述美国宾夕法尼亚州费城普查区的乳腺癌负担;2)绘制乳腺癌负担最重的社区地图;3)将乳腺癌负担最高的普查区与有时用于地理优先排序的人口统计学特征普查区(即种族和收入)进行比较。我们的研究结果表明,种族或收入可能并非衡量社区乳腺癌负担的合适替代指标;在普查区层面将乳腺癌负担与人口统计学特征进行比较时,我们发现与非裔美国人比例最高或收入中位数最低的普查区几乎没有重叠。实施基于社区的乳腺癌干预措施的机构应考虑采用这种方法,为乳腺癌预防干预措施(包括教育、筛查和治疗)的重点社区选择提供参考。