Lee Ming S, Elliott Nancy S, Bethel Valerie D, Balise Raymond R, Kobetz Erin N
Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.
Cancer Epidemiol Biomarkers Prev. 2023 Oct 2;32(10):1275-1283. doi: 10.1158/1055-9965.EPI-23-0132.
Cervical cancer disparities exist in the United States with the highest incidence in Hispanic women and the highest mortality in Black women. Effective control of cervical cancer in the population requires targeted interventions tailored to community composition in terms of race, ethnicity, and social determinants of health (SDOH).
Using cancer registry and SDOH data, geospatial hot spot analyses were carried out to identify statistically significant neighborhood clusters with high numbers of cervical cancer cases within the catchment area of an NCI-Designated Cancer Center. The locations, racial and ethnic composition, and SDOH resources of these hot spots were used by the center's community outreach and engagement office to deploy mobile screening units (MSU) for intervention in communities with women facing heightened risk for cervical cancer.
Neighborhood hot spots with high numbers of cervical cancer cases in south Florida largely overlap with locations of poverty. Cervical cancer hot spots are associated with a high percentage of Hispanic cases and low SDOH status, including low income, housing tenure, and education attainment.
A geospatially referenced cancer surveillance platform integrating cancer registry, SDOH, and cervical screening data can effectively identify targets for cervical cancer intervention in neighborhoods experiencing disparities.
Guided with a data-driven surveillance system, MSUs proactively bringing prevention education and cervical screening to communities with more unscreened, at-risk women are an effective means for addressing disparities associated with cervical cancer control.
美国存在宫颈癌差异，西班牙裔女性发病率最高，黑人女性死亡率最高。要有效控制人群中的宫颈癌，需要根据种族、族裔和健康的社会决定因素（SDOH），针对社区构成制定有针对性的干预措施。
利用癌症登记数据和SDOH数据，进行地理空间热点分析，以确定在一个美国国立癌症研究所指定癌症中心的集水区内，宫颈癌病例数较多的具有统计学意义的社区集群。该中心的社区外展和参与办公室利用这些热点地区的位置、种族和族裔构成以及SDOH资源，部署移动筛查单位（MSU），对面临宫颈癌风险增加的社区的女性进行干预。
佛罗里达州南部宫颈癌病例数较多的社区热点地区与贫困地区基本重叠。宫颈癌热点地区与高比例的西班牙裔病例以及低SDOH状况相关，包括低收入、住房保有率和教育程度低。
一个整合了癌症登记、SDOH和宫颈癌筛查数据的地理空间参考癌症监测平台，可以有效地识别存在差异的社区中宫颈癌干预的目标。
在数据驱动的监测系统指导下，移动筛查单位主动为更多未接受筛查、处于风险中的女性社区带来预防教育和宫颈癌筛查，是解决与宫颈癌控制相关差异的有效手段。
