Rathod Rutu, Beauchamp Alaina, Shahan Kathryn, Lin Katherine, Henry Kevin, Shariff-Marco Salma, Pruitt Sandi L, Hughes Amy
Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Epidemiology, Fay W Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas.
Am J Prev Med. 2025 Apr;68(4):695-706. doi: 10.1016/j.amepre.2024.12.012. Epub 2024 Dec 24.
The purpose of this study is to examine the associations of neighborhood socioeconomic status, ethnic enclaves, and residential Black segregation with screening for breast, cervical, and colorectal cancers across the state of Texas.
Using an ecologic study design, spatial clustering of low breast, cervical and colorectal cancer screening rates were identified across Texas census tracts using local Moran's I statistics. Binomial spatial probit regression was used to estimate the associations between nSES, Hispanic/Latino and Asian American ethnic enclave neighborhoods and residential Black segregation with geospatial clusters of low screening, adjusting for behavioral characteristics. Analysis was conducted in 2024.
Of 5,186 tracts, 5.4%, 4.6%, and 8.7% tracts were in low screening clusters for colorectal, cervical, and breast cancer, respectively. Medium and high neighborhood socioeconomic status tracts had reduced odds of being part of low cervical cancer screening clusters. Medium neighborhood socioeconomic status tracts and Hispanic enclave tracts had increased odds of being within a low breast cancer screening cluster. Asian American enclave tracts displayed an increased odds of being in low colorectal cancer and low cervical cancer screening clusters. Tracts with high residential Black segregation demonstrated reduced odds of being in low colorectal cancer and low breast cancer screening clusters.
Geospatial clusters of screening uptake are associated with neighborhood socioeconomic status and racial and ethnic neighborhood characteristics. This indicates a need for place-based culturally sensitive interventions to address the specific assets and needs of communities with low screening uptake.
本研究旨在考察德克萨斯州邻里社会经济地位、种族聚居区以及居住的黑人隔离情况与乳腺癌、宫颈癌和结直肠癌筛查之间的关联。
采用生态学研究设计，利用局部莫兰指数统计量确定德克萨斯州各人口普查区低乳腺癌、宫颈癌和结直肠癌筛查率的空间聚类情况。使用二项式空间概率回归来估计邻里社会经济地位、西班牙裔/拉丁裔和亚裔美国种族聚居区邻里以及居住的黑人隔离情况与低筛查地理空间聚类之间的关联，并对行为特征进行调整。分析于2024年进行。
在5186个普查区中，分别有5.4%、4.6%和8.7%的普查区处于结直肠癌、宫颈癌和乳腺癌低筛查聚类中。邻里社会经济地位处于中等和高等级的普查区成为宫颈癌低筛查聚类一部分的几率降低。邻里社会经济地位处于中等的普查区和西班牙裔聚居区处于乳腺癌低筛查聚类中的几率增加。亚裔美国聚居区处于结直肠癌和宫颈癌低筛查聚类中的几率增加。居住的黑人隔离程度高的普查区处于结直肠癌和乳腺癌低筛查聚类中的几率降低。
筛查接受情况的地理空间聚类与邻里社会经济地位以及种族和民族邻里特征相关。这表明需要开展基于地点的文化敏感型干预措施，以满足筛查接受率低的社区的特定资产和需求。
