BACKGROUND: Disparities in cancer survival may be related to differences in stage. Segregation may be associated with disparities in stage, particularly for cancers for which screening promotes survival. OBJECTIVES: The objective of the study was to examine whether segregation modifies racial/ethnic disparities in stage. DESIGN: The design of the study was analysis of Surveillance, Epidemiology, and End Results Medicare data for seniors with breast, colorectal, lung, and prostate cancer (n = 410,870). MEASUREMENTS AND MAIN RESULTS: The outcome was early- versus late-stage diagnosis. Area of residence was categorized into 4 groups: low segregation/high income (potentially the most advantaged), high segregation/high income, low segregation/low income, and high segregation/low income (possibly the most disadvantaged). Blacks were less likely than whites to be diagnosed with early-stage breast, colorectal, or prostate cancer, regardless of area. For colorectal cancer, the black/white disparity was largest in low-segregation/low-income areas (black/white odds ratio [OR] of early stage 0.51) and smallest in the most segregated areas (ORs 0.71 and 0.74, P < .005). Differences in disparities in stage by area category were not apparent for breast, prostate, or lung cancer. Whereas there were few Hispanic-white differences in early-stage diagnosis, the Hispanic/white disparity in early-stage diagnosis of breast cancer was largest in low-segregation/low-income areas (Hispanic/white OR of early stage 0.54) and smallest in high-segregation/low-income areas (OR 0.96, P < .05 compared to low-segregation/low-income areas). CONCLUSIONS: Disparities in stages for cancers with an established screening test were smaller in more segregated areas.
BACKGROUND: Disparities in cancer survival may be related to differences in stage. Segregation may be associated with disparities in stage, particularly for cancers for which screening promotes survival. OBJECTIVES: The objective of the study was to examine whether segregation modifies racial/ethnic disparities in stage. DESIGN: The design of the study was analysis of Surveillance, Epidemiology, and End Results Medicare data for seniors with breast, colorectal, lung, and prostate cancer (n = 410,870). MEASUREMENTS AND MAIN RESULTS: The outcome was early- versus late-stage diagnosis. Area of residence was categorized into 4 groups: low segregation/high income (potentially the most advantaged), high segregation/high income, low segregation/low income, and high segregation/low income (possibly the most disadvantaged). Blacks were less likely than whites to be diagnosed with early-stage breast, colorectal, or prostate cancer, regardless of area. For colorectal cancer, the black/white disparity was largest in low-segregation/low-income areas (black/white odds ratio [OR] of early stage 0.51) and smallest in the most segregated areas (ORs 0.71 and 0.74, P < .005). Differences in disparities in stage by area category were not apparent for breast, prostate, or lung cancer. Whereas there were few Hispanic-white differences in early-stage diagnosis, the Hispanic/white disparity in early-stage diagnosis of breast cancer was largest in low-segregation/low-income areas (Hispanic/white OR of early stage 0.54) and smallest in high-segregation/low-income areas (OR 0.96, P < .05 compared to low-segregation/low-income areas). CONCLUSIONS: Disparities in stages for cancers with an established screening test were smaller in more segregated areas.
Authors: Sanae Inagami; Luisa N Borrell; Mitchell D Wong; Jing Fang; Martin F Shapiro; Steven M Asch Journal: J Urban Health Date: 2006-05 Impact factor: 3.671
Authors: Claudia I Henschke; David F Yankelevitz; Daniel M Libby; Mark W Pasmantier; James P Smith; Olli S Miettinen Journal: N Engl J Med Date: 2006-10-26 Impact factor: 91.245
Authors: Rudolph A Rodriguez; Saunak Sen; Kala Mehta; Sandra Moody-Ayers; Peter Bacchetti; Ann M O'Hare Journal: Ann Intern Med Date: 2007-04-03 Impact factor: 25.391
Authors: Paula M Lantz; Mahasin Mujahid; Kendra Schwartz; Nancy K Janz; Angela Fagerlin; Barbara Salem; Lihua Liu; Dennis Deapen; Steven J Katz Journal: Am J Public Health Date: 2006-10-31 Impact factor: 9.308
Authors: Jill Amlong MacKinnon; Robert C Duncan; Youjie Huang; David J Lee; Lora E Fleming; Lydia Voti; Mark Rudolph; James D Wilkinson Journal: Cancer Epidemiol Biomarkers Prev Date: 2007-04 Impact factor: 4.254
Authors: Peter B Bach; James R Jett; Ugo Pastorino; Melvyn S Tockman; Stephen J Swensen; Colin B Begg Journal: JAMA Date: 2007-03-07 Impact factor: 56.272
Authors: Adeyinka O Laiyemo; Chyke Doubeni; Paul F Pinsky; V Paul Doria-Rose; Robert Bresalier; Lois E Lamerato; E David Crawford; Paul Kvale; Mona Fouad; Thomas Hickey; Thomas Riley; Joel Weissfeld; Robert E Schoen; Pamela M Marcus; Philip C Prorok; Christine D Berg Journal: J Natl Cancer Inst Date: 2010-03-31 Impact factor: 13.506
Authors: Kiarri N Kershaw; Ana V Diez Roux; Sarah A Burgard; Lynda D Lisabeth; Mahasin S Mujahid; Amy J Schulz Journal: Am J Epidemiol Date: 2011-06-22 Impact factor: 4.897
Authors: Roger T Anderson; Tse-Chang Yang; Stephen A Matthews; Fabian Camacho; Teresa Kern; Heath B Mackley; Gretchen Kimmick; Christopher Louis; Eugene Lengerich; Nengliang Yao Journal: Health Serv Res Date: 2013-09-30 Impact factor: 3.402
Authors: Michael R Kramer; Hannah L Cooper; Carolyn D Drews-Botsch; Lance A Waller; Carol R Hogue Journal: Int J Health Geogr Date: 2010-06-12 Impact factor: 3.918