Robert T Greenlee1, Holly L Howe. 1. Marshfield Clinic Research Foundation, 1000 North Oak Ave., Mailstop ML2, Marshfield, WI 54449, USA. greenlee.robert@mcrf.mfldclin.edu
Abstract
OBJECTIVE: Late stage cancer at diagnosis increases the likelihood of cancer death. We evaluated the relation of county-level poverty with late stage cancer for 18 anatomic sites using data from the North American Association of Central Cancer Registries. METHODS: Stratified analysis and logistic regression were applied to 2 million incident cancers (1997-2000) from 32 states representing 57% of the United States. RESULTS: For 12 sites, higher county poverty significantly increased the odds of late stage, [adjusted odds ratio (95% confidence interval) comparing highest to lowest county poverty: larynx 2.4 (1.8-3.2), oral cavity 2.2 (1.8-2.7), melanoma 2.0 (1.5-2.8), female breast 1.9 (1.7-2.2), prostate 1.7 (1.5-1.9), corpus uteri 1.6 (1.3-1.9), cervix 1.6 (1.3-2.1), bladder 1.6 (1.2-2.1), colorectum 1.4 (1.3-1.5), esophagus 1.3 (1.1-1.7), stomach 1.3 (1.1-1.5), and kidney 1.3 (1.1-1.5)]. With some exceptions, county poverty associations with stage were comparable across gender and race, but stronger among metropolitan cases. A few differences by age may reflect screening patterns. CONCLUSIONS: In this large population-based study, higher county poverty independently predicted distant stage cancer. This held for several non-screenable cancers, suggesting improved area economic deprivation, including access to and utilization of good medical care might facilitate earlier diagnosis and longer survival even for cancers without practical screening approaches.
OBJECTIVE: Late stage cancer at diagnosis increases the likelihood of cancer death. We evaluated the relation of county-level poverty with late stage cancer for 18 anatomic sites using data from the North American Association of Central Cancer Registries. METHODS: Stratified analysis and logistic regression were applied to 2 million incident cancers (1997-2000) from 32 states representing 57% of the United States. RESULTS: For 12 sites, higher county poverty significantly increased the odds of late stage, [adjusted odds ratio (95% confidence interval) comparing highest to lowest county poverty: larynx 2.4 (1.8-3.2), oral cavity 2.2 (1.8-2.7), melanoma 2.0 (1.5-2.8), female breast 1.9 (1.7-2.2), prostate 1.7 (1.5-1.9), corpus uteri 1.6 (1.3-1.9), cervix 1.6 (1.3-2.1), bladder 1.6 (1.2-2.1), colorectum 1.4 (1.3-1.5), esophagus 1.3 (1.1-1.7), stomach 1.3 (1.1-1.5), and kidney 1.3 (1.1-1.5)]. With some exceptions, county poverty associations with stage were comparable across gender and race, but stronger among metropolitan cases. A few differences by age may reflect screening patterns. CONCLUSIONS: In this large population-based study, higher county poverty independently predicted distant stage cancer. This held for several non-screenable cancers, suggesting improved area economic deprivation, including access to and utilization of good medical care might facilitate earlier diagnosis and longer survival even for cancers without practical screening approaches.
Authors: Sean F Altekruse; Lan Huang; James E Cucinelli; Timothy S McNeel; Kristen M Wells; M Norman Oliver Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-05-25 Impact factor: 4.254
Authors: John M Sung; Jeremy W Martin; Francis A Jefferson; Daniel A Sidhom; Keyhan Piranviseh; Melissa Huang; Nobel Nguyen; Jenny Chang; Argyrios Ziogas; Hoda Anton-Culver; Ramy F Youssef Journal: Clin Genitourin Cancer Date: 2019-05-31 Impact factor: 2.872
Authors: Ryan Morgan; Michael Cassidy; Susanna W L DeGeus; Jennifer Tseng; David McAneny; Teviah Sachs Journal: J Gastrointest Surg Date: 2018-08-10 Impact factor: 3.452
Authors: Andrew Rundle; Michelle Jankowski; Oleksandr N Kryvenko; Deliang Tang; Benjamin A Rybicki Journal: Cancer Epidemiol Biomarkers Prev Date: 2013-04-23 Impact factor: 4.254