Cathy J Bradley1,2,3, Amy Anderson-Mellies4, Evelinn A Borrayo4,5, Jennifer Anne Doherty6,7, Omar A Escontrías8, David O Garcia9,10, Shiraz I Mishra11,12, Andrew L Sussman11,13, Cynthia A Thomson9,10, David W Wetter6,7, Linda S Cook11,14. 1. University of Colorado Comprehensive Cancer Center, Aurora, CO, USA. cathy.bradley@cuanschutz.edu. 2. Colorado School of Public Health, University of Colorado, Aurora, CO, USA. cathy.bradley@cuanschutz.edu. 3. University of Colorado Cancer Center, Mail Stop B119, 13001 E. 17th Place, Bldg. 500, Room N6203L, Aurora, CO, 80045, USA. cathy.bradley@cuanschutz.edu. 4. University of Colorado Comprehensive Cancer Center, Aurora, CO, USA. 5. Colorado School of Public Health, University of Colorado, Aurora, CO, USA. 6. Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA. 7. Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA. 8. ConTrías Policy Associates, LLC, Washington, DC, USA. 9. University of Arizona Cancer Center, Tucson, AZ, USA. 10. Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA. 11. Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA. 12. Department of Pediatrics and Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA. 13. Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA. 14. Division of Epidemiology, Biostatistics, and Preventive Medicine,, Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
Abstract
PURPOSE: National Cancer Institute (NCI)-Designated Cancer Centers are required to assess and address the needs of their catchments. In rural regions, catchment areas are vast, populations small, and infrastructure for data capture limited, making analyses of cancer patterns challenging. METHODS: The four NCI-Designated Comprehensive Cancer Centers in the southern Rocky Mountain region formed the Four Corners Collaboration (4C2) to address these challenges. Colorectal cancer (CRC) was identified as a disease site where disparities exist. The 4C2 leaders examined how geographic and sociodemographic characteristics were correlated to stage at diagnosis and survival in the region and compared those relationships to a sample from the surveillance, epidemiology, and end results (SEER) program. RESULTS: In 4C2, Hispanics were more likely to live in socioeconomically disadvantaged areas relative to their counterparts in the SEER program. These residency patterns were positively correlated with later stage diagnosis and higher mortality. Living in an area with high-income inequality was positively associated with mortality for Non-Hispanic whites in 4C2. In SEER, Hispanics had a slightly higher likelihood of distant stage disease, and disadvantaged socioeconomic status was associated with poor survival. CONCLUSION: CRC interventions in 4C2 will target socioeconomically disadvantaged areas, especially those with higher income inequality, to improve outcomes among Hispanics and Non-Hispanic whites. The collaboration demonstrates how bringing NCI-Designated Cancer Centers together to identify and address common population catchment issues provides opportunity for pooled analyses of small, but important populations, and thus, capitalize on synergies among researchers to reduce cancer disparities.
PURPOSE: National Cancer Institute (NCI)-Designated Cancer Centers are required to assess and address the needs of their catchments. In rural regions, catchment areas are vast, populations small, and infrastructure for data capture limited, making analyses of cancer patterns challenging. METHODS: The four NCI-Designated Comprehensive Cancer Centers in the southern Rocky Mountain region formed the Four Corners Collaboration (4C2) to address these challenges. Colorectal cancer (CRC) was identified as a disease site where disparities exist. The 4C2 leaders examined how geographic and sociodemographic characteristics were correlated to stage at diagnosis and survival in the region and compared those relationships to a sample from the surveillance, epidemiology, and end results (SEER) program. RESULTS: In 4C2, Hispanics were more likely to live in socioeconomically disadvantaged areas relative to their counterparts in the SEER program. These residency patterns were positively correlated with later stage diagnosis and higher mortality. Living in an area with high-income inequality was positively associated with mortality for Non-Hispanic whites in 4C2. In SEER, Hispanics had a slightly higher likelihood of distant stage disease, and disadvantaged socioeconomic status was associated with poor survival. CONCLUSION: CRC interventions in 4C2 will target socioeconomically disadvantaged areas, especially those with higher income inequality, to improve outcomes among Hispanics and Non-Hispanic whites. The collaboration demonstrates how bringing NCI-Designated Cancer Centers together to identify and address common population catchment issues provides opportunity for pooled analyses of small, but important populations, and thus, capitalize on synergies among researchers to reduce cancer disparities.
Authors: Nirmala P Narla; Maria R Pardo-Crespo; Timothy J Beebe; Jeff Sloan; Barbara Yawn; Arthur R Williams; Young J Juhn Journal: J Health Care Poor Underserved Date: 2015-11
Authors: Maria R Pardo-Crespo; Nirmala Priya Narla; Arthur R Williams; Timothy J Beebe; Jeff Sloan; Barbara P Yawn; Philip H Wheeler; Young J Juhn Journal: J Epidemiol Community Health Date: 2013-01-15 Impact factor: 3.710
Authors: Richard M Hoffman; David K Espey; Robert L Rhyne; Melissa Gonzales; Ashwani Rajput; Shiraz I Mishra; S Noell Stone; Charles L Wiggins Journal: J Cancer Epidemiol Date: 2014-01-02