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Correlation of the ratio of metastatic to non-metastatic cancer cases with the degree of socioeconomic deprivation among Texas counties.

Philips BU, Gong G, Hargrave KA, Belasco E, Lyford CP - Int J Health Geogr (2011)

Bottom Line: The ten socioeconomic status variables were subjected to the principal component analysis, and the first principal component scores were grouped into deciles for the WI (1 to 10) and the 254 Texas counties were classified into 10 corresponding groups.The ratios of metastatic to non-metastatic cases of all-type, female genital system and lung cancers at diagnosis were statistically correlated with socioeconomic deprivation.Potential mediators for the correlation warrant further investigation in order to reduce health disparities associated with socioeconomic inequality.

View Article: PubMed Central - HTML - PubMed

Affiliation: F, Marie Hall Institute for Rural Community Health, Texas Tech University Health Science Center, Lubbock, Texas 79430, USA. billy.philips@ttuhsc.edu

ABSTRACT

Background: Previous studies have demonstrated that cancer registrations and hospital discharge rate are closely correlated with census data-based socioeconomic deprivation indices. We hypothesized that communities with higher degrees of socioeconomic deprivation tend to have a higher ratio of metastatic to non-metastatic cancer cases (lung, breast, prostate, female genital system, colorectal cancers or all types of cancers combined). In this study, we investigate the potential link between this ratio and the Wellbeing Index (WI) among Texas counties.

Results: Cancer data in 2000 were provided by the Texas Cancer Registry, while data on the ten socioeconomic variables among the 254 Texas counties in 2000 for building the WI were obtained from U.S. Census Bureau. The ten socioeconomic status variables were subjected to the principal component analysis, and the first principal component scores were grouped into deciles for the WI (1 to 10) and the 254 Texas counties were classified into 10 corresponding groups. Weighted linear regression analyses and a Cochran-Armitage trend test were performed to determine the relationship between the ratio of age-adjusted metastatic to non-metastatic cancer incidence cases and WI. The ratios of metastatic to non-metastatic cases of female genital system cancer (r2 = 0.84, p = 0.0002), all-type cancers (r2= 0.73, p = 0.0017) and lung cancer (r2= 0.54, p = 0.0156) at diagnosis were positively correlated with WI.

Conclusions: The ratios of metastatic to non-metastatic cases of all-type, female genital system and lung cancers at diagnosis were statistically correlated with socioeconomic deprivation. Potential mediators for the correlation warrant further investigation in order to reduce health disparities associated with socioeconomic inequality.

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Ratio of metastatic to non-metastatic cases of lung-bronchial and colorectal cancer in relation to WI in 2000.
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Figure 3: Ratio of metastatic to non-metastatic cases of lung-bronchial and colorectal cancer in relation to WI in 2000.

Mentions: The ratio of metastatic to non-metastatic cases of the female genital system cancer (r2 = 0.839, p = 0.0002), all types of cancer (r2 = 0.728, p = 0.0017) and lung cancer (r2 = 0.539, p = 0.0156) were significantly and positively correlated with WI (Figure 2 and 3 and Table 2). These regressions exhibit relatively high r-squared measures, particularly for a single linear regression model. Similar results were obtained with Cochran-Armitage trend test in terms of statistical significance (Table 2). Notably, all county congregates with WI between 4 and 7 had a ratio of metastatic to non-metastatic cancer cases of female genital system greater than that of any county congregates with WI of 1 to 3, but lower than that of those with WI of 8-10 (Figure 2). Such a linear relationship was also apparent for the metastatic to non-metastatic ratio of all types of cancer combined (Figure 2). This ratio for lung cancer is conspicuously high among counties with a WI of 10 (Figure 3). After log transformation, the linear relationship between the ratio for lung cancer and WI was still significant (p < 0.0268). The ratios for breast, prostate or colorectal cancers were not significantly correlated with WI (blank diamond, circle, and triangle symbols connected with dashed lines in Figure 2 and 3) (p > 0.05). The test for the existence of spatial autocorrelation using Moran's I and Geary's C statistics fail to detect spatial correlation in all the regressions of interest in this study and are shown in table 3. Thus, adjacency of counties had no significant effect on the ratio of metastatic to non-metastatic cancer cases, supporting the use of our regression models without the use of spatial weighting matrix to control for spatial adjacency.


Correlation of the ratio of metastatic to non-metastatic cancer cases with the degree of socioeconomic deprivation among Texas counties.

Philips BU, Gong G, Hargrave KA, Belasco E, Lyford CP - Int J Health Geogr (2011)

Ratio of metastatic to non-metastatic cases of lung-bronchial and colorectal cancer in relation to WI in 2000.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3044097&req=5

Figure 3: Ratio of metastatic to non-metastatic cases of lung-bronchial and colorectal cancer in relation to WI in 2000.
Mentions: The ratio of metastatic to non-metastatic cases of the female genital system cancer (r2 = 0.839, p = 0.0002), all types of cancer (r2 = 0.728, p = 0.0017) and lung cancer (r2 = 0.539, p = 0.0156) were significantly and positively correlated with WI (Figure 2 and 3 and Table 2). These regressions exhibit relatively high r-squared measures, particularly for a single linear regression model. Similar results were obtained with Cochran-Armitage trend test in terms of statistical significance (Table 2). Notably, all county congregates with WI between 4 and 7 had a ratio of metastatic to non-metastatic cancer cases of female genital system greater than that of any county congregates with WI of 1 to 3, but lower than that of those with WI of 8-10 (Figure 2). Such a linear relationship was also apparent for the metastatic to non-metastatic ratio of all types of cancer combined (Figure 2). This ratio for lung cancer is conspicuously high among counties with a WI of 10 (Figure 3). After log transformation, the linear relationship between the ratio for lung cancer and WI was still significant (p < 0.0268). The ratios for breast, prostate or colorectal cancers were not significantly correlated with WI (blank diamond, circle, and triangle symbols connected with dashed lines in Figure 2 and 3) (p > 0.05). The test for the existence of spatial autocorrelation using Moran's I and Geary's C statistics fail to detect spatial correlation in all the regressions of interest in this study and are shown in table 3. Thus, adjacency of counties had no significant effect on the ratio of metastatic to non-metastatic cancer cases, supporting the use of our regression models without the use of spatial weighting matrix to control for spatial adjacency.

Bottom Line: The ten socioeconomic status variables were subjected to the principal component analysis, and the first principal component scores were grouped into deciles for the WI (1 to 10) and the 254 Texas counties were classified into 10 corresponding groups.The ratios of metastatic to non-metastatic cases of all-type, female genital system and lung cancers at diagnosis were statistically correlated with socioeconomic deprivation.Potential mediators for the correlation warrant further investigation in order to reduce health disparities associated with socioeconomic inequality.

View Article: PubMed Central - HTML - PubMed

Affiliation: F, Marie Hall Institute for Rural Community Health, Texas Tech University Health Science Center, Lubbock, Texas 79430, USA. billy.philips@ttuhsc.edu

ABSTRACT

Background: Previous studies have demonstrated that cancer registrations and hospital discharge rate are closely correlated with census data-based socioeconomic deprivation indices. We hypothesized that communities with higher degrees of socioeconomic deprivation tend to have a higher ratio of metastatic to non-metastatic cancer cases (lung, breast, prostate, female genital system, colorectal cancers or all types of cancers combined). In this study, we investigate the potential link between this ratio and the Wellbeing Index (WI) among Texas counties.

Results: Cancer data in 2000 were provided by the Texas Cancer Registry, while data on the ten socioeconomic variables among the 254 Texas counties in 2000 for building the WI were obtained from U.S. Census Bureau. The ten socioeconomic status variables were subjected to the principal component analysis, and the first principal component scores were grouped into deciles for the WI (1 to 10) and the 254 Texas counties were classified into 10 corresponding groups. Weighted linear regression analyses and a Cochran-Armitage trend test were performed to determine the relationship between the ratio of age-adjusted metastatic to non-metastatic cancer incidence cases and WI. The ratios of metastatic to non-metastatic cases of female genital system cancer (r2 = 0.84, p = 0.0002), all-type cancers (r2= 0.73, p = 0.0017) and lung cancer (r2= 0.54, p = 0.0156) at diagnosis were positively correlated with WI.

Conclusions: The ratios of metastatic to non-metastatic cases of all-type, female genital system and lung cancers at diagnosis were statistically correlated with socioeconomic deprivation. Potential mediators for the correlation warrant further investigation in order to reduce health disparities associated with socioeconomic inequality.

Show MeSH
Related in: MedlinePlus