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Using a socioeconomic position index to assess disparities in cancer incidence and mortality, Puerto Rico, 1995-2004.

Torres-Cintrón M, Ortiz AP, Ortiz-Ortiz KJ, Figueroa-Vallés NR, Pérez-Irizarry J, Díaz-Medina G, De la Torre-Feliciano T, Suárez-Pérez E - Prev Chronic Dis (2011)

Bottom Line: We used principal component and factor analysis methods to construct the SEP index at the municipality level.We calculated age-adjusted incidence and mortality for each SEP area and used rate ratios to evaluate the differences by SEP.In general, the incidence and mortality for cancers of the esophagus and stomach were higher for municipalities with the lowest SEP; in contrast, rates for breast, colorectal, kidney, pancreas, prostate, and thyroid were higher for areas with the highest SEP.

View Article: PubMed Central - PubMed

Affiliation: University of Puerto Rico Comprehensive Cancer Center, PMB #315 PO Box 70344, San Juan, PR. mtorres@rcpr.org

ABSTRACT

Introduction: Evaluation of the extent of socioeconomic inequalities in cancer incidence and mortality is essential to generate hypotheses in population health research and provides evidence for population-based strategies for comprehensive cancer control. The objective of this study was to create an area-based socioeconomic position (SEP) index to assess possible socioeconomic disparities in incidence and mortality of selected cancers in Puerto Rico.

Methods: Data for cancer incidence and mortality from 1995 to 2004 were obtained from the Puerto Rico Central Cancer Registry and the Puerto Rico Department of Health, and Puerto Rico socioeconomic data were obtained from the US Census 2000. We used principal component and factor analysis methods to construct the SEP index at the municipality level. We calculated age-adjusted incidence and mortality for each SEP area and used rate ratios to evaluate the differences by SEP.

Results: Incidence and mortality of cancer in Puerto Rico varied by SEP area. In general, the incidence and mortality for cancers of the esophagus and stomach were higher for municipalities with the lowest SEP; in contrast, rates for breast, colorectal, kidney, pancreas, prostate, and thyroid were higher for areas with the highest SEP.

Conclusion: These results highlight cancer disparities in Puerto Rico by SEP level that warrant further research.

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Related in: MedlinePlus

Municipalities by socioeconomic position (SEP) index, Puerto Rico, 2000. SEP 1 is the lowest socioeconomic position, and SEP 5 is the highest socioeconomic position. See Methods for calculations used to derive SEP scores.
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Figure 1: Municipalities by socioeconomic position (SEP) index, Puerto Rico, 2000. SEP 1 is the lowest socioeconomic position, and SEP 5 is the highest socioeconomic position. See Methods for calculations used to derive SEP scores.

Mentions: After we computed the socioeconomic index for each municipality, we defined 5 categories using the quintiles to set the scale boundaries, where SEP 1 represents the lowest socioeconomic level and the SEP 5 represents the highest socioeconomic level (Figure). Then, we calculated age-adjusted incidence and mortality for each SEP level and analyzed them in 2 periods (1995-1999 and 2000-2004), by sex and for overall cancer and selected cancer sites. We also calculated standardized rate ratios to evaluate the relative differences between the SEP levels. Significance was set at P < .05. We present data only for the comparison of the 2 extreme socioeconomic categories (SEP 1 vs SEP 5, reference group). We omit results for categories containing fewer than 15 cases. Rates were per 100,000 and age-adjusted to the Puerto Rico population according to the Census 2000.


Using a socioeconomic position index to assess disparities in cancer incidence and mortality, Puerto Rico, 1995-2004.

Torres-Cintrón M, Ortiz AP, Ortiz-Ortiz KJ, Figueroa-Vallés NR, Pérez-Irizarry J, Díaz-Medina G, De la Torre-Feliciano T, Suárez-Pérez E - Prev Chronic Dis (2011)

Municipalities by socioeconomic position (SEP) index, Puerto Rico, 2000. SEP 1 is the lowest socioeconomic position, and SEP 5 is the highest socioeconomic position. See Methods for calculations used to derive SEP scores.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3298767&req=5

Figure 1: Municipalities by socioeconomic position (SEP) index, Puerto Rico, 2000. SEP 1 is the lowest socioeconomic position, and SEP 5 is the highest socioeconomic position. See Methods for calculations used to derive SEP scores.
Mentions: After we computed the socioeconomic index for each municipality, we defined 5 categories using the quintiles to set the scale boundaries, where SEP 1 represents the lowest socioeconomic level and the SEP 5 represents the highest socioeconomic level (Figure). Then, we calculated age-adjusted incidence and mortality for each SEP level and analyzed them in 2 periods (1995-1999 and 2000-2004), by sex and for overall cancer and selected cancer sites. We also calculated standardized rate ratios to evaluate the relative differences between the SEP levels. Significance was set at P < .05. We present data only for the comparison of the 2 extreme socioeconomic categories (SEP 1 vs SEP 5, reference group). We omit results for categories containing fewer than 15 cases. Rates were per 100,000 and age-adjusted to the Puerto Rico population according to the Census 2000.

Bottom Line: We used principal component and factor analysis methods to construct the SEP index at the municipality level.We calculated age-adjusted incidence and mortality for each SEP area and used rate ratios to evaluate the differences by SEP.In general, the incidence and mortality for cancers of the esophagus and stomach were higher for municipalities with the lowest SEP; in contrast, rates for breast, colorectal, kidney, pancreas, prostate, and thyroid were higher for areas with the highest SEP.

View Article: PubMed Central - PubMed

Affiliation: University of Puerto Rico Comprehensive Cancer Center, PMB #315 PO Box 70344, San Juan, PR. mtorres@rcpr.org

ABSTRACT

Introduction: Evaluation of the extent of socioeconomic inequalities in cancer incidence and mortality is essential to generate hypotheses in population health research and provides evidence for population-based strategies for comprehensive cancer control. The objective of this study was to create an area-based socioeconomic position (SEP) index to assess possible socioeconomic disparities in incidence and mortality of selected cancers in Puerto Rico.

Methods: Data for cancer incidence and mortality from 1995 to 2004 were obtained from the Puerto Rico Central Cancer Registry and the Puerto Rico Department of Health, and Puerto Rico socioeconomic data were obtained from the US Census 2000. We used principal component and factor analysis methods to construct the SEP index at the municipality level. We calculated age-adjusted incidence and mortality for each SEP area and used rate ratios to evaluate the differences by SEP.

Results: Incidence and mortality of cancer in Puerto Rico varied by SEP area. In general, the incidence and mortality for cancers of the esophagus and stomach were higher for municipalities with the lowest SEP; in contrast, rates for breast, colorectal, kidney, pancreas, prostate, and thyroid were higher for areas with the highest SEP.

Conclusion: These results highlight cancer disparities in Puerto Rico by SEP level that warrant further research.

Show MeSH
Related in: MedlinePlus