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Suburbanisation of oral cavity cancers: evidence from a geographically-explicit observational study of incidence trends in British Columbia, Canada, 1981-2010.

Walker BB, Schuurman N, Auluck A, Lear SA, Rosin M - BMC Public Health (2015)

Bottom Line: Suburban cases were found to comprise a growing proportion of OCC incidence.In effect, OCC concentrations have dispersed from dense urban cores to suburban neighbourhoods in recent decades.New suburban concentrations of incidence were found in neighbourhoods with a high proportion of persons aged 65+ and/or born in India, China, or Taiwan.

View Article: PubMed Central - PubMed

Affiliation: Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. bwalker@sfu.ca.

ABSTRACT

Background: Recent studies have demonstrated an elevated risk of oral cavity cancers (OCC) among socioeconomically deprived populations, whose increasing presence in suburban neighbourhoods poses unique challenges for equitable health service delivery. The majority of studies to date have utilised aspatial methods to identify OCC. In this study, we use high-resolution geographical analyses to identify spatio-temporal trends in OCC incidence, emphasising the value of geospatial methods for public health research.

Methods: Using province-wide population incidence data from the British Columbia Cancer Registry (1981-2009, N = 5473), we classify OCC cases by census-derived neighbourhood types to differentiate between urban, suburban, and rural residents at the time of diagnosis. We map geographical concentrations by decade and contrast trends in age-adjusted incidence rates, comparing the results to an index of socioeconomic deprivation.

Results: Suburban cases were found to comprise a growing proportion of OCC incidence. In effect, OCC concentrations have dispersed from dense urban cores to suburban neighbourhoods in recent decades. Significantly higher age-adjusted oral cancer incidence rates are observed in suburban neighbourhoods from 2006 to 2009, accompanied by rising socioeconomic deprivation in those areas. New suburban concentrations of incidence were found in neighbourhoods with a high proportion of persons aged 65+ and/or born in India, China, or Taiwan.

Conclusions: While the aging of suburban populations provides some explanation of these trends, we highlight the role of the suburbanisation of socioeconomically deprived and Asia-born populations, known to have higher rates of risk behaviours such as tobacco, alcohol, and betel/areca consumption. Specifically, betel/areca consumption among Asia-born populations is suspected to be a primary driver of the observed geographical shift in incidence from urban cores to suburban neighbourhoods. We suggest that such geographically-informed findings are complementary to potential and existing place-specific cancer control policy and targeting prevention efforts for high-risk sub-populations, and call for the supplementation of epidemiological studies with high-resolution mapping and geospatial analysis.

No MeSH data available.


Related in: MedlinePlus

Age-adjusted incidence rates (per 500 000 person-years, in five-year intervals) by neighbourhood type, illustrating the shift in incidence from urban cores outwards to the suburbs
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Fig3: Age-adjusted incidence rates (per 500 000 person-years, in five-year intervals) by neighbourhood type, illustrating the shift in incidence from urban cores outwards to the suburbs

Mentions: AAIRs for OCC are shown in Table 2 and Fig. 3. A divergence between urban, suburban, and rural incidence rates is observed following the 1986–1990 5-year period. The steady decline in urban rates is contrasted by increases in rural and suburban incidence. The divergent trend in age-adjusted incidence rates confirms the observed trend of fewer case concentrations in dense urban cores accompanied by increasing incidence in rural/suburban areas, supporting our mapped findings.Table 2


Suburbanisation of oral cavity cancers: evidence from a geographically-explicit observational study of incidence trends in British Columbia, Canada, 1981-2010.

Walker BB, Schuurman N, Auluck A, Lear SA, Rosin M - BMC Public Health (2015)

Age-adjusted incidence rates (per 500 000 person-years, in five-year intervals) by neighbourhood type, illustrating the shift in incidence from urban cores outwards to the suburbs
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4528809&req=5

Fig3: Age-adjusted incidence rates (per 500 000 person-years, in five-year intervals) by neighbourhood type, illustrating the shift in incidence from urban cores outwards to the suburbs
Mentions: AAIRs for OCC are shown in Table 2 and Fig. 3. A divergence between urban, suburban, and rural incidence rates is observed following the 1986–1990 5-year period. The steady decline in urban rates is contrasted by increases in rural and suburban incidence. The divergent trend in age-adjusted incidence rates confirms the observed trend of fewer case concentrations in dense urban cores accompanied by increasing incidence in rural/suburban areas, supporting our mapped findings.Table 2

Bottom Line: Suburban cases were found to comprise a growing proportion of OCC incidence.In effect, OCC concentrations have dispersed from dense urban cores to suburban neighbourhoods in recent decades.New suburban concentrations of incidence were found in neighbourhoods with a high proportion of persons aged 65+ and/or born in India, China, or Taiwan.

View Article: PubMed Central - PubMed

Affiliation: Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. bwalker@sfu.ca.

ABSTRACT

Background: Recent studies have demonstrated an elevated risk of oral cavity cancers (OCC) among socioeconomically deprived populations, whose increasing presence in suburban neighbourhoods poses unique challenges for equitable health service delivery. The majority of studies to date have utilised aspatial methods to identify OCC. In this study, we use high-resolution geographical analyses to identify spatio-temporal trends in OCC incidence, emphasising the value of geospatial methods for public health research.

Methods: Using province-wide population incidence data from the British Columbia Cancer Registry (1981-2009, N = 5473), we classify OCC cases by census-derived neighbourhood types to differentiate between urban, suburban, and rural residents at the time of diagnosis. We map geographical concentrations by decade and contrast trends in age-adjusted incidence rates, comparing the results to an index of socioeconomic deprivation.

Results: Suburban cases were found to comprise a growing proportion of OCC incidence. In effect, OCC concentrations have dispersed from dense urban cores to suburban neighbourhoods in recent decades. Significantly higher age-adjusted oral cancer incidence rates are observed in suburban neighbourhoods from 2006 to 2009, accompanied by rising socioeconomic deprivation in those areas. New suburban concentrations of incidence were found in neighbourhoods with a high proportion of persons aged 65+ and/or born in India, China, or Taiwan.

Conclusions: While the aging of suburban populations provides some explanation of these trends, we highlight the role of the suburbanisation of socioeconomically deprived and Asia-born populations, known to have higher rates of risk behaviours such as tobacco, alcohol, and betel/areca consumption. Specifically, betel/areca consumption among Asia-born populations is suspected to be a primary driver of the observed geographical shift in incidence from urban cores to suburban neighbourhoods. We suggest that such geographically-informed findings are complementary to potential and existing place-specific cancer control policy and targeting prevention efforts for high-risk sub-populations, and call for the supplementation of epidemiological studies with high-resolution mapping and geospatial analysis.

No MeSH data available.


Related in: MedlinePlus