Limits...
The impact of preventive screening resource distribution on geographic and population-based disparities in colorectal cancer in Mississippi.

Faruque FS, Zhang X, Nichols EN, Bradley DL, Reeves-Darby R, Reeves-Darby V, Duhé RJ - BMC Res Notes (2015)

Bottom Line: Significant population-based and geographic disparities in CRC screening behaviors and CRC outcomes exist in Mississippi.The effects of CRC screening resources are related to CRC screening behaviors and outcomes at a regional level, whereas at the county level, socioeconomic factors are more strongly associated with CRC outcomes.Thus, effective control of CRC in rural states with high poverty levels requires both adequate preventive CRC screening capacity and a strategy to address fundamental causes of health care disparities.

View Article: PubMed Central - PubMed

Affiliation: GIS and Remote Sensing Program, University of Mississippi Medical Center, Jackson, MS, 39216-4505, USA. ffaruque@umc.edu.

ABSTRACT

Background: The state of Mississippi has the highest colorectal cancer (CRC) mortality rate in the USA. The geographic distribution of CRC screening resources and geographic- and population-based CRC characteristics in Mississippi are investigated to reveal the geographic disparity in CRC screening.

Methods: The primary practice sites of licensed gastroenterologists and the addresses of licensed medical facilities offering on-site colonoscopies were verified via telephone surveys, then these CRC screening resource data were geocoded and analyzed using Geographic Information Systems. Correlation analyses were performed to detect the strength of associations between CRC screening resources, CRC screening behavior and CRC outcome data.

Results: Age-adjusted colorectal cancer incidence rates, mortality rates, mortality-to-incidence ratios, and self-reported endoscopic screening rates from the years 2006 through 2010 were significantly different for Black and White Mississippians; Blacks fared worse than Whites in all categories throughout all nine Public Health Districts. CRC screening rates were negatively correlated with CRC incidence rates and CRC mortality rates. The availability of gastroenterologists varied tremendously throughout the state; regions with the poorest CRC outcomes tended to be underserved by gastroenterologists.

Conclusions: Significant population-based and geographic disparities in CRC screening behaviors and CRC outcomes exist in Mississippi. The effects of CRC screening resources are related to CRC screening behaviors and outcomes at a regional level, whereas at the county level, socioeconomic factors are more strongly associated with CRC outcomes. Thus, effective control of CRC in rural states with high poverty levels requires both adequate preventive CRC screening capacity and a strategy to address fundamental causes of health care disparities.

No MeSH data available.


Related in: MedlinePlus

Public Health District patterns of colon endoscopy use are inversely correlated with adverse colorectal cancer outcomes. Mississippi BRFSS Public Health District survey report data (http://msdh.ms.gov/brfss/index.htm) from Black Mississippians (blue dots) and White Mississippians (red crosses) were obtained from the District Reports for the years 2006, 2008 and 2010, then averaged and plotted along the abscissa. Panela The average age-adjusted CRC incidence rates from 2006 through 2010 for Black and White subsets were obtained from the Mississippi Cancer Registry for each of the nine Public Health Districts, then plotted on the ordinate. These Black and White subsets were subjected to a common Spearman rank correlation analysis to obtain a correlation coefficient of −0.800 (P < 0.0001). The P values associated with correlation coefficients were reported against the  hypothesis of no association. Panelb Average age-adjusted CRC mortality rates were obtained from the Mississippi Cancer Registry (http://www.cancer-rates.info/ms/index.php) for Black and White subsets from the years 2006 through 2010 for each of the nine Public Health Districts, then plotted along the ordinate. The Spearman rank correlation coefficient between these two variables was −0.796 (P < 0.0001)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4562344&req=5

Fig1: Public Health District patterns of colon endoscopy use are inversely correlated with adverse colorectal cancer outcomes. Mississippi BRFSS Public Health District survey report data (http://msdh.ms.gov/brfss/index.htm) from Black Mississippians (blue dots) and White Mississippians (red crosses) were obtained from the District Reports for the years 2006, 2008 and 2010, then averaged and plotted along the abscissa. Panela The average age-adjusted CRC incidence rates from 2006 through 2010 for Black and White subsets were obtained from the Mississippi Cancer Registry for each of the nine Public Health Districts, then plotted on the ordinate. These Black and White subsets were subjected to a common Spearman rank correlation analysis to obtain a correlation coefficient of −0.800 (P < 0.0001). The P values associated with correlation coefficients were reported against the hypothesis of no association. Panelb Average age-adjusted CRC mortality rates were obtained from the Mississippi Cancer Registry (http://www.cancer-rates.info/ms/index.php) for Black and White subsets from the years 2006 through 2010 for each of the nine Public Health Districts, then plotted along the ordinate. The Spearman rank correlation coefficient between these two variables was −0.796 (P < 0.0001)

Mentions: Correlation analyses were then performed on Black and White subset data to determine whether the use of CRC screening via colonoscopy or sigmoidoscopy affected the primary CRC outcomes of incidence or mortality. A strong negative correlation (r = −0.800) was observed between the age-adjusted CRC incidence rate and percentage of individuals aged 50 years or older who reported having ever received a colonoscopy or flexible sigmoidoscopy (Fig. 1 panel a). Similarly, a strong negative correlation (r = −0.796) was also observed between age-adjusted CRC mortality rates and the percentage of screening-eligible individuals who reported having such endoscopic CRC screens (Fig. 1 panel b).Fig. 1


The impact of preventive screening resource distribution on geographic and population-based disparities in colorectal cancer in Mississippi.

Faruque FS, Zhang X, Nichols EN, Bradley DL, Reeves-Darby R, Reeves-Darby V, Duhé RJ - BMC Res Notes (2015)

Public Health District patterns of colon endoscopy use are inversely correlated with adverse colorectal cancer outcomes. Mississippi BRFSS Public Health District survey report data (http://msdh.ms.gov/brfss/index.htm) from Black Mississippians (blue dots) and White Mississippians (red crosses) were obtained from the District Reports for the years 2006, 2008 and 2010, then averaged and plotted along the abscissa. Panela The average age-adjusted CRC incidence rates from 2006 through 2010 for Black and White subsets were obtained from the Mississippi Cancer Registry for each of the nine Public Health Districts, then plotted on the ordinate. These Black and White subsets were subjected to a common Spearman rank correlation analysis to obtain a correlation coefficient of −0.800 (P < 0.0001). The P values associated with correlation coefficients were reported against the  hypothesis of no association. Panelb Average age-adjusted CRC mortality rates were obtained from the Mississippi Cancer Registry (http://www.cancer-rates.info/ms/index.php) for Black and White subsets from the years 2006 through 2010 for each of the nine Public Health Districts, then plotted along the ordinate. The Spearman rank correlation coefficient between these two variables was −0.796 (P < 0.0001)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4562344&req=5

Fig1: Public Health District patterns of colon endoscopy use are inversely correlated with adverse colorectal cancer outcomes. Mississippi BRFSS Public Health District survey report data (http://msdh.ms.gov/brfss/index.htm) from Black Mississippians (blue dots) and White Mississippians (red crosses) were obtained from the District Reports for the years 2006, 2008 and 2010, then averaged and plotted along the abscissa. Panela The average age-adjusted CRC incidence rates from 2006 through 2010 for Black and White subsets were obtained from the Mississippi Cancer Registry for each of the nine Public Health Districts, then plotted on the ordinate. These Black and White subsets were subjected to a common Spearman rank correlation analysis to obtain a correlation coefficient of −0.800 (P < 0.0001). The P values associated with correlation coefficients were reported against the hypothesis of no association. Panelb Average age-adjusted CRC mortality rates were obtained from the Mississippi Cancer Registry (http://www.cancer-rates.info/ms/index.php) for Black and White subsets from the years 2006 through 2010 for each of the nine Public Health Districts, then plotted along the ordinate. The Spearman rank correlation coefficient between these two variables was −0.796 (P < 0.0001)
Mentions: Correlation analyses were then performed on Black and White subset data to determine whether the use of CRC screening via colonoscopy or sigmoidoscopy affected the primary CRC outcomes of incidence or mortality. A strong negative correlation (r = −0.800) was observed between the age-adjusted CRC incidence rate and percentage of individuals aged 50 years or older who reported having ever received a colonoscopy or flexible sigmoidoscopy (Fig. 1 panel a). Similarly, a strong negative correlation (r = −0.796) was also observed between age-adjusted CRC mortality rates and the percentage of screening-eligible individuals who reported having such endoscopic CRC screens (Fig. 1 panel b).Fig. 1

Bottom Line: Significant population-based and geographic disparities in CRC screening behaviors and CRC outcomes exist in Mississippi.The effects of CRC screening resources are related to CRC screening behaviors and outcomes at a regional level, whereas at the county level, socioeconomic factors are more strongly associated with CRC outcomes.Thus, effective control of CRC in rural states with high poverty levels requires both adequate preventive CRC screening capacity and a strategy to address fundamental causes of health care disparities.

View Article: PubMed Central - PubMed

Affiliation: GIS and Remote Sensing Program, University of Mississippi Medical Center, Jackson, MS, 39216-4505, USA. ffaruque@umc.edu.

ABSTRACT

Background: The state of Mississippi has the highest colorectal cancer (CRC) mortality rate in the USA. The geographic distribution of CRC screening resources and geographic- and population-based CRC characteristics in Mississippi are investigated to reveal the geographic disparity in CRC screening.

Methods: The primary practice sites of licensed gastroenterologists and the addresses of licensed medical facilities offering on-site colonoscopies were verified via telephone surveys, then these CRC screening resource data were geocoded and analyzed using Geographic Information Systems. Correlation analyses were performed to detect the strength of associations between CRC screening resources, CRC screening behavior and CRC outcome data.

Results: Age-adjusted colorectal cancer incidence rates, mortality rates, mortality-to-incidence ratios, and self-reported endoscopic screening rates from the years 2006 through 2010 were significantly different for Black and White Mississippians; Blacks fared worse than Whites in all categories throughout all nine Public Health Districts. CRC screening rates were negatively correlated with CRC incidence rates and CRC mortality rates. The availability of gastroenterologists varied tremendously throughout the state; regions with the poorest CRC outcomes tended to be underserved by gastroenterologists.

Conclusions: Significant population-based and geographic disparities in CRC screening behaviors and CRC outcomes exist in Mississippi. The effects of CRC screening resources are related to CRC screening behaviors and outcomes at a regional level, whereas at the county level, socioeconomic factors are more strongly associated with CRC outcomes. Thus, effective control of CRC in rural states with high poverty levels requires both adequate preventive CRC screening capacity and a strategy to address fundamental causes of health care disparities.

No MeSH data available.


Related in: MedlinePlus