Abstract
BackgroundPrevious 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.ResultsCancer 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.ConclusionsThe 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.
Highlights
Previous studies have demonstrated that cancer registrations and hospital discharge rate are closely correlated with census data-based socioeconomic deprivation indices
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
Previous studies have demonstrated that several aspects of health problems such as mortality of all causes, lung cancer registrations and hospital discharge rate were closely correlated with census data-based deprivation indices [2,4,5,15,16]
Summary
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). The study reported here was undertaken to test a specific hypothesis that the ratio of metastatic to non-metastatic cancer cases (lung, breast, prostate, female genital system, colorectal cancers or all types of cancers) would be positively correlated with the degree of socioeconomic deprivation among Texas counties. Identifying cancer in its relatively earlier non-metastatic stages leads to substantially higher success in treatment and fewer cancer deaths. Such a difference is likely to exist among communities with different levels of socioeconomic deprivation as measured by a deprivation index. Most Texas counties are classified as medically underserved with a limited infrastructure to support population health [8]
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