Abstract
BackgroundNo study has been conducted to investigate the spatial pattern and association of socioeconomic status (such as income) with breast and colorectal cancer incidence in Texas, United States. This study aimed to determine whether median household income was associated with the risk of developing breast and colorectal cancer in Texas and to identify higher cancer risks by race/ethnicity and geographic areas.MethodsThis was a retrospective cohort study with an ecological component in using aggregated measures at the county level. We identified 243,677 women with breast cancer and 155,534 men and women with colorectal cancer residing in 254 counties in Texas in 1995–2011 from the public-use dataset of Texas Cancer Registry. The denominator population and median household income at the county level was obtained from the U.S. Bureau of the Census. Cancer incidence rates were calculated as number of cases per 100,000 persons and age-adjusted using the 2000 US population data. We used the ArcGIS v10.1 (geographic information system software) to identify multiple clustered counties with high and low cancer incidences in Texas.ResultsAge-adjusted breast cancer incidence rate in the highest median income quintile group was 151.51 cases per 100,000 in 2008–2011 as compared to 98.95 cases per 100,000 in the lowest median income quintile group. The risk of colorectal cancer appeared to decrease with increasing median income in racial/ethnic population. Spatial analysis revealed the significant low breast cancer incidence cluster regions located in southwest US-Mexico border counties in Texas.ConclusionsThis study demonstrated that higher income was associated with an increased risk of breast cancer and a decreased risk of colorectal cancer in Texas. There were geographic variations with cancer incidence clustered in high risk areas in Texas. Future studies may need to explore more factors that might explain income and cancer risk associations and their geographic variations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2324-z) contains supplementary material, which is available to authorized users.
Highlights
No study has been conducted to investigate the spatial pattern and association of socioeconomic status with breast and colorectal cancer incidence in Texas, United States
A comprehensive review of socioeconomic status (SES) related to breast and colorectal cancer in 11 registries of Surveillance, Epidemiology, and End Results (SEER) Program showed the similar findings of an increased breast cancer incidence and a decreased colorectal incidence with higher SES [5, 11, 14]
There was a significant association between breast cancer incidence and median household income level
Summary
No study has been conducted to investigate the spatial pattern and association of socioeconomic status (such as income) with breast and colorectal cancer incidence in Texas, United States. Previous studies have used spatial pattern analysis to identify areas with high breast [15,16,17,18] and colorectal [19, 20] cancer incidence associated with socioeconomic factor. No study has been conducted to investigate the spatial pattern and association of SES with breast and colorectal cancer incidence in Texas. This study used the Texas Cancer Registry (TCR) database to determine the association of median household income with breast and colorectal cancer incidence rates from 1995 to 2011 in Texas [22]. Because individual level SES data were not available, group level SES data were frequently used to examine its association with cancer risk in the U.S and in Europe [16, 20, 24,25,26]
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