ArticleCancer2017
County-level cumulative environmental quality associated with cancer incidence.
Article in Cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 56 citations in OpenAlex.
- A Bayesian bivariate spatial modeling framework for stage-specific cancer incidence and targeting of screening efforts.American journal of epidemiology · 2026Article
- Assessing spatial disparities: a Bayesian linear regression approach.Biostatistics (Oxford, England) · 2025Article
- Impact of Environmental Quality on Pancreatic Cancer Outcomes Post Pancreatoduodenectomy: A Retrospective Cohort Study.Journal of gastrointestinal cancer · 2025Article
- Landscape analysis of environmental data sources for linkage with SEER cancer patients database.Journal of the National Cancer Institute. Monographs · 2024Article
- Associations between Structural Racism, Environmental Burden, and Cancer Rates: An Ecological Study of US Counties.Ethnicity & disease · 2024Article
- An exploratory analysis of the impact of area-level exposome on geographic disparities in aggressive prostate cancer.Scientific reports · 2024Article
- Geospatial Modeling Methods in Epidemiological Kidney Research: An Overview and Practical Example.Kidney international reports · 2024Review
- Cumulative environmental quality is associated with breast cancer incidence differentially by summary stage and urbanicity.Scientific reports · 2023Article
- Is gastroschisis associated with county-level socio-environmental quality during pregnancy?Birth defects research · 2023Article
- Creation and Evaluation of the Illinois Cancer Risk Index as a Predictor of Four Common Cancers.Preventing chronic disease · 2022Article
- A cross-sectional analysis of associations between environmental indices and asthma in U.S. counties from 2003 to 2012.Journal of exposure science & environmental epidemiology · 2022Article
- Factors Associated with Oral Cancerous and Precancerous Lesions in an Underserved Community: A Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Association between environmental quality and prostate cancer stage at diagnosis.Prostate cancer and prostatic diseases · 2021Article
- Relationship between Urban Green Spaces and Cancer: A Scoping Review.International journal of environmental research and public health · 2021Article
- Associations between cumulative environmental quality and ten selected birth defects in Texas.Birth defects research · 2021Article
- Identifying county-level factors for female breast cancer incidence rate through a large-scale population study.Applied geography (Sevenoaks, England) · 2020Article
- Environmental Quality and Invasive Breast Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020Article
- Cancer rates not explained by smoking: a county-level analysis.Environmental health : a global access science source · 2020Article
- Watershed integrity and associations with gastrointestinal illness in the United States.Journal of water and health · 2019Article
- Cancer risk from air toxics in relation to neighborhood isolation and sociodemographic characteristics: A spatial analysis of the St. Louis metropolitan area, USA.Environmental research · 2019Article
Corrections and comments
- Commented on by
- Erratum issuedErrata.2019
Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundIndividual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure of cumulative environmental exposures that occur in 5 domains.
methodsThe EQI was linked to county-level annual age-adjusted cancer incidence rates from the Surveillance, Epidemiology, and End Results (SEER) Program state cancer profiles. All-site cancer and the top 3 site-specific cancers for male and female subjects were considered. Incident rate differences (IRDs; annual rate difference per 100,000 persons) and 95% confidence intervals (CIs) were estimated using fixed-slope, random intercept multilevel linear regression models. Associations were assessed with domain-specific indices and analyses were stratified by rural/urban status.
resultsComparing the highest quintile/poorest environmental quality with the lowest quintile/best environmental quality for overall EQI, all-site county-level cancer incidence rate was positively associated with poor environmental quality overall (IRD, 38.55; 95% CI, 29.57-47.53) and for male (IRD, 32.60; 95% CI, 16.28-48.91) and female (IRD, 30.34; 95% CI, 20.47-40.21) subjects, indicating a potential increase in cancer incidence with decreasing environmental quality. Rural/urban stratified models demonstrated positive associations comparing the highest with the lowest quintiles for all strata, except the thinly populated/rural stratum and in the metropolitan/urbanized stratum. Prostate and breast cancer demonstrated the strongest positive associations with poor environmental quality.
conclusionWe observed strong positive associations between the EQI and all-site cancer incidence rates, and associations differed by rural/urban status and environmental domain. Research focusing on single environmental exposures in cancer development may not address the broader environmental context in which cancers develop, and future research should address cumulative environmental exposures. Cancer 2017;123:2901-8. © 2017 American Cancer Society.
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