ArticleCancer epidemiology2021
County-level characteristics associated with incidence, late-stage incidence, and mortality from screenable cancers.
Article in Cancer epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 21 citations in OpenAlex.
- Residential segregation and late-stage colorectal cancer in the United States: a population-based study of 1.2 million adults.American journal of epidemiology · 2026Article
- Colorectal Cancer-One Disease, Two Fires: Distinct Inflammatory Landscapes in Colon and Rectal Cancer.Diagnostics (Basel, Switzerland) · 2025Article
- Spatial analysis of colorectal cancer outcomes: investigating the impact of place-specific factors using causal inference methods for spatial data.Journal of public health (Oxford, England) · 2025Article
- Influence of residential segregation and health provider density on advanced stage endometrial cancer diagnoses.Gynecologic oncology · 2025Article
- Travel burden and bypassing closest site for surgical cancer treatment for urban and rural oncology patients.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Structural Racism in Cervical Cancer Care and Survival Outcomes: A Systematic Review of Inequities and Barriers.Current epidemiology reports · 2025Review
- Breast cancer screening coverage is severely reduced among women who reside in segregated areas: a cross-sectional investigation in Hungary.Frontiers in public health · 2025Article
- Association Between Social Vulnerability and Gastrointestinal Cancer Mortality in the United States Counties.Gastro hep advances · 2024Article
- Tools to Measure the Impact of Structural Racism and Discrimination on Gastrointestinal and Hepatology Disease Outcomes: A Scoping Review.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Cancer Epidemiology in the Northeastern United States (2013-2017).Cancer research communications · 2023Article
- Impact of the COVID-19 pandemic on cancer patients in western Pennsylvania: rural-urban disparities.Cancer causes & control : CCC · 2023Article
- Small-Area Geographic and Socioeconomic Inequalities in Colorectal Cancer in Cyprus.International journal of environmental research and public health · 2022Article
- Post-Acquisition HyperpolarizedDiagnostics (Basel, Switzerland) · 2022Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCancer screening differs by rurality and racial residential segregation, but the relationship between these county-level characteristics is understudied. Understanding this relationship and its implications for cancer outcomes could inform interventions to decrease cancer disparities.
methodsWe linked county-level information from national data sources: 2008-2012 cancer incidence, late-stage incidence, and mortality rates (for breast, cervical, and colorectal cancer) from U.S. Cancer Statistics and the National Death Index; metropolitan status from U.S. Department of Agriculture; residential segregation derived from American Community Survey; and prevalence of cancer screening from National Cancer Institute's Small Area Estimates. We used multivariable, sparse Poisson generalized linear mixed models to assess cancer incidence, late-stage incidence, and mortality rates by county-level characteristics, controlling for density of physicians and median household income.
resultsCancer incidence, late-stage incidence, and mortality rates were 6-18% lower in metropolitan counties for breast and colorectal cancer, and 2-4% lower in more segregated counties for breast and colorectal cancer. Generally, reductions in cancer associated with residential segregation were limited to non-metropolitan counties. Cancer incidence, late-stage incidence, and mortality rates were associated with screening, with rates for corresponding cancers that were 2-9% higher in areas with more breast and colorectal screening, but 2-15% lower in areas with more cervical screening. DISCUSSION: Lower cancer burden was observed in counties that were metropolitan and more segregated. Effect modification was observed by metropolitan status and county-level residential segregation, indicating that residential segregation may impact healthcare access differently in different county types. Additional studies are needed to inform interventions to reduce county-level disparities in cancer incidence, late-stage incidence, and mortality.
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