Area Deprivation Index and Rurality in Relation to Lung Cancer Prevalence and Mortality in a Rural State.

Autor:	Fairfield KM; Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME 04101, USA., Black AW; Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME 04101, USA., Ziller EC; Muskie School of Public Service, University of Southern Maine, Portland, ME 04101, USA., Murray K; Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME 04101, USA., Lucas FL; Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME 04101, USA., Waterston LB; Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME 04101, USA., Korsen N; Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME 04101, USA., Ineza D; Bowdoin College, Brunswick, ME 04011, USA., Han PKJ; Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME 04101, USA.
Jazyk:	angličtina
Zdroj:	JNCI cancer spectrum [JNCI Cancer Spectr] 2020 Mar 07; Vol. 4 (4), pp. pkaa011. Date of Electronic Publication: 2020 Mar 07 (Print Publication: 2020).
DOI:	10.1093/jncics/pkaa011
Abstrakt:	Background: We sought to describe lung cancer prevalence and mortality in relation to socioeconomic deprivation and rurality. Methods: We conducted a population-based cross-sectional analysis of prevalent lung cancers from a statewide all-payer claims dataset from 2012 to 2016, lung cancer deaths in Maine from the state death registry from 2012 to 2016, rurality, and area deprivation index (ADI), a geographic area-based measure of socioeconomic deprivation. Analyses examined rate ratios for lung cancer prevalence and mortality according to rurality (small and isolated rural, large rural, or urban) and ADI (quintiles, with highest reflecting the most deprivation) and after adjusting for age, sex, and area-level smoking rates as determined by the Behavioral Risk Factor Surveillance System. Results: Among 1 223 006 adults aged 20 years and older during the 5-year observation period, 8297 received lung cancer care, and 4616 died. Lung cancer prevalence and mortality were positively associated with increasing rurality, but these associations did not persist after adjusting for age, sex, and smoking rates. Lung cancer prevalence and mortality were positively associated with increasing ADI in models adjusted for age, sex, and smoking rates (prevalence rate ratio for ADI quintile 5 compared with quintile 1 = 1.41, 95% confidence interval [CI] =1.30 to 1.54) and mortality rate ratio = 1.59, 95% CI = 1.41 to 1.79). Conclusion: Socioeconomic deprivation, but not rurality, was associated with higher lung cancer prevalence and mortality. Interventions should target populations with socioeconomic deprivation, rather than rurality per se, and aim to reduce lung cancer risk via tobacco treatment and control interventions and to improve patient access to lung cancer prevention, screening, and treatment services. (© The Author(s) 2020. Published by Oxford University Press.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu