Association between racial residential segregation and screening uptake for colorectal and cervical cancer among Black and White patients in five US health care systems.

Autor: Issaka RB; Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.; Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, Seattle, Washington, USA.; Division of Gastroenterology, University of Washington School of Medicine, Seattle, Washington, USA., Ibekwe LN; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Todd KW; Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA., Burnett-Hartman AN; Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.; Division of Cancer Control and Population Sciences, Epidemiology and Genomics Research Program, Clinical and Translational Epidemiology Branch, National Cancer Institute, Rockville, Maryland, USA., Clark CR; Division General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA., Del Vecchio NJ; Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA., Kamineni A; Department of Epidemiology, University of Washington, Seattle, Washington, USA., Neslund-Dudas C; Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, USA., Chubak J; Department of Epidemiology, University of Washington, Seattle, Washington, USA., Corley DA; Division of Research, Kaiser Permanente Northern California, Oakland, California, USA., Haas JS; Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Honda SA; Hawaii Permanente Medical Group and Center for Integrated Healthcare Research, Kaiser Permanente Hawaii, Honolulu, Hawaii, USA., Li CI; Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA., Winer RL; Department of Epidemiology, University of Washington, Seattle, Washington, USA.; Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA., Pruitt SL; Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2024 Aug 09. Date of Electronic Publication: 2024 Aug 09.
DOI: 10.1002/cncr.35514
Abstrakt: Background: Despite increased recognition that structural racism contributes to poorer health outcomes for racial and ethnic minorities, there are knowledge gaps about how current patterns of racial residential segregation are associated with cancer screening uptake. The authors examined associations between Black residential segregation and screening for colorectal cancer (CRC) and cervical cancer among non-Hispanic Black and non-Hispanic White adults.
Methods: This was a retrospective study of CRC and cervical cancer screening-eligible adults from five health care systems within the Population-Based Research to Optimize the Screening Process (PROSPR II) Consortium (cohort entry, 2010-2012). Residential segregation was measured using site-specific quartiles of the Black local isolation score (LIS). The outcome was receipt of CRC or cervical cancer screening within 3 years of cohort entry (2010-2015). Logistic regression was used to calculate associations between the LIS and screening completion, adjusting for patient-level covariates.
Results: Among CRC (n = 642,661) and cervical cancer (n = 163,340) screening-eligible patients, 456,526 (71.0%) and 106,124 (65.0%), respectively, received screening. Across PROSPR sites, living in neighborhoods with higher LIS tended to be associated with lower odds of CRC screening (Kaiser Permanente Northern California: adjusted odds ratio [aOR] LIS trend in Black patients, 0.95 [p < .001]; aOR LIS trend in White patients, 0.98 [p < .001]; Kaiser Permanente Southern California: aOR LIS trend in Black patients, 0.98 [p = .026]; aOR LIS trend in White patients, 1.01 [p = .023]; Kaiser Permanente Washington: aOR LIS trend in White patients, 0.97 [p = .002]. However, for cervical cancer screening, associations with the LIS varied by site and race (Kaiser Permanente Washington: aOR LIS trend in White patients, 0.95 [p < .001]; Mass General Brigham: aOR LIS trend in Black patients, 1.12 [p < .001]; aOR LIS trend in White patients, 1.03 [p < .001]).
Conclusions: Across five diverse health care systems, the direction of the association between Black residential segregation and screening varied by PROSPR site, race, and screening type. Additional research, including studies that examine multiple dimensions of segregation and structural racism using intersectional approaches, are needed to further disentangle these relationships.
(© 2024 American Cancer Society.)
Databáze: MEDLINE
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