Objectives: To assess the relationship between socioeconomic status (SES) and late stage breast cancer using the cluster detection software SaTScan and U.S. census -derived areabased socioeconomic measures. Materials and Methods: Florida's 18,683 women diagnosed with late stage breast cancer (regional or distant stage) between 1998 and 2002 as identified by Florida's population -based, statewide, incidence registry were analyzed by SaTScan to identify areas of higher-than-expected incidence. The relationship between SES and late stage breast cancer was assessed at the neighborhood (block group) level by combining the SaTScan results with area-based SES data. Results: SaTScan identified 767 of Florida's 9,112 block groups that had higher-than-expected incidence of late stage breast cancer. After controlling for patient level insurance status, county level mammography prevalence, and urban/rural residence in the logistic regression model, women living in neighborhoods of severe and near poverty were respectively 3.0 and 1.6 times more likely to live in areas of higher-than-expected incidence of late stage breast cancer when compared with women living in nonpoverty. Additionally, areas in the lowest quartile of mammography usage were almost seven times more likely to have higher-than-expected incidence than areas in the higher quartiles. Conclusions: In addition to confirming the importance of mammography, results from the present study suggest that ''where'' you live plays an important role in defining the risk of presenting with late stage breast cancer. Additional research is urgently needed to understand this risk and to leverage the strengths and resources present in all communities to lower the late stage breast cancer burden. (Cancer Epidemiol Biomarkers Prev 2007;16(4):756 -62)
Objective To better understand national patterns of invasive cervical cancer (ICC) incidence by race and ethnicity in order to develop appropriate ICC prevention policies. Methods Age-adjusted and age-specific ICC incidence rates were calculated by combined race/ethnicity, making distinct the Hispanic/all races category from three other Non-Hispanic (White, Black and other) racial categories. Results There was a significant downward trend in ICC incidence during both time periods for every combination of race/ethnicity (p-value \0.05) except Hispanic/all races during 1995-1999. Non-Hispanic/Black and Hispanic/all races women had significantly higher incidence rates of ICC compared to Non-Hispanic/White women. ICC incidence peaked much earlier for Non-Hispanic/White women (35-44 years of age) compared to any other racial/ ethnic group. Non-Hispanic (White, Black and other) women had lower rates of adenocarcinoma and squamous cell carcinoma compared to Hispanic/all races women. Non-Hispanic/Black and Hispanic/all races women were more likely to be diagnosed at late stage or unstaged at diagnosis than Non-Hispanic/White women.Conclusion Although ICC incidence decreased significantly over the last 10 years, Black or Hispanic US populations continue to have the highest ICC incidence compared to Non-Hispanic/Whites, highlighting the need for improved health literacy and social support to ensure their equal access to ICC screening and HPV prevention including HPV vaccination.
Background
Firefighters are at increased risk for select cancers. However, many studies are limited by relatively small samples, with virtually no data on the cancer experience of female firefighters. This study examines cancer risk in over 100,000 career Florida firefighters including 5000 + females assessed over a 34‐year period.
Methods
Florida firefighter employment records (n = 109 009) were linked with Florida Cancer Data System registry data (1981‐2014; ~3.3 million records), identifying 3760 male and 168 female‐linked primary cancers. Gender‐specific age and calendar year‐adjusted odds ratios (aOR) and 95% confidence intervals for firefighters vs non‐firefighters were calculated.
Results
Male firefighters were at increased risk of melanoma (aOR = 1.56; 1.39‐1.76), prostate (1.36; 1.27‐1.46), testicular (1.66; 1.34‐2.06), thyroid (2.17; 1.78‐2.66) and late‐stage colon cancer (1.19;1.00‐1.41). Female firefighters showed significantly elevated risk of brain (2.54; 1.19‐5.42) and thyroid (2.42; 1.56‐3.74) cancers and an elevated risk of melanoma that approached statistical significance (1.68; 0.97‐2.90). Among male firefighters there was additional evidence of increased cancer risk younger than the age of 50 vs 50 years and older for thyroid (2.55; 1.96‐3.31 vs 1.69; 1.22‐2.34), prostate (1.88; 1.49‐2.36 vs 1.36; 1.26‐1.47), testicular (1.60; 1.28‐2.01 vs 1.47; 0.73‐2.94), and melanoma (1.87; 1.55‐2.26 vs 1.42; 1.22‐1.66) cancers.
Conclusion
Male career firefighters in Florida are at increased risk for five cancers with typically stronger associations in those diagnosed younger than the age of 50, while there was evidence for increased thyroid and brain cancer, and possibly melanoma risk in female firefighters. Larger cohorts with adequate female representation, along with the collection of well‐characterized exposure histories, are needed to more precisely examine cancer risk in this occupational group.
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