Abstract C083: Exploring relationships between neighborhood social vulnerability and cancer screening in Miami-Dade County

Abstract

Purpose: Social and structural contributors to social vulnerability have been associated with cancer disparities across the continuum. This study aimed to explore relationships between indicators of neighborhood social vulnerability and participation in breast, cervical and colorectal cancer screening in Miami-Dade County. Methods: Data were obtained at the census tract level from the United States Census Bureau American Community Survey (2014-2018), the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (2018), and the CDC PLACES dataset (2018). This analysis was restricted to Miami-Dade census tracts for which PLACES data was available on mammography (n=135), cervical cancer screening (n=115), and colorectal screening (n=136) participation. Census tracts were stratified into tertiles based on screening participation, then social vulnerability indicators were assessed among the tertiles. Principal component analysis (PCA) was used to identify characteristics responsible for most variability in breast, cervical and colorectal cancer screening. Results: Mammography participation was 51.76%, 58.80%, and 65.65% in the lower, middle, and upper tertiles, respectively. Among these tracts, per capita income (p<.001), earning an income below poverty (p<.001), educational attainment below earning an HS diploma (p<.001), the proportion of non-Hispanic White residents (p<.001), unemployed residents (p<.001), residents with a disability (p<.001), and people with no computer or limited access to the internet (p<.001) were significantly different between the tertiles. Cervical cancer screening participation was 79.60%, 84.36%, and 87.80% in the lower, middle, and upper tertiles, respectively. Among these tracts, per capita income (p<.001), earning an income below poverty (p<.001), educational attainment below earning an HS diploma (p<.001), and proportion of single-parent households with children under age 17 (p<.001), non-Hispanic White residents (p<.001), unemployed residents (p<.001), residents with a disability (p<.001), and people with no computer or limited access to the internet (p<.001) were significantly different between the screening tertiles. Colorectal cancer screening participation was 79.26%, 81.06%, and 85.26% in the lower, middle, and upper tertiles, respectively. Among these tracts, per capita income (p<.01), earning an income below poverty (p<.004), educational attainment below earning an HS diploma (p<.001), the proportion of residents with a disability (p<.001), and people with no computer or limited access to the internet (p<.001) were significantly different between the screening tertiles. Conclusions: These data suggest that social vulnerability is associated with cancer screening uptake, namely mammography, cervical cancer screening, and colorectal cancer screening. Further investigation of the social and structural factors contributing to disparities in cancer screening will help appropriately allocate resources and craft effective interventions to reduce the burden of cancer among those most vulnerable. Citation Format: Kilan C. Ashad-Bishop, Jordan A. Baeker-Bispo, Zinzi D. Bailey, Erin K. Kobetz. Exploring relationships between neighborhood social vulnerability and cancer screening in Miami-Dade County [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C083.

Overlooked and Damaging Impact of Structural Racism and Implicit Bias on US Health Care

“…5 In addition to factors aforementioned, other specific influences on cancer outcomes include work and environmental conditions (related to disproportionate exposure to carcinogens) and how health care is valued and utilized differently by certain groups. 6,7 The unfortunate result is disparities in access to preventive services and programs, leading to delayed screening and later-stage diagnosis. [8][9][10][11][12] Further complicated by the lack of representation of racial and ethnic minorities in clinical trials and the high cost of cancer care, many patients often receive lower-quality care because they do not have access to appropriate treatment options or lack the appropriate resources for supportive and palliative care.…”