Standardized cancer incidence disparities in Upper Manhattan New York City neighborhoods: the role of race/ethnicity, socioeconomic status, and known risk factors

Hashim, Dana; Farhat, Zeinab; Wallenstein, Sylvan; Mańczuk, Marta; Holcombe, Randall F.; Thorpe, Lorna E.; Schymura, Maria J.; Lucchini, Roberto; Boffetta, Paolo

doi:10.1097/cej.0000000000000180

Cited by 6 publications

(11 citation statements)

References 41 publications

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“…This study builds on the previous study on cancer incidence among the same three neighborhoods, in which we found both neighborhood and race played a role in cancer incidence (Hashim et al 2015). These standardized incidence rates provided insight on the burden of exposure to causes of cancer development.…”

Section: Introductionmentioning

confidence: 62%

“…Significant differences in CHS means and proportions between neighborhoods were measured using ANOVA and chi-square test, respectively. The methodology for incidence rate analysis has been previously reported (Hashim et al 2015). …”

Section: Methodsmentioning

confidence: 99%

“…Conversely, high proportions of blacks and Hispanics characterize CH and EH, respectively. Both CH and EH have a lower proportion of college graduates and a higher proportion of individuals below the federal poverty level than the UES (Hashim et al 2015). …”

Section: Introductionmentioning

confidence: 99%

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Cancer mortality disparities among New York City’s Upper Manhattan neighborhoods

Hashim¹,

Mańczuk

Holcombe

et al. 2017

European Journal of Cancer Prevention

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Purpose The East Harlem (EH), Central Harlem (CH), and Upper East Side (UES) neighborhoods of New York City are geographically contiguous to tertiary medical care but are characterized by cancer mortality rate disparities. This ecological study aims to disentangle effects of race and neighborhood on cancer deaths. Methods Mortality-to-incidence ratios (MIR) were determined using neighborhood-specific data from the New York State Cancer Registry and Vital Records Office (2007–2011). Ecological data on modifiable cancer risk factors from the New York City Community Health Survey (2002–2006) was stratified by sex, age group, race/ethnicity, and neighborhood and modeled against stratified mortality rates to disentangle race/ethnicity and neighborhood using logistic regression. Results Significant gaps in mortality rates were observed between the UES and both CH and EH across all cancers, favoring UES. MIRs of both CH and EH were similarly elevated in the range of 0.41–0.44 compared to UES (0.26–0.30). After covariate and multivariable adjustment, black race (OR=1.68; 95% CI: 1.46, 1.93) and EH residence (OR=1.20; 95% CI: 1.07, 1.35) remained significant risk factors in all cancers combined mortality. Conclusions Mortality disparities remain among EH, CH, and UES neighborhoods. Both neighborhood and race are significantly associated with cancer mortality, independent of each other. Multivariable adjusted models that include CHS risk factors demonstrate that this mortality gap may be avoidable through community-based public health interventions.

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Section: Introductionmentioning

confidence: 62%

Section: Methodsmentioning

confidence: 99%

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Cancer mortality disparities among New York City’s Upper Manhattan neighborhoods

Hashim¹,

Mańczuk

Holcombe

et al. 2017

European Journal of Cancer Prevention

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“…Although a recent review examined racial/ethnic liver cancer disparities in the US ( 8 ), it has not been studied on a local level. A study of cancer incidence in NYC and three of its neighborhoods (East Harlem, Central Harlem, and Upper East Side) found that neighborhood was associated with incidence of all cancers, including liver cancer ( 9 ). To understand the basis for NYC disparities in liver cancer incidence and mortality, it is crucial to identify high-risk subpopulations, the risk factors most strongly associated with liver cancer, and how they are distributed in the city.…”

Section: Introductionmentioning

confidence: 99%

Liver Cancer Disparities in New York City: A Neighborhood View of Risk and Harm Reduction Factors

et al. 2018

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IntroductionLiver cancer is the fastest increasing cancer in the United States and is one of the leading causes of cancer-related death in New York City (NYC), with wide disparities among neighborhoods. The purpose of this cross-sectional study was to describe liver cancer incidence by neighborhood and examine its association with risk factors. This information can inform preventive and treatment interventions.Materials and methodsPublicly available data were collected on adult NYC residents (n = 6,407,022). Age-adjusted data on liver and intrahepatic bile duct cancer came from the New York State Cancer Registry (1) (2007–2011 average annual incidence); and the NYC Vital Statistics Bureau (2015, mortality). Data on liver cancer risk factors (2012–2015) were sourced from the New York City Department of Health and Mental Hygiene: (1) Community Health Survey, (2) A1C registry, and (3) NYC Health Department Hepatitis surveillance data. They included prevalence of obesity, diabetes, diabetic control, alcohol-related hospitalizations or emergency department visits, hepatitis B and C rates, hepatitis B vaccine coverage, and injecting drug use.ResultsLiver cancer incidence in NYC was strongly associated with neighborhood poverty after adjusting for race/ethnicity (β = 0.0217, p = 0.013); and with infection risk scores (β = 0.0389, 95% CI = 0.0088–0.069, p = 0.011), particularly in the poorest neighborhoods (β = 0.1207, 95% CI = 0.0147–0.2267, p = 0.026). Some neighborhoods with high hepatitis rates do not have a proportionate number of hepatitis prevention services.ConclusionHigh liver cancer incidence is strongly associated with infection risk factors in NYC. There are gaps in hepatitis prevention services like syringe exchange and vaccination that should be addressed. The role of alcohol and metabolic risk factors on liver cancer in NYC warrants further study.

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“…Low‐income populations are more likely to be diagnosed with preventable cancers at later stages than the general population. Although disparities in cancer mortality have decreased over the past two decades (American Cancer Society, ), there are still marked differences due to race (DeSantis et al., ; Krok‐Schoen, Fisher, Baltic & Paskett, ), socioeconomic status (Singh & Jemal, ), neighborhood resources (Hashim et al., ), and, in some instances, immigration status (Consedine, Tuck, Ragin & Spencer, ; Torre et al., ). Cancer disparities arise in part due to differences in screening, risk behaviors, and access to high‐quality care (American Cancer Society, , ; Bradley, Schlesinger, Webster, Baker & Inouye, ; Bradley, Webster et al., ; Doubeni, Laiyemo, Reed, Field & Fletcher, ; Elk & Landrine, ; Emmons et al., ; Husaini et al., ; Johnson, Mues, Mayne & Kiblawi, ; Miranda, Tarraf & Gonzalez, ; Taplin et al., ).…”

Section: Introductionmentioning

confidence: 99%

Reducing Disparities in Cancer Screening and Prevention through Community‐Based Participatory Research Partnerships with Local Libraries: A Comprehensive Dynamic Trial

Rapkin

Weiss

Lounsbury

et al. 2017

American J of Comm Psychol

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Background Reduction of cancer-related disparities requires strategies that link medically underserved communities to preventive care. In this community-based participatory research project, a public library system brought together stakeholders to plan and undertake programs to address cancer screening and risk behavior. Methods This study was implemented over 48 months in 20 large urban neighborhoods, selected to reach diverse communities disconnected from care. In each neighborhood, Cancer Action Councils were organized to conduct a comprehensive dynamic trial, an iterative process of program planning, implementation and evaluation. This process was phased into neighborhoods in random, stepped-wedge sequence. Population-level outcomes included self-reported screening adherence and smoking cessation, based on street-intercept interviews. Results Event history regressions (n=9,374) demonstrated that adherence outcomes were associated with program implementation, as were mediators such as awareness of screening programs and cancer information-seeking. Findings varied by ethnicity, and were strongest among respondents born outside the U.S. or least engaged in care. Conclusion This intervention impacted health behavior in diverse, underserved and vulnerable neighborhoods. It has been sustained as a routine library system program for several years after conclusion of grant support. In sum, participatory research with the public library system offers a flexible, scalable approach to reduce cancer health disparities.

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Standardized cancer incidence disparities in Upper Manhattan New York City neighborhoods: the role of race/ethnicity, socioeconomic status, and known risk factors

Cited by 6 publications

References 41 publications

Cancer mortality disparities among New York City’s Upper Manhattan neighborhoods

Cancer mortality disparities among New York City’s Upper Manhattan neighborhoods

Liver Cancer Disparities in New York City: A Neighborhood View of Risk and Harm Reduction Factors

Reducing Disparities in Cancer Screening and Prevention through Community‐Based Participatory Research Partnerships with Local Libraries: A Comprehensive Dynamic Trial

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