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Effect Modification of the Association Between Race and Stage at Colorectal Cancer Diagnosis by Socioeconomic Status
- Source :
- J Public Health Manag Pract
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- OBJECTIVES To compare risks of distant-stage colorectal cancer (CRC) diagnosis between whites and American Indian/Alaska Natives (AI/ANs) and to explore effect modification by area-based socioeconomic status (SES). DESIGN Retrospective cohort study using data from the Oklahoma Central Cancer Registry. SETTING Oklahoma. PARTICIPANTS White and AI/AN cases of CRC diagnosed in Oklahoma between 2001 and 2008 (N = 8 438). A subanalysis was performed on the cohort of those aged 50 years and older (N = 7 728). MAIN OUTCOME MEASURE Risk of distant-stage CRC diagnosis stratified by SES score. RESULTS Race and SES were independently associated with distant-stage diagnosis. In SES-stratified analyses, AI/ANs in the 2 lowest SES groups experienced increased risks in the overall cohort and among those aged 50 years and older. In multivariable models, risks remained significant among those aged 50 years and older in the lowest SES groups (Adjusted risk ratio SES score of 2: 1.31, 95% confidence interval: 1.06-1.63 and adjusted risk ratio SES score of 1: 1.21, 95% confidence interval: 1.01-1.44). CONCLUSION Socioeconomic status is an effect modifier in the association between race/ethnicity and stage at CRC diagnosis. Disparities in stage at CRC diagnosis exist between AI/ANs and whites with lower estimated SES. Efforts are needed to increase CRC screening among lower SES AI/ANs.
- Subjects :
- Adult
Male
Colorectal cancer
Article
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Humans
Medicine
030212 general & internal medicine
Correlation of Data
Socioeconomic status
Early Detection of Cancer
Aged
Neoplasm Staging
Retrospective Studies
Aged, 80 and over
030505 public health
business.industry
Health Policy
Racial Groups
Public Health, Environmental and Occupational Health
Oklahoma
Retrospective cohort study
social sciences
Middle Aged
medicine.disease
Confidence interval
Cancer registry
Social Class
Relative risk
Cohort
Indians, North American
population characteristics
Female
Colorectal Neoplasms
0305 other medical science
business
Cohort study
Demography
Subjects
Details
- ISSN :
- 10784659
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Journal of Public Health Management and Practice
- Accession number :
- edsair.doi.dedup.....ba479c7caa58a013141dcded323537d7