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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2012

Open Access 01-12-2012 | Research

Determinants of delayed detection of cancers in Texas Counties in the United States of America

Authors: Gordon Gong, Eric Belasco, Kristopher A Hargrave, Conrad P Lyford, Billy U Philips Jr

Published in: International Journal for Equity in Health | Issue 1/2012

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Abstract

Introduction

Previous studies have shown that delayed detection of several cancers is related to socioeconomic deprivation as measured by the Wellbeing Index (WI) in Texas, the United States of America (USA). The current study investigates whether delayed cancer detection is related to lack of health insurance, physician shortage and higher percentages of Hispanics rather than WI per se since these factors are directly related to delayed cancer detection and may confound WI.

Methods

Cancer data and potential determinants of delayed cancer detection are derived from Texas Cancer Registry, Texas State Data Center, and Texas Department of State Health Services and U.S. Census Bureau. Texas cancer data from 1997 to 2003 are aggregated to calculate age-adjusted late- and early-stage cancer detection rates. The WI for each county is computed using data from the USA Census 2000. A weighted Tobit regression model is used to account for population size and censoring. The percentage of late-stage cancer cases is the dependent variable while independent variables include WI and the aforementioned potential confounders.

Results

Delayed detection of breast, lung, colorectal and female genital cancers is associated with higher percentage of uninsured residents (p < 0.05). Delayed detection is also associated with physician shortage and lower percentages of Hispanics for certain cancers ceteris paribus ( p < 0.05). The percentage of late-stage cases is positively correlated with WI for lung, and prostate cancers after adjusting for confounders ( p < 0.05).

Conclusions

The percentages of uninsured and Hispanic residents as well as physician supply are determinants of delayed detection for several cancers independently of WI, and vice versa. Identification of these determinants provides the evidence-base critical for decision makers to address specific issues for promoting early detection in effective cancer control.
Appendix
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Metadata
Title
Determinants of delayed detection of cancers in Texas Counties in the United States of America
Authors
Gordon Gong
Eric Belasco
Kristopher A Hargrave
Conrad P Lyford
Billy U Philips Jr
Publication date
01-12-2012
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2012
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/1475-9276-11-29

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