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Published in: Cancer Causes & Control 8/2018

01-08-2018 | Original paper

Mapping hot spots of breast cancer mortality in the United States: place matters for Blacks and Hispanics

Authors: Justin Xavier Moore, Kendra J. Royston, Marvin E. Langston, Russell Griffin, Bertha Hidalgo, Henry E. Wang, Graham Colditz, Tomi Akinyemiju

Published in: Cancer Causes & Control | Issue 8/2018

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Abstract

Purpose

The goals of this study were to identify geographic and racial/ethnic variation in breast cancer mortality, and evaluate whether observed geographic differences are explained by county-level characteristics.

Methods

We analyzed data on breast cancer deaths among women in 3,108 contiguous United States (US) counties from years 2000 through 2015. We applied novel geospatial methods and identified hot spot counties based on breast cancer mortality rates. We assessed differences in county-level characteristics between hot spot and other counties using Wilcoxon rank-sum test and Spearman correlation, and stratified all analysis by race/ethnicity.

Results

Among all women, 80 of 3,108 (2.57%) contiguous US counties were deemed hot spots for breast cancer mortality with the majority located in the southern region of the US (72.50%, p value < 0.001). In race/ethnicity-specific analyses, 119 (3.83%) hot spot counties were identified for NH-Black women, with the majority being located in southern states (98.32%, p value < 0.001). Among Hispanic women, there were 83 (2.67%) hot spot counties and the majority was located in the southwest region of the US (southern = 61.45%, western = 33.73%, p value < 0.001). We did not observe definitive geographic patterns in breast cancer mortality for NH-White women. Hot spot counties were more likely to have residents with lower education, lower household income, higher unemployment rates, higher uninsured population, and higher proportion indicating cost as a barrier to medical care.

Conclusions

We observed geographic and racial/ethnic disparities in breast cancer mortality: NH-Black and Hispanic breast cancer deaths were more concentrated in southern, lower SES counties.
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Literature
1.
go back to reference Richardson LC et al (2016) Patterns and trends in age-specific black-white differences in breast cancer incidence and mortality: United States, 1999–2014. MMWR Morb Mortal Wkly Rep 65(40):1093–1098CrossRefPubMed Richardson LC et al (2016) Patterns and trends in age-specific black-white differences in breast cancer incidence and mortality: United States, 1999–2014. MMWR Morb Mortal Wkly Rep 65(40):1093–1098CrossRefPubMed
3.
go back to reference Carey LA et al (2006) Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA 295(21):2492–2502CrossRefPubMed Carey LA et al (2006) Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA 295(21):2492–2502CrossRefPubMed
4.
go back to reference Barry J, Breen N (2005) The importance of place of residence in predicting late-stage diagnosis of breast or cervical cancer. Health Place 11(1):15–29CrossRefPubMed Barry J, Breen N (2005) The importance of place of residence in predicting late-stage diagnosis of breast or cervical cancer. Health Place 11(1):15–29CrossRefPubMed
6.
go back to reference Akinyemiju T et al (2016) Racial disparities in individual breast cancer outcomes by hormone-receptor subtype, area-level socio-economic status and healthcare resources. Breast Cancer Res Treat 157(3):575–586CrossRefPubMedPubMedCentral Akinyemiju T et al (2016) Racial disparities in individual breast cancer outcomes by hormone-receptor subtype, area-level socio-economic status and healthcare resources. Breast Cancer Res Treat 157(3):575–586CrossRefPubMedPubMedCentral
7.
go back to reference Bradley CJ, Given CW, Roberts C (2001) Disparities in cancer diagnosis and survival. Cancer 91(1):178–188CrossRefPubMed Bradley CJ, Given CW, Roberts C (2001) Disparities in cancer diagnosis and survival. Cancer 91(1):178–188CrossRefPubMed
8.
go back to reference Bradley CJ, Given CW, Roberts C (2002) Race, socioeconomic status, and breast cancer treatment and survival. J Natl Cancer Inst 94(7):490–496CrossRefPubMed Bradley CJ, Given CW, Roberts C (2002) Race, socioeconomic status, and breast cancer treatment and survival. J Natl Cancer Inst 94(7):490–496CrossRefPubMed
9.
go back to reference Meliker JR et al (2009) Breast and prostate cancer survival in Michigan: can geographic analyses assist in understanding racial disparities? Cancer 115(10):2212–2221CrossRefPubMedPubMedCentral Meliker JR et al (2009) Breast and prostate cancer survival in Michigan: can geographic analyses assist in understanding racial disparities? Cancer 115(10):2212–2221CrossRefPubMedPubMedCentral
10.
go back to reference Pruitt SL et al (2015) Residential racial segregation and mortality among black, white, and Hispanic urban breast cancer patients in Texas, 1995 to 2009. Cancer 121(11):1845–1855CrossRefPubMedPubMedCentral Pruitt SL et al (2015) Residential racial segregation and mortality among black, white, and Hispanic urban breast cancer patients in Texas, 1995 to 2009. Cancer 121(11):1845–1855CrossRefPubMedPubMedCentral
11.
go back to reference Ward E et al (2004) Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin 54(2):78–93CrossRefPubMed Ward E et al (2004) Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin 54(2):78–93CrossRefPubMed
12.
go back to reference Dai D (2010) Black residential segregation, disparities in spatial access to health care facilities, and late-stage breast cancer diagnosis in metropolitan Detroit. Health Place 16(5):1038–1052CrossRefPubMed Dai D (2010) Black residential segregation, disparities in spatial access to health care facilities, and late-stage breast cancer diagnosis in metropolitan Detroit. Health Place 16(5):1038–1052CrossRefPubMed
14.
go back to reference Kuo TM, Mobley LR, Anselin L (2011) Geographic disparities in late-stage breast cancer diagnosis in California. Health Place 17(1):327–334CrossRefPubMed Kuo TM, Mobley LR, Anselin L (2011) Geographic disparities in late-stage breast cancer diagnosis in California. Health Place 17(1):327–334CrossRefPubMed
15.
go back to reference Gumpertz ML et al (2006) Geographic patterns of advanced breast cancer in Los Angeles: associations with biological and sociodemographic factors (United States). Cancer Causes Control 17(3):325–339CrossRefPubMed Gumpertz ML et al (2006) Geographic patterns of advanced breast cancer in Los Angeles: associations with biological and sociodemographic factors (United States). Cancer Causes Control 17(3):325–339CrossRefPubMed
16.
go back to reference Baquet CR, Commiskey P (2000) Socioeconomic factors and breast carcinoma in multicultural women. Cancer 88(5 Suppl):1256–1264CrossRefPubMed Baquet CR, Commiskey P (2000) Socioeconomic factors and breast carcinoma in multicultural women. Cancer 88(5 Suppl):1256–1264CrossRefPubMed
17.
go back to reference Li CI, Malone KE, Daling JR (2003) Differences in breast cancer stage, treatment, and survival by race and ethnicity. Arch Intern Med 163(1):49–56CrossRefPubMed Li CI, Malone KE, Daling JR (2003) Differences in breast cancer stage, treatment, and survival by race and ethnicity. Arch Intern Med 163(1):49–56CrossRefPubMed
18.
go back to reference McBride R et al (2007) Within-stage racial differences in tumor size and number of positive lymph nodes in women with breast cancer. Cancer 110(6):1201–1208CrossRefPubMed McBride R et al (2007) Within-stage racial differences in tumor size and number of positive lymph nodes in women with breast cancer. Cancer 110(6):1201–1208CrossRefPubMed
19.
go back to reference Canto MT, Anderson WF, Brawley O (2001) Geographic variation in breast cancer mortality for white and black women: 1986–1995. CA Cancer J Clin 51(6):367–370CrossRefPubMed Canto MT, Anderson WF, Brawley O (2001) Geographic variation in breast cancer mortality for white and black women: 1986–1995. CA Cancer J Clin 51(6):367–370CrossRefPubMed
20.
go back to reference Chien LC, Yu HL, Schootman M (2013) Efficient mapping and geographic disparities in breast cancer mortality at the county-level by race and age in the U.S. Spat Spatiotemporal Epidemiol 5:27–37CrossRefPubMed Chien LC, Yu HL, Schootman M (2013) Efficient mapping and geographic disparities in breast cancer mortality at the county-level by race and age in the U.S. Spat Spatiotemporal Epidemiol 5:27–37CrossRefPubMed
21.
go back to reference Grann V et al (2006) Regional and racial disparities in breast cancer-specific mortality. Soc Sci Med 62(2):337–347CrossRefPubMed Grann V et al (2006) Regional and racial disparities in breast cancer-specific mortality. Soc Sci Med 62(2):337–347CrossRefPubMed
22.
go back to reference Markossian TW, Hines RB, Bayakly R (2014) Geographic and racial disparities in breast cancer-related outcomes in Georgia. Health Serv Res 49(2):481–501CrossRefPubMed Markossian TW, Hines RB, Bayakly R (2014) Geographic and racial disparities in breast cancer-related outcomes in Georgia. Health Serv Res 49(2):481–501CrossRefPubMed
23.
go back to reference Mobley LR et al (2017) Modeling geospatial patterns of late-stage diagnosis of breast cancer in the US. Int J Environ Res Public Health 14(5):484CrossRefPubMedCentral Mobley LR et al (2017) Modeling geospatial patterns of late-stage diagnosis of breast cancer in the US. Int J Environ Res Public Health 14(5):484CrossRefPubMedCentral
25.
go back to reference Scott L, Mobley LR, Il’yasova D (2017) Geospatial analysis of inflammatory breast cancer and associated community characteristics in the United States. Int J Environ Res Public Health 14(4):404CrossRefPubMedCentral Scott L, Mobley LR, Il’yasova D (2017) Geospatial analysis of inflammatory breast cancer and associated community characteristics in the United States. Int J Environ Res Public Health 14(4):404CrossRefPubMedCentral
26.
go back to reference Tatalovich Z et al (2015) Geographic disparities in late stage breast cancer incidence: results from eight states in the United States. Int J Health Geogr 14:31CrossRefPubMedPubMedCentral Tatalovich Z et al (2015) Geographic disparities in late stage breast cancer incidence: results from eight states in the United States. Int J Health Geogr 14:31CrossRefPubMedPubMedCentral
27.
go back to reference Tian N, Wilson JG, Zhan FB (2011) Spatial association of racial/ethnic disparities between late-stage diagnosis and mortality for female breast cancer: where to intervene? Int J Health Geogr 10:24CrossRefPubMedPubMedCentral Tian N, Wilson JG, Zhan FB (2011) Spatial association of racial/ethnic disparities between late-stage diagnosis and mortality for female breast cancer: where to intervene? Int J Health Geogr 10:24CrossRefPubMedPubMedCentral
29.
go back to reference Manson S et al (2017) Minnesota population center: national historical geographic information system: version 2.0. University of Minnesota, Minneapolis Manson S et al (2017) Minnesota population center: national historical geographic information system: version 2.0. University of Minnesota, Minneapolis
30.
go back to reference University of Wisconsin Population Health Institute (2016) County health rankings & roadmaps University of Wisconsin Population Health Institute (2016) County health rankings & roadmaps
31.
go back to reference Kirchhoff AC, Hart G, Campbell EG (2014) Rural and urban primary care physician professional beliefs and quality improvement behaviors. J Rural Health 30(3):235–243CrossRefPubMed Kirchhoff AC, Hart G, Campbell EG (2014) Rural and urban primary care physician professional beliefs and quality improvement behaviors. J Rural Health 30(3):235–243CrossRefPubMed
32.
go back to reference Gruca TS, Pyo TH, Nelson GC (2016) Improving rural access to orthopaedic care through visiting consultant clinics. J Bone Joint Surg Am 98(9):768–774CrossRefPubMed Gruca TS, Pyo TH, Nelson GC (2016) Improving rural access to orthopaedic care through visiting consultant clinics. J Bone Joint Surg Am 98(9):768–774CrossRefPubMed
34.
go back to reference Wartenberg D (2001) Investigating disease clusters: why, when, and how? J R Stat Soc A 164(Part 1):13–22CrossRef Wartenberg D (2001) Investigating disease clusters: why, when, and how? J R Stat Soc A 164(Part 1):13–22CrossRef
35.
go back to reference Moore JX, Donnelly JP, Griffin R, Howard G, Safford MM, Wang HE (2016) Defining sepsis mortality clusters in the United States. Crit Care Med 44(7):1380–1387CrossRefPubMedPubMedCentral Moore JX, Donnelly JP, Griffin R, Howard G, Safford MM, Wang HE (2016) Defining sepsis mortality clusters in the United States. Crit Care Med 44(7):1380–1387CrossRefPubMedPubMedCentral
36.
go back to reference Anselin L (1995) Local indicators of spatial association: LISA. Geogr Anal 27:93–115CrossRef Anselin L (1995) Local indicators of spatial association: LISA. Geogr Anal 27:93–115CrossRef
37.
go back to reference Getis A, Ord K (1992) The analysis of spatial association by use of distance statistics. Geogr Anal 24:189–206CrossRef Getis A, Ord K (1992) The analysis of spatial association by use of distance statistics. Geogr Anal 24:189–206CrossRef
38.
go back to reference Nassel AF, Root ED, Haukoos JS, McVaney K, Colwell C, Robinson J, Eigel B, Magid DJ, Sasson C (2014) Multiple cluster analysis for the identification of high-risk census tracts for out-of-hospital cardiac arrest (OHCA) in Denver, Colorado. Resuscitation 85:1667–1673CrossRefPubMedPubMedCentral Nassel AF, Root ED, Haukoos JS, McVaney K, Colwell C, Robinson J, Eigel B, Magid DJ, Sasson C (2014) Multiple cluster analysis for the identification of high-risk census tracts for out-of-hospital cardiac arrest (OHCA) in Denver, Colorado. Resuscitation 85:1667–1673CrossRefPubMedPubMedCentral
39.
go back to reference Anselin L (2004) Exploring spatial data with GeoDa: a workbook. University of Illinois, Urbana-Champaign Anselin L (2004) Exploring spatial data with GeoDa: a workbook. University of Illinois, Urbana-Champaign
40.
go back to reference Li H, Calder CA, Cressie NAC (2007) Beyond Moran’s I: testing for spatial dependence based on the spatial autoregressive model. Geogr Anal 39:357–375CrossRef Li H, Calder CA, Cressie NAC (2007) Beyond Moran’s I: testing for spatial dependence based on the spatial autoregressive model. Geogr Anal 39:357–375CrossRef
41.
go back to reference Li H, Calder CA, Cressie NAC (2012) One-step estimation of spatial dependence parameters: properties and extensions of the APLE statistic. J Multivariate Anal 105:68–84CrossRef Li H, Calder CA, Cressie NAC (2012) One-step estimation of spatial dependence parameters: properties and extensions of the APLE statistic. J Multivariate Anal 105:68–84CrossRef
42.
go back to reference Schootman M et al (2009) The role of poverty rate and racial distribution in the geographic clustering of breast cancer survival among older women: a geographic and multilevel analysis. Am J Epidemiol 169(5):554–561CrossRefPubMed Schootman M et al (2009) The role of poverty rate and racial distribution in the geographic clustering of breast cancer survival among older women: a geographic and multilevel analysis. Am J Epidemiol 169(5):554–561CrossRefPubMed
43.
go back to reference Schootman M et al (2010) Temporal trends in geographic disparities in small-area breast cancer incidence and mortality, 1988 to 2005. Cancer Epidemiol Biomarkers Prev 19(4):1122–1131CrossRefPubMedPubMedCentral Schootman M et al (2010) Temporal trends in geographic disparities in small-area breast cancer incidence and mortality, 1988 to 2005. Cancer Epidemiol Biomarkers Prev 19(4):1122–1131CrossRefPubMedPubMedCentral
44.
go back to reference Akinyemiju T, Meng Q, Vin-Raviv N (2016) Race/ethnicity and socio-economic differences in colorectal cancer surgery outcomes: analysis of the nationwide inpatient sample. BMC Cancer 16:715CrossRefPubMedPubMedCentral Akinyemiju T, Meng Q, Vin-Raviv N (2016) Race/ethnicity and socio-economic differences in colorectal cancer surgery outcomes: analysis of the nationwide inpatient sample. BMC Cancer 16:715CrossRefPubMedPubMedCentral
45.
go back to reference Akinyemiju TF et al (2013) Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities. J Cancer Epidemiol 2013:490472CrossRefPubMedPubMedCentral Akinyemiju TF et al (2013) Individual and neighborhood socioeconomic status and healthcare resources in relation to black-white breast cancer survival disparities. J Cancer Epidemiol 2013:490472CrossRefPubMedPubMedCentral
46.
go back to reference Akinyemiju TF et al (2015) Race/ethnicity and socio-economic differences in breast cancer surgery outcomes. Cancer Epidemiol 39(5):745–751CrossRefPubMed Akinyemiju TF et al (2015) Race/ethnicity and socio-economic differences in breast cancer surgery outcomes. Cancer Epidemiol 39(5):745–751CrossRefPubMed
47.
go back to reference Damle RN et al (2016) Examination of racial disparities in the receipt of minimally invasive surgery among a national cohort of adult patients undergoing colorectal surgery. Dis Colon Rectum 59(11):1055–1062CrossRefPubMed Damle RN et al (2016) Examination of racial disparities in the receipt of minimally invasive surgery among a national cohort of adult patients undergoing colorectal surgery. Dis Colon Rectum 59(11):1055–1062CrossRefPubMed
48.
go back to reference Fedewa SA et al (2011) Race and ethnicity are associated with delays in breast cancer treatment (2003–2006). J Health Care Poor Underserved 22(1):128–141PubMed Fedewa SA et al (2011) Race and ethnicity are associated with delays in breast cancer treatment (2003–2006). J Health Care Poor Underserved 22(1):128–141PubMed
49.
go back to reference Fedewa SA et al (2010) Delays in adjuvant chemotherapy treatment among patients with breast cancer are more likely in African American and Hispanic populations: a national cohort study 2004–2006. J Clin Oncol 28(27):4135–4141CrossRefPubMed Fedewa SA et al (2010) Delays in adjuvant chemotherapy treatment among patients with breast cancer are more likely in African American and Hispanic populations: a national cohort study 2004–2006. J Clin Oncol 28(27):4135–4141CrossRefPubMed
50.
go back to reference Freedman RA et al (2011) The association of race/ethnicity, insurance status, and socioeconomic factors with breast cancer care. Cancer 117(1):180–189CrossRefPubMed Freedman RA et al (2011) The association of race/ethnicity, insurance status, and socioeconomic factors with breast cancer care. Cancer 117(1):180–189CrossRefPubMed
51.
go back to reference Hershman DL et al (2015) Household net worth, racial disparities, and hormonal therapy adherence among women with early-stage breast cancer. J Clin Oncol 33(9):1053–1059CrossRefPubMedPubMedCentral Hershman DL et al (2015) Household net worth, racial disparities, and hormonal therapy adherence among women with early-stage breast cancer. J Clin Oncol 33(9):1053–1059CrossRefPubMedPubMedCentral
52.
53.
go back to reference Shavers VL, Brown ML (2002) Racial and ethnic disparities in the receipt of cancer treatment. J Natl Cancer Inst 94(5):334–357CrossRefPubMed Shavers VL, Brown ML (2002) Racial and ethnic disparities in the receipt of cancer treatment. J Natl Cancer Inst 94(5):334–357CrossRefPubMed
54.
go back to reference Sheppard VB et al (2015) Disparities in breast cancer surgery delay: the lingering effect of race. Ann Surg Oncol 22(9):2902–2911CrossRefPubMed Sheppard VB et al (2015) Disparities in breast cancer surgery delay: the lingering effect of race. Ann Surg Oncol 22(9):2902–2911CrossRefPubMed
55.
go back to reference Wang EH et al (2016) Disparities in treatment of patients with high-risk prostate cancer: results from a population-based cohort. Urology 95:88–94CrossRefPubMed Wang EH et al (2016) Disparities in treatment of patients with high-risk prostate cancer: results from a population-based cohort. Urology 95:88–94CrossRefPubMed
56.
57.
go back to reference Casper ML, Wing S, Anda RF, Knowles M, Pollard RA (1995) The shifting stroke belt: changes in the geographic pattern of stroke mortality in the United States, 1962 to 1988. Stroke 26(5):755–760CrossRefPubMed Casper ML, Wing S, Anda RF, Knowles M, Pollard RA (1995) The shifting stroke belt: changes in the geographic pattern of stroke mortality in the United States, 1962 to 1988. Stroke 26(5):755–760CrossRefPubMed
59.
go back to reference Chang BA, Pearson WS, Owusu-Edusei K Jr (2017) Correlates of county-level nonviral sexually transmitted infection hot spots in the US: application of hot spot analysis and spatial logistic regression. Ann Epidemiol 27(4):231–237CrossRefPubMed Chang BA, Pearson WS, Owusu-Edusei K Jr (2017) Correlates of county-level nonviral sexually transmitted infection hot spots in the US: application of hot spot analysis and spatial logistic regression. Ann Epidemiol 27(4):231–237CrossRefPubMed
60.
61.
go back to reference Karp DN et al (2016) Reassessing the Stroke belt: using small area spatial statistics to identify clusters of high stroke mortality in the United States. Stroke 47(7):1939–1942CrossRefPubMedPubMedCentral Karp DN et al (2016) Reassessing the Stroke belt: using small area spatial statistics to identify clusters of high stroke mortality in the United States. Stroke 47(7):1939–1942CrossRefPubMedPubMedCentral
62.
go back to reference Aschengrau A, Paulu C, Ozonoff D (1998) Tetrachloroethylene-contaminated drinking water and the risk of breast cancer. Environ Health Perspect 106(Suppl 4):947–953CrossRefPubMedPubMedCentral Aschengrau A, Paulu C, Ozonoff D (1998) Tetrachloroethylene-contaminated drinking water and the risk of breast cancer. Environ Health Perspect 106(Suppl 4):947–953CrossRefPubMedPubMedCentral
63.
go back to reference Terry PD, Miller AB, Rohan TE (2002) Cigarette smoking and breast cancer risk: a long latency period? Int J Cancer 100(6):723–728CrossRefPubMed Terry PD, Miller AB, Rohan TE (2002) Cigarette smoking and breast cancer risk: a long latency period? Int J Cancer 100(6):723–728CrossRefPubMed
64.
go back to reference Petralia SA et al (1999) Risk of premenopausal breast cancer in association with occupational exposure to polycyclic aromatic hydrocarbons and benzene. Scand J Work Environ Health 25(3):215–221CrossRefPubMed Petralia SA et al (1999) Risk of premenopausal breast cancer in association with occupational exposure to polycyclic aromatic hydrocarbons and benzene. Scand J Work Environ Health 25(3):215–221CrossRefPubMed
65.
Metadata
Title
Mapping hot spots of breast cancer mortality in the United States: place matters for Blacks and Hispanics
Authors
Justin Xavier Moore
Kendra J. Royston
Marvin E. Langston
Russell Griffin
Bertha Hidalgo
Henry E. Wang
Graham Colditz
Tomi Akinyemiju
Publication date
01-08-2018
Publisher
Springer International Publishing
Published in
Cancer Causes & Control / Issue 8/2018
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-018-1051-y

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