-
[show abstract]
[hide abstract]
ABSTRACT: The study's purpose was to investigate thyroid cancer incidence time trends, birth cohort effects, and association with socioeconomic status (SES) in New Jersey (NJ), a high incidence state, using NJ State Cancer Registry data. Thyroid cancer incidence rates in each sex, nearly all age groups, two major histologies and all stages significantly increased between 1979 and 2006. For each sex, age-specific incidence rates began greatly increasing in the 1924 birth cohort and, generally, the highest thyroid cancer incidence rate for each five-year age group occurred in the latest birth cohort and diagnosis period. Thyroid cancer incidence rates were significantly higher in NJ Census tracts with higher SES and in counties with a higher percentage of insured residents. These results support further investigation into the relationship between rising thyroid cancer incidence and increasing population exposure to medical (including diagnostic) radiation, as well as widespread use of more sensitive diagnostic techniques.
Journal of Environmental and Public Health 01/2011; 2011:850105.
-
[show abstract]
[hide abstract]
ABSTRACT: We investigated racial/ethnic and socioeconomic disparities in cancer survival and assessed if racial disparities can be explained by socioeconomic status (SES) using New Jersey State Cancer Registry data. We included cancer cases diagnosed during 1986-1999 (n=471,939). Hazard ratios were calculated for all cancers combined and female breast, colorectal, lung, and prostate cancers by race/ethnicity and SES for cases diagnosed in 1993-1999. Survival rates were compared for diagnosis years 1986-1992 and 1993-1999. We observed worse survival in Black patients and a SES gradient in the risk of cancer death after adjusting for age and stage at diagnosis. Following adjustment by SES, the higher risks of cancer death for Blacks were attenuated for breast, colorectal, and prostate cancer and became non-significant for lung cancer. Racial/ethnic disparities in cancer survival can be partially explained by SES. Cancer survival rates improved significantly from 1986-1992 to 1993-1999 except for women in the poorest areas.
Journal of Health Care for the Poor and Underserved 02/2010; 21(1):144-60. · 1.10 Impact Factor
-
Clinical Medicine Insights : Dermatology. 01/2010;
-
[show abstract]
[hide abstract]
ABSTRACT: Despite effective screening methods, research suggests consistently higher rates of late stage colorectal cancer (CRC) among persons living in low socioeconomic areas compared to those living in affluent areas. This population-based study evaluated the association between area-based socioeconomic measures (ABSMs) and CRC stage at diagnosis in New Jersey. Cases of CRC among persons 50 years and older, diagnosed from 2000-2005, were obtained from the New Jersey State Cancer Registry. Associations between census tract-level ABSMs and CRC stage at diagnosis were evaluated using logistic regression and geographic variation assessed using a spatial scan statistic. After adjusting for covariates, including individual-level health insurance, ABSMs were significantly associated with stage at diagnosis. As area socioeconomic conditions worsened, the odds of being diagnosed at a late stage increased. While increasing CRC screening services for all New Jersey populations is warranted, this study suggests that persons living in low socioeconomic areas could benefit the most from enhanced CRC education, screening efforts, and guided interventions.
Health & Place 11/2008; 15(2):505-13. · 2.67 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Although the etiology of prostate cancer is uncertain, cancer control programs need to know the factors that contribute to variations in prostate cancer incidence from place to place. Geographic patterns of prostate cancer cases diagnosed at the distant stage are particularly important, because survival is substantially lower than for prostate cancer diagnosed at earlier stages. The purpose of this study was to identify and characterize clusters of census tracts in New Jersey with significantly high proportions of men diagnosed with distant-stage prostate cancer.
Prostate cancer cases diagnosed in New Jersey residents from 1995 to 1999 (n=30,505) were geocoded at the census tract level (n=1938) based on their residences at time of diagnosis. A spatial scan statistic (SaTScan) then was applied to identify clusters of census tracts with elevated proportions of cases of distant stage prostate cancer, using a case-control Bernoulli probability model study design. Distant-stage prostate cancers were defined as cases (n=1230), and all other prostate cancers as controls. Population characteristics from the 1990 Census for the area of the most likely cluster were compared to the remainder of the state.
SaTScan identified a large geographic area in northeast New Jersey as the most likely cluster (RR=1.25, p=0.001). Compared to the remainder of the state, the underlying population in the most likely cluster area had higher proportions of African-American, Hispanic, and Asian men, and was more likely to be foreign-born, undereducated, in poverty, and have limited English speaking ability.
Spatial analyses of late stage prostate cancer cases can provide additional insights into less favorable outcomes for disadvantaged populations and racial and ethnic minorities.
American Journal of Preventive Medicine 03/2006; 30(2 Suppl):S60-6. · 4.04 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Description of the epidemiology of noncutaneous melanoma has been hampered by its rarity. The current report was the largest in-depth descriptive analysis of incidence of noncutaneous melanoma in the United States, using data from the North American Association of Central Cancer Registries.
Pooled data from 27 states and one metropolitan area were used to examine the incidence of noncutaneous melanoma by anatomic subsite, gender, age, race, and geography (northern/southern and coastal/noncoastal) for cases diagnosed between 1996 and 2000. Percent distribution by stage of disease at diagnosis and histology were also examined.
Between 1996 and 2000, 6691 cases of noncutaneous melanoma (4885 ocular and 1806 mucosal) were diagnosed among 851 million person-years at risk. Ocular melanoma was more common among men compared with women (6.8 cases per million men compared with 5.3 cases per million women, age-adjusted to the 2000 U.S. population standard), whereas mucosal melanoma was more common among women (2.8 cases per million women compared with 1.5 cases per million men). Rates of ocular melanoma among whites were greater than eight times higher than among blacks. Rates of mucosal melanoma were approximately two times higher among whites compared with blacks.
In contrast to cutaneous melanoma, there was no apparent pattern of increased noncutaneous melanoma among residents of southern or coastal states, with the exception of melanoma of the ciliary body and iris. Despite their shared cellular origins, both ocular and mucosal melanomas differ from cutaneous melanoma in terms of incidence by gender, race, and geographic area.
Cancer 04/2005; 103(5):1000-7. · 4.77 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A spatial scan statistic was used to search for geographic areas with significantly elevated proportions of women diagnosed with distant stage breast cancer in New Jersey in 1995-1997. The identified areas then were mapped and characterized using data from the 1990 U.S. Census and locations of mammography facilities. These areas' population characteristics included relatively high proportions of black or Hispanic women and linguistically isolated households. Targeted education and screening programs using this information may increase the diagnosis of breast cancer in the early stages, thereby reducing breast cancer mortality.
Journal of public health management and practice: JPHMP 04/2002; 8(2):26-32. · 0.96 Impact Factor
