Mapping Colorectal Cancer in Texas Counties: How Age and Socioeconomic Factors Interact with Patients' Stage at Diagnosis with Colorectal Cancer

Kelly G McGauhey, The University of Texas School of Public Health

Abstract

Background: Colorectal cancer deaths, the second highest among U.S. cancer deaths, are preventable through mass screening, the aim of which is to catch cancers at an early stage, such as a stage 0 polyp. In the US, several colorectal cancer screening methods are available and recommended for people aged 50 or older who lack a family history of colorectal cancer. At the national level, demographic disparities in colorectal cancer screening, incidence, and mortality are well described in the literature; however, demographic disparities for emerging age-based trends in colorectal cancer incidence and mortality are not well understood. The aim of this study is to explore the relationship between socioeconomic determinants of health and stage at diagnosis with colorectal cancer, stratified by age, among Texans diagnosed with colorectal cancer between 2005 and 2014. Methods: Data were collected through surveillance by the Texas Cancer Registry, a department of the Texas Department of State Health Services. Multivariable logistic regression was used to test for associations between socioeconomic variables and stage at diagnosis with colorectal cancer, stratified by age at diagnosis in univariable and multivariable models. Results were used to create maps of Texas counties with populations that may be at increased risk of late stage colorectal cancer diagnosis. Results: The relationship between race/ethnicity and stage at colorectal cancer diagnosis, insurance status and stage at colorectal cancer diagnosis, and census tract poverty level and late stage colorectal cancer diagnosis differed between younger and older Texans. Among participants aged 50 and older, non-Hispanic Black participants (OR=1.25) were at higher odds of late stage diagnosis than White participants, participants with Medicaid (OR=1.38) or no insurance (OR=1.39) had higher odds of late stage colorectal cancer diagnosis than privately insured participants, and participants who lived in census tracts with greater than 5% poverty levels were at increased odds of late stage colorectal cancer compared to those in census tracts with 0-4.9% poverty. Among participants aged 18-49, participants with Medicaid had higher odds of late stage colorectal cancer diagnosis as compared to privately insured participants. Conclusion: This analysis found that associations between socioeconomic factors and late stage colorectal cancer differed between age-based strata. Information on socioeconomic factors associated with increased odds of late stage diagnosis was mapped and used to identify niche county level populations at elevated odds of late stage colorectal diagnosis.

Subject Area

Public health|Epidemiology

Recommended Citation

McGauhey, Kelly G, "Mapping Colorectal Cancer in Texas Counties: How Age and Socioeconomic Factors Interact with Patients' Stage at Diagnosis with Colorectal Cancer" (2018). Texas Medical Center Dissertations (via ProQuest). AAI10789839.
https://digitalcommons.library.tmc.edu/dissertations/AAI10789839

Share

COinS