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Disentangling the effects of race/ethnicity and socioeconomic status of neighborhood in cancer stage distribution in New York City

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Abstract

Purpose

Stage at diagnosis is an important prognostic factor for the majority of cancers; it may be an indicator for quality of access to health care and is usually correlated with socioeconomic status (SES) and ethnicity/race. We aimed to investigate the association between stage of cancer at diagnosis with neighborhood of residence (as proxy for SES) and ethnicity/race, while controlling for each other, in selected areas of New York City (NYC).

Methods

The cancer summary data (1999–2008) were provided by the New York State Cancer Registry. Multinomial logistic regression models were applied to calculate risk estimates for being diagnosed with late- or unknown-stage (versus early-stage) cancers in two low-SES and two high-SES neighborhoods of NYC and among several ethnic/racial groups for all cancers combined and cancers of the female breast, lung, colorectum, and prostate, with additional adjustments for sex (for all cancers combined), age, and year of diagnosis.

Results

A total of 34,981 cancer cases were included in this study. There were significant and independent ethnic/racial and neighborhood disparities in stage of cancer at diagnosis of most of the cancers studied. The effect of ethnicity/race on the disparity appeared stronger than the effect of neighborhood. There was an overall decreasing trend in the proportion of late-stage cancers, particularly for colorectal cancer, and to a greater extent in the proportion of cancers without staging information.

Conclusions

In this population, ethnicity/race seems to be a stronger predictor for late stage at diagnosis than SES, stressing the need for ethnicity/race-oriented programs for cancer screening and improved access to care.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. The Tisch Cancer Institute and Institute for Transitional Epidemiology, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA

    Farhad Islami & Paolo Boffetta

  2. New York State Department of Health, New York State Cancer Registry, Albany, NY, USA

    Amy R. Kahn & Maria J. Schymura

  3. Departments of Health Evidence and Policy and Medicine, Mount Sinai School of Medicine, New York, NY, USA

    Nina A. Bickell

  4. International Prevention Research Institute, Lyon, France

    Paolo Boffetta

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  1. Farhad Islami
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  2. Amy R. Kahn
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  3. Nina A. Bickell
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  4. Maria J. Schymura
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  5. Paolo Boffetta
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Correspondence to Farhad Islami.

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Islami, F., Kahn, A.R., Bickell, N.A. et al. Disentangling the effects of race/ethnicity and socioeconomic status of neighborhood in cancer stage distribution in New York City. Cancer Causes Control 24, 1069–1078 (2013). https://doi.org/10.1007/s10552-013-0184-2

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