Association of cutaneous melanoma incidence with area-based socioeconomic indicators–United States, 2004-2006 - 20/10/11
, Umed A. Ajani, MBBS, MPH a, Christopher J. Johnson, MPH b, Katherine B. Roland, MPH a, Melody Eide, MD, MPH c, Ahmedin Jemal, DVM, PhD d, Serban Negoita, MD, DrPH e, Rana A. Bayakly, MPH f, Donatus U. Ekwueme, PhD a
Reprint requests: Simple D. Singh, MD, MPH, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS K-53, Atlanta, GA 30341.Abstract |
Background |
Socioeconomic status (SES) has been associated with melanoma incidence and outcomes. Examination of the relationship between melanoma and SES at the national level in the United States is limited. Expanding knowledge of this association is needed to improve early detection and eliminate disparities.
Objective |
We sought to provide a detailed description of cutaneous melanoma incidence and stage of disease in relationship to area-based socioeconomic measures including poverty level, education, income, and unemployment in the United States.
Methods |
Invasive cutaneous melanoma data reported by 44 population-based central cancer registries for 2004 to 2006 were merged with county-level SES estimates from the US Census Bureau. Age-adjusted incidence rates were calculated by gender, race/ethnicity, poverty, education, income, unemployment, and metro/urban/rural status using software. Poisson multilevel mixed models were fitted, and incidence density ratios were calculated by stage for area-based SES measures, controlling for age, gender, and state random effects.
Results |
Counties with lower poverty, higher education, higher income, and lower unemployment had higher age-adjusted melanoma incidence rates for both early and late stage. In multivariate models, SES effects persisted for early-stage but not late-stage melanoma incidence.
Limitations |
Individual-level measures of SES were unavailable, and estimates were based on county-level SES measures.
Conclusion |
Our findings show that melanoma incidence in the United States is associated with aggregate county-level measures of high SES. Analyses using finer-level SES measures, such as individual or census tract level, are needed to provide more precise estimates of these associations.
Le texte complet de cet article est disponible en PDF.Key words : cancer, cancer registry, disparities, melanoma, socioeconomic status
Abbreviations used : CDC, CI, IR, NCI, RUCC, SEER, SES, USDA, UV
Plan
| Publication of this supplement to the JAAD was supported by the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC). Dr Eide was supported by a Dermatology Foundation Career Development Award in Health Care Policy. |
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| Conflicts of interest: None declared. |
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| The opinions or views expressed in this supplement are those of the authors and do not necessarily reflect the opinions, recommendations, or official position of the journal editors or the Centers for Disease Control and Prevention. |
Vol 65 - N° 5S1
P. S58.e1-S58.e12 - novembre 2011 Retour au numéro
Article précédent
- Association between cutaneous melanoma incidence rates among white US residents and county-level estimates of solar ultraviolet exposure
- Thomas B. Richards, Christopher J. Johnson, Zaria Tatalovich, Myles Cockburn, Melody J. Eide, Kevin A. Henry, Sue-Min Lai, Sai S. Cherala, Youjie Huang, Umed A. Ajani
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