Cancer Data Visualization: Developing Tools to Serve the Needs of Diverse Stakeholders

Purpose of review To describe how cancer data visualization tools can catalyze novel research and inform local cancer control planning. Recent findings In recent years, cancer centers across the nation have increasingly embraced geospatial tools to respond to the unique distributions of disease and multilevel risk factors within their catchment areas. Sylvester Comprehensive Cancer Center in Miami, Florida, recently developed a publicly available, interactive, web-based cancer data visualization tool called SCAN360. Using SCAN360 as an example, we discuss key considerations and challenges for the development of cancer data visualization tools that serve the needs of stakeholders in community, academic and government settings. Cancer data visualization tools are useful for stakeholders from diverse sectors and may facilitate a range of cancer control efforts, from identifying regions for targeted outreach and engagement, to informing the allocation of resources for government and community initiatives, and motivating collaborative, interdisciplinary cancer research

Epidemiology and Etiology of Leukemia and Lymphoma

Available evidence suggests that the incidence of leukemia and lymphoma tends to be higher in highly developed regions of the world and among Whites in the United States. Temporal trends in incidence are dynamic and multifactorial; for instance, the incidence of non-Hodgkin's lymphoma increased around the turn of the century, in part because of the acquired immune deficiency syndrome (AIDS) epidemic. Most leukemias and lymphomas are sporadic and the specific etiology remains elusive. Still, research shows that these malignancies often develop in the context of genetic abnormalities, immunosuppression, and exposure to risk factors like ionizing radiation, carcinogenic chemicals, and oncogenic viruses. The prognosis varies by subtype, with poorer survival outcomes for acute leukemias among adults, and more favorable outcomes for Hodgkin's lymphoma. At a time when specific prevention efforts targeting these malignancies are nonexistent, there is a great need to ensure equitable access to diagnostic services and treatments worldwide

Abstract C083: Exploring relationships between neighborhood social vulnerability and cancer screening in Miami-Dade County

Abstract Purpose: Social and structural contributors to social vulnerability have been associated with cancer disparities across the continuum. This study aimed to explore relationships between indicators of neighborhood social vulnerability and participation in breast, cervical and colorectal cancer screening in Miami-Dade County. Methods: Data were obtained at the census tract level from the United States Census Bureau American Community Survey (2014-2018), the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (2018), and the CDC PLACES dataset (2018). This analysis was restricted to Miami-Dade census tracts for which PLACES data was available on mammography (n=135), cervical cancer screening (n=115), and colorectal screening (n=136) participation. Census tracts were stratified into tertiles based on screening participation, then social vulnerability indicators were assessed among the tertiles. Principal component analysis (PCA) was used to identify characteristics responsible for most variability in breast, cervical and colorectal cancer screening. Results: Mammography participation was 51.76%, 58.80%, and 65.65% in the lower, middle, and upper tertiles, respectively. Among these tracts, per capita income (p<.001), earning an income below poverty (p<.001), educational attainment below earning an HS diploma (p<.001), the proportion of non-Hispanic White residents (p<.001), unemployed residents (p<.001), residents with a disability (p<.001), and people with no computer or limited access to the internet (p<.001) were significantly different between the tertiles. Cervical cancer screening participation was 79.60%, 84.36%, and 87.80% in the lower, middle, and upper tertiles, respectively. Among these tracts, per capita income (p<.001), earning an income below poverty (p<.001), educational attainment below earning an HS diploma (p<.001), and proportion of single-parent households with children under age 17 (p<.001), non-Hispanic White residents (p<.001), unemployed residents (p<.001), residents with a disability (p<.001), and people with no computer or limited access to the internet (p<.001) were significantly different between the screening tertiles. Colorectal cancer screening participation was 79.26%, 81.06%, and 85.26% in the lower, middle, and upper tertiles, respectively. Among these tracts, per capita income (p<.01), earning an income below poverty (p<.004), educational attainment below earning an HS diploma (p<.001), the proportion of residents with a disability (p<.001), and people with no computer or limited access to the internet (p<.001) were significantly different between the screening tertiles. Conclusions: These data suggest that social vulnerability is associated with cancer screening uptake, namely mammography, cervical cancer screening, and colorectal cancer screening. Further investigation of the social and structural factors contributing to disparities in cancer screening will help appropriately allocate resources and craft effective interventions to reduce the burden of cancer among those most vulnerable. Citation Format: Kilan C. Ashad-Bishop, Jordan A. Baeker-Bispo, Zinzi D. Bailey, Erin K. Kobetz. Exploring relationships between neighborhood social vulnerability and cancer screening in Miami-Dade County [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C083

Variation in type II endometrial cancer risk by Hispanic subpopulation: An exploratory analysis

Minorities have demonstrated an increased risk for type II endometrial cancers, but no data exists about risk among minority subpopulations. Our objective was to evaluate heterogeneity in risk of type II endometrial cancer (EC) histologies across race and Hispanic sub-groups using data from Florida's statewide cancer registry (FCDS). FCDS contains data on N=26,416 women diagnosed with EC from 2004 to 2013. Our analysis included women ≥18years of age who were classified as non-Hispanic White (NHW), non-Hispanic Black (NHB) or belonged to one of five Hispanic sub-groups, and had a histology code consistent with type I or type II EC. Binary logistic regression analyses were performed to model risk of type II versus type I ECs across racial and ethnic groups relative to NHW. Relative to NHW, overall odds of being diagnosed with a type II EC were significantly higher in NHB (OR=2.64, 95%CI: 2.38–2.92), Cubans (OR=1.35, 95%CI: 1.08–1.68) and South and Central Americans (SCA) (OR=1.84, 95%CI: 1.40–2.43). Compared to NHW, odds of serous EC were significantly higher in Cubans (OR=2.15, 95% CI: 1.51–3.05) and NHB (OR=2.51, 95% CI: 2.11–2.97); odds of carcinosarcoma (CS) were significantly higher in NHB (OR=2.97, 95% CI: 2.47–3.57) and Puerto Ricans (OR=2.35, 95%CI: 1.32–4.17); and odds of grade III adenocarcinoma (AG3) were significantly higher in NHB (OR=1.60, 95% CI: 1.42–1.81) and SCA (OR=1.76, 95%CI: 1.29–2.40). Risk of type II EC varies considerably across Hispanic sub-groups, with Cubans, Puerto Ricans and SCA characterized by elevated odds for specific type II histologies. •Type II endometrial cancer disproportionally affects non-White women.•Hispanic subgroups display variable risks for type II endometrial histologies.•Cuban women have a significantly elevated odds of uterine serous carcinoma.•Risk of grade 3 endometrioid carcinoma is similar in Black and South American women

Perceptions of Practitioner Support for Patient Autonomy are Associated with Delayed Health Care Seeking among Haitian Immigrant Women in South Florida

Few empirical studies have evaluated how perceptions of the patient-provider relationship affect health care seeking among Haitian immigrants. In this cross-sectional study, we examined whether perceptions of practitioner support for patient autonomy facilitate or hinder health care seeking among Haitian women enrolled in a cervical self-sampling trial. Perceived autonomy support was measured using an adapted health care climate questionnaire. Associations between perceived autonomy support and health care seeking were modeled using logistic regression and classification and regression trees. Covariates included socioeconomic and structural access indicators. Dependent variables included receipt of any medical care in the past year and delayed health care seeking. Having a usual source of care was strongly associated with both dependent variables. Lower perceived autonomy support was associated with delayed health care seeking in regression models and classification and regression trees. Addressing the capacity of health workers to deliver autonomy-supportive care is essential for improving health services utilization in vulnerable populations

Social-Environmental Injustice and Cancer Screening Prevalence

This cross-sectional study characterizes the prevalence of cancer screening across geographic clusters of social risk factors, environmental burden, and compounded social-environmental injustice in densely-populated urban areas of the US

Hyperlocal disparities in breast, cervical, and colorectal cancer screening: An ecological study of social vulnerability in Miami-Dade county

Neighborhoods have been identified as important determinants of health-related outcomes, but limited research has assessed the influence of neighborhood context along the cancer continuum. This study used census tract-level data from the United States Census Bureau and Centers for Disease Control and Prevention to characterize Miami-Dade County census tracts (n = 492) into social vulnerability clusters and assess their associated breast, cervical, and colorectal cancer screening participation rates. We identified disparities by social vulnerability cluster in cancer screening participation rates. Further investigation of geographic disparities in social vulnerability and cancer screening participation could inform equity-focused cancer control efforts