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Cancer Causes Control. 2018 Sep;29(9):875-881. doi: 10.1007/s10552-018-1063-7. Epub 2018 Jul 28.

The influence of neighborhood socioeconomic status and ethnic enclave on endometrial cancer mortality among Hispanics and Asian Americans/Pacific Islanders in California.

Author information

1
Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, 2201 Walnut Ave, Suite 300, Fremont, CA, 94538, USA. Julie.VonBehren@UCSF.edu.
2
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA. Julie.VonBehren@UCSF.edu.
3
Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, 2201 Walnut Ave, Suite 300, Fremont, CA, 94538, USA.
4
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
5
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

Abstract

PURPOSE:

We investigated the role of neighborhood socioeconomic status (nSES) and residence in ethnic enclaves on mortality following endometrial cancer (EC) diagnosis among Hispanics and Asian Americans/Pacific Islanders (AAPI).

METHODS:

Using California Cancer Registry data, enhanced with census block group information on ethnic enclave and nSES, we examined 9,367 Hispanics and 5,878 AAPIs diagnosed with EC from 1988 to 2011. Cox proportional hazard models were used to estimate associations between all-cause and EC-specific mortality with nSES and ethnic enclaves, adjusting for subject sociodemographic and tumor characteristics.

RESULTS:

Hispanics in the lowest SES neighborhoods had a 39% and 36% increased risk of all-cause and EC-specific mortality, respectively, compared to Hispanics in the highest SES neighborhoods. AAPIs in the lowest SES neighborhoods had a 37% increased risk of all-cause mortality compared to AAPIs in the highest SES neighborhoods. Living in an ethnic enclave was associated with lower all-cause mortality risk for AAPIs.

CONCLUSIONS:

Mortality risk varied by nSES and ethnic enclave among Hispanics and AAPIs. Women living in lower SES communities experienced significantly higher risk, highlighting the need to identify the specific neighborhood factors underlying these associations so that community-based interventions may be properly targeted.

KEYWORDS:

Asian Americans; California; Endometrial neoplasms; Hispanic Americans; Mortality; Proportional hazards models; Registries; Residence Characteristics; Social class

PMID:
30056614
DOI:
10.1007/s10552-018-1063-7
[Indexed for MEDLINE]

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