Dataset Information

What are the contextual risk factors for low colorectal cancer screening uptake in El Paso County, Texas? Spatial cross-sectional analysis.

ABSTRACT: OBJECTIVE:This study examines the geographical and socioeconomic factors associated with uptake of colorectal cancer (CRC) screening (colonoscopies or faecal immunochemical test (FIT) testing). DESIGN:Secondary data analysis. SETTING:The Against Colorectal Cancer in our Community (ACCION) programme was implemented in El Paso County, Texas, to increase screening rates among the uninsured and underinsured. PARTICIPANTS:We successfully geocoded 5777 who were offered a free colonoscopy or FIT testing kit. PRIMARY OUTCOME MEASURE:Census-tract CRC screening uptake average. RESULTS:Medicare recipient mortality (?=0.409, p-value=0.049) and % 65 years or older (?=-0.577, p value=0.000) were significant census tract contextual factors that were associated with the prevalence of CRC screening uptake in the geographically weighted Poisson regression. Neither Latino ethnicity nor immigrant concentration were significant predictors of CRC screening uptake in the ACCION programme. Hot spot analysis demonstrated that there was a significant low-value cluster in South Central El Paso. There was a similar hot spot for % 65 years or older in this same area, suggesting that uptake was lowest in an area that had the highest concentration of older adults. CONCLUSION:The results from this study revealed not only feasibility of hot spot analysis but also its utility in geographically tracking successful CRC screening uptake in cancer prevention and intervention programmes.

SUBMITTER: Salinas J

PROVIDER: S-EPMC7549472 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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What are the contextual risk factors for low colorectal cancer screening uptake in El Paso County, Texas? Spatial cross-sectional analysis.

Salinas Jennifer J Brito Jacquelyn J Rincones Cheyenne C Shokar Navkiran K NK

BMJ open 20201010 10

<h4>Objective</h4>This study examines the geographical and socioeconomic factors associated with uptake of colorectal cancer (CRC) screening (colonoscopies or faecal immunochemical test (FIT) testing).<h4>Design</h4>Secondary data analysis.<h4>Setting</h4>The Against Colorectal Cancer in our Community (ACCION) programme was implemented in El Paso County, Texas, to increase screening rates among the uninsured and underinsured.<h4>Participants</h4>We successfully geocoded 5777 who were offered a f ...[more]

PMID: 33040009

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Project description:El Paso County (Texas) is prone to still air inversions and is one of the dust "hot spots" in North America. In this context, we examined the sub-lethal effects of airborne dust and low wind events on human respiratory health (i.e., asthma and acute bronchitis) between 2000 and 2003, when 110 dust and 157 low wind events occurred. Because environmental conditions may not affect everyone the same, we explored the effects of dust and low wind within three age groups (children, adults, and the elderly), testing for effect modifications by sex and insurance status, while controlling for weather and air pollutants.We used a case-crossover design using events matched with referent days on the same day-of-the-week, month, and year with conditional logistic regression to estimate the probability of hospital admission, while controlling for apparent temperature (lag 1), nitrogen dioxide, and particulate matter of 2.5?m or less.Children (aged 1-17) were 1.19 (95% confidence interval: 1.00-1.41) times more likely to be hospitalized for asthma three days after a low wind event, and 1.33 (95% CI: 1.01-1.75) times more likely to be hospitalized for acute bronchitis one day after a dust event than on a clear day. Girls were more sensitive to acute bronchitis hospitalizations after dust events (1.83, 95% CI: 1.09-3.08) than boys, but less sensitive than boys to acute bronchitis hospitalizations after low wind events (0.68, 95% CI: 0.46-1.00). We found general trends with regard to dust and low wind events being associated with increased odds of hospitalization for asthma and bronchitis amongst all ages and adults (aged 18-64). Adults covered by Medicaid and adults without health insurance had higher risks of hospitalization for asthma and acute bronchitis after both low wind and dust events.Results suggest that there were respiratory health effects associated with dust and low wind events in El Paso, with stronger impacts among children and poor adults. Girls and boys with acute bronchitis were differentially sensitive to dust and low wind events.

Project description:BackgroundProtecting the health of refugees and other migrant populations in the United States is key to ensuring successful resettlement. Therefore, to identify and address health concerns early, the US Centers for Disease Control and Prevention (CDC) recommends a domestic medical examination (screening for infectious and noninfectious diseases/conditions) shortly after arrival in the US. However, because refugee/migrant populations often have differing health patterns from one another and the US population, the collection and analysis of health information is key to developing population-specific clinical guidelines to guide the care of resettled individuals. Yet little is known regarding the health status of Cubans resettling in the US. Among the tens of thousands of Cuban migrants who have resettled in the US, some applied as refugees in Cuba, some applied for parole (a term used to indicate temporary US admission status for urgent humanitarian reasons or reasons of public benefit under US immigration law) in Cuba, and others applied for parole status after crossing the border. These groups were eligible for US government benefits to help them resettle, including a domestic medical examination. We reviewed health differences found in these examinations of those who were determined to be refugees or parolees in Cuba and those who were given parole status after arrival.Methods and findingsWe conducted a retrospective cross-sectional analysis of the Texas Department of State Health Services database. Cubans who arrived from 2010 to 2015 and received a domestic medical examination in Texas were included. Those granted refugee/parolee status in Cuba were listed in federal databases for US-bound refugees/parolees; those who were paroled after arrival were not listed. Overall, 2,189 (20%) obtained either refugee or parolee status in Cuba, and 8,709 (80%) received parolee status after arrival. Approximately 62% of those who received parolee status after arrival at the border were male, compared with 49% of those who obtained prior refugee/parolee status in Cuba. Approximately one-half (45%) of those paroled after arrival were 19-34 years old (versus 26% among those who obtained refugee/parolee status in Cuba). Separate models were created for each screening indicator as the outcome, with entry route as the main exposure variable. Crude and adjusted prevalence ratios were estimated using PROC GENMOD procedures in SAS 9.4. Individuals paroled after arrival were less likely to screen positive for parasitic infections (9.6% versus 12.2%; adjusted prevalence ratio: 0.79, 0.71-0.88) and elevated blood lead levels (children ≤16 years old, 5.2% versus 12.3%; adjusted prevalence ratio: 0.42, 0.28-0.63). Limitations include potential disease misclassification, missing clinical information, and cross-sectional nature.ConclusionsWithin-country variations in health status are often not examined in refugee populations, yet they are critical to understand granular health trends. Results suggests that the health profiles of Cuban Americans in Texas differed by entry route. This information could assist in developing targeted screenings and health interventions.

Project description:BackgroundSpatial access to primary care has been associated with late-stage and fatal breast cancer, but less is known about its relation to outcomes of other screening-preventable cancers such as colorectal cancer. This population-based retrospective cohort study examined whether spatial access to primary care providers associates with colorectal cancer-specific survival.MethodsApproximately 26 600 incident colorectal cancers diagnosed between 2000 and 2008 in adults residing in Cook County, Illinois were identified through the state cancer registry and georeferenced to the census tract of residence at diagnosis. An enhanced two-step floating catchment area method measured tract-level access to primary care physicians (PCPs) in the year of diagnosis using practice locations obtained from the American Medical Association. Vital status and underlying cause of death were determined using the National Death Index. Fine-Gray proportional subdistribution hazard models analyzed the association between tract-level PCP access scores and colorectal cancer-specific survival after accounting for tract-level socioeconomic status, case demographics, tumor characteristics, and other factors.ResultsIncreased tract-level access to PCPs was associated with a lower risk of death from colorectal cancer (hazard ratio [HR], 95% confidence interval [CI]) = 0.87 [0.79, 0.96], P = .008, highest vs lowest quintile), especially among persons diagnosed with regional-stage tumors (HR, 95% CI = 0.80 [0.69, 0.93], P = .004, highest vs lowest quintile).ConclusionsSpatial access to primary care providers is a predictor of colorectal cancer-specific survival in Cook County, Illinois. Future research is needed to determine which areas within the cancer care continuum are most affected by spatial accessibility to primary care such as referral for screening, accessibility of screening and diagnostic testing, referral for treatment, and access to appropriate survivorship-related care.

Dataset Information

What are the contextual risk factors for low colorectal cancer screening uptake in El Paso County, Texas? Spatial cross-sectional analysis.

Publications

What are the contextual risk factors for low colorectal cancer screening uptake in El Paso County, Texas? Spatial cross-sectional analysis.

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