Epidemiology & Biostatistics Theses and Dissertations

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COUNTY AND CENSUS TRACT SOCIOECONOMIC ATTRIBUTES OF ESOPHAGEAL ADENOCARCINOMA CASES SEER 15 (2000-2007)
(2011) Ghazarian, Armen Alex; Saksvig, Brit I; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Esophageal adenocarcinoma (EAC) incidence rates have increased among U.S. men. We examined associations between area-level socioeconomic attributes and stage at diagnosis, an important prognostic predictor of survival time. Logistic regression models were developed to estimate odds ratios (OR) adjusted for age, race, gender and year of diagnosis and 95% confidence intervals (CI) for localized and regional versus distant stage by census tract and county level socioeconomic attributes. At the county level, a high percent of foreign born population was associated with distant stage EAC: >15.4%-26.6%, (OR=1.15, 95% CI: 1.04-1.28) and >26.6% (OR 1.16, 95% CI: 1.03-1.31). Median household income from $40.8-$45.6K (OR=1.14, 95% CI: 1.01-1.28) was also associated with distant stage EAC. Conversely, residence in an urban county was associated with localized or regional stage EAC (OR=0.90, 95% CI: 0.82-0.98). Findings regarding area level disparities in EAC stage may inform cancer control efforts.