Neighborhood Factors Related to Cancer Screening in Texas: A Spatioecological Study

Area of Science:

• Public Health
• Spatial Epidemiology
• Health Disparities

Background:

• Cancer screening rates vary significantly across different geographic and demographic groups.
• Understanding the role of neighborhood characteristics is crucial for targeted public health interventions.

Purpose of the Study:

• To examine associations between neighborhood socioeconomic status (nSES), ethnic enclaves, and Black segregation with breast, cervical, and colorectal cancer screening.
• To identify geospatial clusters of low cancer screening rates in Texas.

Main Methods:

• Ecologic study design utilizing Texas census tract data.
• Spatial clustering analysis (local Moran's I) to identify areas with low screening rates.
• Binomial spatial probit regression to assess associations between neighborhood factors and low screening clusters, adjusting for behaviors.

Main Results:

• 5.4% (colorectal), 4.6% (cervical), and 8.7% (breast) of tracts were in low screening clusters.
• Higher nSES associated with reduced odds of low cervical cancer screening.
• Hispanic and Asian American enclaves showed increased odds of low screening for certain cancers.
• High Black segregation associated with reduced odds of low colorectal and breast cancer screening.

Conclusions:

• Geospatial clusters of cancer screening uptake are linked to neighborhood socioeconomic status and racial/ethnic composition.
• Place-based, culturally sensitive interventions are necessary to address disparities in screening uptake.