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Residential Segregation and Lung Cancer Risk in African American Adults.

Yi Xiao1, Xiaoke Zou1, Calvin P Tribby1

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Summary

Residential segregation is linked to higher lung cancer risk in African Americans. Reducing segregation and addressing factors like menthol smoking and air pollution may lower cancer incidence.

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Area of Science:

  • Public Health
  • Epidemiology
  • Environmental Health

Background:

  • Structural racism, through residential segregation, contributes to race-based disparities in lung cancer care and survival.
  • The impact of residential segregation on lung cancer development is not well understood.

Purpose of the Study:

  • To investigate the association between residential segregation and lung cancer incidence.
  • To identify modifiable factors that mediate this association.

Main Methods:

  • Cohort study using data from the Southern Community Cohort Study (SCCS) with 71,634 participants (African American and non-Hispanic White).
  • Residential segregation measured by the isolation index; lung cancer incidence identified via cancer registries and National Death Index.
  • Parametric g-computation and mediation analyses (inverse propensity weighting, marginal structural models) were used.

Main Results:

  • Lower residential segregation was associated with reduced lung cancer incidence in African American individuals, but not non-Hispanic White individuals.
  • Menthol smoking (24.7%), particulate matter exposure (13.1%), secondhand smoke (4.7%), and education (4.6%) mediated the association between segregation and lung cancer risk in African Americans.

Conclusions:

  • Lowering residential segregation may decrease lung cancer risk for African Americans.
  • Interventions targeting menthol smoking and air pollution exposure are crucial for reducing lung cancer incidence in this population.
  • Public health policies should incorporate segregation metrics and address identified mediators.