Assessing residential neighborhood exposome exposures and the associations with cancer incidence

评估住宅区暴露暴露及其与癌症发病率的关联

基本信息

批准号：
10734602
负责人：
David Charles Wheeler
金额：
$ 37.2万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-07-08 至 2028-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10734602
关键词：
Area Automobile Driving Back Bayesian Method Breast Characteristics Colorectal Colorectal Cancer Crime Data Diagnosis Disadvantaged Disparity Elderly Environmental Exposure Environmental Pollutants Environmental Risk Factor Ethnic Origin Exposure to Female Female Breast Carcinoma Geography Green space Health Incidence Individual Influentials Intervention Life Life Cycle Stages Link Location Lung Malignant Neoplasms Malignant neoplasm of lung Measures Methods Motivation Nature Neighborhoods Outcome Outcomes Research Pennsylvania Policies Policy Developments Population Prevention Research Public Health Race Racial Segregation Recording of previous events Registries Risk Risk Assessment Risk Factors Role Shapes Societal Factors Time Variant Virginia Work built environment cancer health disparity cancer prevention cancer risk cancer site carcinogenicity case control deprivation disparity reduction early life exposure ethnic disparity evidence base experience geographic disparity indexing innovation interest malignant breast neoplasm mortality neighborhood association neighborhood disadvantage neoplasm registry novel novel strategies pollutant population based racial disparity segregation sex socioeconomics structural determinants time use walkability

项目摘要

Colorectal, lung, and female breast cancers are major public health burdens and there are clear geographic and racial/ethnic disparities in their incidence. Each of these cancers has been linked to neighborhood factors including socioeconomic deprivation, the built environment, and environmental pollutants in attempts to explain existing disparities in risk. While associations exist, most previous studies considered neighborhood exposures at only one time (e.g., time of diagnosis) and used only single measures of neighborhood exposures (e.g., neighborhood deprivation or singular environmental pollutants), which is a simplification of the multifactorial nature of cancer. As a result, the relative importance of exposure domains is unknown, effects may be underestimated, and a cumulative assessment of risk factors is lacking. Increasing interest in the exposome calls for a more thorough assessment of neighborhood exposures over time that could better explain the factors leading to disparities in cancers. Therefore, we propose to study comprehensive neighborhood disadvantage (ND), a combination of socioeconomic deprivation, racial segregation, environmental pollutant, and built environment domains, to provide stronger evidence of neighborhood associations and identify risk factors that could be modified to eliminate geographic and racial cancer disparities. The important limitations of existing work that this proposal overcomes are 1) the temporality and extent of exposures (i.e., earlier life exposure, later life exposure, or cumulative lifetime exposure), 2) the identification of key neighborhood exposure variables for cancer incidence, and 3) consideration of different domains of the neighborhood exposome over time both independently and in combination to more comprehensively consider relationships with cancer. Our specific aims are to estimate exposure effects for ND domains over time and study the trajectories of these domain exposures and effects by cancer site, race, and sex. We will bring together data from the Virginia and Pennsylvania state cancer registries, population-based controls, residential histories, and exposure data documenting historical disadvantage indicators. Highly innovative aspects of our approach include: 1) examination of historical levels of exposure to several important neighborhood disadvantage domains and 2) the application of novel Bayesian statistical methods that our team has been refining for estimating neighborhood disadvantage and its effects. We hypothesize that our novel approaches to estimating neighborhood disadvantage will better explain variation in cancer incidence than existing methods and will identify the most influential exposure variables over time for each cancer. This study is highly significant as it is the first study to estimate neighborhood disadvantage effects for multiple cancers that considers cumulative risk from several historic exposure domains using residential histories. The expected outcomes of this research will be the identification of historic neighborhood disadvantage exposures associated with significant cancer risk to target for policy development and interventions and to help reduce disparities in cancer.

结直肠癌，肺和女性乳腺癌是主要的公共卫生负担，有明确的地理位置和种族/种族差异。这些癌症中的每一个都与邻里因素有关包括社会经济剥夺，建筑环境和环境污染物，以解释现有风险差异。尽管存在关联，但大多数以前的研究都考虑了邻里暴露仅一次（例如，诊断时间），仅使用单一的邻里暴露量度（例如，邻里剥夺或奇异的环境污染物），这是多因素的简化癌症的性质。结果，暴露域的相对重要性尚不清楚，效果可能是缺乏低估的危险因素的累积评估。对展览组的兴趣增加随着时间的流逝，要求对邻里暴露进行更彻底的评估，以更好地解释导致癌症差异的因素。因此，我们建议研究全面的社区劣势（ND），社会经济剥夺，种族隔离，环境污染物的结合，并建立环境领域，提供更强大的社区关联证据并确定风险可以修改以消除地理和种族癌症差异的因素。重要的局限该提案克服的现有工作是1）暴露的时间和程度（即早期生活暴露，以后的生活暴露或累积终生暴露），2）识别关键社区癌症发病率的暴露变量和3）考虑邻里的不同领域随着时间的推移，独立和结合使用，更全面地考虑关系癌症。我们的具体目的是估计随着时间的推移对ND域的暴露影响，并研究这些领域暴露和效果的轨迹会受到癌症部位，种族和性别的影响。我们将汇总数据来自弗吉尼亚州和宾夕法尼亚州癌症登记处，基于人群的控制，住宅历史和暴露数据记录了历史劣势指标。我们方法的高度创新方面包括：1）检查历史水平暴露于几个重要邻里劣势域和2）我们团队一直在精炼的新型贝叶斯统计方法的应用估计邻里劣势及其影响。我们假设我们的新颖方法估计与现有方法相比确定每种癌症随着时间的影响最大的暴露变量。这项研究非常重要，因为它是首次估计多种癌症的邻里劣势效应的研究，这些癌症认为累积使用住宅历史的几个历史曝光领域的风险。这项研究的预期结果将是与重大癌症相关的历史社区劣势暴露旨在实现政策制定和干预措施的风险，并有助于减少癌症的差异。