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

• 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
• 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

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、肺癌和女性乳腺癌是主要的公共卫生负担，并且存在明显的地理分布 以及其发病率的种族/民族差异。这些癌症中的每一种都与邻里因素有关 包括社会经济剥夺、建筑环境和环境污染物，试图解释 现有的风险差异。虽然存在关联，但之前的大多数研究都考虑了邻里暴露 仅在一次（例如，诊断时）并且仅使用单一的邻里暴露测量（例如， 邻里剥夺或单一环境污染物），这是多因素的简化 癌症的性质。因此，暴露领域的相对重要性未知，影响可能是 被低估，并且缺乏对风险因素的累积评估。人们对暴露组的兴趣日益浓厚 呼吁对社区随时间的暴露情况进行更彻底的评估，以更好地解释 导致癌症差异的因素。因此，我们建议研究综合邻里 劣势（ND），社会经济剥夺、种族隔离、环境污染物的组合， 和建筑环境领域，为邻里协会提供更有力的证据并识别风险 可以修改这些因素以消除地理和种族癌症差异。的重要限制 该提案克服的现有工作是 1）暴露的时间性和程度（即早年生活） 暴露、晚年暴露或累积一生暴露），2）关键邻域的识别 癌症发病率的暴露变量，以及 3) 考虑邻近的不同领域 随着时间的推移，独立和组合地暴露，以更全面地考虑关系 患有癌症。我们的具体目标是估计 ND 域随时间的暴露影响并研究 这些领域暴露的轨迹以及癌症部位、种族和性别的影响。我们将汇集数据 来自弗吉尼亚州和宾夕法尼亚州癌症登记处、基于人口的控制、居住史以及 记录历史劣势指标的暴露数据。我们方法的高度创新方面 包括：1）检查几个重要邻里劣势的历史暴露水平 领域和 2）我们团队一直在改进的新颖贝叶斯统计方法的应用 估计邻里劣势及其影响。我们假设我们的新估计方法 与现有方法相比，邻里劣势将更好地解释癌症发病率的变化，并将 确定随时间推移对每种癌症影响最大的暴露变量。这项研究非常重要，因为它 第一项评估多种癌症的邻里不利影响并考虑累积效应的研究 使用住宅历史记录的几个历史暴露领域的风险。本研究的预期结果 将识别与重大癌症相关的历史街区劣势暴露 风险作为政策制定和干预措施的目标，并帮助减少癌症方面的差异。