Among the 2007 strategic goals of the National Cancer Institute (NCI) are improving early detection of cancers and overcoming cancer health disparities. To help NCI achieve the vision of """"""""A Nation free from the suffering and death due to cancer by 2015 with dramatic reductions in cancer incidence,"""""""" RTI International and the University of Illinois at Urbana-Champaign have partnered to advance the understanding of discrepancies in the participation in cancer screening across subpopulations and regions of the United States. The major aims are to (1) contribute to a better understanding of the factors that influence cancer screening rates and characteristics of locales with the lowest rates, so that these disparities might be reduced, and (2) advance new geospatial methods and measurements in social science and behavioral health research and apply them to the study of cancer screening rates. We will achieve this by: developing and making publicly available a database of geospatial measures, which include characteristics of people in places and characteristics of the places themselves; developing and making publicly available new spatial analysis software capabilities and a Web application, built to standards developed by the Open Geospatial Consortium, that allows analysis of data in the databases along with proprietary data linked to the system by the user;and using these data and tools to estimate multivariate models explaining variability in cancer screening across people and places, and disseminating the findings and other support materials, providing information that will guide other researchers who use these data and tools. In our research, we will examine determinants of screening for two types of cancer (breast and colorectal) among large retrospective cohorts of the elderly population residing in all areas of the United States. We will combine the information contained in detailed health administrative records (Medicare claims) with our newly constructed geospatial variables pertaining to contextual factors that vary across small areas of geography. Our research papers will contribute to a better understanding of the factors that cause variability in cancer screening, and show the significance of place-specific heterogeneity in assessing health behaviors and outcomes. We will demonstrate how this approach might be used to identify locales where targeted interventions could be most effective. Our research, readily available software, public-use geospatial database and Web portal with interactive mapping and geovisualization capabilities will advance the application of new geospatial methods and measurement in social science and behavioral health research.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Community Influences on Health Behavior (CIHB)
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Lewis, Denise
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Research Triangle Institute
Research Triangle
United States
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Mobley, Lee R; Kuo, Tzy-Mey; Scott, Lia et al. (2017) Modeling Geospatial Patterns of Late-Stage Diagnosis of Breast Cancer in the US. Int J Environ Res Public Health 14:
Mobley, Lee R; Scott, Lia; Rutherford, Yamisha et al. (2017) Using residential segregation to predict colorectal cancer stage at diagnosis: two different approaches. Ann Epidemiol 27:10-19
Mobley, Lee R; Amaral, Pedro; Kuo, Tzy-Mey et al. (2017) Medicare modernization and diffusion of endoscopy in FFS medicare. Health Econ Rev 7:13
Scott, Lia; Mobley, Lee R; Il'yasova, Dora (2017) Geospatial Analysis of Inflammatory Breast Cancer and Associated Community Characteristics in the United States. Int J Environ Res Public Health 14:
Mobley, Lee R; Kuo, Tzy-Mey (2017) Demographic Disparities in Late-Stage Diagnosis of Breast and Colorectal Cancers Across the USA. J Racial Ethn Health Disparities 4:201-212
Folch, David C; Arribas-Bel, Daniel; Koschinsky, Julia et al. (2016) Spatial Variation in the Quality of American Community Survey Estimates. Demography 53:1535-1554
Kuo, Tzy-Mey; Mobley, Lee R (2016) How generalizable are the SEER registries to the cancer populations of the USA? Cancer Causes Control 27:1117-26
Mobley, Lee R; Kuo, Tzy-Mey May (2015) Geographic and Demographic Disparities in Late-stage Breast and Colorectal Cancer Diagnoses Across the US. AIMS Public Health 2:583-600
Mobley, Lee R; Kuo, Tzy-Mey (2015) United States Health Policies and Late-stage Breast and colorectal cancer diagnosis: Why such disparities by age? Health Econ Rev 5:58
Mobley, Lee R; Kuo, Tzy-Mey; Traczynski, Jeffrey et al. (2014) Macro-level factors impacting geographic disparities in cancer screening. Health Econ Rev 4:13

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