The overall objective of the proposed study is to provide a better understanding of the joint effects of racial and socioeconomic characteristics of census tracts of residence on cancer incidence rates. We propose to examine these associations with cancer incidence rates at five sites (lung/bronchus, breast, prostate, colon/rectum, and cervix) in Black and White men and women in the Detroit Metropolitan Area, 1973-2002. First, census tracts of residence will be considered a proxy for individual measures of socioeconomic position and defined by the following characteristics of census tracts of residence: (i) percent poverty, (ii) the Darden and Kamel index, 2000 and (iii) a modified Krieger Socioeconomic Position (SEP) index, 2002. Next, we consider area-based characteristics of census tracts of residence and examine the association between racial and socioeconomic segregation (including concentration, centralization and clustering) and cancer incidence rates. Information on race and cancer status will be obtained from the SEER (Surveillance, Epidemiology and End Results) Detroit Metropolitan Area cancer registry, which is ideal for these analyses because it has one the highest percentages of Blacks, compared to other SEER registries. Information on characteristics of cancer patients' residences have been geocoded to identify their census tract of residence and characteristics of these census tracts will be identified through the U.S. Census of Population and Housing for the Detroit Metropolitan Area for 1970-2000. Information on the denominator populations residing in the Detroit Metropolitan Area will also be obtained from the U.S.1970-2000 Census. Cancer incidence rates will be calculated using Poisson regression, adjusted for age and examined within strata of gender, race, and five-year time intervals between 1973-2002. Investigating the association between race, SEP, and segregation, may provide insight into disparities in cancer incidence, point to more specific etiologic hypotheses for cancer incidence, and identify target populations for prevention.
