Socio-ecological and cultural factors attributed to later stage cancer diagnosis

Researchers from the Keck School of Medicine of the University of Southern California (USC) found that patients who received a later stage cancer diagnosis were likely to be living in an unsafe neighborhood, using public transportation and traveling at least 45 minutes to get to a doctor's office.

The study was presented at the American Association of Cancer Research (AACR) annual meeting in Los Angeles.

A survey of more than 350 stomach and kidney cancer patients in Los Angeles revealed patients were more likely to receive a later stage cancer diagnosis because of a combination of personal risk factors and neighborhood conditions.

“In this study, we looked at three types of factors that may cause late detection of cancer, including personal risk factors, neighborhood factors and the combination of both, ” says lead author Ann Hamilton, Ph.D., assistant professor of preventive medicine of the Keck School of Medicine. “Using census tract, we wanted to see if where someone lived posed any risks for later stage diagnosis in addition to personal risk factors.”

The study cites two general types of personal risk factors that correlate to later detection. Socio-ecological and cultural factors, including unsafe neighborhoods, lower level of education, language barriers and lack of transportation, were associated with a higher risk. Also, patients who gave medical care low priority because of busy work or family lives demonstrated a higher risk for late diagnosis.

“Our study also demonstrated that people who spoke little to no English and lived in an area where few people spoke English, had a higher risk compared to someone with poor English skills living in an area where English is frequently spoken, ” adds Hamilton. “Understanding how both personal risk factors and neighborhood environment affect risk of later stage of diagnosis may help identify population subgroups in need of more prevention, education and screening efforts.”

The survey included questions about access to physicians, health insurance coverage, neighborhood environment (e.g., are parks safe during the day) as well as what primarily language was spoken at home. Census tract measures the percentage of the population who do not speak English well, uses public transportation, percentage who are below the poverty level and other measures were correlated with the percentage of cancers diagnosed at a later stage.

“Community leaders and health advocates should consider making more of an effort to target non-English speaking communities regarding the importance of cancer screenings and preventive measures to ensure cancer is caught at an earlier stage,” adds Hamilton. “In addition, people with busy schedules need to give priority to these health related concerns. We hope this study will initiate larger studies to investigate these situations in greater depth. ”

Ann Hamilton and Myles Cockburn. “Exploring new measures of socio-demographic factors associated with later stage of cancer diagnosis.” Presented at the American Association of Cancer Research on April 15, 2007.

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