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Publications

Journal Article Ppublish

PubMed: 40293949 DOI: 10.1158/2767-9764.CRC-24-0503

Social-Environmental Burden Is Associated with Increased Colorectal Cancer Mortality in Metropolitan Detroit.

Cancer Res Commun 5(4):694-705

Authors: Natalie G Snider-Hoy, R Blake Buchalter, Theresa A Hastert, Gregory Dyson, Carina Gronlund, Julie J Ruterbusch, Ann G Schwartz, Elena M Stoffel, Laura S Rozek, Kristen S Purrington

Affiliations

  • Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.
  • Population Science and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan.
  • Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
  • Social Environment and Health Program, Survey Research Center, University of Michigan Institute for Social Research, Ann Arbor, Michigan.
  • Division of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan.
  • Department of Oncology, Georgetown University School of Medicine, Washington, District of Columbia.

Abstract

ABSTRACT

Neighborhood quality affects both socioeconomic factors and exposure to carcinogenic environmental pollutants, but the impacts of these factors on racial disparities in colorectal cancer mortality are not well described. We used the Centers for Disease Control and Prevention Environmental Justice Index social vulnerability module, environmental burden module (EBM), and the combined social–environmental score (SER) to assess relationships with colorectal cancer mortality by race and age in the Metropolitan Detroit Cancer Surveillance System. Among 13,505 patients with colorectal cancer [9,727 non-Hispanic White (NHW) and 3,778 non-Hispanic Black (NHB)], EBM quartile 4 versus 1 was more strongly associated with mortality among NHB early-onset (EO) cases than NHW EO cases [NHB: HR = 1.98, 95% confidence interval (CI), 1.20–3.26; NHW: HR = 1.40, 95% CI, 0.88–2.25]. SER quartile 4 versus 1 was more strongly associated with colorectal cancer mortality in EO (NHB: HR = 1.76, 95% CI, 0.93–3.31; NHW: HR = 1.53, 95% CI, 0.79–2.96) compared with later-onset cases (NHB: HR = 1.15, 95% CI, 0.87–1.52; NHW: HR = 1.39, 95% CI, 1.17–1.65) regardless of race. These associations in EO cases were strongest in colon tumors versus rectal tumors (EO EBM: colon HR = 2.08, 95% CI, 1.24–3.48 vs. rectum HR = 1.03, 95% CI, 0.64–1.66; EO SER: colon HR = 2.57, 95% CI, 1.38–4.79 vs. rectum HR = 0.84, 95% CI, 0.48–1.45). These results suggest the combination of socio-environmental burdens contributes to age and racial disparities in colorectal cancer mortality in metropolitan Detroit.

SIGNIFICANCE

Understanding the role of environmental justice in cancer survivorship could influence policy decisions, aiding intervention practices.

MeSH

Mortality, Neoplasms, Colorectal Neoplasms