A spatial assessment of prostate cancer mortality-to-incidence ratios among South Carolina veterans: 1999-2015

Peter Georgantopoulos; Jan M Eberth; Bo Cai; Gowtham Rao; Charles L Bennett; Christopher T Emrich; Kathlyn S Haddock; James R Hébert

doi:10.1016/j.annepidem.2021.03.010

A spatial assessment of prostate cancer mortality-to-incidence ratios among South Carolina veterans: 1999-2015

Ann Epidemiol. 2021 Jul:59:24-32. doi: 10.1016/j.annepidem.2021.03.010. Epub 2021 Apr 6.

Authors

Peter Georgantopoulos¹, Jan M Eberth², Bo Cai³, Gowtham Rao³, Charles L Bennett⁴, Christopher T Emrich⁵, Kathlyn S Haddock⁶, James R Hébert²

Affiliations

¹ South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Southern Network on Adverse Reactions (SONAR), South Carolina Center of Economic Excellence for Medication Safety, College of Pharmacy, University of South Carolina, Columbia, SC; Columbia Veterans Affairs Health Care System, Columbia, SC. Electronic address: georgant@email.sc.edu.
² South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
³ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
⁴ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Southern Network on Adverse Reactions (SONAR), South Carolina Center of Economic Excellence for Medication Safety, College of Pharmacy, University of South Carolina, Columbia, SC; Columbia Veterans Affairs Health Care System, Columbia, SC.
⁵ College of Community Innovation and Education, University of Central Florida, Orlando, FL.
⁶ Columbia Veterans Affairs Health Care System, Columbia, SC.

PMID: 33836289
DOI: 10.1016/j.annepidem.2021.03.010

Abstract

Purpose: To assess veteran-specific prostate cancer (PrCA) mortality-to-incidence ratios (MIR) in South Carolina's (SC) veteran population.

Methods: U.S. Veterans Health Administration electronic medical records from January 1999 to December 2015 identified 3,073 PrCA patients residing in 345 ZIP code tabulation areas (ZCTA) within SC. MIRs were calculated for all SC ZCTAs and by key patient- and neighborhood-level risk factors for PrCA. Comparisons between ZCTAs identified as part of a spatial cluster were compared with non-significant ZCTAs using t tests.

Results: The MIR was 0.17 overall, ranging from a low of 0.15 among Black men to 0.20 among White men. Among metropolitan ZCTAs, the MIR was 0.18 compared to 0.16 in non-metropolitan ZCTAs. Two clusters of higher-than-expected MIRs were found in the Upstate region.

Conclusions: Identification of spatial clusters of higher- or lower-than-expected MIRs allows for further testing of possible explanatory factors, and the capacity to target resources and policies according to greatest need.

Keywords: Electronic medical records; Geographic Information Systems; Health disparities; Prostate cancer; Social vulnerability; Spatial epidemiology; Veterans.

Published by Elsevier Inc.

MeSH terms

Humans
Incidence
Male
Prostatic Neoplasms* / epidemiology
South Carolina / epidemiology
Veterans*
White People