Ethnicity and Nativity in Cancer - Latino & Asian Enclaves: The ENCLAVE Study

癌症中的种族和出生地 - 拉丁裔

• 批准号: 9885937
• 负责人: Sandi Leigh Pruitt
• 金额: $ 62.92万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9885937
• 关键词: Address; Adopted; American; Asian Americans; Asians; Attention; Automobile Driving; Breast; Businesses; California; Cancer Center; Cancer Control; Cause of Death; Cervix Uteri; Chinese People; Collaborations; Colorectal; Colorectal Cancer; Communities; Community Outreach; Country; Cuban; Data; Development; Diagnosis; Early Diagnosis; Ensure; Environment; Ethnic Origin; Ethnic group; Filipino; Florida; Funding; Future; Geography; Health; Health Promotion; Healthcare; Heterogeneity; Immigrant; Immigration; Incidence; Individual; Infrastructure; Intervention; Japanese Population; Joints; Koreans; Latina; Latino; Leadership; Linguistics; Link; Literature; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Measures; Methodology; Methods; Mexican; NCI-Designated Cancer Center; Neighborhoods; New Jersey; New York; Outcome; Patients; Pattern; Population; Population Growth; Procedures; Puerto Rican; Race; Research Personnel; Resources; Role; Science; South Asian; Stage at Diagnosis; Subgroup; Texas; Time; cancer health disparity; cancer prevention; cancer site; cancer type; data registry; design; disadvantaged population; disparity reduction; ethnic minority population; evidence base; experience; health disparity; improved; improved outcome; indexing; malignant breast neoplasm; mortality; multilevel analysis; neighborhood disadvantage; neoplasm registry; novel; population based; programs; racial and ethnic; residence; resilience; response; social; social capital; socioeconomic disadvantage; stressor; surveillance data

Project Summary/Abstract Cancer is the leading cause of death for Latinos and Asian Americans, who are among the fastest growing populations in the U.S. A large proportion of Latinos and Asian Americans live in ethnic enclaves—distinct neighborhoods with high concentrations of individuals of the same ethnic origin (“co-ethnic residents”) that are also characterized by recent immigration and linguistic isolation. The existing literature is mixed, with some studies showing that ethnic enclave residence (vs. non-enclave residence) and foreign- (vs. U.S.-) birthplace are associated with both better and/or worse outcomes across the cancer continuum. In this study, we will pool cancer registry data across five states (CA, FL, NJ, NY, TX) comprising the majority of Latinos and Asian Americans in the U.S. and link these data to contextual data characterizing the social, built and healthcare environments. We will determine whether and how ethnic enclave residence and foreign-birthplace are associated with three cancer outcomes (incidence, stage at diagnosis, survival) experienced by nine of the largest Latino and Asian ethnic groups (Cuban, Mexican, Puerto Rican, Chinese, Filipino, Japanese, Korean, South Asian, Vietnamese) diagnosed with three cancer types (breast, cervical, and colorectal cancers). Specifically, we aim to define and characterize ethnic enclaves, and examine cancer incidence by enclave residence (Aim 1) and determine independent and joint associations of ethnic enclave residence and nativity (foreign vs. US birthplace) on stage at diagnosis (Aim 2) as well as on mortality (Aim 3). With over 200,000 Latino and Asian American breast, colorectal, and cervical cancer cases, we will use multilevel models to understand the impact of ethnic enclaves on cancer outcomes for these understudied populations. In doing so, our study will accelerate discovery about the intersections between neighborhoods, ethnicity, nativity, and cancer and will improve data and methods used by central cancer registries across the U.S. Findings have potential to inform development of multilevel interventions to leverage enclave attributes that promote health and to address any barriers to reduce disparities and improve outcomes for our fastest growing ethnic minority and immigrant communities. We will disseminate our enclave measure and imputation procedures for missing data to the North American Association of Central Cancer Registries (NAACCR). In doing so, our methods will improve completeness of cancer registry data for surveillance of the growing Latino and Asian American populations. Our dissemination plan with collaboration from NAACCR leadership as well as the Offices of Community Outreach and Engagement at NCI Designated Cancer Centers in five states will ensure 1) methods are readily adopted by cancer registries and health disparities researchers across the nation; and 2) findings inform community-engaged efforts to address multilevel cancer disparities among Latino and Asian populations.

项目总结/摘要 癌症是拉美裔和亚裔美国人死亡的主要原因， 很大一部分拉美裔和亚裔美国人生活在种族飞地--独特的 社区与高浓度的个人相同的种族起源（“同种族居民”）， 也以最近的移民和语言隔离为特点。现有的文献是混合的，其中一些 研究表明，族裔飞地居住（与非飞地居住）和外国-（与美国-）发源地 与整个癌症连续体的更好和/或更差结果相关。在这项研究中，我们将 五个州（加利福尼亚州、佛罗里达州、新泽西州、纽约州、德克萨斯州）的癌症登记数据，包括大多数拉丁美洲人和亚洲人 在美国的美国人，并将这些数据与表征社会，建筑和医疗保健的上下文数据联系起来 环境.我们将确定族裔飞地居住地和外国出生地是否以及如何 与9名受试者经历的三种癌症结局（发病率、诊断时的分期、生存率）相关。 最大的拉丁裔和亚裔群体（古巴人、墨西哥人、波多黎各人、中国人、菲律宾人、日本人、韩国人、 南亚人，越南人）被诊断患有三种癌症类型（乳腺癌，宫颈癌和结肠直肠癌）。 具体来说，我们的目标是定义和描述种族飞地，并通过飞地检查癌症发病率 居住地（目标1），并确定族裔飞地居住地和出生地的独立和联合联系 （国外与美国出生地）在诊断阶段（目标2）以及死亡率（目标3）上的差异。有超过20万的 拉丁裔和亚裔美国人乳腺癌、结直肠癌和宫颈癌病例，我们将使用多水平模型， 了解种族飞地对这些研究不足的人群的癌症结局的影响。在这样做时， 我们的研究将加速发现社区、种族、耶稣诞生和 并将改善美国中央癌症登记处使用的数据和方法。 为制定多层次干预措施提供信息的潜力，以利用飞地属性促进健康 并解决任何障碍，以减少差距，改善我们增长最快的少数民族的结果 和移民社区。我们将传播我们的飞地措施和估算程序， 北美中央癌症登记协会（NAACCR）。这样做，我们的方法将 提高癌症登记数据的完整性，以监测不断增长的拉丁美洲人和亚裔美国人 人口。我们的传播计划与NAACCR领导层以及 在五个州的NCI指定癌症中心的社区外展和参与将确保1） 方法很容易被全国的癌症登记处和健康差异研究人员采用; 2） 研究结果为社区参与解决拉丁美洲人和亚洲人之间多层次癌症差异的努力提供了信息 人口。