Assessing residential neighborhood exposome exposures and the associations with cancer incidence

结直肠癌、肺癌和女性乳腺癌是主要的公共卫生负担， 和种族/族裔差异。这些癌症中的每一种都与邻里因素有关 包括社会经济贫困，建筑环境和环境污染物，试图解释 存在风险差异。虽然存在相关性，但大多数先前的研究认为邻居暴露 仅在一个时间（例如，诊断时间）并且仅使用单个邻近暴露测量（例如， 邻里剥夺或单一的环境污染物），这是一个简化的多因素 癌症的性质。因此，暴露领域的相对重要性是未知的，影响可能是 估计不足，缺乏对风险因素的累积评估。越来越多的人对麻烦感兴趣 呼吁对社区暴露进行更彻底的评估，以更好地解释 导致癌症差异的因素。因此，我们建议研究综合邻域 弱势群体，社会经济贫困、种族隔离、环境污染， 和建筑环境领域，以提供更有力的证据，邻里协会和识别风险 这些因素可以被修改，以消除地理和种族癌症差异。的重要局限性 该建议克服的现有工作是1）暴露的时间性和程度（即，早年生活 暴露，以后的生活暴露，或累积的终身暴露），2）关键邻域的识别 癌症发病率的暴露变量，以及3）考虑邻域的不同域 随着时间的推移，无论是独立还是组合，都很难更全面地考虑关系 得了癌症我们的具体目标是估计ND域随时间的暴露效应，并研究 这些领域的暴露轨迹和癌症部位，种族和性别的影响。我们将收集数据 来自弗吉尼亚州和宾夕法尼亚州癌症登记处，基于人群的控制，居住史， 记录历史不利指标的暴露数据。我们的方法具有高度创新性 包括：（1）检查几个重要邻里不利条件的历史暴露水平 领域和2）新的贝叶斯统计方法的应用，我们的团队一直在完善 估计邻域劣势及其影响。我们假设，我们的新方法来估计 与现有的方法相比，邻域劣势将更好地解释癌症发病率的变化， 确定每种癌症随时间变化的最具影响力的暴露变量。这项研究是非常重要的，因为它是 第一项评估多种癌症的社区不利影响的研究， 使用居住历史的几个历史暴露域的风险。本研究的预期结果 将是识别与重大癌症相关的历史性邻里不利暴露 这将有助于减少癌症风险，并将其作为政策制定和干预措施的目标，并帮助减少癌症方面的差距。

Colorectal, lung, and female breast cancers are major public health burdens and there are clear geographic and racial/ethnic disparities in their incidence. Each of these cancers has been linked to neighborhood factors including socioeconomic deprivation, the built environment, and environmental pollutants in attempts to explain existing disparities in risk. While associations exist, most previous studies considered neighborhood exposures at only one time (e.g., time of diagnosis) and used only single measures of neighborhood exposures (e.g., neighborhood deprivation or singular environmental pollutants), which is a simplification of the multifactorial nature of cancer. As a result, the relative importance of exposure domains is unknown, effects may be underestimated, and a cumulative assessment of risk factors is lacking. Increasing interest in the exposome calls for a more thorough assessment of neighborhood exposures over time that could better explain the factors leading to disparities in cancers. Therefore, we propose to study comprehensive neighborhood disadvantage (ND), a combination of socioeconomic deprivation, racial segregation, environmental pollutant, and built environment domains, to provide stronger evidence of neighborhood associations and identify risk factors that could be modified to eliminate geographic and racial cancer disparities. The important limitations of existing work that this proposal overcomes are 1) the temporality and extent of exposures (i.e., earlier life exposure, later life exposure, or cumulative lifetime exposure), 2) the identification of key neighborhood exposure variables for cancer incidence, and 3) consideration of different domains of the neighborhood exposome over time both independently and in combination to more comprehensively consider relationships with cancer. Our specific aims are to estimate exposure effects for ND domains over time and study the trajectories of these domain exposures and effects by cancer site, race, and sex. We will bring together data from the Virginia and Pennsylvania state cancer registries, population-based controls, residential histories, and exposure data documenting historical disadvantage indicators. Highly innovative aspects of our approach include: 1) examination of historical levels of exposure to several important neighborhood disadvantage domains and 2) the application of novel Bayesian statistical methods that our team has been refining for estimating neighborhood disadvantage and its effects. We hypothesize that our novel approaches to estimating neighborhood disadvantage will better explain variation in cancer incidence than existing methods and will identify the most influential exposure variables over time for each cancer. This study is highly significant as it is the first study to estimate neighborhood disadvantage effects for multiple cancers that considers cumulative risk from several historic exposure domains using residential histories. The expected outcomes of this research will be the identification of historic neighborhood disadvantage exposures associated with significant cancer risk to target for policy development and interventions and to help reduce disparities in cancer.