Geospatial Factors and Impacts II

描述（由申请人提供）：这是1 R 01 CA 126858的续期申请，其母授权名为“地理空间因素和影响：测量和使用”。“乳腺癌（BC）和结直肠癌（CRC）预防和结果的地理差异已经存在了几十年。它们的持续存在可能表明，由于地理区域之间的因素不同，国家和地方在癌症控制预防方面的医疗资源利用效率低下。然而，在我们自己的工作之外，空间分析方法在过去很少被用来消除这些差异。在母基金中，我们增强了分析空间数据的软件，使其广泛可用（迄今为止有62，500名研究人员使用），将其应用于有限的数据集，并证明了在分析中忽略空间效应的影响。在这 新的应用程序，我们将扩展现有的软件，纳入新的空间分析方法，解决两个特定的问题，超出了母基金的范围。我们将广泛提供新的增强软件，并使用新获得的数据进行全面分析。结果将为卫生规划者提供可操作的信息，这些信息将提高减少BC和CRC预防和结果差异的能力（即，在癌症诊断时的癌症阶段），通过对特定地方的特定人群采取有针对性的干预措施。 使用增强的软件，我们将应用新的方法能力来估计新提供的国家综合癌症登记数据中的空间关系，这些数据覆盖了美国的所有地区。这些合并的国家癌症登记/监测流行病学和最终结果计划（NPCR/SEER）登记数据是有限的，个人水平的数据（包括癌症分期）可用于RDC内批准的项目。我们将对美国BC和CRC人群进行复杂的地理空间多层次分析，将癌症患者与他们的县，州和区域特征联系起来。新方法将允许适当纳入空间异质性和空间依赖性，在建模的复杂的多层次因素影响的差异，在癌症预防和诊断阶段。

DESCRIPTION (provided by applicant): This is a renewal application of 1R01CA126858, the parent grant titled "Geospatial Factors and Impacts: Measurement and Use." Geographic disparities in breast cancer (BC) and colorectal cancer (CRC) prevention and outcomes have existed for decades. Their persistence may indicate inefficient use of healthcare resources in national and local efforts concerning cancer control prevention due to factors that differ between geographic areas. However, outside of our own work, spatial analytic methods have rarely been used in the past to combat these disparities. In the parent grant we enhanced software to analyze spatial data, made it widely available (to date used by 62,500 researchers), applied it to limited data sets, and demonstrated the impact of ignoring spatial effects in the analyses. In this new application, we will extend the existing software to incorporate new spatial analytic methods addressing two particular problems that were beyond the scope of the parent grant. We will make the new enhanced software widely available, and use newly available data to conduct comprehensive analyses. The results will provide actionable information to health planners that will improve the ability to reduce disparities in BC and CRC prevention and outcomes (i.e., cancer stage at time of cancer diagnosis), by using targeted interventions to identified populations in specific places. Using the enhanced software, we will apply the new methodological capabilities to estimate spatial relationships in the newly available national comprehensive cancer registry data, which cover all areas of the United States. These combined National Program of Cancer Registry/Surveillance Epidemiology and End Results (NPCR/SEER) registry data are restricted, person-level data (including cancer stage) available for approved projects inside the RDCs. We will conduct complex geospatial-multilevel analysis of U.S. BC and CRC populations, linking persons with cancer to their county, state, and regional characteristics. The new methods will allow for the proper incorporation of both spatial heterogeneity and spatial dependence in modeling the complex multilevel factors influencing disparities in cancer prevention and stage at diagnosis.