SEER RRSS Improving SES Data: Linkage State Vital Records, Birth Certificate Data

许多研究已经观察到，较低的SES与某些部位发生癌症的风险增加和许多癌症部位的存活率降低有关。一个例外是女性乳腺癌，因为更高的SES与更高的风险和更好的生存相关。然而，关于SES影响的证据有限，因为SES通常是在总体或区域层面上衡量的(例如，邮政编码或人口普查区域的平均家庭收入，街区组中贫困人口的比例)。这项提议将实施一项战略，允许通过将记录与犹他州人口数据库中提供的州出生证明记录联系起来，在个人一级直接衡量社会经济地位。在可能与其他SEER登记机构合作的情况下，这项建议将评估将犹他州S连锁方法应用于1997年或以后出生的加州儿童癌症病例的可行性，并将结果与犹他州可比的儿科人口进行比较。这一策略可能会更好地了解SES方面的健康和癌症差异。对SES如何影响这些风险的理解仍然令人惊讶地不发达。文献中的这一缺陷部分归因于这样一个事实，即SES通常是以总体或区域的水平来衡量的(例如，邮政编码或人口普查区域的平均家庭收入，在街区组中比例较差)。虽然SES的空间指标无疑很重要，但它们不能替代SES的个人或家庭一级的衡量标准。此外，空间指标被视为静态指标，因此不考虑SES的向上或向下变化。最后，空间数据通常基于诊断时、死亡时或调查时的SES，此时感兴趣的SES值可能来自生命早期。对124项考察SES对癌症风险影响的研究的回顾表明，虽然只有25%的研究收集了个人SES数据，但大多数都是基于小样本(N&lt；5000)，并且在调查时只测量过一次SES。

Numerous studies have observed that lower SES is associated with increased risk of incident cancer for some sites and reduced survival for many cancer sites. One exception is for female breast cancer as higher SES is associated with increased risk and better survival. However, evidence of the impact of SES is limited in the fact that SES is often measured at an aggregate or area level (e.g., mean household income for a zip code or census tract, proportion poor in a block group). This proposal will implement a strategy that permits a direct measurement of SES at the individual level through record linkage to state birth certificate records available in the Utah Population Database. In possible collaboration with other SEER registries, this proposal will assess the feasibility of applying Utah¿s linkage methodologies to a California population of pediatric cancer cases born on or after 1997, and compare and contrast results with the comparable pediatric population in Utah. This strategy may provide a better understanding of health and cancer disparities in terms of SES. The understanding of how SES affects these risks remains surprisingly underdeveloped. This deficiency in the literature is partly attributable to the fact that SES is often measured at an aggregate or area level (e.g., mean household income for a zip code or census tract, proportion poor in a block group). While there is no question that spatial indicators of SES are important, they are not substitutes for individual or family level measures of SES. Moreover, spatial indicators are treated as a static measure so that upward or downward changes in SES are not considered. Finally, the spatial data are often based on SES at the time of diagnosis, death, or at the time of a survey when it is likely that the SES value of interest could be from earlier in life. A review of 124 studies examining SES effects on cancer risk shows that while only about 25 percent collected individual SES data, most of these were based on small samples (N<5000) and where SES was measured once at the time of the survey.