Geospatial Factors and Impacts II

描述（由申请人提供）：这是1R01CA126858的续期申请，标题为“地理空间因素和影响：测量和使用”。乳腺癌（BC）和结直肠癌（CRC）预防和预后的地理差异已经存在了几十年。它们的持续存在可能表明，由于地理区域的差异，国家和地方在癌症控制预防方面的卫生保健资源利用效率低下。然而，在我们自己的工作之外，过去很少使用空间分析方法来对抗这些差异。在父母资助中，我们增强了分析空间数据的软件，使其广泛可用（迄今已有62,500名研究人员使用），将其应用于有限的数据集，并展示了在分析中忽略空间效应的影响。在这个

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.