Abstract IA14: Not the same everywhere: The moderating role of context on cancer disparities

In the emerging field of multilevel cancer disparities research, investigators typically examine the independent contribution of factors such as individual- and neighborhood-level race/ethnicity and socioeconomic status. The moderating role of context is often neglected. In the real world, people interact with and are nested within multiple contexts that may influence the processes whereby disparities are generated and reinforced. The moderating role of context will be explored using two illustrative examples drawn from colorectal cancer screening and breast cancer mortality. Specific contexts explored include patient residence, neighborhood, health care system, and state. In the first example, expected patterns of individual- and neighborhood- level disparity were not evident in colorectal cancer screening among patients of an urban safety-net health care system. For example, neighborhood disparity was limited and the expected pattern of patient-level racial and ethnic disparity (i.e., advantage of white patients as compared to African American and Hispanic patients) was not observed. In the second example, differences in neighborhood context between Texas and California are explored in a study of breast cancer mortality. State-level differences in both neighborhood socioeconomic status and density of Hispanic residents are explored as potential moderators of the association between patient ethnicity, birthplace, and mortality. To conclude the discussion, contextual variables potentially influencing cancer behaviors and outcomes will be identified and described in regard to existing evidence about their influence, methods, and datasets for their analysis, and opportunities for future research.

Citation Format: Sandi L. Pruitt. Not the same everywhere: The moderating role of context on cancer disparities [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr IA14.