Evaluating Neighborhood Exposomes and Their Links to Cancer Rates
Overview
This study investigates how neighborhood disadvantage (ND) across socioeconomic, racial, environmental, and built environment domains cumulatively influences colorectal, lung, and female breast cancer incidence. Utilizing residential histories and state cancer registry data from Virginia and Pennsylvania, the research aims to identify critical ND exposures over time that contribute to cancer disparities.
Background
Cancer remains the second leading cause of death in the US, with breast, lung, and colorectal cancers accounting for substantial new cases annually. Geographic and racial/ethnic disparities in cancer incidence are partially attributed to neighborhood context, including socioeconomic deprivation, racial segregation, environmental pollutants, and built environment factors. Traditional studies often assess neighborhood exposures at a single time point, neglecting the temporal and cumulative nature of these exposures over an individual's life course. Addressing these gaps is essential to better understand and mitigate cancer disparities linked to neighborhood disadvantage.
Data Highlights
The study leverages data from Virginia and Pennsylvania state cancer registries, residential histories from LexisNexis®, and multiple historical and current indicators of neighborhood disadvantage. It focuses on three major cancers: female breast (estimated 310,720 new cases in 2024), lung (234,850 new cases), and colorectal cancer (152,810 new cases). The approach accounts for temporal exposure patterns over the life course, considering mobility and cumulative neighborhood disadvantage effects.
Key Findings
Neighborhood disadvantage comprises four key domains: socioeconomic deprivation, racial segregation, environmental pollutants, and built environment.
Exposure timing and residential mobility critically influence cancer risk assessment, with many cancers having long latency periods.
Previous studies' reliance on single time-point and single-domain measures limits understanding of cumulative and multifactorial neighborhood effects on cancer incidence.
The study introduces new methods to estimate neighborhood disadvantage effects over time using residential histories and comprehensive exposure data.
Identification of historically undetected neighborhood disadvantage exposures may reveal novel risk factors contributing to cancer disparities.
Integrating multiple domains of neighborhood exposures provides a more complete picture of environmental and social determinants influencing cancer risk.
Clinical Implications
Clinicians and public health professionals should consider patients' cumulative neighborhood exposures over their life course when assessing cancer risk, especially for breast, lung, and colorectal cancers. Addressing modifiable neighborhood factors such as socioeconomic deprivation and environmental pollutants could inform targeted interventions to reduce cancer disparities. Incorporating residential history into risk assessments may improve precision in identifying high-risk populations.
Conclusion
This research framework advances understanding of how cumulative and multifaceted neighborhood disadvantage exposures contribute to cancer disparities. By integrating temporal and multidomain data, it offers potential pathways to identify modifiable neighborhood risk factors and inform strategies to reduce geographic and racial/ethnic cancer inequities.
References
Article Abstract and Introduction -- Evaluating Neighborhood Exposomes and Their Links to Cancer Rates
