Socioeconomic disparities seen in geospatial clusters of urothelial carcinoma
Spatially related clusters of urothelial carcinoma (UC) appear to correlate with locoregional environmental exposures rather than tobacco exposure, suggests a study. Such clusters may also be associated with socioeconomic disparities.
The authors sought to identify microregional UC hotspots and associated industrial and environmental risk factors by retrospectively probing a multi-institutional database for UC patients diagnosed between 2008 and 2018.
They geocoded and used addresses to conduct a hotspot analysis on the census block level. Demographic and clinicopathological characteristics, census data, and proximity to sources of industrial byproducts and environmental pollutants (IBP/EP) were compared between patients who did vs did not reside in a hotspot. Multilevel logistic regression models were generated to examine the associations.
Of the 5,080 patients who met the eligibility criteria, 148 (2.9 percent) were identified as living in one of three UC hotspots. Univariate analyses revealed that race, tobacco and alcohol use, household income, IBP/EP exposure and proximity to traffic, industrial discharge, and airports significantly correlated with UC hotspots.
In multivariate analysis, polycyclic aromatic hydrocarbon exposure (odds ratio [OR], 48.09; p≤0.001) and proximity to high-density traffic (OR, >999; p≤0.001) were associated with a higher likelihood of living in a hotspot. In addition, patients living in a hotspot were less likely to be White (OR, 0.06; p≤0.001) or tobacco users (OR, 0.39; p=0.031).
“Geospatial analysis can help to identify at-risk populations, offering the opportunity to better focus preventive and diagnostic interventions,” the authors said.