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Grant Details

Grant Number: 2R01CA126858-05 Interpret this number
Primary Investigator: Mobley, Lee
Organization: Arizona State University-Tempe Campus
Project Title: Geospatial Factors and Impacts II
Fiscal Year: 2012
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Abstract

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. PUBLIC HEALTH RELEVANCE: In this project we will develop, apply, and disseminate the most scientifically rigorous approach to solving the nagging problem of persistent disparities. Although spatial analytic methodologies have existed for some time, application of these methods in comprehensive cancer control activities has been hindered by the lack of spatially explicit, fine-grained data regarding population health outcomes and behaviors and the lack of software to estimate large population science problems with spatial effects. New comprehensive cancer registry data used together with our proposed advances in spatial analytic software will enable population science analyses addressing the effective use of limited health care resources.

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Publications

Geographic disparities in late-stage cancer diagnosis: multilevel factors and spatial interactions.
Authors: Mobley LR, Kuo TM, Watson L, Gordon Brown G
Source: Health Place, 2012 Sep;18(5), p. 978-90.
EPub date: 2012 Jun 26.
PMID: 22789866
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Spatial Heterogeneity in Cancer Control Planning and Cancer Screening Behavior.
Authors: Mobley LR, Kuo TM, Urato M, Subramanian S, Watson L, Anselin L
Source: Ann Assoc Am Geogr, 2012;102(5), p. 1113-1124.
PMID: 24944346
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Managed care and the diffusion of endoscopy in fee-for-service Medicare.
Authors: Mobley LR, Subramanian S, Koschinsky J, Frech HE, Trantham LC, Anselin L
Source: Health Serv Res, 2011 Dec;46(6pt1), p. 1905-27.
EPub date: 2011 Aug 16.
PMID: 22092022
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Geographic disparities in late-stage breast cancer diagnosis in California.
Authors: Kuo TM, Mobley LR, Anselin L
Source: Health Place, 2011 Jan;17(1), p. 327-34.
EPub date: 2010 Nov 26.
PMID: 21144791
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Community contextual predictors of endoscopic colorectal cancer screening in the USA: spatial multilevel regression analysis.
Authors: Mobley LR, Kuo TM, Urato M, Subramanian S
Source: Int J Health Geogr, 2010 Sep 3;9, p. 44.
EPub date: 2010 Sep 3.
PMID: 20815882
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Predictors of endoscopic colorectal cancer screening over time in 11 states.
Authors: Mobley L, Kuo TM, Urato M, Boos J, Lozano-Gracia N, Anselin L
Source: Cancer Causes Control, 2010 Mar;21(3), p. 445-61.
EPub date: 2009 Nov 28.
PMID: 19946738
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Mammography facilities are accessible, so why is utilization so low?
Authors: Mobley LR, Kuo TM, Clayton LJ, Evans WD
Source: Cancer Causes Control, 2009 Aug;20(6), p. 1017-28.
EPub date: 2009 Feb 11.
PMID: 19205911
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Heterogeneity in mammography use across the nation: separating evidence of disparities from the disproportionate effects of geography.
Authors: Mobley LR, Kuo TM, Driscoll D, Clayton L, Anselin L
Source: Int J Health Geogr, 2008 Jun 30;7, p. 32.
EPub date: 2008 Jun 30.
PMID: 18590540
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How sensitive are multilevel regression findings to defined area of context?: a case study of mammography use in California.
Authors: Mobley LR, Kuo TM, Andrews L
Source: Med Care Res Rev, 2008 Jun;65(3), p. 315-37.
EPub date: 2008 Feb 7.
PMID: 18259047
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