Grant Number:	1R01CA137750-01A1 Interpret this number
Primary Investigator:	Schootman, Mario
Organization:	Washington University
Project Title:	Geographic Disparities in Colorectal Cancer Survival
Fiscal Year:	2009

DESCRIPTION (provided by applicant): Colorectal cancer (CRC) is the fourth most common cancer in the United States and the second leading cause of cancer deaths. Despite declines in CRC incidence rates, survival following diagnosis has improved only modestly over the past few decades. Even though environmental contexts play an important role in health, disease, and behavior, most studies about CRC survival have largely ignored the geographic variation and importance of area-level socioeconomic conditions that have been associated with CRC screening, CRC stage at diagnosis, and with the survival of many other cancers. CRC patients who live in areas with worse socioeconomic conditions have decreased survival than those who live under more affluent conditions; however, the mechanisms by which these area-level factors exert their influence on CRC survival remain unclear. This amended application of the proposed population-based, prospective study has three specific aims. Aim 1) Determine the extent of the geographic variation of CRC survival across the United States based on small geographic areas at the sub-county (census-tract) level using the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data for over 100,000 men and women aged 66 or older diagnosed with CRC. Aim 2) Determine the extent to which lower CRC survival can be explained by higher area socioeconomic deprivation among persons age 66 and older. Aim 3) Identify potential mediating pathways by which higher area socioeconomic deprivation is associated with lower CRC survival among persons age 66 and older, namely a) patient characteristics, b) physician and hospital characteristics, c) tumor characteristics, d) type of treatment received, and e) surveillance for CRC after diagnosis to detect recurrence and metastases. A multilevel spatial model will be developed to address the specific aims of the proposed study. We will use the following existing data sources: 1) 1992-2005 data from NCI's SEER program (survival, patient characteristics, type of treatment, tumor characteristics); 2) 1991-2005 Medicare data (patient characteristics, type of treatment, surveillance after diagnosis) which is linked to the SEER data; 3) 1991-2005 data from the Provider of Services File (hospital and physician characteristics), 4) 1990-2005 census data (area deprivation measures), and 5) Medicare Current Beneficiary Survey data. Advanced Bayesian spatial analyses of CRC survival will be performed and a geographic information system will be used to display the results. Our study will increase understanding of and identify important mechanisms of the role of area-level socioeconomic deprivation on CRC survival. In addition, this study will help provide opportunities for targeting specific geographic areas to allocate resources and interventions locally to improve CRC survival using evidence- based approaches, thereby reducing health disparities associated with living in socioeconomically deprived areas. PUBLIC HEALTH RELEVANCE: Colorectal cancer is the second leading cause of cancer deaths. To reduce geographic disparities in survival following colorectal cancer and to develop and implement interventions that can be targeted locally, it is imperative to identify reasons for lower-than-expected survival.




Patient, Hospital, and Geographic Disparities in Laparoscopic Surgery Use Among Surveillance, Epidemiology, and End Results-Medicare Patients With Colon Cancer.
Authors: Ratnapradipa K.L. , Lian M. , Jeffe D.B. , Davidson N.O. , Eberth J.M. , Pruitt S.L. , Schootman M. .
Source: Diseases Of The Colon And Rectum, 2017 Sep; 60(9), p. 905-913.
PMID: 28796728
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Geospatial Approaches To Cancer Control And Population Sciences
Authors: Schootman M. , Gomez S.L. , Henry K.A. , Paskett E.D. , Ellison G.L. , Oh A. , Taplin S.H. , Tatalovich Z. , Berrigan D.A. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2017 Apr; 26(4), p. 472-475.
PMID: 28325736
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Adoption of Robotic Technology for Treating Colorectal Cancer.
Authors: Schootman M. , Hendren S. , Ratnapradipa K. , Stringer L. , Davidson N.O. .
Source: Diseases Of The Colon And Rectum, 2016 Nov; 59(11), p. 1011-1018.
PMID: 27749475
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Explaining large mortality differences between adjacent counties: a cross-sectional study.
Authors: Schootman M. , Chien L. , Yun S. , Pruitt S.L. .
Source: Bmc Public Health, 2016-08-02 00:00:00.0; 16, p. 681.
EPub date: 2016-08-02 00:00:00.0.
PMID: 27484009
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Development of a claims-based algorithm to identify colorectal cancer recurrence.
Authors: Deshpande A.D. , Schootman M. , Mayer A. .
Source: Annals Of Epidemiology, 2015 Apr; 25(4), p. 297-300.
PMID: 25794767
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Missed opportunities: racial and neighborhood socioeconomic disparities in emergency colorectal cancer diagnosis and surgery.
Authors: Pruitt S.L. , Davidson N.O. , Gupta S. , Yan Y. , Schootman M. .
Source: Bmc Cancer, 2014-12-09 00:00:00.0; 14, p. 927.
EPub date: 2014-12-09 00:00:00.0.
PMID: 25491412
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Postoperative 30-day mortality in patients undergoing surgery for colorectal cancer: development of a prognostic model using administrative claims data.
Authors: de Vries S. , Jeffe D.B. , Davidson N.O. , Deshpande A.D. , Schootman M. .
Source: Cancer Causes & Control : Ccc, 2014 Nov; 25(11), p. 1503-12.
PMID: 25104569
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Hospital and geographic variability in thirty-day all-cause mortality following colorectal cancer surgery.
Authors: Schootman M. , Lian M. , Pruitt S.L. , Deshpande A.D. , Hendren S. , Mutch M. , Jeffe D.B. , Davidson N. .
Source: Health Services Research, 2014 Aug; 49(4), p. 1145-64.
PMID: 24673560
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Physicians, clinics, and neighborhoods: multiple levels of influence on colorectal cancer screening.
Authors: Pruitt S.L. , Leonard T. , Zhang S. , Schootman M. , Halm E.A. , Gupta S. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2014 Jul; 23(7), p. 1346-55.
PMID: 24732630
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Patient, hospital, and geographic disparities associated with comanagement during hospitalization for colorectal cancer surgery.
Authors: de Vries S. , Jeffe D.B. , Pruitt S.L. , Davidson N.O. , Schootman M. .
Source: Journal Of Hospital Medicine, 2014 Apr; 9(4), p. 226-31.
PMID: 24493477
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The health and welfare of rural and urban cancer survivors in Missouri.
Authors: Schootman M. , Homan S. , Weaver K.E. , Jeffe D.B. , Yun S. .
Source: Preventing Chronic Disease, 2013-09-12 00:00:00.0; 10, p. E152.
EPub date: 2013-09-12 00:00:00.0.
PMID: 24028832
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Do diagnostic and treatment delays for colorectal cancer increase risk of death?
Authors: Pruitt S.L. , Harzke A.J. , Davidson N.O. , Schootman M. .
Source: Cancer Causes & Control : Ccc, 2013 May; 24(5), p. 961-77.
PMID: 23446843
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The modifying effect of patient location on stage-specific survival following colorectal cancer using geosurvival models.
Authors: Chien L.C. , Schootman M. , Pruitt S.L. .
Source: Cancer Causes & Control : Ccc, 2013 Mar; 24(3), p. 473-84.
PMID: 23306551
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Epidemiology and neuropsychiatric manifestations of Young Onset Parkinson's Disease in the United States.
Authors: Willis A.W. , Schootman M. , Kung N. , Racette B.A. .
Source: Parkinsonism & Related Disorders, 2013 Feb; 19(2), p. 202-6.
PMID: 23083512
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Contribution of behavioral risk factors and obesity to socioeconomic differences in colorectal cancer incidence.
Authors: Doubeni C.A. , Major J.M. , Laiyemo A.O. , Schootman M. , Zauber A.G. , Hollenbeck A.R. , Sinha R. , Allison J. .
Source: Journal Of The National Cancer Institute, 2012-09-19 00:00:00.0; 104(18), p. 1353-62.
EPub date: 2012-09-19 00:00:00.0.
PMID: 22952311
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Socioeconomic status and the risk of colorectal cancer: an analysis of more than a half million adults in the National Institutes of Health-AARP Diet and Health Study.
Authors: Doubeni C.A. , Laiyemo A.O. , Major J.M. , Schootman M. , Lian M. , Park Y. , Graubard B.I. , Hollenbeck A.R. , Sinha R. .
Source: Cancer, 2012-07-15 00:00:00.0; 118(14), p. 3636-44.
EPub date: 2012-07-15 00:00:00.0.
PMID: 22898918
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Health status, neighborhood socioeconomic context, and premature mortality in the United States: The National Institutes of Health-AARP Diet and Health Study.
Authors: Doubeni C.A. , Schootman M. , Major J.M. , Stone R.A. , Laiyemo A.O. , Park Y. , Lian M. , Messer L. , Graubard B.I. , Sinha R. , et al. .
Source: American Journal Of Public Health, 2012 Apr; 102(4), p. 680-8.
PMID: 21852636
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Socioeconomic deprivation impact on meat intake and mortality: NIH-AARP Diet and Health Study.
Authors: Major J.M. , Cross A.J. , Doubeni C.A. , Park Y. , Lian M. , Hollenbeck A.R. , Schatzkin A. , Graubard B.I. , Sinha R. .
Source: Cancer Causes & Control : Ccc, 2011 Dec; 22(12), p. 1699-707.
PMID: 21971817
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Geographic variation in colorectal cancer survival and the role of small-area socioeconomic deprivation: a multilevel survival analysis of the NIH-AARP Diet and Health Study Cohort.
Authors: Lian M. , Schootman M. , Doubeni C.A. , Park Y. , Major J.M. , Stone R.A. , Laiyemo A.O. , Hollenbeck A.R. , Graubard B.I. , Schatzkin A. .
Source: American Journal Of Epidemiology, 2011-10-01 00:00:00.0; 174(7), p. 828-38.
EPub date: 2011-10-01 00:00:00.0.
PMID: 21836166
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Temporal trends in geographic disparities in small-area-level colorectal cancer incidence and mortality in the United States.
Authors: Schootman M. , Lian M. , Deshpande A.D. , McQueen A. , Pruitt S.L. , Jeffe D.B. .
Source: Cancer Causes & Control : Ccc, 2011 Aug; 22(8), p. 1173-81.
PMID: 21688130
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Neighborhood socioeconomic deprivation and mortality: NIH-AARP diet and health study.
Authors: Major J.M. , Doubeni C.A. , Freedman N.D. , Park Y. , Lian M. , Hollenbeck A.R. , Schatzkin A. , Graubard B.I. , Sinha R. .
Source: Plos One, 2010-11-23 00:00:00.0; 5(11), p. e15538.
EPub date: 2010-11-23 00:00:00.0.
PMID: 21124858
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National estimates of racial disparities in health status and behavioral risk factors among long-term cancer survivors and non-cancer controls.
Authors: Schootman M. , Deshpande A.D. , Pruitt S.L. , Aft R. , Jeffe D.B. .
Source: Cancer Causes & Control : Ccc, 2010 Sep; 21(9), p. 1387-95.
PMID: 20401529
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An evaluation of lower-body functional limitations among long-term survivors of 11 different types of cancers.
Authors: Schootman M. , Aft R. , Jeffe D.B. .
Source: Cancer, 2009-11-15 00:00:00.0; 115(22), p. 5329-38.
PMID: 19676109
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