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

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.




Geospatial analysis of multiple cancers in individuals in the US, 2004-2014.
Authors: Scott L.C. , Kuo T.M. , Il'yasova D. , Mobley L.R. .
Source: Annals of cancer epidemiology, 2021 Mar; 5, .
EPub date: 2021-03-30.
PMID: 33880445
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What Happened to Disparities in CRC Screening Among FFS Medicare Enrollees Following Medicare Modernization?
Authors: Mobley L.R. , Kuo T.M. , Zhou M. , Rutherford Y. , Meador S. , Koschinsky J. .
Source: Journal of racial and ethnic health disparities, 2019 Apr; 6(2), p. 273-291.
EPub date: 2018-09-19.
PMID: 30232793
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Medicare modernization and diffusion of endoscopy in FFS medicare.
Authors: Mobley L.R. , Amaral P. , Kuo T.M. , Zhou M. , Bose S. .
Source: Health economics review, 2017 Dec; 7(1), p. 13.
EPub date: 2017-03-09.
PMID: 28281245
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Modeling Geospatial Patterns of Late-Stage Diagnosis of Breast Cancer in the US.
Authors: Mobley L.R. , Kuo T.M. , Scott L. , Rutherford Y. , Bose S. .
Source: International journal of environmental research and public health, 2017-05-05; 14(5), .
EPub date: 2017-05-05.
PMID: 28475134
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Geospatial Analysis of Inflammatory Breast Cancer and Associated Community Characteristics in the United States.
Authors: Scott L. , Mobley L.R. , Il'yasova D. .
Source: International journal of environmental research and public health, 2017-04-11; 14(4), .
EPub date: 2017-04-11.
PMID: 28398259
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Demographic Disparities in Late-Stage Diagnosis of Breast and Colorectal Cancers Across the USA.
Authors: Mobley L.R. , Kuo T.M. .
Source: Journal of racial and ethnic health disparities, 2017 Apr; 4(2), p. 201-212.
EPub date: 2016-04-12.
PMID: 27072541
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Using residential segregation to predict colorectal cancer stage at diagnosis: two different approaches.
Authors: Mobley L.R. , Scott L. , Rutherford Y. , Kuo T.M. .
Source: Annals of epidemiology, 2017 Jan; 27(1), p. 10-19.
EPub date: 2016-11-25.
PMID: 27939165
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Spatial Variation in the Quality of American Community Survey Estimates.
Authors: Folch D.C. , Arribas-Bel D. , Koschinsky J. , Spielman S.E. .
Source: Demography, 2016 Oct; 53(5), p. 1535-1554.
PMID: 27541024
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How generalizable are the SEER registries to the cancer populations of the USA?
Authors: Kuo T.M. , Mobley L.R. .
Source: Cancer causes & control : CCC, 2016 Sep; 27(9), p. 1117-26.
EPub date: 2016-07-21.
PMID: 27443170
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United States Health Policies and Late-stage Breast and colorectal cancer diagnosis: Why such disparities by age?
Authors: Mobley L.R. , Kuo T.M. .
Source: Health economics review, 2015 Dec; 5(1), p. 58.
EPub date: 2015-07-15.
PMID: 26170153
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Geographic and Demographic Disparities in Late-stage Breast and Colorectal Cancer Diagnoses Across the US.
Authors: Mobley L.R. , Kuo T.M. .
Source: AIMS public health, 2015; 2(3), p. 583-600.
EPub date: 2015-08-28.
PMID: 27981060
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Macro-level factors impacting geographic disparities in cancer screening.
Authors: Mobley L.R. , Kuo T.M. , Traczynski J. , Udalova V. , Frech H.E. .
Source: Health economics review, 2014 Dec; 4(1), p. 13.
EPub date: 2014-08-20.
PMID: 26054402
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Spatial Sufficiency of 5% Medicare Standard Analytic Files.
Authors: Mobley L.R. .
Source: Spatial demography, 2013 Jun; 1(2), p. 202-218.
EPub date: 2015-05-14.
PMID: 30023426
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Geographic disparities in late-stage cancer diagnosis: multilevel factors and spatial interactions.
Authors: Mobley L.R. , Kuo T.M. , Watson L. , Gordon Brown G. .
Source: Health & place, 2012 Sep; 18(5), p. 978-90.
EPub date: 2012-06-26.
PMID: 22789866
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Spatial Heterogeneity in Cancer Control Planning and Cancer Screening Behavior.
Authors: Mobley L.R. , Kuo T.M. , Urato M. , Subramanian S. , Watson L. , Anselin L. .
Source: Annals of the Association of American Geographers. Association of American Geographers, 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 L.R. , Subramanian S. , Koschinsky J. , Frech H.E. , Trantham L.C. , Anselin L. .
Source: Health services research, 2011 Dec; 46(6pt1), p. 1905-27.
EPub date: 2011-08-16.
PMID: 22092022
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Building a biomedical cyberinfrastructure for collaborative research.
Authors: Schad P.A. , Mobley L.R. , Hamilton C.M. .
Source: American journal of preventive medicine, 2011 May; 40(5 Suppl 2), p. S144-50.
PMID: 21521587
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Geographic disparities in late-stage breast cancer diagnosis in California.
Authors: Kuo T.M. , Mobley L.R. , Anselin L. .
Source: Health & place, 2011 Jan; 17(1), p. 327-34.
EPub date: 2010-11-26.
PMID: 21144791
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Community contextual predictors of endoscopic colorectal cancer screening in the USA: spatial multilevel regression analysis.
Authors: Mobley L.R. , Kuo T.M. , Urato M. , Subramanian S. .
Source: International journal of health geographics, 2010-09-03; 9, p. 44.
EPub date: 2010-09-03.
PMID: 20815882
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Predictors of endoscopic colorectal cancer screening over time in 11 states.
Authors: Mobley L. , Kuo T.M. , Urato M. , Boos J. , Lozano-Gracia N. , Anselin L. .
Source: Cancer causes & control : CCC, 2010 Mar; 21(3), p. 445-61.
EPub date: 2009-11-28.
PMID: 19946738
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Mammography facilities are accessible, so why is utilization so low?
Authors: Mobley L.R. , Kuo T.M. , Clayton L.J. , Evans W.D. .
Source: Cancer causes & control : CCC, 2009 Aug; 20(6), p. 1017-28.
EPub date: 2009-02-11.
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 L.R. , Kuo T.M. , Driscoll D. , Clayton L. , Anselin L. .
Source: International journal of health geographics, 2008-06-30; 7, p. 32.
EPub date: 2008-06-30.
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 L.R. , Kuo T.M. , Andrews L. .
Source: Medical care research and review : MCRR, 2008 Jun; 65(3), p. 315-37.
EPub date: 2008-02-07.
PMID: 18259047
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