Journal article
Socio-Environmental Conditions Associated with Geospatial Clusters of Urothelial Carcinoma: A Multi-Institutional Analysis
The Journal of urology, v 206(6), pp 1390-1401
Dec 2021
PMID: 34288718
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The interaction between sources of industrial byproducts and environmental pollutants (IBP/EP) and the prevalence of urothelial carcinoma (UC) in surrounding communities has been infrequently explored. The purpose of this research is to identify microregional UC hotspots and associated industrial and environmental risk factors.
We retrospectively queried a multi-institutional database for UC patients diagnosed between 2008 and 2018. Addresses were geocoded and used to perform hotspot analysis on the census block level. Demographic and clinicopathological characteristics, census data and proximity to sources of IBP/EP were compared between patients who did vs did not reside in a hotspot. Associations were tested using multilevel logistic regression models using 95% confidence intervals.
A total of 5,080 patients met inclusion criteria and 148 (2.9%) were identified as living in 1 of 3 UC hotspots. In univariate analyses, race, tobacco and alcohol use, household income, IBP/EP exposure and proximity to traffic, industrial discharge and airports were significantly associated with UC hotspots. Multivariable analysis demonstrated that polycyclic aromatic hydrocarbon exposure (OR: 48.09, p ≤0.001) and proximity to high-density traffic (OR: >999, p ≤0.001) increased the odds of living in a hotspot. Patients living in a hotspot were significantly less likely to be white (OR: 0.06, p ≤0.001) or tobacco users (OR: 0.39, p=0.031) on multivariate analysis.
Spatially related clusters of UC may be associated with locoregional environmental exposures rather than tobacco exposure and may also be correlated with socioeconomic disparities. Geospatial analysis can help to identify at-risk populations, offering the opportunity to better focus preventive and diagnostic interventions.
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Details
- Title
- Socio-Environmental Conditions Associated with Geospatial Clusters of Urothelial Carcinoma: A Multi-Institutional Analysis
- Creators
- Gabrielle R Yankelevich - Medical University of South CarolinaPaulette C Dreher - Main Line HealthZachariah Taylor - Main Line HealthDaniel Kim - Main Line HealthMeghan Buckley - Lankenau Institute for Medical ResearchSharon Larson - Lankenau Institute for Medical ResearchLaurence Belkoff - Main Line HealthGuy Bernstein - Lankenau Institute for Medical ResearchDaniel C Edwards - Main Line Health
- Publication Details
- The Journal of urology, v 206(6), pp 1390-1401
- Publisher
- Lippincott
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000716572000012
- Scopus ID
- 2-s2.0-85121949436
- Other Identifier
- 991021916909404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Urology & Nephrology