Abstract C060: Does the border play a role? Cancer-related disparities by neighborhood proximity to the US-MX border
Authors: McDaniels-Davidson Corinne , Vu Harvey , Chagolla Priscila , Patel Sandip , Gupta Samir , Crespo Noe , Nodora Jesse , Martinez M Elena 
Published: September 2020

Abstract
Background Disparities in cancer outcomes have been documented among populations along the United States (US)-Mexico border. However, the drivers of these disparities have not been well characterized. We sought to identify differences in cancer-related knowledge, attitudes, and behaviors at a granular level, within the 5th largest US county. Methods The University of California, San Diego Moores Cancer Center and San Diego State University Institute for Public Health administered a county-wide assessment to a random sample of 4,000 residents with an additional random sample of 1,000 households in border-adjacent ZIP codes. Mailed in English and Spanish, the survey assessed access to care, health and cancer screening history, cancer beliefs, HPV vaccination, precision medicine knowledge, and socio-demographics. Data collection is ongoing; 494 completed surveys were included in this analysis comparing those residing in border-adjacent ZIP codes (BA; n=72) to the remainder of the county (RC; n=422) using t-tests and chi-square tests. Results Respondents from BA were demographically similar to those from those from RC in mean age and percent female (65 and 59 years; 66% and 63%, respectively). No significant differences were observed between BA and RC respondents in proportion earning &lt;$35,000 per year (26% versus 16% in RC; p=0.05) or the proportion finding it difficult or very difficult on their present income (19% versus 13% in RC; p=0.186). Although slight differences were observed in health care coverage (90% versus 97% in RC; p=0.022), there were no significant differences in access to a usual source of care or age-appropriate colorectal, breast, or cervical cancer screening. Participants from BA were less likely to rate their overall health as excellent or very good (34% versus 54% in RC; p=0.003). Agreement with fatalistic cancer statements was higher among BA respondents: 73% agreed that it seems like everything causes cancer (50% RC; p=0.001) and 36% agreed that there is not much you can do to lower your chances of getting cancer (19% RC; p=0.002). There were more HPV vaccine misperceptions among BA with significantly higher agreement with statements such as: the HPV vaccine was not properly tested (36% versus 16% in RC; p=0.001), the HPV vaccine encourages promiscuity (31% versus 12% in RC; p=0.001), and the HPV vaccine can give you HPV and cause cancer (24% versus 8% in RC; p=0.001). BA residents were less likely to have heard about physician-ordered genetic tests (56% versus 78% in RC; p&lt;0.001) and were less familiar with 9 of 13 precision medicine terms assessed (p&lt;0.05). Conclusions Despite relatively similar levels of health coverage, access to care, and screening adherence, there were significant differences between BA and RC in cancer-related misperceptions, mistrust, and knowledge. Interventions from trusted community organizations that target these areas may begin to reduce cancer disparities among border populations.
Citation Format: Corinne McDaniels-Davidson, Harvey Vu, Priscila Chagolla, Sandip Patel, Samir Gupta, Noe Crespo, Jesse Nodora, M Elena Martinez. Does the border play a role? Cancer-related disparities by neighborhood proximity to the US-MX border [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C060.