Abstract A046: Disparities in cancer burden and survival rates in persistent poverty communities in Los Angeles County
Authors: Gorbatov Miriam L , Mendez Joel S. , Cockburn Myles , Thompson Laura K. , Liu Lihua , Tsui Jennifer , Zhou Kali , Setiawan V. Wendy , Hughes-Halbert Chanita , Stern Mariana C. 
Published: September 2024

Abstract
Objective: Persistent poverty census tracts (PPT) are those with socioeconomic challenges where prolonged economic disadvantages may significantly influence health outcomes. This study examined the cancer burden and survival patterns in PPTs compared to non-PPTs in Los Angeles County (LAC) considering disparities by race/ethnicity and stage at diagnosis. Methods: A comprehensive analysis of 2012-2021 Cancer Registry data examined age-adjusted incidence rates (AAIRs) and survival rates for lung, colorectal, liver, stomach, breast, and prostate cancers, which are the Norris Comprehensive Cancer Center priority cancers. Cancer-specific data were further stratified by racial/ethnic group and stage at diagnosis, and compared across residents in PPTs, non-PPTs, and LAC overall. Survival rates were calculated using the Kaplan-Meier method and differences between groups were assessed by log-rank tests. Results: PPTs in LAC were characterized by a higher proportion of racial/ethnic minorities, lower education levels, and higher unemployment compared to non-PPTs. In all racial/ethnic groups combined, AAIRs for lung, breast, and prostate cancers were lower in PPTs than non-PPTs, whereas AAIRS for liver and stomach cancers were higher in PPTs, with no differences for colorectal cancer. Disparities emerged when considering race and ethnicity, with higher lung cancer AAIRs among Non-Hispanic White (NHW) and Black/African American (B/AA) PPT residents compared to non-PPT, while AAIRs for lung and colorectal cancers were lower among Hispanic/Latino (H/L) PPT residents compared to non-PPTs. Breast and prostate cancer AAIRs remained lower in PPTs than in non-PPTS regardless of racial/ethnic group. Patients in PPTs exhibit significantly lower five-year survival rates across all studied cancers, except stomach, compared to non-PPTs. B/AA patients showed the lowest five-year survival rates for lung and colorectal cancer, with patients in PPTs experiencing significantly lower rates than patients in non-PPTs regardless of disease stage (p &lt; 0.01 for early- or late-stage). Liver cancer survival rates were notably low, especially for H/L and Asian/Pacific Islander patients in PPTs, with five-year survival for late-stage cancer at 4.9% (95%CI: 2.8-8.5) and 5.4% (95%CI: 2.1-14.0), respectively. Patients in PPTs with late-stage breast or prostate cancer exhibited significantly lower 5-year survival (compared to non-PPTs) across all race/ethnicities, with B/AA patients experiencing the lowest survival rates for breast cancer and NHW patients experiencing the lowest survival rates for prostate cancer. Conclusions: Cancer outcomes for patients in PPTs were significantly poorer compared to those in non-PPT communities. The notably lower AAIRs in PPTs versus non-PPTs for more screen-able cancers, such as breast, prostate, and early-stage colorectal cancer, suggest a need for greater efforts to provide access to routine screening in areas affected by persistent poverty, though other causes cannot be ruled out.
Citation Format: Miriam L Gorbatov, Joel S. Mendez, Myles Cockburn, Laura K. Thompson, Lihua Liu, Jennifer Tsui, Kali Zhou, V. Wendy Setiawan, Chanita Hughes-Halbert, Mariana C. Stern. Disparities in cancer burden and survival rates in persistent poverty communities in Los Angeles County [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A046.