Citation
Major, Jacqueline M., et al. "Local Geographic Variation in Chronic Liver Disease and Hepatocellular Carcinoma: Contributions of Socioeconomic Deprivation, Alcohol Retail Outlets, and Lifestyle." Annals of Epidemiology, vol. 24, no. 2, 2014, pp. 104-10.
Major JM, Sargent JD, Graubard BI, et al. Local geographic variation in chronic liver disease and hepatocellular carcinoma: contributions of socioeconomic deprivation, alcohol retail outlets, and lifestyle. Ann Epidemiol. 2014;24(2):104-10.
Major, J. M., Sargent, J. D., Graubard, B. I., Carlos, H. A., Hollenbeck, A. R., Altekruse, S. F., Freedman, N. D., & McGlynn, K. A. (2014). Local geographic variation in chronic liver disease and hepatocellular carcinoma: contributions of socioeconomic deprivation, alcohol retail outlets, and lifestyle. Annals of Epidemiology, 24(2), 104-10. https://doi.org/10.1016/j.annepidem.2013.11.006
Major JM, et al. Local Geographic Variation in Chronic Liver Disease and Hepatocellular Carcinoma: Contributions of Socioeconomic Deprivation, Alcohol Retail Outlets, and Lifestyle. Ann Epidemiol. 2014;24(2):104-10. PubMed PMID: 24332863.
TY - JOUR
T1 - Local geographic variation in chronic liver disease and hepatocellular carcinoma: contributions of socioeconomic deprivation, alcohol retail outlets, and lifestyle.
AU - Major,Jacqueline M,
AU - Sargent,James D,
AU - Graubard,Barry I,
AU - Carlos,Heather A,
AU - Hollenbeck,Albert R,
AU - Altekruse,Sean F,
AU - Freedman,Neal D,
AU - McGlynn,Katherine A,
Y1 - 2013/11/21/
PY - 2013/05/03/received
PY - 2013/11/08/revised
PY - 2013/11/11/accepted
PY - 2013/12/17/entrez
PY - 2013/12/18/pubmed
PY - 2014/3/25/medline
KW - Census
KW - Cohort
KW - Health care
KW - Kernel density estimation
KW - Liver cancer
KW - Liver disease
KW - Multilevel
KW - Neighborhood
KW - Socioeconomic disparities
SP - 104
EP - 10
JF - Annals of epidemiology
JO - Ann Epidemiol
VL - 24
IS - 2
N2 - PURPOSE: Hepatocellular carcinoma (HCC) incidence rates continue to increase in the United States. Geographic variation in rates suggests a potential contribution of area-based factors, such as neighborhood socioeconomic deprivation, retail alcohol availability, and access to health care. METHODS: Using the National Institutes of Health-American Association of Retired Persons Diet and Health Study, we prospectively examined area socioeconomic variations in HCC incidence (n = 434 cases) and chronic liver disease (CLD) mortality (n = 805 deaths) and assessed contribution of alcohol outlet density, health care infrastructure, diabetes, obesity, and health behaviors. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from hierarchical Cox regression models. RESULTS: Area socioeconomic deprivation was associated with increased risk of HCC incidence and CLD mortality (HR, 1.48; 95% CI, 1.03-2.14 and HR, 2.36; 95% CI, 1.79-3.11, respectively) after accounting for age, sex, and race. After additionally accounting for educational attainment and health risk factors, associations for HCC incidence were no longer significant; associations for CLD mortality remained significant (HR, 1.78; 95% CI, 1.34-2.36). Socioeconomic status differences in alcohol outlet density and health behaviors explained the largest proportion of socioeconomic status-CLD mortality association, 10% and 29%, respectively. No associations with health care infrastructure were observed. CONCLUSIONS: Our results suggest a greater effect of area-based factors for CLD than HCC. Personal risk factors accounted for the largest proportion of variance for HCC but not for CLD mortality.
SN - 1873-2585
UR - https://www.unboundmedicine.com/medline/citation/24332863/Local_geographic_variation_in_chronic_liver_disease_and_hepatocellular_carcinoma:_contributions_of_socioeconomic_deprivation_alcohol_retail_outlets_and_lifestyle_
L2 - https://linkinghub.elsevier.com/retrieve/pii/S1047-2797(13)00444-4
DB - PRIME
DP - Unbound Medicine
ER -