Quantification of Potential Inequities in Breast Cancer Incidence in New Mexico Through Bayesian Disease Mapping
ORIGINAL RESEARCH — Volume 18 — March 11, 2021
PEER REVIEWED
The SEER registry yielded 39,293 people living in New Mexico aged 15 or older who received a diagnosis of breast cancer, 38,977 of which were women. Of these, 13,135 were diagnosed from 2005 through 2014. County of residence was known for 12,974 of these. Among those with known county of residence, 8,794 were non-Hispanic, and 8,461 were American Indian/Alaska Native (567) or White (7,894).
Figure 1.
Data flow diagram describing the selection of New Mexico women with breast cancer for inclusion in a study of potential inequities in breast cancer incidence among non-Hispanic American Indian/Alaska Native and non-Hispanic White women. Abbreviation: SEER, Surveillance, Epidemiology, and End Results program.
Figure 2.
County-level Area Deprivation Index (ADI) quintiles for 33 New Mexico counties in 2012 categorized as the lower 20% (Q1), middle 60% (Q 2–4), and upper 20% (Q5). Higher quintiles indicate increased socioeconomic disadvantage. Red diamonds depict major cites (Albuquerque in Bernalillo County, Las Cruces in Dona Ana County, Rio Rancho in Sandoval County, and Santa Fe in Santa Fe County). ADI scores were developed by Mayo Clinic researchers (10), and are derived from 17 indicators that served as surrogates for income, employment, housing, and education.
| County | Rate Ratio, Non-Hispanic AI/AN vs Non-Hispanic White Women |
|---|---|
| Posterior Mean Rate Ratio (95% Credible Interval Rate Ratio) | |
| Bernalillo | 0.311 (0.121–0.600) |
| Catron | 0.346 (0.066–0.927) |
| Chaves | 0.446 (0.092–0.991) |
| Cibola | 0.440 (0.175–0.834) |
| Colfax | 0.488 (0.109–1.284) |
| Curry | 0.490 (0.064–1.348) |
| De Baca | 0.460 (0.095–1.073) |
| Dona Ana | 0.407 (0.066–0.910) |
| Eddy | 0.372 (0.058–1.061) |
| Grant | 0.432 (0.067–1.062) |
| Guadalupe | 0.456 (0.108–1.037) |
| Harding | 0.477 (0.112–1.162) |
| Hidalgo | 0.492 (0.048–1.436) |
| Lea | 0.480 (0.069–1.215) |
| Lincoln | 0.335 (0.081–0.822) |
| Los Alamos | 0.370 (0.080–1.072) |
| Luna | 0.432 (0.063–1.058) |
| McKinley | 0.462 (0.228–0.808) |
| Mora | 0.460 (0.132–1.044) |
| Otero | 0.437 (0.112–0.930) |
| Quay | 0.455 (0.109–1.026) |
| Rio Arriba | 0.416 (0.131–0.816) |
| Roosevelt | 0.463 (0.085–1.087) |
| San Juan | 0.478 (0.250–0.820) |
| San Miguel | 0.465 (0.132–1.078) |
| Sandoval | 0.339 (0.120–0.715) |
| Santa Fe | 0.326 (0.106–0.737) |
| Sierra | 0.419 (0.092–0.903) |
| Socorro | 0.422 (0.106–0.860) |
| Taos | 0.492 (0.139–1.296) |
| Torrance | 0.432 (0.123–0.889) |
| Union | 0.499 (0.092–1.341) |
| Valencia | 0.421 (0.100–0.882) |
Figure 3.
Exponentiated sum of the posterior average county-level heterogeneity effects obtained from the proposed model. Map A gives the results for non-Hispanic White women and Map B gives the results for non-Hispanic American Indian/Alaska Native women. Red diamonds depict major cites (Albuquerque in Bernalillo County, Las Cruces in Dona Ana County, Rio Rancho in Sandoval County, and Santa Fe in Santa Fe County).
| County | Exponentiated Sum of the Posterior Average County-Level Heterogeneity Effects, EXP(Φ+Θ), Obtained From the Proposed Model | |
|---|---|---|
| Non-Hispanic White Women | Non-Hispanic American Indian/Alaska Native Women | |
| Bernalillo | 1.003 | 0.996 |
| Catron | 0.995 | 0.960 |
| Chaves | 0.963 | 0.947 |
| Cibola | 1.012 | 1.055 |
| Colfax | 1.029 | 1.074 |
| Curry | 0.960 | 0.952 |
| De Baca | 0.972 | 0.976 |
| Dona Ana | 1.002 | 0.880 |
| Eddy | 0.914 | 0.928 |
| Grant | 1.010 | 0.921 |
| Guadalupe | 0.991 | 0.999 |
| Harding | 1.011 | 1.050 |
| Hidalgo | 0.983 | 0.913 |
| Lea | 0.928 | 0.927 |
| Lincoln | 0.977 | 0.964 |
| Los Alamos | 1.050 | 1.069 |
| Luna | 1.001 | 0.909 |
| McKinley | 1.010 | 1.133 |
| Mora | 1.039 | 1.071 |
| Otero | 0.993 | 0.981 |
| Quay | 0.990 | 1.002 |
| Rio Arriba | 1.042 | 1.008 |
| Roosevelt | 0.954 | 0.955 |
| San Juan | 0.992 | 1.158 |
| San Miguel | 1.027 | 1.073 |
| Sandoval | 1.010 | 1.070 |
| Santa Fe | 1.074 | 1.075 |
| Sierra | 1.001 | 0.935 |
| Socorro | 0.991 | 0.952 |
| Taos | 1.073 | 1.162 |
| Torrance | 1.009 | 0.997 |
| Union | 1.010 | 1.040 |
| Valencia | 1.003 | 0.953 |
The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions.