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Cancer Prevention and Control: How Systemic Inequities, Place, and Context Matters

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Infectious Diseases, Chronic Diseases, and Disease Prevention".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 11598

Special Issue Editors

Dr. Marvin Langston

E-Mail Website
Guest Editor
Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA 94305, USA
Interests: epidemiology of benign and malignant prostate conditions including etiologic research on racial/ethnic and sexual minority cancer health inequities
Dr. Justin Xavier Moore

E-Mail Website
Guest Editor
1. Center for Health Equity Transformation, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY 40506, USA
2. Assistant Director for Population Science, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY 40506, USA
3. Assistant Director for Community Impact, Markey Cancer Center, University of Kentucky College of Medicine, Lexington, KY 40506, USA
Interests: intersection between race (including effects of racism) and place (social and built environment) on various health outcomes including cancer and infectious diseases

Special Issue Information

Dear Colleagues,

The cancer control continuum is often described as distinct phases including prevention, detection, diagnosis, treatment, and survivorship. The burden of cancer along this continuum can vary considerably while disproportionally affecting some populations over others. Examples include higher or lower rates in cancer incidence or mortality or cancer-related risk factors based on race/ethnicity, socioeconomic status, rurality, religious affiliation, sexual orientation, and/or gender expression. The neighborhoods and communities where people live, work, and play are also key determinants of inequities in the cancer control continuum. Sources of these inequities may be structural (e.g., residential segregation or the built environment) and may interact with other cancer-related factors, such as reduced resources for physical activity and lack of access to healthy foods creating an obesogenic environment. Often, inequities may be further driven by a lack of access to screening and quality care. 

In this Special Issue, we are broadly interested in research that helps to better understand how underserved populations may be affected by cancer and the ways neighborhood, environments, and health system factors may increase inequities across the cancer control continuum.

Dr. Marvin Langston
Dr. Justin Xavier Moore
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • racial/ethnic minorities
  • LGBT health
  • built environment
  • neighborhood deprivation
  • cancer risk factors
  • screening

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Published Papers (5 papers)

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Research

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15 pages, 1632 KiB  
Article
Exploring the Role of Communication Asset Mapping (CAM) as a Strategy to Promote Hereditary Cancer Risk Assessment Information Within African American Communities
by Crystal Y. Lumpkins, Kimberly A. Kaphingst, Lynn R. Miller, Evelyn Cooper, Margaret Smith, Katie Belshe, Garry Lumpkins, Jill Peltzer, Prajakta Adsul and Ricardo Wray
Int. J. Environ. Res. Public Health 2025, 22(1), 75; https://doi.org/10.3390/ijerph22010075 - 8 Jan 2025
Viewed by 1002
Abstract
Objective: African Americans (AAs) carry the largest burden for almost every type of cancer in the US and are also more likely to die from cancer. Approximately 10% of cancers can be explained by a hereditary factor and detected earlier. Many AAs, [...] Read more.
Objective: African Americans (AAs) carry the largest burden for almost every type of cancer in the US and are also more likely to die from cancer. Approximately 10% of cancers can be explained by a hereditary factor and detected earlier. Many AAs, however, have inequitable access to hereditary cancer risk assessment (HCRA) tools and information, further exacerbating disparities in cancer rates. Innovative communication strategies to promote community-based HCRA information have promise as a means encouraging optimal primary cancer screening among AAs. The current pilot study followed a participatory process where researchers engaged with a Community Advisory Board (CAB) to explore how Communication Asset Mapping (CAM) could assist lay health advisors with the dissemination of evidence-based HC/RA information within AA faith communities. Methods: The research team and CAB conducted exploratory community-engaged group discussions with residents (n = 21) guided by Communication Infrastructure Theory, and used a community-engaged mapping process to inform the development of a CAM dissemination strategy. Results: Through textual analysis, the following conclusions were reached: (1) optimal locations (e.g., community centers) within specified neighborhood networks should have representatives who are trusted ambassadors to assist with HCRA information dissemination; (2) trusted community member voices should fully represent the neighborhood network in the community-engagement mapping process; (3) well-known and frequented geographic locations should provide a true representation of participants’ neighborhoods to create a robust health information network concerning HCRA. Conclusions: Community residents appreciated the engagement process; however, they felt that its impact was limited due to the lack of community voices within their neighborhoods to identify important communication resources within the network for optimal HCRA information dissemination. CAM, therefore, is an important public health strategy for the identification of trusted networks and useful communication resources within these networks. The strategy was also helpful in pinpointing people who could be critical communicators of emerging health information akin to HCRA. Full article
(This article belongs to the Special Issue Cancer Prevention and Control: How Systemic Inequities, Place, and Context Matters)
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14 pages, 1361 KiB  
Article
Lung and Colorectal Cancer Disparities in Appalachian Kentucky: Spatial Analysis on the Influence of Education and Literacy
by Nicole M. Robertson, Todd Burus, Lauren Hudson, Pamela C. Hull, Lee Park and Nathan L. Vanderford
Int. J. Environ. Res. Public Health 2023, 20(14), 6363; https://doi.org/10.3390/ijerph20146363 - 14 Jul 2023
Cited by 8 | Viewed by 3824
Abstract
Low educational attainment and high cancer incidence and mortality rates have long been a challenge in Appalachian Kentucky. Prior studies have reported disparities in cancer incidence and mortality between Appalachian and non-Appalachian populations, but the influence of education on this disparity has not [...] Read more.
Low educational attainment and high cancer incidence and mortality rates have long been a challenge in Appalachian Kentucky. Prior studies have reported disparities in cancer incidence and mortality between Appalachian and non-Appalachian populations, but the influence of education on this disparity has not been extensively studied. Herein, all cancers and two cancer sites with available screenings (colorectal and lung) were joined with education indicators (educational attainment and literacy) and one geographic indicator across all 120 Kentucky counties. This dataset was used to build choropleth maps and perform simple linear and spatial regression to assess statistical significance and to measure the strength of the linear relationship between county-level education and cancer-related outcomes in Appalachian and non-Appalachian Kentucky. Among all cancer sites, age-adjusted cancer incidence and mortality was higher in Appalachian versus non-Appalachian Kentucky. The percentage of the population not completing high school was positively correlated with increased colorectal and lung cancer incidence and mortality in Appalachia. Similarly, counties with a higher percentage of the population lacking basic literacy had the strongest correlation with colorectal and lung cancer incidence and mortality, which were concentrated in Appalachian Kentucky. Our findings suggest a need for implementing interventions that increase educational attainment and enhance basic literacy as a means of improving cancer outcomes in Appalachia. Full article
(This article belongs to the Special Issue Cancer Prevention and Control: How Systemic Inequities, Place, and Context Matters)
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11 pages, 320 KiB  
Article
“Ultimately, You Realize You’re on Your Own”: The Impact of Prostate Cancer on Gay and Bisexual Men Couples
by Joseph Daniels, Rob Stephenson, Shelby Langer, Laurel Northouse, Roxana Odouli, Channa Amarasekera, Stephen Vandeneeden and Marvin Langston
Int. J. Environ. Res. Public Health 2023, 20(10), 5756; https://doi.org/10.3390/ijerph20105756 - 9 May 2023
Cited by 4 | Viewed by 2639
Abstract
An estimated one in three gay and bisexual (GB) male couples receive a prostate cancer (PCa) diagnosis over their life course with limited understanding of the impacts on their relationships. Psychological distress related to PCa diagnosis and treatment-related side effects have been shown [...] Read more.
An estimated one in three gay and bisexual (GB) male couples receive a prostate cancer (PCa) diagnosis over their life course with limited understanding of the impacts on their relationships. Psychological distress related to PCa diagnosis and treatment-related side effects have been shown to disrupt established GB partnership dynamics. Communication barriers often develop within GB relationships affected by PCa, further exacerbating couple tensions, isolating partners, and lowering quality of life for both patients and partners. In order to elaborate on these phenomena following a PCa diagnosis, we conducted focus group discussions with GB men in relationships. Men were recruited nationally through PCa support groups, and after completing consent procedures, they were invited to one of two focus group discussions conducted through video conference. Topics discussed included the diagnosis and medical decision making pertaining to PCa; healthcare provider experiences; the emotional, physical, and sexual impact of PCa diagnosis and treatment; sources of support and appraisal of resources; and partner involvement and communication. There were twelve GB men who participated in focus group discussions that were audio-recorded and transcribed, and analyzed using a thematic approach. GB couple experiences with PCa during and after treatment choice and recovery identified common patient–provider communication barriers. In particular, GB men reported difficulties in disclosing their sexuality and relationship to their providers, limiting conversations about treatment choice and partner engagement in care. Both patients and partners experienced times of being alone after treatment, either by choice or to give space to their partner. However, partners often did not explicitly discuss their preferences for being alone or together, which resulted in partners’ disengagement in their relationship and the prostate cancer healthcare process. This disengagement could blunt the notable PCa survival benefits of partnership for GB men. Full article
(This article belongs to the Special Issue Cancer Prevention and Control: How Systemic Inequities, Place, and Context Matters)
14 pages, 374 KiB  
Article
Racial, Lifestyle, and Healthcare Contributors to Perceived Cancer Risk among Physically Active Adolescent and Young Adult Women Aged 18–39 Years
by Jordyn A. Brown, Mahmood A. Alalwan, Sumaya Absie, Naa D. Korley, Claudia F. Parvanta, Cathy M. Meade, Alicia L. Best, Clement K. Gwede and Aldenise P. Ewing
Int. J. Environ. Res. Public Health 2023, 20(9), 5740; https://doi.org/10.3390/ijerph20095740 - 8 May 2023
Cited by 1 | Viewed by 2217
Abstract
The cancer incidence among adolescents and young adults (AYAs) has significantly increased in recent years, but there is limited information about the factors that influence the perceived cancer risk among AYAs. A cross-sectional, web-based survey of 281 physically active Black and White AYA [...] Read more.
The cancer incidence among adolescents and young adults (AYAs) has significantly increased in recent years, but there is limited information about the factors that influence the perceived cancer risk among AYAs. A cross-sectional, web-based survey of 281 physically active Black and White AYA women was administered to assess the influences of demographic characteristics, family history of cancer, cancer risk factor knowledge, and lifestyle-related risk and protective behaviors on perceived cancer risk. Linear regression analyses were performed in SAS version 9.4. Self-reported Black race (β = −0.62, 95% CI: −1.07, −0.17) and routine doctor visits (β = −0.62, 95% CI: −1.18, −0.07) were related to a lower perceived cancer risk. Family history of cancer (β = 0.56, 95% CI: 0.13, 0.99), cancer risk factor knowledge (β = 0.11, 95% CI: 0.03, 0.19), and current smoking status (β = 0.80, 95% CI: 0.20, 1.40) were related to a higher perceived cancer risk. Perceptions of cancer risk varied among this sample of physically active, AYA women. Lower perceptions of cancer risk among Black AYA women demonstrate a need for culturally tailored cancer educational information that presents objective data on lifetime cancer risk. Reportedly higher perceptions of cancer risk among AYA smokers presents an ideal opportunity to promote smoking cessation interventions. Future interventions to address cancer risk perception profiles among physically active, AYA women should tailor approaches that are inclusive of these unique characteristics. Full article
(This article belongs to the Special Issue Cancer Prevention and Control: How Systemic Inequities, Place, and Context Matters)

Review

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26 pages, 1691 KiB  
Review
Second-Hand Smoke Exposure and Risk of Lung Cancer Among Nonsmokers in the United States: A Systematic Review and Meta-Analysis
by Safa Elkefi, Gabriel Zeinoun, Achraf Tounsi, Jean-Marie Bruzzese, Corina Lelutiu-Weinberger and Alicia K. Matthews
Int. J. Environ. Res. Public Health 2025, 22(4), 595; https://doi.org/10.3390/ijerph22040595 - 10 Apr 2025
Viewed by 644
Abstract
This study aims to explore the link between exposure to tobacco smoke among nonsmokers and the risk of lung cancer in the United States. We searched six databases for studies on second-hand smoke (SHS) and lung cancer following PRISMA guidelines. Following the random [...] Read more.
This study aims to explore the link between exposure to tobacco smoke among nonsmokers and the risk of lung cancer in the United States. We searched six databases for studies on second-hand smoke (SHS) and lung cancer following PRISMA guidelines. Following the random effects model and specific statistical methods, our meta-analysis analyzed studies based on SHS exposure type. A total of 19 eligible studies were included in the review and 15 in the meta-analysis. We covered exposure from parents (childhood), spouses and partners (household), and work-related exposure (colleagues), with higher risk among non-smoking children and domestic partners. Findings reveal a consistent link between SHS exposure and increased lung cancer risk for this population (exposure effect sizes: 1.05–3.11). Analysis of childhood SHS exposure reveals a distinct increased risk associated with parental exposure. For nonsmokers living with smoking spouses, there is a marked 41% increase in risk. Higher risk was associated with more and more prolonged SHS exposure. Exposure to SHS in the workplace shows a correlation with lung cancer risk. Our findings highlight increased SHS-related lung cancer risk, particularly among non-smoking children and domestic partners, intensifying with the amount and duration of exposure, indicating the significant impact of SHS within domestic environments. Full article
(This article belongs to the Special Issue Cancer Prevention and Control: How Systemic Inequities, Place, and Context Matters)
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