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Continuous Rural-Urban Coding for Cancer Disparity Studies: Is It Appropriate for Statistical Analysis?

Background: The dichotomization or categorization of rural-urban codes, as nominal variables, is a prevailing paradigm in cancer disparity studies. The paradigm represents continuous rural-urban transition as discrete groups, which results in a loss of ordering information and landscape continuum, a...

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Autores principales: Yaghjyan, Lusine, Cogle, Christopher R., Deng, Guangran, Yang, Jue, Jackson, Pauline, Hardt, Nancy, Hall, Jaclyn, Mao, Liang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466258/
https://www.ncbi.nlm.nih.gov/pubmed/30917515
http://dx.doi.org/10.3390/ijerph16061076
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author Yaghjyan, Lusine
Cogle, Christopher R.
Deng, Guangran
Yang, Jue
Jackson, Pauline
Hardt, Nancy
Hall, Jaclyn
Mao, Liang
author_facet Yaghjyan, Lusine
Cogle, Christopher R.
Deng, Guangran
Yang, Jue
Jackson, Pauline
Hardt, Nancy
Hall, Jaclyn
Mao, Liang
author_sort Yaghjyan, Lusine
collection PubMed
description Background: The dichotomization or categorization of rural-urban codes, as nominal variables, is a prevailing paradigm in cancer disparity studies. The paradigm represents continuous rural-urban transition as discrete groups, which results in a loss of ordering information and landscape continuum, and thus may contribute to mixed findings in the literature. Few studies have examined the validity of using rural-urban codes as continuous variables in the same analysis. Methods: We geocoded cancer cases in north central Florida between 2005 and 2010 collected by Florida Cancer Data System. Using a linear hierarchical model, we regressed the occurrence of late stage cancer (including breast, colorectal, hematological, lung, and prostate cancer) on the rural-urban codes as continuous variables. To validate, the results were compared to those from using a truly continuous rurality data of the same study region. Results: In term of associations with late-stage cancer risk, the regression analysis showed that the use of rural-urban codes as continuous variables produces consistent outcomes with those from the truly continuous rurality for all types of cancer. Particularly, the rural-urban codes at the census tract level yield the closest estimation and are recommended to use when the continuous rurality data is not available. Conclusions: Methodologically, it is valid to treat rural-urban codes directly as continuous variables in cancer studies, in addition to converting them into categories. This proposed continuous-variable method offers researchers more flexibility in their choice of analytic methods and preserves the information in the ordering. It can better inform how cancer risk varies, degree by degree, over a finer spectrum of rural-urban landscape.
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spelling pubmed-64662582019-04-22 Continuous Rural-Urban Coding for Cancer Disparity Studies: Is It Appropriate for Statistical Analysis? Yaghjyan, Lusine Cogle, Christopher R. Deng, Guangran Yang, Jue Jackson, Pauline Hardt, Nancy Hall, Jaclyn Mao, Liang Int J Environ Res Public Health Article Background: The dichotomization or categorization of rural-urban codes, as nominal variables, is a prevailing paradigm in cancer disparity studies. The paradigm represents continuous rural-urban transition as discrete groups, which results in a loss of ordering information and landscape continuum, and thus may contribute to mixed findings in the literature. Few studies have examined the validity of using rural-urban codes as continuous variables in the same analysis. Methods: We geocoded cancer cases in north central Florida between 2005 and 2010 collected by Florida Cancer Data System. Using a linear hierarchical model, we regressed the occurrence of late stage cancer (including breast, colorectal, hematological, lung, and prostate cancer) on the rural-urban codes as continuous variables. To validate, the results were compared to those from using a truly continuous rurality data of the same study region. Results: In term of associations with late-stage cancer risk, the regression analysis showed that the use of rural-urban codes as continuous variables produces consistent outcomes with those from the truly continuous rurality for all types of cancer. Particularly, the rural-urban codes at the census tract level yield the closest estimation and are recommended to use when the continuous rurality data is not available. Conclusions: Methodologically, it is valid to treat rural-urban codes directly as continuous variables in cancer studies, in addition to converting them into categories. This proposed continuous-variable method offers researchers more flexibility in their choice of analytic methods and preserves the information in the ordering. It can better inform how cancer risk varies, degree by degree, over a finer spectrum of rural-urban landscape. MDPI 2019-03-26 2019-03 /pmc/articles/PMC6466258/ /pubmed/30917515 http://dx.doi.org/10.3390/ijerph16061076 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yaghjyan, Lusine
Cogle, Christopher R.
Deng, Guangran
Yang, Jue
Jackson, Pauline
Hardt, Nancy
Hall, Jaclyn
Mao, Liang
Continuous Rural-Urban Coding for Cancer Disparity Studies: Is It Appropriate for Statistical Analysis?
title Continuous Rural-Urban Coding for Cancer Disparity Studies: Is It Appropriate for Statistical Analysis?
title_full Continuous Rural-Urban Coding for Cancer Disparity Studies: Is It Appropriate for Statistical Analysis?
title_fullStr Continuous Rural-Urban Coding for Cancer Disparity Studies: Is It Appropriate for Statistical Analysis?
title_full_unstemmed Continuous Rural-Urban Coding for Cancer Disparity Studies: Is It Appropriate for Statistical Analysis?
title_short Continuous Rural-Urban Coding for Cancer Disparity Studies: Is It Appropriate for Statistical Analysis?
title_sort continuous rural-urban coding for cancer disparity studies: is it appropriate for statistical analysis?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466258/
https://www.ncbi.nlm.nih.gov/pubmed/30917515
http://dx.doi.org/10.3390/ijerph16061076
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