title: Using a socioeconomic position index to assess disparities in cancer incidence and mortality, Puerto Rico, 1995-2004.
abstract: BACKGROUND
  Evaluation of the extent of socioeconomic inequalities in cancer incidence and mortality is essential to generate hypotheses in population health research and provides evidence for population-based strategies for comprehensive cancer control. The objective of this study was to create an area-based socioeconomic position (SEP) index to assess possible socioeconomic disparities in incidence and mortality of selected cancers in Puerto Rico.
  
  
  METHODS
  Data for cancer incidence and mortality from 1995 to 2004 were obtained from the Puerto Rico Central Cancer Registry and the Puerto Rico Department of Health, and Puerto Rico socioeconomic data were obtained from the US Census 2000. We used principal component and factor analysis methods to construct the SEP index at the municipality level. We calculated age-adjusted incidence and mortality for each SEP area and used rate ratios to evaluate the differences by SEP.
  
  
  RESULTS
  Incidence and mortality of cancer in Puerto Rico varied by SEP area. In general, the incidence and mortality for cancers of the esophagus and stomach were higher for municipalities with the lowest SEP; in contrast, rates for breast, colorectal, kidney, pancreas, prostate, and thyroid were higher for areas with the highest SEP.
  
  
  CONCLUSIONS
  These results highlight cancer disparities in Puerto Rico by SEP level that warrant further research.
authors.affiliation: University of Puerto Rico Comprehensive Cancer Center, PMB #315 PO Box 70344, San Juan, PR. mtorres@rcpr.org
authors.forename: Mariela
authors.initials: M
authors.lastname: Torres-Cintrón
authors.forename: Ana P
authors.initials: AP
authors.lastname: Ortiz
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Ortiz-Ortiz
authors.forename: Nayda R
authors.initials: NR
authors.lastname: Figueroa-Vallés
authors.forename: Javier
authors.initials: J
authors.lastname: Pérez-Irizarry
authors.forename: Gwendolyn
authors.initials: G
authors.lastname: Díaz-Medina
authors.forename: Taína
authors.initials: T
authors.lastname: De la Torre-Feliciano
authors.forename: Erick
authors.initials: E
authors.lastname: Suárez-Pérez
mesh_terms: D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000453:epidemiology*; D011159:Population Surveillance / Q000379:methods*; D011647:Puerto Rico / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D015996:Survival Rate / Q000639:trends