title: Area-based socioeconomic position and adult glioma: a hierarchical analysis of surveillance epidemiology and end results data.
abstract: BACKGROUND
  Glioma rates vary by demographic factors and geo-political boundaries and this variation suggests higher glioma rates in groups of higher socioeconomic position. The primary goal of this analysis is to investigate the relationship between glioma and county socioeconomic position using U.S. Surveillance Epidemiology and End Results (SEER) data.
  
  
  METHODS
  Cases were individuals 25+ years diagnosed with glioma between 2000 and 2006 and residing within the SEER-17 catchment area. County-, sex-, race-, age-specific rates were created in order to investigate individual-level associations (population data from U.S. Census 2000). A Bayesian hierarchical Poisson spatial conditionally autoregressive (CAR) model was utilized to simultaneously estimate individual- and county-level associations while controlling for county spatial dependence.
  
  
  RESULTS
  Those residing in counties of the second, third, and fourth highest quartiles of socioeconomic position have glioma incidence rates that are 1.10 (95% CI: 1.02,1.19), 1.11 (95% CI: 1.02,1.20), 1.14 (95% CI: 1.05,1.23) times that of the first quartile, respectively. A CAR model properly controlled for error spatial dependence. Investigated lag times suggest year 2000 census data yields superior model fit.
  
  
  CONCLUSIONS
  Demographically adjusted rates of glioma are elevated in counties of higher socioeconomic position. More well-grounded theory concerning the glioma-socioeconomic position association along with socioeconomic data collected at multiple levels is recommended for future studies investigating this relationship.
authors.affiliation: Ohio State University Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute, Columbus, Ohio, United States of America.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Plascak
authors.forename: James L
authors.initials: JL
authors.lastname: Fisher
mesh_terms: D000328:Adult; D000368:Aged; D001499:Bayes Theorem; D044383:Black People; D016543:Central Nervous System Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000208:ethnology / Q000473:pathology; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000191:economics* / Q000208:ethnology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D018426:SEER Program / Q000706:statistics & numerical data*; D012923:Social Class; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American