Date of Award

Spring 5-10-2018

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dora Il'yasova, PhD

Second Advisor

Lee Mobley,PhD

Abstract

INTRODUCTION: Gliomas are most common and fatal primary brain neoplasms, with few known risk factors. High dose ionizing radiation is the only known environmental risk factor. Previous studies show Caucasians having greater rates compared to African Americans, and higher rates of glioblastoma found in areas with higher socio-economic status (SES), suggesting involvement of SES-related factors. We examine spatial distribution of glioma incidence in Caucasians and African Americans to determine geographical disparities related to race, SES, and radon.

AIM: To determine whether geospatial clusters of high glioma incidence exist, intending to identify potential environmental risk factors in areas with high glioma risk.

METHODS: Data from Surveillance, Epidemiology, and End Results (SEER) Program 2001-2014 were used to generate descriptive statistics for adult glioma. Global Moran’s I test was performed for glioma rates, radon levels, and SES contextual factors and predicated use of Local Indicator of Spatial Association analysis, and results were compared.

RESULTS: Glioma rates per 100,000 were highest for ages 70-79 (18.85, 95% CI: 17.96-19.75). Incidence rates were more than twice greater for Caucasians, 7.86 (7.65-8.07), compared to African Americans, 3.48 (2.66-4.30), and other races 2.83 (1.48-3.80). County rates varied from 0 to 27.84 for all races combined.

CONCLUSION: High and low rates of glioma are not spatially random, indicating environmental risk factors for glioma. Racial disparity in glioma is persistent. An inverse relationship with low SES is demonstrated, while a positive correlation is seen with radon. Understanding risk factors and focus on high-rate areas could lead to development of prevention.

Available for download on Friday, April 19, 2019

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