Understanding Cancer Prevention through Geospatial Science: Putting Cancer in its Place (Global Perspectives on Health Geography)

The worldwide cancer burden will double over the next two decades, with the number of new cancer diagnoses increasing in all regions of the world. However, it is estimated that around 40% of all cancers are preventable through the appropriate application of existing epidemiological and public health knowledge, and with further research this proportion will increase considerably. This edited volume explores the role of place in cancer prevention and how geospatial tools can be used to support this globally important goal. Its chapters detail many aspects of the application of geospatial science to cancer control, including quantifying exposure to environmental carcinogens, access to screening services, the importance of partnership building, and more through a variety of geographically diverse case studies. The book also offers background on geospatial modeling tools and methods for adding spatial analysis to cancer surveillance systems. The book is rooted firmly in the notion that geography significantly influences the accumulation of cancer risks (at the individual and community level) that are modifiable through policy, regulatory, and behavioral changes. The landscape of cancer prevention is vast, encompassing the building blocks of population and public health—i.e., epidemiology and causation—through risk factor modifications, behavior and policy change, to the interface of the cellular with society, including epigenetic modifications and gene/environment interactions, cancer genomics and precision medicine/health. It is clear that geography (space, place, setting, context) is central to all these activities. Geospatial methods and data support risk factor identification, can elucidate the interaction between individual behavioral, demographic, and genetic factors with community level contextual factors, and can be used to prioritize interventions more accurately towards at-risk people and at-risk population groups. Geography is also central to the organization of health services and hence, by definition, is fundamental to the organization of preventative services. More broadly, adopting a geographical approach can help move cancer prevention beyond a narrow medical definition of health, to tackle the upstream and structural determinants of cancer. Preface Acknowledgements Contents Contributors Abbreviations Part I: Cancer, Place, Prevention Introduction: People, Place, Cancer 1 Introduction 2 Tackling the Global Cancer Crisis 3 Geospatial Science, Cancer, and Prevention 3.1 Health Geography 3.2 Preventing Cancer 3.3 Challenges Adopting Geospatial Cancer Prevention Approaches 4 Looking Forward References Cancer Prevention: Principles and Approaches 1 The Preventability of Cancer 2 Studies on Cancer Preventability 2.1 Behavioural Cancer Risk Factors 2.1.1 Tobacco 2.1.2 Alcohol 2.1.3 Diet and Nutrition 2.1.4 Physical Activity and Sedentary Behaviour 2.2 Environmental and Occupational Exposures 2.2.1 Air Pollution 2.2.2 Radon 2.2.3 Arsenic 2.2.4 Ultraviolet Radiation 2.2.5 Asbestos and Related Occupational Hazards 2.3 Physiological Conditions and Infections 2.3.1 Metabolism 2.3.2 Infections 3 Cancer Prevention: Policies, Frameworks, Actions 3.1 Primary Cancer Prevention 3.1.1 Tobacco 3.1.2 Alcohol 3.1.3 Nutrition, Physical Activity, and Metabolism 3.1.4 Infections 3.1.5 Environmental and Occupational Exposures 3.1.6 Education & Knowledge 3.1.7 Health Policy 3.2 Secondary Cancer Prevention 3.2.1 Screening and Early Detection 4 Conclusion References Current State of Geospatial Approaches in Cancer Prevention Worldwide 1 Introduction 2 Summary of the Current State of Geospatial Approaches to Cancer Prevention Worldwide 3 Spatial Distribution of Cancer Incidence and Mortality 3.1 Geospatial Approaches and Cancer 3.2 Role of Geographic Information Systems in Cancer Research 4 Environmental Exposure Assessment in Cancer Control and Prevention 4.1 Wildfires and Cancer 5 Geospatial Approaches for Evaluating Spatial Access to Lung Cancer Screening Services 5.1 Spatial Access to Lung Cancer Screening Services 5.2 Geospatial Studies Examining Spatial Access to Lung Screening 5.2.1 Case Study #1: Geographic Access to Lung Cancer Screening in the United States 5.2.2 Case Study #2: Assessing Inequities in Access to Lung Cancer Screening in Canada 6 Prediction Modeling Using Geospatial Methods 7 Brief Introduction to Spatial Clustering Approaches 8 Conclusion References Part II: Geospatial Methods and Data Geospatial Science and Health: Overview of Data and Methods 1 Introduction 2 Geospatial Technology and Data 2.1 Geospatial Technology 2.2 Data Sources 2.3 Spatial Resolution 2.4 Georeferencing Health and Exposure Data 3 Mapping Health Data 3.1 Thematic Maps 4 Analysis of Health-Related Data 4.1 Handling Spatial Autocorrelation and the MAUP 4.2 Detecting Spatial Patterns 4.2.1 Area Data 4.2.2 Point Data 4.2.3 Linear Data 4.3 Deciphering Spatial Relationships 4.4 Preserving Privacy 5 Conclusions References Cohort Studies and Context: Infrastructure to Support Cancer Prevention 1 Introduction 2 The Canadian Partnership for Tomorrow’s Health (CanPath) 3 The Canadian Urban Environmental Health Research Consortium (CANUE) 4 Overview of Studies Utilizing CanPath and CANUE Data 4.1 Lifestyle and Behavioural Factors 4.2 Cancer Prevention 5 The BC Generations Project 5.1 Case Study 1: Relationships Between the Built Environment and Physical Activity and Body Mass Index 5.2 Case Study 2: Bladder Cancer Risk and the Built Environment 6 Conclusions Appendix References Applying Spatial Analysis Functionality to Enhance Routine Cancer Surveillance Systems 1 Introduction 1.1 Fundamentals of Cancer Registries 1.2 Registry Data and Cancer Surveillance 1.3 Understanding the Importance of Geographic Variation in Cancer Risk 2 Practical Applications: Walk-Through of Geospatial Analysis Using R Code 2.1 Understanding the Importance of Geographic Variation in Cancer Risk Through Disease Mapping 2.1.1 Exploring Spatial Patterns 2.2 Small Area Disease Mapping 2.3 Disease Mapping Dashboards and Applications 2.4 Environmental Exposures, Social Determinants, and Contextual Factors 2.5 Assignment of Level of Urbanization Using a Spatial Join 2.5.1 Proximity Analysis and the OSRM R Package 3 Conclusion References Part III: Applications Not Only Smoking: Preventing Lung Cancers Caused by Environmental Exposures 1 Introduction 1.1 Air Pollution Is a Significant Cause of Lung Cancer 1.2 Other Environmental Lung Cancer Risk Factors 2 Air Pollution Assessment Using Geospatial Tools 2.1 Spatial Interpolation Modeling 2.2 Dispersion Modeling 2.3 Land Use Regression Modeling 2.4 Machine-Learning Methods 3 Geospatial Approaches to Reducing Air Pollution Impacts 3.1 Challenges and Opportunities in Air Pollution Exposure Assessment 3.1.1 Low-Cost Sensors as a Tool for Assessing PM2.5 Concentrations 3.1.2 Real-Time Data Streaming 3.2 Emerging Air Pollution Challenges 3.3 Lung Cancer Risk Prediction and Screening for Secondary Prevention 4 Conclusion References Place-Based Approaches to Tobacco Control in China 1 Introduction 1.1 Progress in Tobacco Control 1.2 Linking Place and Smoking, a Spatial Turn of Tobacco Control 2 Applying Spatial Analysis in Tobacco Control Research and Policy 2.1 Estimating Geographical Exposure of Tobacco Retail 2.2 Identifying the Determinants of Tobacco Retail Patterning 2.3 Simulating Place-Based Tobacco Control Policies 2.4 Applying Spatial Methods in Tobacco Control Research in China 3 The Application of Spatial Approaches to Tobacco Control: A Case Study of Shanghai, China 3.1 Geographical Setting 3.2 Policy Context 3.3 Data and Methods 3.3.1 Data 3.3.2 Simulating ‘What If’ Tobacco Control Policy Scenarios 3.4 Analysis 3.4.1 Operationalisation of the 12 Simulation Scenarios 3.4.2 Estimating Local Availability of Tobacco Retailers 3.4.3 Measuring Social Inequalities in Tobacco Retail Availability 3.5 Results 3.5.1 Baseline Retail Patterning of Tobacco in Shanghai in 2019 3.5.2 The Impact on Availability Reduction 3.5.3 The Impact on Social Inequality in Availability 4 Conclusion References The Nova Scotia Community Cancer Matrix: Small-Area Spatiotemporal Estimation of Local Patterns of Cancer Co-occurrence, Risk and Inequity 1 Background 1.1 The Problem 1.2 The Solution 1.3 The Barriers 1.4 The Reality 1.5 The Opportunity 2 Study Aims 3 Study Design and Analysis 3.1 Data Sources 3.1.1 Study Cohort 3.1.2 Geographic Data 3.1.3 Population at Risk 3.1.4 Community Socioeconomic Status 3.2 Data Analyses 3.2.1 Spatial and Spatiotemporal Variations in Cancer Risk 3.2.2 Composite Indicators of Cancer 3.3 Knowledge Translation and Dissemination 4 Results 4.1 Cohort Characteristics Summary 4.2 Model Parameters 4.3 Fixed Effects 4.3.1 Fixed Effects—Males 4.3.2 Fixed Effects—Females 4.4 Posterior Predictions 4.4.1 Posterior Predictions—Males 4.4.2 Posterior Predictions—Females 4.5 Posterior Spatial Random Effects 4.5.1 Posterior Spatial Random Effects—Males 4.5.2 Posterior Spatial Random Effects—Females 4.6 Exceedance Probabilities 4.6.1 Exceedance Probabilities—Males 4.6.2 Exceedance Probabilities—Females 4.7 Patterns of Similarity in Cancer Profile 4.7.1 Posterior Predictions 4.7.2 Posterior Spatial Random Effects 5 Discussion 6 Conclusion Appendix References Situating People and Place in Cancer Prevention: Arsenic in Drinking Water in Global to Local Context 1 Introduction 2 Conceptualizing Arsenic Contaminated Waters in the Hydrosocial Cycle 3 Arsenic as a Global Concern in Drinking Water 3.1 Overview of the Global Arsenic Risk in Drinking Water 3.2 Exploring the Arsenic Hydrosocial Cycle in Bangladesh 3.2.1 Natural Dimensions of the Arsenic Problem in Bangladesh 3.2.2 Social Dimensions of the Arsenic Problem in Bangladesh 3.2.3 Infrastructure Dimensions of the Arsenic Problem in Bangladesh 3.2.4 Arsenic Risk Perceptions and Risk Prevention in Bangladesh 4 Arsenic as a Local Concern in Drinking Water 4.1 Overview of the Arsenic Risk in North America’s Drinking Waters 4.2 Exploring the Arsenic Hydrosocial Cycle in Nova Scotia 4.2.1 Natural Dimensions of the Arsenic Problem in Nova Scotia 4.2.2 Social Dimensions of the Arsenic Problem in Nova Scotia 4.2.3 Infrastructure Dimensions of the Arsenic Problem in Nova Scotia 4.2.4 Arsenic Risk Perceptions and Risk Prevention in Nova Scotia 5 Discussion: Integrating People and Cancer Prevention in Place 6 Conclusion References The Development of the Australian Cancer Atlas: Understanding the Geography of Cancer 1 Need for an Australian Cancer Atlas 1.1 Introduction 1.2 History of Cancer Atlases in Australia 1.3 Limitations of Previous Atlases 1.4 Background Developments 1.5 Geographical Information 1.6 Other National Work 2 Beginning the Australian Cancer Atlas 2.1 Scoping 2.2 Accessing the Cancer Registry Data 2.3 Choosing the Appropriate Statistical Indicators to Report in the Atlas 2.4 Selection of Statistical Models 2.5 Visualisation Development 2.6 Digital Development 2.7 Launch of Atlas 1.0 2.8 Translation into Policy and Collaborations 3 Implications of the Australian Cancer Atlas for Cancer Prevention, Diagnosis, and Treatment 3.1 Liver Cancer 3.2 Lung Cancer 4 Motivation for an Updated Atlas 4.1 Methods of Visual Dissemination 4.2 Expanded Data Sources 4.3 Capacity Building 5 Lessons Learned References Understanding the Role of Place in Breast and Cervical Cancer Screening in Kenya and Ghana 1 Introduction 2 Methodology 3 Results 3.1 Location-Based Factors and Cancer Screening Among Women 3.2 Multivariate Results of Breast and Cervical Cancer Screening in Kenya 3.3 Multivariate Results of Breast and Cervical Cancer Screening in Ghana 4 Factors Influencing Utilization of Cancer Screening Services in Sub-Saharan Africa 4.1 Geographical Factors Influencing Access to and Utilization of Cancer Services 4.2 Non-Geographical Factors 4.2.1 Belief Systems 4.2.2 Awareness and Understanding of Cancer 4.2.3 Role of Socioeconomic Factors 5 Summary and Conclusion Appendix References Index