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Date Available

5-1-2026

Year of Publication

2026

Document Type

Graduate Capstone Project

Degree Name

Master of Public Health (M.P.H.)

College

Public Health

Department/School/Program

Public Health

Faculty

Wanye Sanderson

Committee Member

Florence Folk

Faculty

Mark Dignan

Abstract

Objective: Given colorectal cancer incidence rates are increasing, especially in socioeconomic disadvantaged areas, this study aims to determine if there is an association between specific socioeconomic variables, such as food insecurity, and colon cancer at the county-level in Kentucky.

Methods: Colorectal cancer age-adjusted incidence rates at the county-level were collected from the Kentucky Cancer Registry. Conty-level data was collected from County Health Ranking, The U.S Census Bureau, National Institute on Minority Health and Health Disparities and the Behavioral Risk Factor Surveillance System from 2019 to 2023. R was used to run statical analyses such as a linear regression and a correlation matrix. QGIS was used to make a spatial temporal scan to identify clusters of colorectal cancer and a choropleth map.

Results: Food insecurity, poverty, diabetes and obesity were all identified as being significantly associated with increased colorectal cancer rates. Food insecurity is responsible for 17 percent of the variance in colon cancer rates. Food insecurity is highly correlated with the other variables in this study. Eastern Kentucky had the largest cluster of colon cancer cases, the highest poverty rates and faces many socioeconomic challenges.

Conclusion: Food insecurity and poverty rates significantly impact rates of colon cancer in Kentucky. To further examine the association between colon cancer and food insecurity, a cohort or case-control study should be conducted. Due to the highly correlated nature of the variables, a generic variable of risk could be created to assess the increase in colon cancer incidence.

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