Abstract B005: Geospatial and structural determinants of colorectal cancer burden among Black patients in Brooklyn: A composite score approach including food insecurity

Abstract Background: Black patients in urban settings suffer disproportionate colorectal cancer (CRC) outcomes, driven by social determinants that remain insufficiently quantified at the neighborhood level. We developed a composite burden score integrating socioeconomic and clinical outcomes and examined its association with environmental factors like food insecurity across Brooklyn neighborhoods. Methods: We conducted a hospital-based analysis of Black patients diagnosed with CRC in Central, East, and South Brooklyn from 2017 to 2024. Neighborhood-level composite CRC burden scores (scaled 0–100) were derived by min-max normalization of median income (inverted), CRC-specific mortality, and young-onset CRC prevalence. Neighborhood assignment was based on ZIP code mapping. Food insecurity rates were extracted from the 2019 USDA-NYC Emergency Food Gap Atlas. We compared CRC burden across neighborhoods and evaluated Spearman correlations with income, mortality, young-onset CRC, and food insecurity. High-risk neighborhoods were visualized using geospatial heatmaps. Results: Neighborhoods with >10 patients were included in the comparative analysis (N=15). The highest CRC burden was concentrated in a “high-risk triangle” formed by East New York, Brownsville, and Canarsie. Composite burden showed strong inverse correlation with income (ρ = -0.72, p < 0.01) and positive correlations with mortality (ρ = 0.68) and young-onset prevalence (ρ = 0.59). Food insecurity demonstrated a statistically significant correlation with CRC burden (ρ = 0.82, p < 0.01). A multivariable regression model confirmed food insecurity and income as independent predictors. Neighborhoods with low burden (e.g., Park Slope, Sheepshead Bay) consistently had higher income and lower food insecurity. Conclusions: Our composite burden score identified stark disparities in CRC outcomes among Black Brooklyn residents, especially within a reproducible high-risk triangle. The integration of food insecurity data provides an environmental lens to complement traditional social determinants. These findings offer actionable targets for screening policy, food access interventions, and neighborhood-focused resource allocation. Citation Format: Omar Gandarilla Cuellar, Brandon Swed, Uqba Khan. Geospatial and structural determinants of colorectal cancer burden among Black patients in Brooklyn: A composite score approach including food insecurity [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B005.