The Role of Race/Ethnicity on the Association between Neighborhood Deprivation and Breast Cancer Outcomes among Kentucky Patients with Breast Cancer (2010-2022).

IF 3.7 3区医学 Q2 ONCOLOGY

Cancer Epidemiology Biomarkers & Prevention Pub Date : 2025-04-03 DOI:10.1158/1055-9965.EPI-24-1139

Breyanna Walker, Elinita Pollard, Sydney P Howard, V Morgan Jones, Kathleen L O'Connor, Eric B Durbin, Pamela C Hull, Samantha R Jones, Adebola Adegboyega, Xiaoqin Wang, Wendi A B Owen, Margaret M Szabunio, Lovoria B Williams, Justin X Moore

{"title":"The Role of Race/Ethnicity on the Association between Neighborhood Deprivation and Breast Cancer Outcomes among Kentucky Patients with Breast Cancer (2010-2022).","authors":"Breyanna Walker, Elinita Pollard, Sydney P Howard, V Morgan Jones, Kathleen L O'Connor, Eric B Durbin, Pamela C Hull, Samantha R Jones, Adebola Adegboyega, Xiaoqin Wang, Wendi A B Owen, Margaret M Szabunio, Lovoria B Williams, Justin X Moore","doi":"10.1158/1055-9965.EPI-24-1139","DOIUrl":null,"url":null,"abstract":"Background: Kentucky is within the top five leading states for breast cancer mortality nationwide. This study investigates the association between neighborhood socioeconomic disadvantage and breast cancer outcomes, including surgical treatment, radiotherapy, chemotherapy, and survival, and how associations vary by race and ethnicity in Kentucky.Methods: We conducted a retrospective cohort analysis using data from the Kentucky Cancer Registry for patients with breast cancer diagnosed between 2010 and 2017, with follow-up through December 31, 2022. We linked Kentucky Cancer Registry data with census tract data to examine the relationship between area deprivation index (ADI) and breast cancer outcomes. Logistic regression and Cox proportional hazards models analyzed binary outcomes and time-to-event data, respectively.Results: Women in the most disadvantaged (ADI fourth quartile) neighborhoods were more likely to be diagnosed at later stages (OR, 1.26; 95% confidence interval, 1.12-1.41) and 34% more likely to die from breast cancer (HR, 1.34; 95% confidence interval, 1.14-1.57) after adjusting for age, race, tobacco use, tobacco pack-years, marital status, insurance status, family history, stage at diagnosis, breast cancer subtype, and residence in Appalachia when compared with women living in the least disadvantaged neighborhoods (ADI first quartile).Conclusions: Women in disadvantaged neighborhoods had significantly higher odds of late-stage diagnosis and breast cancer death, regardless of race, indicating that neighborhood factors contribute to breast cancer disparities.Impact: Socioeconomic and neighborhood factors may contribute to breast cancer outcomes, suggesting the necessity for targeted interventions. Future research should explore the effectiveness of such interventions and investigate additional social determinants contributing to disparities.","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"474-482"},"PeriodicalIF":3.7000,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966108/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Epidemiology Biomarkers & Prevention","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1158/1055-9965.EPI-24-1139","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Kentucky is within the top five leading states for breast cancer mortality nationwide. This study investigates the association between neighborhood socioeconomic disadvantage and breast cancer outcomes, including surgical treatment, radiotherapy, chemotherapy, and survival, and how associations vary by race and ethnicity in Kentucky.

Methods: We conducted a retrospective cohort analysis using data from the Kentucky Cancer Registry for patients with breast cancer diagnosed between 2010 and 2017, with follow-up through December 31, 2022. We linked Kentucky Cancer Registry data with census tract data to examine the relationship between area deprivation index (ADI) and breast cancer outcomes. Logistic regression and Cox proportional hazards models analyzed binary outcomes and time-to-event data, respectively.

Results: Women in the most disadvantaged (ADI fourth quartile) neighborhoods were more likely to be diagnosed at later stages (OR, 1.26; 95% confidence interval, 1.12-1.41) and 34% more likely to die from breast cancer (HR, 1.34; 95% confidence interval, 1.14-1.57) after adjusting for age, race, tobacco use, tobacco pack-years, marital status, insurance status, family history, stage at diagnosis, breast cancer subtype, and residence in Appalachia when compared with women living in the least disadvantaged neighborhoods (ADI first quartile).

Conclusions: Women in disadvantaged neighborhoods had significantly higher odds of late-stage diagnosis and breast cancer death, regardless of race, indicating that neighborhood factors contribute to breast cancer disparities.

Impact: Socioeconomic and neighborhood factors may contribute to breast cancer outcomes, suggesting the necessity for targeted interventions. Future research should explore the effectiveness of such interventions and investigate additional social determinants contributing to disparities.

查看原文本刊更多论文

种族/民族在2010-2022年肯塔基州乳腺癌患者邻里剥夺与乳腺癌结局之间的关系中的作用

背景：肯塔基州是全国乳腺癌死亡率最高的五个州之一。本研究调查了肯塔基州社区社会经济劣势与乳腺癌预后（包括手术治疗、放疗、化疗和生存率）之间的关系，以及这种关系如何因种族和民族而异。方法：我们对2010年至2017年肯塔基州癌症登记处（KCR）诊断的乳腺癌患者进行了回顾性队列分析，随访至2022年12月31日。我们将KCR数据与人口普查区数据联系起来，以检验地区剥夺指数（ADI）与乳腺癌预后的关系。Logistic回归和Cox比例风险模型分别分析二元结果和事件时间数据。结果：生活在最弱势社区（ADI第4四分位数）的女性更有可能在乳腺癌晚期被诊断出来（OR: 1.26, 95% CI: 1.12-1.41）， 34%的女性死于乳腺癌(HR: 1.34, 95% CI：1.14-1.57)，在调整了年龄、种族、烟草使用、烟草包装年限、婚姻状况、保险状况、家族史、诊断阶段、乳腺癌亚型和居住在阿巴拉契亚地区后，与生活在最弱势社区的妇女相比（ADI第1四分位数）。结论：不论种族，生活在弱势社区的女性晚期诊断和乳腺癌死亡的几率都明显更高，这表明社区因素导致了乳腺癌的差异。影响：社会经济和社区因素可能影响乳腺癌的预后，提示有针对性干预的必要性。未来的研究应探讨这些干预措施的有效性，并调查造成差异的其他社会决定因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cancer Epidemiology Biomarkers & Prevention 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.50

自引率

2.60%

发文量

538

审稿时长

1.6 months

期刊介绍： Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.