Anna Gottschlich, Jamaica R M Robinson, Julie J Ruterbusch, Kaitlin Burchett, Rebecca M Adams, Ariel Washington, Michele L Cote, Ann G Schwartz, Kristen S Purrington, Mike R Wilson
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引用次数: 0
Abstract
Background: Black women with endometrial cancer (EC) have twice the mortality compared to White. Survival disparities remain after accounting for individual-level socioeconomic and cancer-related factors. We investigated associations between area-based deprivation and survival and explored whether area-based deprivation attenuates the association between race and survival, among a cohort of Black and White women.
Methods: Data from ECs diagnosed between 2013-2022 were collected from a comprehensive cancer registry covering Metropolitan Detroit. Addresses at diagnosis were linked to Area Deprivation (ADI) and Social Vulnerability (SVI) indices. Adjusted Fine & Gray and Cox proportional hazard models were run investigating associations between area-based deprivation measures and survival; analyses were conducted estimating the proportion of the association between race and survival that was attenuated by area-based measures.
Results: Higher deprivation was associated with poorer survival, adjusted for race, insurance status, and tumor characteristics. Compared to the least disadvantaged quartile, the quartile with the highest disadvantage using ADI and SVI had 1.18 (95% CI: 0.99, 1.43) and 1.40 (1.14, 1.71) times the hazard of EC-specific mortality, respectively. ADI and SVI attenuated 18% (3-38%) and 27% (10-48%) of associations between race and mortality overall, and 24% (95% CI: 3-61%) and 40% (95% CI: 16-78%) among those with high-grade histology.
Conclusions: This study demonstrates a clear association between neighborhood-level disadvantage and survival among women with EC living in Metropolitan Detroit. Neighborhood disadvantage attenuates the relationship between race and survival, particularly among those with high-grade histology.
Impact: These findings serve as motivation to understand how neighborhood impacts cancer outcomes.
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.