American journal of epidemiology最新文献_第10页

Hepatitis C virus transmission among people who inject drugs in rural United States: mathematical modeling study using stochastic agent-based network simulation. 美国农村注射吸毒者中的丙型肝炎病毒传播：基于随机代理的网络模拟的数学建模研究（AJE-00824-2024）

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf052

Lin Zhu, Jennifer R Havens, Abby E Rudolph, April M Young, Golnaz Eftekhari Yazdi, William W Thompson, Liesl M Hagan, Liisa M Randall, Jianing Wang, Rebecca Earnest, Shayla Nolen, Benjamin P Linas, Joshua A Salomon

{"title":"Hepatitis C virus transmission among people who inject drugs in rural United States: mathematical modeling study using stochastic agent-based network simulation.","authors":"Lin Zhu, Jennifer R Havens, Abby E Rudolph, April M Young, Golnaz Eftekhari Yazdi, William W Thompson, Liesl M Hagan, Liisa M Randall, Jianing Wang, Rebecca Earnest, Shayla Nolen, Benjamin P Linas, Joshua A Salomon","doi":"10.1093/aje/kwaf052","DOIUrl":"10.1093/aje/kwaf052","url":null,"abstract":"People who inject drugs (PWID) account for the majority of hepatitis C virus (HCV) infections in the United States. The injection-equipment-sharing network likely plays an important role in shaping the dynamics of HCV transmission. Recognizing the emerging HCV epidemic in rural communities, we developed an agent-based network simulation model of HCV transmission via injection equipment sharing and used data on rural PWID networks to inform model parameterization and calibration. We then simulated an array of networks that varied key network properties to understand their impact on the magnitude and distribution of HCV incidence. The results show substantial heterogeneity in HCV acquisition risks across the network, summarized using the Gini coefficient. In addition, although PWID with fewer injection partners had lower incidence, they collectively acquired more infections due to their larger population size. Higher prevalence, average number of partners, and homophily in HCV infection were associated with lower heterogeneity in infection risk across the network and higher overall incidence; other network properties including population size did not have a substantial impact. Our findings illustrate the heterogeneity of HCV transmission among PWID and suggest key network properties that could be measured, evaluated, or considered in the design of interventions for PWID in future studies.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"937-947"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Guideline-based physical activity and health-related quality of life among prostate cancer survivors: a target trial emulation in the Health Professionals Follow-up Study. 前列腺癌幸存者中基于指南的身体活动和健康相关生活质量：卫生专业人员随访研究中的目标试验模拟

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf117

Naiyu Chen, Emma E McGee, Rachel C Nethery, Lorelei A Mucci, Barbra A Dickerman

{"title":"Guideline-based physical activity and health-related quality of life among prostate cancer survivors: a target trial emulation in the Health Professionals Follow-up Study.","authors":"Naiyu Chen, Emma E McGee, Rachel C Nethery, Lorelei A Mucci, Barbra A Dickerman","doi":"10.1093/aje/kwaf117","DOIUrl":"10.1093/aje/kwaf117","url":null,"abstract":"Prostate cancer and its treatment can impact health-related quality of life. Evidence for physical activity strategies sustained over long periods to improve quality of life is limited. Given the limited feasibility of a randomized trial to answer this question, we emulated a target trial of physical activity strategies based on current clinical guidelines and 6-year quality of life using observational data from 1549 men in the Health Professionals Follow-up Study diagnosed with nonmetastatic prostate cancer between 2004 and 2016. Eligible individuals were free of conditions that may preclude high levels of physical activity at baseline. We estimated 6-year mean physical quality of life scores (based on the Expanded Prostate Cancer Index Composite for Clinical Practice [EPIC-CP] symptom domains; range: 1-12, lower is better) under sustained, dynamic physical activity strategies, adjusting for baseline and time-varying variables using the parametric g-formula. Estimated 6-year mean differences (adherence to physical activity recommendations vs nonadherence) were 0.1 (95% confidence interval, 0.0 to 0.2) for bowel symptoms, -0.1 (-0.2 to 0.1) for urinary incontinence, 0.0 (-0.1 to 0.2) for urinary irritation/obstruction, -0.3 (-0.7 to 0.1) for sexual symptoms, and -0.1 (-0.2 to 0.1) for vitality/hormonal symptoms. Estimated 6-year mean differences comparing adherence to physical activity recommendations vs no intervention (observed physical activity in this population) were close to 0. Adhering to current physical activity recommendations may help to improve 6-year symptoms in the sexual domain, with little expected influence on symptoms in the bowel, urinary, and vitality/hormonal domains.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"966-974"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recommendations for estimating and reporting vaccine effectiveness by time since vaccination: a COVID-19 case study. 按接种后时间估计和报告疫苗有效性的建议：一项COVID-19病例研究。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf254

Esther Kissling, Baltazar Nunes, Mariëtte Hooiveld, Iván Martínez-Baz, Susana Monge, Chris Robertson, Mirjam Knol, Noémie Sève, Ivan Mlinarić, Lisa Domegan, Ausenda Machado, Heather Whitaker, Mihaela Lazar, Adam Meijer, Theresa Enkirch, Itziar Casado, Gloria Pérez-Gimeno, Naoma William, Vincent Enouf, Sanja Kurečić Filipović, Adele McKenna, Ana Paula Rodrigues, Simon de Lusignan, Olivia-Carmen Timnea, Neus Latorre-Margalef, Jesús Castilla, Francisco Pozo, Mark Hamilton, Shirley Masse, Maja Ilić, Luca Basile, Joan O'Donnell, Raquel Guiomar, Maximilian Riess, Rodica-Manuela Popescu, Angela M C Rose, Nick Andrews, Sabrina Bacci, Lucia Pastore Celentano, Marta Valenciano, Alain Moren, Philippe Beutels, Niel Hens

{"title":"Recommendations for estimating and reporting vaccine effectiveness by time since vaccination: a COVID-19 case study.","authors":"Esther Kissling, Baltazar Nunes, Mariëtte Hooiveld, Iván Martínez-Baz, Susana Monge, Chris Robertson, Mirjam Knol, Noémie Sève, Ivan Mlinarić, Lisa Domegan, Ausenda Machado, Heather Whitaker, Mihaela Lazar, Adam Meijer, Theresa Enkirch, Itziar Casado, Gloria Pérez-Gimeno, Naoma William, Vincent Enouf, Sanja Kurečić Filipović, Adele McKenna, Ana Paula Rodrigues, Simon de Lusignan, Olivia-Carmen Timnea, Neus Latorre-Margalef, Jesús Castilla, Francisco Pozo, Mark Hamilton, Shirley Masse, Maja Ilić, Luca Basile, Joan O'Donnell, Raquel Guiomar, Maximilian Riess, Rodica-Manuela Popescu, Angela M C Rose, Nick Andrews, Sabrina Bacci, Lucia Pastore Celentano, Marta Valenciano, Alain Moren, Philippe Beutels, Niel Hens","doi":"10.1093/aje/kwaf254","DOIUrl":"10.1093/aje/kwaf254","url":null,"abstract":"Estimating COVID-19 vaccine effectiveness (VE) by time since vaccination (TSV) is essential for understanding how protection may change over time and enables meaningful comparisons across studies. This is important for accurate comparisons of VE against different SARS-CoV-2 variants/sublineages, across age groups, during different periods post vaccination campaign, or by vaccine type/brand. We provide recommendations for case-control VE studies on estimating and reporting VE analyses by TSV, with the aim of improving quality of these estimates. Our recommendations cover study design and pre-analysis considerations, descriptive analyses, choice of categories of TSV, categorical and continuous modeling approaches, and best practices for reporting VE by TSV. Using a real-life case-control study, we apply these recommendations and include accompanying statistical scripts in R and Stata. These recommendations will serve as a practical resource for researchers conducting VE analyses by TSV. We encourage ongoing refinement of them through input from other study groups.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1108-1119"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145538113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Residential segregation and late-stage colorectal cancer in the United States: a population-based study of 1.2 million adults. 居住隔离与美国晚期结直肠癌：一项基于120万成年人的人群研究

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf285

Eduardo J Santiago-Rodríguez, Justin S White, Zinzi D Bailey, Isabel E Allen, Robert A Hiatt, Salma Shariff-Marco

{"title":"Residential segregation and late-stage colorectal cancer in the United States: a population-based study of 1.2 million adults.","authors":"Eduardo J Santiago-Rodríguez, Justin S White, Zinzi D Bailey, Isabel E Allen, Robert A Hiatt, Salma Shariff-Marco","doi":"10.1093/aje/kwaf285","DOIUrl":"10.1093/aje/kwaf285","url":null,"abstract":"We examined the association between residential segregation and late-stage colorectal cancer (CRC) in the United States. The restricted-use United States Cancer Statistics database was used to identify all CRC cases diagnosed during 2009 to 2017. Late-stage CRC was determined according to the presence of distant involvement of the tumor at diagnosis. Residential segregation was measured at the county level by the Index of Concentration at the Extremes based on income, race/ethnicity, and its combination, using the 2013-2017 American Community Survey data. Multilevel logistic regression models accounting for clustering at counties were fit. Analyses were stratified by race/ethnicity, sex, and age. Overall, patients residing in counties with a high concentration of least advantaged residents had increased odds of late-stage CRC compared to their counterparts residing in counties with a high concentration of most advantaged people. These findings were observed on all measures of residential segregation, with clear gradients for economic and racialized economic segregation. In stratified analyses, stronger associations were observed among racial/ethnic minoritized people and younger age groups; results did not differ by sex. These findings underscore the role of institutionalized racism as a contributor to health inequities, such that laws and policies driving residential segregation may impact timely preventive care.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1163-1174"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145817384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypertensive disorders of pregnancy, maternal cardiovascular disease mortality and the role of familial predisposition: a Norwegian population-based sibling-comparison, sibling-spillover and negative-control cohort study. 妊娠高血压疾病、孕产妇心血管疾病死亡率和家族易感性的作用：一项基于挪威人群的兄弟姐妹比较、兄弟姐妹溢出和阴性对照队列研究

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf257

Aditi Singh, Sage Wyatt, Liv Grimstvedt Kvalvik, Rolv Skjærven

{"title":"Hypertensive disorders of pregnancy, maternal cardiovascular disease mortality and the role of familial predisposition: a Norwegian population-based sibling-comparison, sibling-spillover and negative-control cohort study.","authors":"Aditi Singh, Sage Wyatt, Liv Grimstvedt Kvalvik, Rolv Skjærven","doi":"10.1093/aje/kwaf257","DOIUrl":"10.1093/aje/kwaf257","url":null,"abstract":"Hypertensive disorders of pregnancy (HDP) are associated with increased maternal cardiovascular disease (CVD) mortality, with risks varying by HDP subtypes and subsequent pregnancy outcomes. The contribution of shared familial factors given this heterogeneity is unclear. We conducted a population-based study using Norwegian registries (1967-2020) including 1 106 658 women with complete pregnancy histories, of whom 628 345 had at least one full sibling. Women with HDP were classified into low-risk (gestational hypertension or term pre-eclampsia followed by no HDPs) and high-risk (all other patterns) trajectories. CVD mortality before age 70 was assessed using population-level and sibling-based models: sibling-comparison (discordant-sisters), sibling-spillover (by sister's HDP history), and negative-control models (by sister-in-law's HDP history). CVD mortality among women with HDP varied by trajectory (population-level adjusted hazard ratios [aHR]low-risk 1.03 [95% confidence intervals, 0.89-1.20]; aHRhigh-risk 1.89 [1.74-2.06]). These differences persisted when compared to sisters without HDP (sibling-comparison aHRlow-risk 0.66 [0.44-1.01]; aHRhigh-risk 1.51 [1.16-1.97]). Women without HDP had slightly elevated CVD mortality if sisters had HDP (sibling-spillover aHRlow-risk 1.28 [1.03-1.60]; aHRhigh-risk 1.25 [1.06-1.49]), but not if sisters-in-law had HDP (negative-control aHRlow-risk 1.10 [0.85-1.40]; aHRhigh-risk 1.01 [0.83-1.22]). Individual-specific factors drive the CVD mortality heterogeneity among women with HDP. Shared familial factors modestly elevate CVD mortality in women without HDP.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"991-1000"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145538707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Target trial emulation under nonmutually exclusive assignment: structural pitfalls and methodological remedies. 非互斥分配下的目标试验模拟：结构缺陷和方法补救。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwag014

Atsushi Takayama, Shiro Tanaka, Koji Kawakami

{"title":"Target trial emulation under nonmutually exclusive assignment: structural pitfalls and methodological remedies.","authors":"Atsushi Takayama, Shiro Tanaka, Koji Kawakami","doi":"10.1093/aje/kwag014","DOIUrl":"10.1093/aje/kwag014","url":null,"abstract":"Traditional epidemiologic designs typically assume that the exposed and unexposed groups are mutually exclusive, forming the foundation for causal inference. Target trial emulation (TTE), an increasingly adopted framework for estimating causal effects from observational data, may not always require this assumption. Although often applied in settings with nonmutually exclusive treatment assignment, the implications of such structures for causal estimation are underexplored. In real-world contexts, patients may receive combination or single-agent treatments, or neither, leading to ambiguous group distinctions that challenge effect validity. We conducted a simulation study evaluating multiple TTE implementation strategies under nonmutually exclusive treatment assignment. Treatment overlap and covariate alignment were systematically varied to assess how emulation strategies perform under violations of mutual exclusivity. Our results show that nonmutually exclusive assignment can introduce substantial bias unless treatment overlap and positivity are explicitly addressed during propensity score estimation and outcome modeling. Notably, when covariate overlap is sufficient, nonmutually exclusive assignment can recover marginal effects with performance comparable to or exceeding mutually exclusive assignment. However, when overlap is poor, even advanced strategies fail to recover the true marginal effect. These findings underscore the importance of aligning study design, estimand, and treatment-assignment structure when applying TTE in real-world settings.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1045-1055"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multimorbidity patterns, sociodemographic characteristics, and mortality: Data science insights from low-resource settings. 多发病模式、社会人口特征和死亡率：来自低资源环境的数据科学见解。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwae466

Juan Carlos Bazo-Alvarez, Darwin Del Castillo, Luis Piza, Antonio Bernabé-Ortiz, Rodrigo M Carrillo-Larco, Liam Smeeth, Robert H Gilman, William Checkley, J Jaime Miranda

{"title":"Multimorbidity patterns, sociodemographic characteristics, and mortality: Data science insights from low-resource settings.","authors":"Juan Carlos Bazo-Alvarez, Darwin Del Castillo, Luis Piza, Antonio Bernabé-Ortiz, Rodrigo M Carrillo-Larco, Liam Smeeth, Robert H Gilman, William Checkley, J Jaime Miranda","doi":"10.1093/aje/kwae466","DOIUrl":"10.1093/aje/kwae466","url":null,"abstract":"Multimorbidity data typically are analyzed by tallying disease counts, an approach that overlooks nuanced relationships among conditions. We identified clusters of multimorbidity and subpopulations with varying risks and examined their association with all-cause mortality using a data-driven approach. We analyzed 8-year follow-up data of people aged 35 years or older who were part of the CRONICAS Cohort Study, a multisite cohort from Peru. First, we used Partitioning Around Medoids and multidimensional scaling to identify multimorbidity clusters. We then estimated the association between multimorbidity clusters and all-cause mortality. Second, we identified subpopulations using finite mixture modeling. Our analysis revealed three clusters of chronic conditions: respiratory (cluster 1: bronchitis, chronic obstructive pulmonary disease, and asthma); lifestyle, hypertension, depression, and diabetes (cluster 2); and circulatory (cluster 3: heart disease, stroke, and peripheral artery disease). Although only the cluster comprising circulatory diseases showed a significant association with all-cause mortality in the overall population, we identified two latent subpopulations (named I and II) exhibiting differential mortality risks associated with specific multimorbidity clusters. These findings underscore the importance of considering multimorbidity clusters and sociodemographic characteristics in understanding mortality risks. They also highlight the need for tailored interventions to address the unique needs of different subpopulations living with multimorbidity to reduce mortality risks effectively.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"901-911"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Screening of adolescents for testicular cancer-a nationwide retrospective cohort study. 青少年睾丸癌筛查——一项全国性的回顾性队列研究。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf241

Yair Zloof, Tomer Erlich, Maya Braun, Ruth Lev Bar-Or, Dotan Yaari, Emmanuel S Sirat, Lidor Peretz, Arik Eisenkraft, Limor Friedensohn, Gilad Twig, Amir Shlaifer

{"title":"Screening of adolescents for testicular cancer-a nationwide retrospective cohort study.","authors":"Yair Zloof, Tomer Erlich, Maya Braun, Ruth Lev Bar-Or, Dotan Yaari, Emmanuel S Sirat, Lidor Peretz, Arik Eisenkraft, Limor Friedensohn, Gilad Twig, Amir Shlaifer","doi":"10.1093/aje/kwaf241","DOIUrl":"10.1093/aje/kwaf241","url":null,"abstract":"Testicular cancer is the most common malignancy in males aged 15 to 34 years, yet the value of screening asymptomatic adolescents remains unclear. We conducted a nationwide, population-based cohort study of 300 793 Israeli males aged 16 to 21 years who underwent clinical testicular examinations between 2012 and 2021 before mandatory military service, generally lasting 3 years. Participants were followed for incident testicular cancer during their service. Screening involved inspection and palpation by general physicians, with referrals to ultrasound and urologists for suspicious findings. During 1 172 603 person-years of follow-up, 43 cases of testicular cancer were identified (incidence rate, 3.67 per 100 000 person-years). The sensitivity of screening was 66.7% and 40% at 6 and 12 months, respectively. Each cancer detected required screening 75 198 adolescents and included 176 ultrasound tests and 112 specialist consultations. Most cancers were diagnosed at stage I regardless of screening. The low sensitivity, high number needed to screen, frequent unnecessary evaluations, and low incidence of testicular cancer suggest that routine screening of asymptomatic adolescents is ineffective. These findings do not support routine testicular cancer screening in this population.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1009-1014"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145429667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Historical redlining, breast cancer survival, and the mediating and modifying role of contemporary neighborhood socioeconomic conditions. 历史红线，乳腺癌生存，以及当代社区社会经济条件的中介和调节作用。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf282

Sarah M Lima, Tia M Palermo, Lili Tian, Furrina F Lee, Tabassum Z Insaf, Henry Louis Taylor, Helen C S Meier, Deborah O Erwin, Heather M Ochs-Balcom

{"title":"Historical redlining, breast cancer survival, and the mediating and modifying role of contemporary neighborhood socioeconomic conditions.","authors":"Sarah M Lima, Tia M Palermo, Lili Tian, Furrina F Lee, Tabassum Z Insaf, Henry Louis Taylor, Helen C S Meier, Deborah O Erwin, Heather M Ochs-Balcom","doi":"10.1093/aje/kwaf282","DOIUrl":"10.1093/aje/kwaf282","url":null,"abstract":"Historical redlining, a 1930s residential segregation policy, has been associated with contemporary breast cancer survival, but the role of contemporary neighborhood socioeconomic condition is unclear. We investigated mediating and modifying effects of neighborhood socioeconomic condition. This New York State Cancer Registry-based cohort included 60 773 invasive breast cancer cases. Cases were assigned a historical redlining grade (A-D) through linkage to residential census tract at diagnosis. We used labor class index of concentration at the extremes to proxy neighborhood socioeconomic condition. Four-way decomposition evaluated mediation and modification of neighborhood socioeconomic condition on redlining and breast cancer survival. The total effect risk ratio (RR) on 5-year mortality from D-grade vs A-grade = 1.20 (95% CI, 1.09-1.31), which decomposed to a controlled direct effect excess relative risk (ERR) = 0.10 (95% CI, -0.01 to 0.21) and a pure indirect effect ERR = 0.09 (95% CI, 0.05-0.13); significant interaction was not detected. Results were consistent among hormone receptor+, local-stage, and regional-stage tumors, but not hormone receptor- or distant-stage tumors. Decomposition differs by race/ethnicity. Contemporary neighborhood socioeconomic condition mediates approximately half the association between historical redlining and all-cause breast cancer survival, while the other half is attributed to historical redlining. Interventions addressing neighborhood socioeconomic condition may attenuate redlining-based breast cancer survival disparities.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1015-1026"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Childhood adversity and spontaneous abortion in a North American preconception cohort study. 北美孕前队列研究中的童年逆境与自然流产。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf246

Andrea S Kuriyama, Sharonda M Lovett, Amelia K Wesselink, Krystal E Kuan, Molly N Hoffman, Yael I Nillni, Collette N Ncube, Lauren A Wise, Renee Boynton-Jarrett

{"title":"Childhood adversity and spontaneous abortion in a North American preconception cohort study.","authors":"Andrea S Kuriyama, Sharonda M Lovett, Amelia K Wesselink, Krystal E Kuan, Molly N Hoffman, Yael I Nillni, Collette N Ncube, Lauren A Wise, Renee Boynton-Jarrett","doi":"10.1093/aje/kwaf246","DOIUrl":"10.1093/aje/kwaf246","url":null,"abstract":"Childhood adversity has been associated with adverse adult health outcomes. We investigated its association with spontaneous abortion (SAB) risk and the potential buffering effects of social support and integration (SSI). This analysis included 6100 participants from Pregnancy Study Online, a North American preconception cohort study of females attempting spontaneous conception (2013-2024). We assessed childhood adversity via the Adverse Childhood Experiences (ACE) scale and Brief Trauma Questionnaire (BTQ), lifetime SSI via the Berkman-Syme Social Network Index, and pregnancy outcomes via follow-up questionnaires. We used Cox proportional hazards regression models to estimate HRs and 95% CIs, adjusted for potential confounders. Neither the ACE score nor individual ACE domains were appreciably associated with SAB risk. However, participants who reported childhood physical (HR = 1.11 [95% CI, 0.92-1.35]), sexual (HR = 1.12 [95% CI, 0.96-1.30]), or both abuse types (HR = 1.09 [95% CI, 0.90-1.32]) on the BTQ had slightly increased SAB risk compared with those who reported no abuse. Associations were stronger among participants who reported lower childhood SSI (physical and sexual abuse vs no abuse: HR = 1.76 [95% CI, 1.15-2.68]). These findings indicate that BTQ-ascertained physical and sexual abuse may be associated with SAB risk among those with lower childhood SSI.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"982-990"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0