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Racial disparities in triple negative breast cancer: toward a causal architecture approach.
Siegel, Scott D; Brooks, Madeline M; Lynch, Shannon M; Sims-Mourtada, Jennifer; Schug, Zachary T; Curriero, Frank C.
Afiliação
  • Siegel SD; Helen F. Graham Cancer Center and Research Institute, Christiana Care Health System, 4701 Ogletown-Stanton Road, Newark, DE, 19713, USA. ssiegel@christianacare.org.
  • Brooks MM; Institute for Research on Equity and Community Health, Christiana Care Health System, Newark, USA. ssiegel@christianacare.org.
  • Lynch SM; Institute for Research on Equity and Community Health, Christiana Care Health System, Newark, USA.
  • Sims-Mourtada J; Fox Chase Cancer Center, Philadelphia, USA.
  • Schug ZT; Helen F. Graham Cancer Center and Research Institute, Christiana Care Health System, 4701 Ogletown-Stanton Road, Newark, DE, 19713, USA.
  • Curriero FC; The Wistar Institute Cancer Center, Philadelphia, USA.
Breast Cancer Res ; 24(1): 37, 2022 06 01.
Article em En | MEDLINE | ID: mdl-35650633
ABSTRACT

BACKGROUND:

Triple negative breast cancer (TNBC) is an aggressive subtype of invasive breast cancer that disproportionately affects Black women and contributes to racial disparities in breast cancer mortality. Prior research has suggested that neighborhood effects may contribute to this disparity beyond individual risk factors.

METHODS:

The sample included a cohort of 3316 breast cancer cases diagnosed between 2012 and 2020 in New Castle County, Delaware, a geographic region of the US with elevated rates of TNBC. Multilevel methods and geospatial mapping evaluated whether the race, income, and race/income versions of the neighborhood Index of Concentration at the Extremes (ICE) metric could efficiently identify census tracts (CT) with higher odds of TNBC relative to other forms of invasive breast cancer. Odds ratios (OR) and 95% confidence intervals (CI) were reported; p-values < 0.05 were significant. Additional analyses examined area-level differences in exposure to metabolic risk factors, including unhealthy alcohol use and obesity.

RESULTS:

The ICE-Race, -Income-, and Race/Income metrics were each associated with greater census tract odds of TNBC on a bivariate basis. However, only ICE-Race was significantly associated with higher odds of TNBC after adjustment for patient-level age and race (most disadvantaged CT OR = 2.09; 95% CI 1.40-3.13), providing support for neighborhood effects. Higher counts of alcohol and fast-food retailers, and correspondingly higher rates of unhealthy alcohol use and obesity, were observed in CTs that were classified into the most disadvantaged ICE-Race quintile and had the highest odds of TNBC.

CONCLUSION:

The use of ICE can facilitate the monitoring of cancer inequities and advance the study of racial disparities in breast cancer.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias de Mama Triplo Negativas Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Female / Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias de Mama Triplo Negativas Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Female / Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article