Neighborhood Disadvantages Associated with Breast Cancer-Specific Shorter Survival

Important points:

• The researchers looked at associations independent of individual patient or treatment characteristics.
• Unmeasured social determinants of health and barriers to care can influence breast cancer-specific survival.

According to data published in , women living in disadvantaged areas had shorter breast cancer-specific survival times than women in advantaged areas. JAMA network open.

This finding persisted even after controlling for several individual patient and disease factors and treatment characteristics consistent with National Comprehensive Cancer Network guidelines, the researchers wrote.

“Together, this persistent disparity associated with neighborhood disadvantage for breast cancer-specific survival disparities suggests an unexplained mechanism.” Neha Goel, M.D. assistant professor of surgical oncology at the Sylvester Comprehensive Cancer Center at the University of Miami Miller College of Medicine, and the researcher wrote. “These immense inequalities exist along the breast cancer care continuum, from late diagnosis to lack of completion of treatment. This may result in delayed diagnosis, delayed onset, and shorter breast cancer-specific survival.”

Background and methodology

Despite the decreasing breast cancer Although advances in screening, diagnostic, and treatment modalities have led to declining rates across the United States, persistent disparities in breast cancer survival exist, which may be related in part to . Neighborhood Disadvantage.

Researchers conducted a retrospective cohort study investigating neighborhood-level socioeconomic status and breast cancer-specific survival rates in the South Florida majority/minority population.

The study included patients with stage I to stage IV breast cancer (mean age 55.5 years; 55.8% Hispanic; , 17.5% black) included 5,027 women. , 2007, and 9 September 2016.

Breast cancer-specific survival served as the primary outcome and to control for individual characteristics such as sociodemographics, comorbidities, breast cancer risk factors, access to treatment, tumor and NCCN guideline-compliant treatment factors A random-effects frailty model was run. They measured neighborhood socioeconomic status using a regional deprivation index at the census block group level for each patient.

The researchers conducted data analysis from March 2022 to March 2023 and reported an average follow-up of 60.3 months.

Result, next step

Findings showed that women living in the most disadvantaged areas had shorter breast cancer-specific survival than those living in the most advantaged areas (HR = 1.29; 95% CI 1.01-1.65). It is irrelevant to other characteristics.

Other factors significantly associated with increased breast cancer-specific mortality included non-Hispanic black race (HR = 1.7; 95%CI, 1.26-2.3) and aggressive tumor subtype (ER-negative/ERBB2-negative). HR, 2.07; 95%CI). , 1.67-2.56).

According to the researchers, additional research is needed on the more aggressive tumor biologic factors in women with breast cancer from disadvantaged areas compared to women from disadvantaged areas.

“Thus, this study advances the field of breast cancer disparity research by suggesting additional pathways by which neighborhood disadvantage may affect breast cancer-specific survival disparities beyond access to care.” “This suggests that neighborhood disadvantage may influence the biological factors of breast cancer and, ultimately, breast cancer-specific survival rates,” Goel and the researchers wrote in the study. It is a call to action for future research on scientific mechanisms.”