Associations Between Neighborhood Disinvestment and Breast Cancer Outcomes Within a Populous State Registry

Details

• Alternative Title:
  Cancer
• Personal Author:
  Plascak, Jesse J. ; Rundle, Andrew G. ; Xu, Xinyi ; Mooney, Stephen J. ; Schootman, Mario ; Lu, Bo ; Roy, Jason ; Stroup, Antoinette M. ; Llanos, Adana A. M.
• Description:
  BACKGROUND:
  
  Breast cancer (BrCa) outcomes vary by social environmental factors, but the role of built-environment factors is understudied. The authors investigated associations between environmental physical disorder—indicators of residential disrepair and disinvestment—and BrCa tumor prognostic factors (stage at diagnosis, tumor grade, triple-negative [negative for estrogen receptor, progesterone receptor, and HER2 receptor] BrCa) and survival within a large state cancer registry linkage.
  
  METHODS:
  
  Data on sociodemographic, tumor, and vital status were derived from adult women who had invasive BrCa diagnosed from 2008 to 2017 ascertained from the New Jersey State Cancer Registry. Physical disorder was assessed through virtual neighborhood audits of 23,276 locations across New Jersey, and a personalized measure for the residential address of each woman with BrCa was estimated using universal kriging. Continuous covariates were z scored (mean ± standard deviation [SD], 0 ± 1) to reduce collinearity. Logistic regression models of tumor factors and accelerated failure time models of survival time to BrCa-specific death were built to investigate associations with physical disorder adjusted for covariates (with follow-up through 2019).
  
  RESULTS:
  
  There were 3637 BrCa-specific deaths among 40,963 women with a median follow-up of 5.3 years. In adjusted models, a 1-SD increase in physical disorder was associated with higher odds of late-stage BrCa (odds ratio, 1.09; 95% confidence interval, 1.02–1.15). Physical disorder was not associated with tumor grade or triple-negative tumors. A 1-SD increase in physical disorder was associated with a 10.5% shorter survival time (95% confidence interval, 6.1%−14.6%) only among women who had early stage BrCa.
  
  CONCLUSIONS:
  
  Physical disorder is associated with worse tumor prognostic factors and survival among women who have BrCa diagnosed at an early stage.
  
  
• Subjects:
  Adult Article Breast Cancer Outcomes Breast Neoplasms Built-environment Physical Disorder Cancer Registry Linkage Female Humans Neighborhood Disinvestment New Jersey Prognosis Receptors, Estrogen Registries

  More +
• Source:
  Cancer. 128(1):131-138
• Pubmed ID:
  34495547
• Pubmed Central ID:
  PMC9070603
• Document Type:
  Journal Article
• Funding:
  U58 DP003931/DP/NCCDPHP CDC HHSUnited States/ ; P30 CA072720/CA/NCI NIH HHSUnited States/ ; K07 CA222158/CA/NCI NIH HHSUnited States/ ; 5U58DP003931/CC/CDC HHSUnited States/ ; R01 HD087460/HD/NICHD NIH HHSUnited States/ ; P2C HD058486/HD/NICHD NIH HHSUnited States/ ; HHSN261201300021I/CA/NCI NIH HHSUnited States/ ; K99 LM012868/LM/NLM NIH HHSUnited States/ ; R01HD087460/Eunice Kennedy Shriver National Institute of Child Health and Human Development/
• Volume:
  128
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:4f4e0a63eebf8f4ee8d081f41a4c78a61868711ebe9749054fb073d69000d3bd
• Download URL:
  https://stacks.cdc.gov/view/cdc/117069/cdc_117069_DS1.pdf
• File Type:
  [PDF - 743.14 KB ]