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Nativity, ethnic enclave residence and breast cancer survival among Latinas: variations between California and Texas
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6 15 2020
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Source: Cancer. 126(12):2849-2858
Details:
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Alternative Title:Cancer
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Personal Author:
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Description:Background
Residence in an ethnic enclave may be associated with survival among Latinas with breast cancer, but findings from prior studies are inconsistent.
Methods
We conducted parallel analyses of California and Texas cancer registry data for adult (≥18 years of age) Latinas diagnosed with invasive breast cancer from 1996 to 2005, with follow-up through 2014. We used existing indices applied to tract-level 2000 US Census data to measure Latinx enclaves and neighborhood socioeconomic status (nSES). We fitted multivariable Cox Proportional Hazard models for all-cause and breast cancer specific mortality adjusted for diagnosis year, patient age, nativity (with multiple imputation), tumor stage, histology, grade, size, and clustering by census tract.
Results
Among 38,858 Latinas, the majority (61.3% in CA, 70.5% in TX) lived in enclaves. In fully adjusted models for both states, foreign-born women, compared to US-born women, were more likely to die from breast cancer and all causes. Living in enclaves and in neighborhoods with higher SES were independently associated with improved survival from both causes. When combined into a four-level variable, compared to those living in low nSES enclaves, those in low nSES non-enclaves had worse survival for both causes; and, in the all-cause but not breast-cancer specific models, those in high nSES neighborhoods, regardless of enclave status, had improved survival from all-causes.
Conclusion
Applying the same methods across two states eliminated previously published inconsistent associations between enclave residence and breast cancer survival. Future studies should identify specific protective effects of enclave residence to inform interventions.
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Pubmed ID:32181892
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Pubmed Central ID:PMC7245543
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Volume:126
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Issue:12
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