Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factors
Abstract Background Despite similar incidence rates among Black and White women, breast cancer mortality rates are 40% higher among Black women. More than half of the racial difference in breast cancer mortality can be attributed to triple negative breast cancer (TNBC), an aggressive subtype of inva...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-05-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.5808 |
| _version_ | 1797810403314499584 |
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| author | Scott D. Siegel Madeline M. Brooks Jesse D. Berman Shannon M. Lynch Jennifer Sims‐Mourtada Zachary T. Schug Frank C. Curriero |
| author_facet | Scott D. Siegel Madeline M. Brooks Jesse D. Berman Shannon M. Lynch Jennifer Sims‐Mourtada Zachary T. Schug Frank C. Curriero |
| author_sort | Scott D. Siegel |
| collection | DOAJ |
| description | Abstract Background Despite similar incidence rates among Black and White women, breast cancer mortality rates are 40% higher among Black women. More than half of the racial difference in breast cancer mortality can be attributed to triple negative breast cancer (TNBC), an aggressive subtype of invasive breast cancer that disproportionately affects Black women. Recent research has implicated neighborhood conditions in the etiology of TNBC. This study investigated the relationship between cumulative neighborhood‐level exposures and TNBC risk. Methods This single‐institution retrospective study was conducted on a cohort of 3316 breast cancer cases from New Castle County, Delaware (from 2012 to 2020), an area of the country with elevated TNBC rates. Cases were stratified into TNBC and “Non‐TNBC” diagnosis and geocoded by residential address. Neighborhood exposures included census tract‐level measures of unhealthy alcohol use, metabolic dysfunction, breastfeeding, and environmental hazards. An overall cumulative risk score was calculated based on tract‐level exposures. Results Univariate analyses showed each tract‐level exposure was associated with greater TNBC odds. In multivariate analyses that controlled for patient‐level race and age, tract‐level exposures were not associated with TNBC odds. However, in a second multivariate model that included patient‐level variables and considered tract‐level risk factors as a cumulative exposure risk score, each one unit increase in cumulative exposure was significantly associated with a 10% increase in TNBC odds. Higher cumulative exposure risk scores were found in census tracts with relatively high proportions of Black residents. Conclusions Cumulative exposure to neighborhood‐level risk factors that disproportionately affect Black communities was associated with greater TNBC risk. |
| first_indexed | 2024-03-13T07:07:13Z |
| format | Article |
| id | doaj.art-139abdceea784988a1b227ba547260cc |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-13T07:07:13Z |
| publishDate | 2023-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-139abdceea784988a1b227ba547260cc2023-06-06T07:30:47ZengWileyCancer Medicine2045-76342023-05-011210117601177210.1002/cam4.5808Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factorsScott D. Siegel0Madeline M. Brooks1Jesse D. Berman2Shannon M. Lynch3Jennifer Sims‐Mourtada4Zachary T. Schug5Frank C. Curriero6Institute for Research on Equity & Community Health, Christiana Care Health System Newark Delaware USAInstitute for Research on Equity & Community Health, Christiana Care Health System Newark Delaware USADivision of Environmental Health Sciences University of Minnesota School of Public Health Minneapolis Minnesota USACancer Prevention and Control, Fox Chase Cancer Center Philadelphia Pennsylvania USAHelen F. Graham Cancer Center & Research Institute, Christiana Care Health System Newark Delaware USAThe Wistar Institute Cancer Center Philadelphia Pennsylvania USADepartment of Epidemiology, Johns Hopkins School of Public Health John Hopkins Spatial Science for Public Health Center Baltimore Maryland USAAbstract Background Despite similar incidence rates among Black and White women, breast cancer mortality rates are 40% higher among Black women. More than half of the racial difference in breast cancer mortality can be attributed to triple negative breast cancer (TNBC), an aggressive subtype of invasive breast cancer that disproportionately affects Black women. Recent research has implicated neighborhood conditions in the etiology of TNBC. This study investigated the relationship between cumulative neighborhood‐level exposures and TNBC risk. Methods This single‐institution retrospective study was conducted on a cohort of 3316 breast cancer cases from New Castle County, Delaware (from 2012 to 2020), an area of the country with elevated TNBC rates. Cases were stratified into TNBC and “Non‐TNBC” diagnosis and geocoded by residential address. Neighborhood exposures included census tract‐level measures of unhealthy alcohol use, metabolic dysfunction, breastfeeding, and environmental hazards. An overall cumulative risk score was calculated based on tract‐level exposures. Results Univariate analyses showed each tract‐level exposure was associated with greater TNBC odds. In multivariate analyses that controlled for patient‐level race and age, tract‐level exposures were not associated with TNBC odds. However, in a second multivariate model that included patient‐level variables and considered tract‐level risk factors as a cumulative exposure risk score, each one unit increase in cumulative exposure was significantly associated with a 10% increase in TNBC odds. Higher cumulative exposure risk scores were found in census tracts with relatively high proportions of Black residents. Conclusions Cumulative exposure to neighborhood‐level risk factors that disproportionately affect Black communities was associated with greater TNBC risk.https://doi.org/10.1002/cam4.5808cumulative exposuredisparityenvironmental hazardsneighborhoodsegregationtriple negative breast cancer |
| spellingShingle | Scott D. Siegel Madeline M. Brooks Jesse D. Berman Shannon M. Lynch Jennifer Sims‐Mourtada Zachary T. Schug Frank C. Curriero Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factors Cancer Medicine cumulative exposure disparity environmental hazards neighborhood segregation triple negative breast cancer |
| title | Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factors |
| title_full | Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factors |
| title_fullStr | Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factors |
| title_full_unstemmed | Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factors |
| title_short | Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factors |
| title_sort | neighborhood factors and triple negative breast cancer the role of cumulative exposure to area level risk factors |
| topic | cumulative exposure disparity environmental hazards neighborhood segregation triple negative breast cancer |
| url | https://doi.org/10.1002/cam4.5808 |
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