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Neighborhood Social Determinants of Triple Negative Breast Cancer

Triple Negative Breast Cancer (TNBC) is an aggressive, heterogeneous subtype of breast cancer, which is more frequently diagnosed in African American (AA) women than in European American (EA) women. The purpose of this study is to investigate the role of social determinants in racial disparities in...

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Autores principales: Hossain, Fokhrul, Danos, Denise, Prakash, Om, Gilliland, Aubrey, Ferguson, Tekeda F., Simonsen, Neal, Leonardi, Claudia, Yu, Qingzhao, Wu, Xiao-Cheng, Miele, Lucio, Scribner, Richard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387917/
https://www.ncbi.nlm.nih.gov/pubmed/30834239
http://dx.doi.org/10.3389/fpubh.2019.00018
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author Hossain, Fokhrul
Danos, Denise
Prakash, Om
Gilliland, Aubrey
Ferguson, Tekeda F.
Simonsen, Neal
Leonardi, Claudia
Yu, Qingzhao
Wu, Xiao-Cheng
Miele, Lucio
Scribner, Richard
author_facet Hossain, Fokhrul
Danos, Denise
Prakash, Om
Gilliland, Aubrey
Ferguson, Tekeda F.
Simonsen, Neal
Leonardi, Claudia
Yu, Qingzhao
Wu, Xiao-Cheng
Miele, Lucio
Scribner, Richard
author_sort Hossain, Fokhrul
collection PubMed
description Triple Negative Breast Cancer (TNBC) is an aggressive, heterogeneous subtype of breast cancer, which is more frequently diagnosed in African American (AA) women than in European American (EA) women. The purpose of this study is to investigate the role of social determinants in racial disparities in TNBC. Data on Louisiana TNBC patients diagnosed in 2010–2012 were collected and geocoded to census tract of residence at diagnosis by the Louisiana Tumor Registry. Using multilevel statistical models, we analyzed the role of neighborhood concentrated disadvantage index (CDI), a robust measure of physical and social environment, in racial disparities in TNBC incidence, stage at diagnosis, and stage-specific survival for the study population. Controlling for age, we found that AA women had a 2.21 times the incidence of TNBC incidence compared to EA women. Interestingly, the incidence of TNBC was independent of neighborhood CDI and adjusting for neighborhood environment did not impact the observed racial disparity. AA women were more likely to be diagnosed at later stages and CDI was associated with more advanced stages of TNBC at diagnosis. CDI was also significantly associated with poorer stage-specific survival. Overall, our results suggest that neighborhood disadvantage contributes to racial disparities in stage at diagnosis and survival among TNBC patients, but not to disparities in incidence of the disease. Further research is needed to determine the mechanisms through which social determinants affect the promotion and progression of this disease and guide efforts to improve overall survival.
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spelling pubmed-63879172019-03-04 Neighborhood Social Determinants of Triple Negative Breast Cancer Hossain, Fokhrul Danos, Denise Prakash, Om Gilliland, Aubrey Ferguson, Tekeda F. Simonsen, Neal Leonardi, Claudia Yu, Qingzhao Wu, Xiao-Cheng Miele, Lucio Scribner, Richard Front Public Health Public Health Triple Negative Breast Cancer (TNBC) is an aggressive, heterogeneous subtype of breast cancer, which is more frequently diagnosed in African American (AA) women than in European American (EA) women. The purpose of this study is to investigate the role of social determinants in racial disparities in TNBC. Data on Louisiana TNBC patients diagnosed in 2010–2012 were collected and geocoded to census tract of residence at diagnosis by the Louisiana Tumor Registry. Using multilevel statistical models, we analyzed the role of neighborhood concentrated disadvantage index (CDI), a robust measure of physical and social environment, in racial disparities in TNBC incidence, stage at diagnosis, and stage-specific survival for the study population. Controlling for age, we found that AA women had a 2.21 times the incidence of TNBC incidence compared to EA women. Interestingly, the incidence of TNBC was independent of neighborhood CDI and adjusting for neighborhood environment did not impact the observed racial disparity. AA women were more likely to be diagnosed at later stages and CDI was associated with more advanced stages of TNBC at diagnosis. CDI was also significantly associated with poorer stage-specific survival. Overall, our results suggest that neighborhood disadvantage contributes to racial disparities in stage at diagnosis and survival among TNBC patients, but not to disparities in incidence of the disease. Further research is needed to determine the mechanisms through which social determinants affect the promotion and progression of this disease and guide efforts to improve overall survival. Frontiers Media S.A. 2019-02-18 /pmc/articles/PMC6387917/ /pubmed/30834239 http://dx.doi.org/10.3389/fpubh.2019.00018 Text en Copyright © 2019 Hossain, Danos, Prakash, Gilliland, Ferguson, Simonsen, Leonardi, Yu, Wu, Miele and Scribner. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Hossain, Fokhrul
Danos, Denise
Prakash, Om
Gilliland, Aubrey
Ferguson, Tekeda F.
Simonsen, Neal
Leonardi, Claudia
Yu, Qingzhao
Wu, Xiao-Cheng
Miele, Lucio
Scribner, Richard
Neighborhood Social Determinants of Triple Negative Breast Cancer
title Neighborhood Social Determinants of Triple Negative Breast Cancer
title_full Neighborhood Social Determinants of Triple Negative Breast Cancer
title_fullStr Neighborhood Social Determinants of Triple Negative Breast Cancer
title_full_unstemmed Neighborhood Social Determinants of Triple Negative Breast Cancer
title_short Neighborhood Social Determinants of Triple Negative Breast Cancer
title_sort neighborhood social determinants of triple negative breast cancer
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387917/
https://www.ncbi.nlm.nih.gov/pubmed/30834239
http://dx.doi.org/10.3389/fpubh.2019.00018
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