Predictors of breast cancer mortality among white and black women in large United States cities: an ecologic study

Hunt, Bijou R.; Silva, Abigail; Lock, Derrick; Hurlbert, Marc

doi:10.1007/s10552-018-1125-x

Cited by 9 publications

(13 citation statements)

References 43 publications

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“…Overall, breast cancer mortality rates are about 40% higher in Black women compared with White women [38]. Black women in Tennessee rank first in breast cancer mortality nationally [39]. Few studies have assessed cancer incidence patterns by Appalachian designation or residence in the state.…”

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confidence: 99%

Assessing health disparities in breast cancer incidence burden in Tennessee: geospatial analysis

et al. 2021

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Background Tennessee women experience the 12th highest breast cancer mortality in the United States. We examined the geographic differences in breast cancer incidence in Tennessee between Appalachian and non-Appalachian counties from 2005 to 2015. Methods We used ArcGIS 10.7 geospatial analysis and logistic regression on the Tennessee Cancer Registry incidence data for adult women aged ≥ 18 years (N = 59,287) who were diagnosed with breast cancer from 2005 to 2015 to evaluate distribution patterns by Appalachian county designation. The Tennessee Cancer Registry is a population-based, central cancer registry serving the citizens of Tennessee and was established by Tennessee law to collect and monitor cancer incidence. The main outcome was breast cancer stage at diagnosis. Independent variables were age, race, marital status, type of health insurance, and county of residence. Results Majority of the sample were White (85.5%), married (58.6%), aged ≥ 70 (31.3%) and diagnosed with an early stage breast cancer (69.6%). More than half of the women had public health insurance (54.2%), followed by private health insurance coverage (44.4%). Over half of the women resided in non-Appalachian counties, whereas 47.6% were in the Appalachian counties. We observed a significant association among breast cancer patients with respect to marital status and type of health insurance coverage (p = < 0.0001). While the logistic regression did not show a significant result between county of residence and breast cancer incidence, the spatial analysis revealed geographic differences between Appalachian and non-Appalachian counties. The highest incidence rates of 997.49–1164.59/100,000 were reported in 6 Appalachian counties (Anderson, Blount, Knox, Rhea, Roane, and Van Buren) compared to 3 non-Appalachian counties (Fayette, Marshall, and Williamson). Conclusions There is a need to expand resources in Appalachian Tennessee to enhance breast cancer screening and early detection. Using geospatial techniques can further elucidate disparities that may be overlooked in conventional linear analyses to improve women’s cancer health and associated outcomes.

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confidence: 99%

Assessing health disparities in breast cancer incidence burden in Tennessee: geospatial analysis

et al. 2021

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“…Many risk factors have been identified as causing cancer mortality disparities among U.S. racial groups [50]. Lower SES was related to lower awareness for breast cancer symptoms and prevention [17,51], resulting in more advanced stage cancer presentations at diagnosis than disparities in treatment or access to health insurance [16,17,22,[52][53][54][55].…”

Section: Discussionmentioning

confidence: 99%

“…Compared to neighborhoods with favorable economic indicators, higher breast cancer mortality rates have been reported in places where people with unfavorable social determinants of health clustered (lower education, lower household income, and higher unemployment and proportion of uninsured population) [18][19][20][21]. The difference in breast cancer mortality between NHW and NHB women has been linked to education, family income, access to primary care physicians, and mammography in communities [22]. Complex interactions between race and different SES such as education and neighborhood SES (nSES) were identified as a factor in higher breast cancer mortality among various racial groups [23].…”

Section: Introductionmentioning

confidence: 99%

The role of education on Cancer amenable mortality among non-Hispanic blacks & non-Hispanic whites in the United States (1989–2018)

et al. 2021

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Background Cancer mortality in the U.S. has fallen in recent decades; however, individuals with lower levels of education experienced a smaller decline than more highly educated individuals. This analysis aimed to measure the influence of education lower than a high school diploma, on cancer amenable mortality among Non-Hispanic Whites (NHW) and Non-Hispanic Blacks (NHB) in the U.S. from 1989 to 2018. Methods We analyzed data from 8.2 million death certificates of men and women who died from cancer between 1989 and 2018. We examined 5-year and calendar period intervals, as well as annual percent changes (APC). APC was adjusted for each combination of sex, educational level, and race categories (8 models) to separate the general trend from the effects of age. Results Our study demonstrated an increasing mortality gap between the least and the most educated NHW and NHB males and females who died from all cancers combined and for most other cancer types included in this study. The gap between the least and the most educated was broader among NHW males and females than among NHB males and females, respectively, for most malignancies. Conclusions In summary, we reported an increasing gap in the age-adjusted cancer mortality among the most and the least educated NHW and NHB between 25 and 74 years of age. We demonstrated that although NHB exhibited the greatest age-adjusted mortality rates for most cancer locations, the gap between the most and the least educated was shown for NHW.

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“…However, population studies have shown disparities in BC incidence and mortality among ethnic and racial groups persistently over the past ve decades. In the US, White/European Americans (EA) have historically demonstrated the highest incidence of breast cancer, while Black or African Americans (AA) have the highest mortality rates reported in any race/ethnic group 3,4 . Interestingly, this mortality gap only emerged in the late 1970s, coinciding with implementation of targeted hormone therapies.…”

Section: Introductionmentioning

confidence: 99%

Investigation of Triple-Negative Breast Cancer Risk Alleles in An International African-Enriched Cohort

Martini

Chen

Jenkins

et al. 2020

Preprint

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Large-scale efforts to identify breast cancer risk alleles have historically taken place among women on European ancestry, with recent efforts to validate these alleles or identify risk alleles applicable to women of African descent. We investigated the effect of previously reported breast cancer and triple-negative breast cancer (TNBC) risk alleles in our African enriched International Center for the Study of Breast Cancer Subtypes (ICSBCS) cohort. Using case-control and nested case-series approaches, we report that the Duffy-null allele (rs2814778) is associated with TNBC risk (OR = 3.814, p = 0.001), specifically among AA individuals, after adjusting for self-indicated race and west African ancestry (OR = 3.368, p = 0.007). We have also validated the protective effect of the minor allele of the ANKLE1 missense variant rs2363956 among AA for TNBC (OR = 0.4204, p = 0.005). We have shown that differential prevalence of the protective allele may reflect a polymorphic function of ANKLE1 in TNBC breast cancer outcomes. These AA specific risk alleles present opportunities for future studies of therapeutic potential that address race-specific differences in BC and TNBC risk and disease outcome.

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Predictors of breast cancer mortality among white and black women in large United States cities: an ecologic study

Cited by 9 publications

References 43 publications

Assessing health disparities in breast cancer incidence burden in Tennessee: geospatial analysis

Assessing health disparities in breast cancer incidence burden in Tennessee: geospatial analysis

The role of education on Cancer amenable mortality among non-Hispanic blacks & non-Hispanic whites in the United States (1989–2018)

Investigation of Triple-Negative Breast Cancer Risk Alleles in An International African-Enriched Cohort

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