Neighborhood Social Environmental Factors and Breast Cancer Subtypes among Black Women.
Neighborhood Social Environmental Factors and Breast Cancer Subtypes among Black Women.
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DOI：
10.1158/1055-9965.epi-20-1055
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发表时间：
2021-03
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影响因子：
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通讯作者：
Llanos AAM
中科院分区：
文献类型：
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作者：
Qin B;Babel RA;Plascak JJ;Lin Y;Stroup AM;Goldman N;Ambrosone CB;Demissie K;Hong CC;Bandera EV;Llanos AAM
非裔美国人/黑人妇女中侵袭性更强的乳腺癌亚型的不成比例的负担可能源于多层次的决定因素。然而，数据是有限的邻里社会环境特征的黑人妇女的影响。我们在妇女健康圈和妇女健康圈随访研究中评估了社区社会经济地位（nSES）与乳腺癌亚型之间的关联，其中包括2005年至2017年诊断为浸润性乳腺癌的1，220名黑人妇女。诊断时的nSES使用NCI的人口普查区级SES指数进行测量。我们使用多水平多项逻辑回归模型估计nSES与乳腺癌亚型[三阴性乳腺癌（TNBC），HER 2阳性vs.管腔A]的相关性，调整个体水平SES，体重指数和生殖因素。我们测试了邻里种族组成的相互作用。与以高nSES为特征的人口普查区相比，居住在中等和低nSES地区的妇女的TNBC相对风险比（RRR）分别为1.81（95%CI：1.20-2.71）和1.95（95%CI：1.27-2.99）（p趋势：0.002）。邻里种族组成修改nSES和TNBC之间的关联; TNBC的相对风险最高的是居住在低nSES地区的黑人居民比例低的妇女。居住在社会经济弱势社区的黑人妇女可能会增加TNBC的风险，特别是在黑人居民比例较低的地区。人们居住的地方可能会影响乳腺肿瘤生物学。需要更深入地了解肿瘤生物学的多层次途径。
The disproportionate burden of more aggressive breast cancer subtypes among African American/Black women may stem from multilevel determinants. However, data are limited regarding the impacts of neighborhood social environmental characteristics among Black women. We evaluated the association between neighborhood-level socioeconomic status (nSES) and breast cancer subtypes in the Women’s Circle of Health and Women’s Circle of Health Follow-up Study, which included 1,220 Black women diagnosed from 2005 to 2017 with invasive breast cancer. nSES at diagnosis was measured using NCI’s census tract-level SES index. We used multilevel multinomial logistic regression models to estimate the association of nSES with breast cancer subtypes [triple-negative breast cancer (TNBC), HER2-positive vs. luminal A], adjusting for individual-level SES, body mass index, and reproductive factors. We tested for interactions by neighborhood racial composition. Compared to census tracts characterized as high nSES, the relative risk ratios (RRR) for TNBC were 1.81 (95% CI: 1.20–2.71) and 1.95 (95% CI: 1.27–2.99) for women residing in areas with intermediate and low nSES, respectively (p-trend: .002). Neighborhood racial composition modified the association between nSES and TNBC; the highest relative risk of TNBC was among women residing in low nSES areas with low proportions of Black residents. Black women residing in socioeconomically disadvantaged neighborhoods may have an increased risk of TNBC, particularly among areas with lower proportions of Black residents. Places people live may influence breast tumor biology. A deeper understanding of multilevel pathways contributing to tumor biology is needed.