Post-diagnosis social networks, and lifestyle and treatment factors in the After Breast Cancer Pooling Project.
Post-diagnosis social networks, and lifestyle and treatment factors in the After Breast Cancer Pooling Project.
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DOI：
10.1002/pon.4059
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发表时间：
2017-04
期刊：
影响因子：
3.6
通讯作者：
Chen WY
中科院分区：
文献类型：
--
作者：
Kroenke CH;Michael YL;Shu XO;Poole EM;Kwan ML;Nechuta S;Caan BJ;Pierce JP;Chen WY
更大的社交网络与更好的乳腺癌生存有关。为了研究潜在的介质，我们评估了社会网络的大小和多样性与预后相关的生活方式和治疗因素的关系。我们纳入了来自乳腺癌后汇集项目的9,331名妇女，她们在诊断后大约两年内提供了社交网络的数据。社交网络指数是从配偶或亲密伴侣的存在、宗教关系、社区参与、友谊关系和在世亲属数量等信息中得出的。多样性被评估为各种关系，独立于大小。我们使用逻辑回归来评估与结果的关联，并使用荟萃分析技术评估效果估计值是否不同。虽然吸烟和饮酒的分析仅包括美国队列，但由于这些行为在上海队列中的患病率较低，因此这些队列之间的相关性相似。与融入社会的女性相比，社交孤立的女性更容易肥胖（OR=1.21，95%CI：1.03-1.42），体力活动量低（<10 MET-h/wk，OR=1.55，95%CI：1.36-1.78），目前吸烟（OR=2.77，95%CI：2.09-3.68），酒精摄入量高（≥15 g/d，OR=1.23，95%CI：1.00-1.51）。在三个队列的淋巴结阳性病例中，社会孤立的女性更可能不接受化疗（OR=2.10，95%CI：1.30-3.39）;第四个队列的相关性不同。其他协会（不显着）与社会孤立的妇女不太密集的治疗是一致的。低社会网络多样性与更多不良生活方式独立相关，但与临床因素无关。诊断后测量的小的、不太多样化的社交网络与更多的不良生活方式因素和不太密集的癌症治疗相关。
Larger social networks have been associated with better breast cancer survival. To investigate potential mediators, we evaluated associations of social network size and diversity with lifestyle and treatment factors associated with prognosis. We included 9,331 women from the After Breast Cancer Pooling Project who provided data on social networks within approximately two years following diagnosis. A social network index was derived from information about the presence of a spouse or intimate partner, religious ties, community participation, friendship ties, and numbers of living relatives. Diversity was assessed as variety of ties, independent of size. We used logistic regression to evaluate associations with outcomes and evaluated whether effect estimates differed using meta-analytic techniques. Associations were similar across cohorts though analyses of smoking and alcohol included US cohorts only due to low prevalence of these behaviors in the Shanghai cohort. Socially isolated women were more likely to be obese (OR=1.21, 95% CI:1.03-1.42), have low physical activity (<10 MET-h/wk, OR=1.55, 95% CI:1.36-1.78), be current smokers (OR=2.77, 95% CI:2.09-3.68), and have high alcohol intake (≥15 g/d, OR=1.23, 95% CI:1.00-1.51), compared to socially integrated women. Among node positive cases from three cohorts, socially isolated women were more likely not to receive chemotherapy (OR=2.10, 95% CI:1.30-3.39); associations differed in a fourth cohort. Other associations (nonsignificant) were consistent with less intensive treatment in socially isolated women. Low social network diversity was independently associated with more adverse lifestyle, but not clinical, factors. Small, less diverse social networks measured post-diagnosis were associated with more adverse lifestyle factors and less intensive cancer treatment.