A local area analysis of racial, ethnic, and neighborhood disparities in breast cancer staging

Sandra E. Echeverría, Luisa N. Borrell, Diane Brown, George Rhoads

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Few studies have examined the role of neighborhood socioeconomic condition in shaping breast cancer disparities in defined local areas. We tested associations between three measures of neighborhood socioeconomic condition (poverty, median income, and a composite neighborhood score) on breast cancer staging in two urban counties of the state of New Jersey. Data for these counties were obtained from the New Jersey Surveillance, Epidemiology, and End Results tumor registry and were selected because of their large racial/ethnic and socioeconomic diversity and pilot prevention efforts taking place in these areas. Our study population included Black, Latina, and White women (N = 4,589) diagnosed with breast cancer from 1999 to 2004. Each cancer case was geocoded and linked to socioeconomic data obtained from the 2000 U.S. census. Census tracts served as proxies for neighborhoods. Logistic regression models accounting for clustering of individuals within neighborhoods were fitted with Generalized Estimating Equations. Women living in neighborhoods with lower versus higher neighborhood scores were significantly more likely to have advanced-stage disease (odds ratio, 1.6; confidence intervals, 1.1-2.3), after adjusting for age at diagnosis and race/ethnicity. In analyses stratified by race/ethnicity, results remained significant for all neighborhood measures for White and Black women, but not for Latinas. Moreover, neighborhood poverty showed a weaker socioeconomic gradient in breast cancer staging among White women. Our study findings support the use of a multidimensional neighborhood indexto better capture differences in cancer staging risk across racial/ethnic groups and provides evidence that population-based cancer data could be used to identify local needs specific to local populations.

Original languageEnglish (US)
Pages (from-to)3024-3029
Number of pages6
JournalCancer Epidemiology Biomarkers and Prevention
Volume18
Issue number11
DOIs
StatePublished - Nov 1 2009

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Neoplasm Staging
Breast Neoplasms
Censuses
Poverty
Hispanic Americans
Logistic Models
Geographic Mapping
Population
Neoplasms
Proxy
Ethnic Groups
Cluster Analysis
Registries
Epidemiology
Odds Ratio
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Oncology
  • Epidemiology

Cite this

Echeverría, Sandra E. ; Borrell, Luisa N. ; Brown, Diane ; Rhoads, George. / A local area analysis of racial, ethnic, and neighborhood disparities in breast cancer staging. In: Cancer Epidemiology Biomarkers and Prevention. 2009 ; Vol. 18, No. 11. pp. 3024-3029.
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A local area analysis of racial, ethnic, and neighborhood disparities in breast cancer staging. / Echeverría, Sandra E.; Borrell, Luisa N.; Brown, Diane; Rhoads, George.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 18, No. 11, 01.11.2009, p. 3024-3029.

Research output: Contribution to journalArticle

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