A Comparison of Neighborhood Socioeconomic Deprivation Measures and the Association with Survival among Black and White Women with Endometrial Cancer.

IF 3.4 3区医学 Q2 ONCOLOGY Cancer Epidemiology Biomarkers & Prevention Pub Date : 2025-06-03 DOI:10.1158/1055-9965.EPI-24-1833

Anna Gottschlich, Jamaica R M Robinson, Julie J Ruterbusch, Kaitlin Burchett, Rebecca M Adams, Ariel Washington, Michele L Cote, Ann G Schwartz, Kristen S Purrington, Mike R Wilson

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Abstract

Background: Black women with endometrial cancer have twice the mortality compared with White. Survival disparities remain after accounting for individual-level socioeconomic and cancer-related factors. We investigated associations between area-based deprivation and survival and explored whether area-based deprivation attenuates the association between race and survival, among a cohort of Black and White women.

Methods: Data from endometrial cancers diagnosed between 2013 and 2022 were collected from a comprehensive cancer registry covering Metropolitan Detroit. Addresses at diagnosis were linked to the area deprivation (ADI) and social vulnerability (SVI) indices. Adjusted Fine and Gray models and Cox proportional hazard models were run investigating associations between area-based deprivation measures and survival; analyses were conducted estimating the proportion of the association between race and survival that was attenuated by area-based measures.

Results: Higher deprivation was associated with poorer survival, adjusted for race, insurance status, and tumor characteristics. Compared with the least disadvantaged quartile, the quartile with the highest disadvantage using ADI and SVI had 1.18 [95% confidence interval (CI), 0.99-1.43] and 1.40 (1.14-1.71) times the hazard of endometrial cancer-specific mortality, respectively. ADI and SVI attenuated 18% (3%-38%) and 27% (10%-48%) of associations between race and mortality overall and 24% (95% CI, 3%-61%) and 40% (95% CI, 16%-78%) among those with high-grade histology.

Conclusions: This study demonstrates a clear association between neighborhood-level disadvantage and survival among women with endometrial cancer living in Metropolitan Detroit. Neighborhood disadvantage attenuates the relationship between race and survival, particularly among those with high-grade histology.

Impact: These findings serve as motivation to understand how neighborhood affects cancer outcomes.

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黑人和白人子宫内膜癌患者的社区社会经济剥夺措施及其与生存的关系的比较

背景：黑人女性子宫内膜癌（EC）的死亡率是白人的两倍。在考虑到个人层面的社会经济和癌症相关因素后，生存差异仍然存在。我们调查了基于区域的剥夺与生存之间的联系，并探讨了基于区域的剥夺是否减弱了种族与生存之间的联系，在一组黑人和白人妇女中。方法：从涵盖底特律大都会的综合癌症登记处收集2013-2022年间诊断的ECs数据。诊断时的地址与区域剥夺（ADI）和社会脆弱性（SVI）指数有关。运行调整后的Fine & Gray和Cox比例风险模型，调查基于区域的剥夺措施与生存之间的关系；进行了分析，估计种族和生存率之间的关联比例，该比例被基于区域的措施所削弱。结果：在种族、保险状况和肿瘤特征调整后，较高的剥夺与较差的生存率相关。与最不利的四分位数相比，使用ADI和SVI的最不利四分位数的ec特异性死亡率风险分别为1.18倍（95% CI: 0.99, 1.43）和1.40倍（1.14,1.71）。ADI和SVI降低了种族和死亡率之间18%（3-38%）和27%（10-48%）的相关性，在高级别组织学患者中降低了24% （95% CI: 3-61%）和40% （95% CI: 16-78%）的相关性。结论：本研究表明，居住在底特律大都会的EC妇女的社区水平劣势与生存之间存在明确的关联。邻里不利削弱了种族和生存之间的关系，特别是在那些高级别组织学。影响：这些发现为了解社区如何影响癌症结果提供了动力。

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来源期刊

Cancer Epidemiology Biomarkers & Prevention 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.50

自引率

2.60%

发文量

538

审稿时长

1.6 months

期刊介绍： Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.