Impact of neighborhood and individual socioeconomic status on survival after breast cancer varies by race/ethnicity: The neighborhood and breast cancer study

Salma Shariff-Marco, Juan Yang, Esther M. John, Meera Sangaramoorthy, Andrew Hertz, Jocelyn Koo, David O. Nelson, Clayton W. Schupp, Sarah J. Shema, Myles Cockburn, William A. Satariano, Irene H. Yen, Ninez A. Ponce, Marilyn Winkleby, Theresa H Keegan, Scarlett L. Gomez

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Research is limited on the independent and joint effects of individual- and neighborhood-level socioeconomic status (SES) on breast cancer survival across different racial/ethnic groups. Methods: We studied individual-level SES, measured by self-reported education, and a composite neighborhood SES (nSES) measure in females (1,068 non-Hispanic whites, 1,670 Hispanics, 993 African-Americans, and 674 Asian-Americans), ages 18 to 79 years and diagnosed 1995 to 2008, in the San Francisco Bay Area. We evaluated all-cause and breast cancer-specific survival using stage-stratified Cox proportional hazards models with cluster adjustment for census block groups. Results: In models adjusting for education and nSES, lower nSES was associated with worse all-cause survival among African-Americans (Ptrend = 0.03), Hispanics (Ptrend = 0.01), and Asian-Americans (P trend = 0.01). Education was not associated with all-cause survival. For breast cancer-specific survival, lower nSES was associated with poorer survival only among Asian-Americans (Ptrend = 0.01). When nSES and education were jointly considered, women with low education and low nSES had 1.4 to 2.7 times worse all-cause survival than women with high education and high nSES across all races/ethnicities. Among African-Americans and Asian- Americans, women with high education and low nSES had 1.6 to 1.9 times worse survival, respectively. For breast cancer-specific survival, joint associations were found only among Asian-Americans with worse survival for those with low nSES regardless of education. Conclusions: Both neighborhood and individual SES are associated with survival after breast cancer diagnosis, but these relationships vary by race/ethnicity. Impact: A better understanding of the relative contributions and interactions of SES with other factors will inform targeted interventions toward reducing long-standing disparities in breast cancer survival.

Original languageEnglish (US)
Pages (from-to)793-811
Number of pages19
JournalCancer Epidemiology Biomarkers and Prevention
Volume23
Issue number5
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Social Class
Breast Neoplasms
Survival
Asian Americans
Education
African Americans
Hispanic Americans
San Francisco
Censuses
Proportional Hazards Models
Ethnic Groups

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Impact of neighborhood and individual socioeconomic status on survival after breast cancer varies by race/ethnicity : The neighborhood and breast cancer study. / Shariff-Marco, Salma; Yang, Juan; John, Esther M.; Sangaramoorthy, Meera; Hertz, Andrew; Koo, Jocelyn; Nelson, David O.; Schupp, Clayton W.; Shema, Sarah J.; Cockburn, Myles; Satariano, William A.; Yen, Irene H.; Ponce, Ninez A.; Winkleby, Marilyn; Keegan, Theresa H; Gomez, Scarlett L.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 23, No. 5, 2014, p. 793-811.

Research output: Contribution to journalArticle

Shariff-Marco, S, Yang, J, John, EM, Sangaramoorthy, M, Hertz, A, Koo, J, Nelson, DO, Schupp, CW, Shema, SJ, Cockburn, M, Satariano, WA, Yen, IH, Ponce, NA, Winkleby, M, Keegan, TH & Gomez, SL 2014, 'Impact of neighborhood and individual socioeconomic status on survival after breast cancer varies by race/ethnicity: The neighborhood and breast cancer study', Cancer Epidemiology Biomarkers and Prevention, vol. 23, no. 5, pp. 793-811. https://doi.org/10.1158/1055-9965.EPI-13-0924
Shariff-Marco, Salma ; Yang, Juan ; John, Esther M. ; Sangaramoorthy, Meera ; Hertz, Andrew ; Koo, Jocelyn ; Nelson, David O. ; Schupp, Clayton W. ; Shema, Sarah J. ; Cockburn, Myles ; Satariano, William A. ; Yen, Irene H. ; Ponce, Ninez A. ; Winkleby, Marilyn ; Keegan, Theresa H ; Gomez, Scarlett L. / Impact of neighborhood and individual socioeconomic status on survival after breast cancer varies by race/ethnicity : The neighborhood and breast cancer study. In: Cancer Epidemiology Biomarkers and Prevention. 2014 ; Vol. 23, No. 5. pp. 793-811.
@article{3086e75e808c4fde94966c26f11c423b,
title = "Impact of neighborhood and individual socioeconomic status on survival after breast cancer varies by race/ethnicity: The neighborhood and breast cancer study",
abstract = "Background: Research is limited on the independent and joint effects of individual- and neighborhood-level socioeconomic status (SES) on breast cancer survival across different racial/ethnic groups. Methods: We studied individual-level SES, measured by self-reported education, and a composite neighborhood SES (nSES) measure in females (1,068 non-Hispanic whites, 1,670 Hispanics, 993 African-Americans, and 674 Asian-Americans), ages 18 to 79 years and diagnosed 1995 to 2008, in the San Francisco Bay Area. We evaluated all-cause and breast cancer-specific survival using stage-stratified Cox proportional hazards models with cluster adjustment for census block groups. Results: In models adjusting for education and nSES, lower nSES was associated with worse all-cause survival among African-Americans (Ptrend = 0.03), Hispanics (Ptrend = 0.01), and Asian-Americans (P trend = 0.01). Education was not associated with all-cause survival. For breast cancer-specific survival, lower nSES was associated with poorer survival only among Asian-Americans (Ptrend = 0.01). When nSES and education were jointly considered, women with low education and low nSES had 1.4 to 2.7 times worse all-cause survival than women with high education and high nSES across all races/ethnicities. Among African-Americans and Asian- Americans, women with high education and low nSES had 1.6 to 1.9 times worse survival, respectively. For breast cancer-specific survival, joint associations were found only among Asian-Americans with worse survival for those with low nSES regardless of education. Conclusions: Both neighborhood and individual SES are associated with survival after breast cancer diagnosis, but these relationships vary by race/ethnicity. Impact: A better understanding of the relative contributions and interactions of SES with other factors will inform targeted interventions toward reducing long-standing disparities in breast cancer survival.",
author = "Salma Shariff-Marco and Juan Yang and John, {Esther M.} and Meera Sangaramoorthy and Andrew Hertz and Jocelyn Koo and Nelson, {David O.} and Schupp, {Clayton W.} and Shema, {Sarah J.} and Myles Cockburn and Satariano, {William A.} and Yen, {Irene H.} and Ponce, {Ninez A.} and Marilyn Winkleby and Keegan, {Theresa H} and Gomez, {Scarlett L.}",
year = "2014",
doi = "10.1158/1055-9965.EPI-13-0924",
language = "English (US)",
volume = "23",
pages = "793--811",
journal = "Cancer Epidemiology Biomarkers and Prevention",
issn = "1055-9965",
publisher = "American Association for Cancer Research Inc.",
number = "5",

}

TY - JOUR

T1 - Impact of neighborhood and individual socioeconomic status on survival after breast cancer varies by race/ethnicity

T2 - The neighborhood and breast cancer study

AU - Shariff-Marco, Salma

AU - Yang, Juan

AU - John, Esther M.

AU - Sangaramoorthy, Meera

AU - Hertz, Andrew

AU - Koo, Jocelyn

AU - Nelson, David O.

AU - Schupp, Clayton W.

AU - Shema, Sarah J.

AU - Cockburn, Myles

AU - Satariano, William A.

AU - Yen, Irene H.

AU - Ponce, Ninez A.

AU - Winkleby, Marilyn

AU - Keegan, Theresa H

AU - Gomez, Scarlett L.

PY - 2014

Y1 - 2014

N2 - Background: Research is limited on the independent and joint effects of individual- and neighborhood-level socioeconomic status (SES) on breast cancer survival across different racial/ethnic groups. Methods: We studied individual-level SES, measured by self-reported education, and a composite neighborhood SES (nSES) measure in females (1,068 non-Hispanic whites, 1,670 Hispanics, 993 African-Americans, and 674 Asian-Americans), ages 18 to 79 years and diagnosed 1995 to 2008, in the San Francisco Bay Area. We evaluated all-cause and breast cancer-specific survival using stage-stratified Cox proportional hazards models with cluster adjustment for census block groups. Results: In models adjusting for education and nSES, lower nSES was associated with worse all-cause survival among African-Americans (Ptrend = 0.03), Hispanics (Ptrend = 0.01), and Asian-Americans (P trend = 0.01). Education was not associated with all-cause survival. For breast cancer-specific survival, lower nSES was associated with poorer survival only among Asian-Americans (Ptrend = 0.01). When nSES and education were jointly considered, women with low education and low nSES had 1.4 to 2.7 times worse all-cause survival than women with high education and high nSES across all races/ethnicities. Among African-Americans and Asian- Americans, women with high education and low nSES had 1.6 to 1.9 times worse survival, respectively. For breast cancer-specific survival, joint associations were found only among Asian-Americans with worse survival for those with low nSES regardless of education. Conclusions: Both neighborhood and individual SES are associated with survival after breast cancer diagnosis, but these relationships vary by race/ethnicity. Impact: A better understanding of the relative contributions and interactions of SES with other factors will inform targeted interventions toward reducing long-standing disparities in breast cancer survival.

AB - Background: Research is limited on the independent and joint effects of individual- and neighborhood-level socioeconomic status (SES) on breast cancer survival across different racial/ethnic groups. Methods: We studied individual-level SES, measured by self-reported education, and a composite neighborhood SES (nSES) measure in females (1,068 non-Hispanic whites, 1,670 Hispanics, 993 African-Americans, and 674 Asian-Americans), ages 18 to 79 years and diagnosed 1995 to 2008, in the San Francisco Bay Area. We evaluated all-cause and breast cancer-specific survival using stage-stratified Cox proportional hazards models with cluster adjustment for census block groups. Results: In models adjusting for education and nSES, lower nSES was associated with worse all-cause survival among African-Americans (Ptrend = 0.03), Hispanics (Ptrend = 0.01), and Asian-Americans (P trend = 0.01). Education was not associated with all-cause survival. For breast cancer-specific survival, lower nSES was associated with poorer survival only among Asian-Americans (Ptrend = 0.01). When nSES and education were jointly considered, women with low education and low nSES had 1.4 to 2.7 times worse all-cause survival than women with high education and high nSES across all races/ethnicities. Among African-Americans and Asian- Americans, women with high education and low nSES had 1.6 to 1.9 times worse survival, respectively. For breast cancer-specific survival, joint associations were found only among Asian-Americans with worse survival for those with low nSES regardless of education. Conclusions: Both neighborhood and individual SES are associated with survival after breast cancer diagnosis, but these relationships vary by race/ethnicity. Impact: A better understanding of the relative contributions and interactions of SES with other factors will inform targeted interventions toward reducing long-standing disparities in breast cancer survival.

UR - http://www.scopus.com/inward/record.url?scp=84899760198&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899760198&partnerID=8YFLogxK

U2 - 10.1158/1055-9965.EPI-13-0924

DO - 10.1158/1055-9965.EPI-13-0924

M3 - Article

C2 - 24618999

AN - SCOPUS:84899760198

VL - 23

SP - 793

EP - 811

JO - Cancer Epidemiology Biomarkers and Prevention

JF - Cancer Epidemiology Biomarkers and Prevention

SN - 1055-9965

IS - 5

ER -