Effects of housing stability and contemporary mortgage lending bias on breast cancer stage at diagnosis among older women in the United States.

Autor: Rademacher N; Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Zhou Y; Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., McGinley EL; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Laud PW; Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.; MCW Cancer Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Yen TWF; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.; MCW Cancer Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Ponce SB; Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Nattinger AB; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.; MCW Cancer Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.; Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Beyer KMM; Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.; MCW Cancer Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2024 Jul; Vol. 13 (14), pp. e7397.
DOI: 10.1002/cam4.7397
Abstrakt: Background: Interventions aimed at upstream factors contributing to late-stage diagnoses could reduce disparities and improve breast cancer outcomes. This study examines the association between measures of housing stability and contemporary mortgage lending bias on breast cancer stage at diagnosis among older women in the United States.
Methods: We studied 67,588 women aged 66-90 from the SEER-Medicare linked database (2010-2015). The primary outcome was breast cancer stage at diagnosis. Multinomial regression models adjusted for individual and neighborhood socio-economic factors were performed using a three-category outcome (stage 0, early stage, and late stage). Key census tract-level independent variables were residence in the same house as the previous year, owner-occupied homes, and an index of contemporary mortgage lending bias.
Results: In models adjusted for individual factors, higher levels of mortgage lending bias were associated with later stage diagnosis (RR = 1.10, 95% CI 1.02-1.20; RR = 1.31, 95% CI 1.16-1.49; RR = 1.41, 95% CI 1.24-1.60 for least to high, respectively). In models adjusted for individual and neighborhood socio-economic factors, moderate and high levels of mortgage lending bias were associated with later stage diagnosis (RR = 1.16, 95% CI 1.02-1.33 for moderate and RR = 1.18, 95% CI 1.02-1.37 for high). Owner occupancy and tenure were not associated with later stage diagnosis in adjusted models.
Conclusions: Contemporary mortgage lending bias demonstrated a significant gradient relationship with later stage at diagnosis of breast cancer. Policy interventions aimed at reducing place-based mortgage disinvestment and its impacts on local resources and opportunities should be considered as part of an overall strategy to decrease late-stage breast cancer diagnosis and improve prognosis.
(© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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