Neighborhood socioeconomic deprivation, tumor subtypes, and causes of death after non-metastatic invasive breast cancer diagnosis: a multilevel competing-risk analysis
| Autor: | Mario Schootman, Ann C. Frisse, Ellen Foldes, Ying Liu, Maria Pérez, Donna B. Jeffe, Min Lian |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Oncology Gerontology Cancer Research medicine.medical_specialty Multivariate analysis Adolescent Breast Neoplasms Triple Negative Breast Neoplasms Comorbidity Article Young Adult Breast cancer Residence Characteristics Risk Factors Cause of Death Internal medicine medicine Humans Young adult Survival rate Aged Cause of death Missouri business.industry Hazard ratio Middle Aged medicine.disease Confidence interval Black or African American Survival Rate Socioeconomic Factors Multivariate Analysis Female business |
| Zdroj: | Breast Cancer Research and Treatment. 147:661-670 |
| ISSN: | 1573-7217 0167-6806 |
| Popis: | The purpose of this study is to examine the associations of neighborhood socioeconomic deprivation and triple-negative breast cancer (TNBC) subtype with causes of death [breast cancer (BC)-specific and non-BC-specific] among non-metastatic invasive BC patients. We identified 3,312 patients younger than 75 years (mean age 53.5 years; 621 [18.8 %] TNBC) with first primary BC treated at an academic medical center from 1999 to 2010. We constructed a census-tract-level socioeconomic deprivation index using the 2000 U.S. Census data and performed a multilevel competing-risk analysis to estimate the hazard ratios (HR) and 95 % confidence intervals (CI) of BC-specific and non-BC-specific mortality associated with neighborhood socioeconomic deprivation and TNBC subtype. The adjusted models controlled for patient sociodemographics, health behaviors, tumor characteristics, comorbidity, and cancer treatment. With a median 62-month follow-up, 349 (10.5 %) patients died; 233 died from BC. In the multivariate models, neighborhood socioeconomic deprivation was independently associated with non-BC-specific mortality (the most- vs. the least-deprived quartile: HR = 2.98, 95 % CI = 1.33-6.66); in contrast, its association with BC-specific mortality was explained by the aforementioned patient-level covariates, particularly sociodemographic factors (HR = 1.15, 95 % CI = 0.71-1.87). TNBC subtype was independently associated with non-BC-specific mortality (HR = 2.15; 95 % CI = 1.20-3.84), while the association between TNBC and BC-specific mortality approached significance (HR = 1.42; 95 % CI = 0.99-2.03, P = 0.057). Non-metastatic invasive BC patients who lived in more socioeconomically deprived neighborhoods were more likely to die as a result of causes other than BC compared with those living in the least socioeconomically deprived neighborhoods. TNBC was associated with non-BC-specific mortality but not BC-specific mortality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink