Socioeconomic Disadvantage Linked to Breast Cancer Tumor Disparity
October 29, 2012
- ER- and PR-negative tumors were more common among black and Hispanic patients.
- Non-Hispanic black and Hispanic patients lived in more disadvantaged areas.
- Socioeconomic disadvantage accounted for half of the racial/ethnic disparity.
SAN DIEGO — Racial and ethnic disparities in breast tumor aggressiveness might be explained by social factors that influence the developing tumor and place those in disadvantaged groups at higher risk for aggressive breast cancer, according to data presented at the Fifth AACR Conference on The Science of Cancer Health Disparities, held here Oct. 27-30, 2012.
“There is a disparity in the biological aggressiveness of breast cancer,” said Garth H. Rauscher, Ph.D., associate professor of epidemiology at the University of Illinois at Chicago. “We tend to think about biological differences being due to differences in genes, but tumor biology can be affected by social or behavioral factors that are associated with socioeconomic status. Our study highlights the importance of the social environment in influencing tumor biology and ultimately influencing disparities.”
Rauscher and colleagues examined data from a population-based sample of 989 patients with a recent diagnosis of breast cancer (397 non-Hispanic whites, 411 non-Hispanic blacks and 181 Hispanics) from the Breast Cancer Care in Chicago Study. Patients were aged 30 to 79 years and had primary in situ or invasive breast cancer. A total of 742 patients consented to medical record abstraction and had medical record data available for estrogen receptor (ER) and progesterone receptor (PR) status.
Researchers established socioeconomic disadvantage using four measurements: individual income, individual education and two census tract measures of socioeconomic status — concentrated disadvantage and concentrated affluence.
Compared with 12 percent of non-Hispanic white patients, 29 percent of non-Hispanic black patients and 20 percent of Hispanic patients had ER- and PR-negative tumors. Non-Hispanic black and Hispanic patients were also more likely to have lower income and less education and to reside in more disadvantaged and less affluent neighborhoods. In addition, all four measures of socioeconomic disadvantage used in the study were strongly associated with ER/PR-negative status.
“It was interesting to see that the main finding remained unchanged regardless of the measure of socioeconomic status we used,” Rauscher said. “Patient levels of income and education, as well as neighborhood-level measures of socioeconomic status, were each associated with tumor biology. In each instance, lower socioeconomic status was associated with more aggressive breast cancers that lacked these hormone receptors.”
The study was funded by the National Institutes of Health Centers for Population Health and Health Disparities.
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Founded in 1907, the American Association for Cancer Research (AACR) is the world’s first and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR membership includes more than 34,000 laboratory, translational and clinical researchers; population scientists; other health care professionals; and cancer advocates residing in more than 90 countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention, biology, diagnosis and treatment of cancer by annually convening more than 20 conferences and educational workshops, the largest of which is the AACR Annual Meeting with more than 17,000 attendees. In addition, the AACR publishes seven peer-reviewed scientific journals and a magazine for cancer survivors, patients and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the scientific partner of Stand Up To Cancer, the AACR provides expert peer review, grants administration and scientific oversight of team science and individual grants in cancer research that have the potential for near-term patient benefit. The AACR actively communicates with legislators and policymakers about the value of cancer research and related biomedical science in saving lives from cancer.
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(215) 446-7109Jeremy.Moore@aacr.org In San Diego, Oct. 27-30: