Association between Neighborhood Social Deprivation and Stage at Diagnosis among Breast Cancer Patients in South Carolina

Oluwole Adeyemi Babatunde, Whitney E. Zahnd, Jan M. Eberth, Andrew B. Lawson, Swann Arp Adams, Eric Adjei Boakye, Melanie S. Jefferson, Caitlin G. Allen, John L. Pearce, Hong Li and Chanita Hughes Halbert
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Oluwole Adeyemi Babatunde: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Whitney E. Zahnd: Rural & Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC 29210, USA
Jan M. Eberth: Rural & Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC 29210, USA
Andrew B. Lawson: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Swann Arp Adams: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
Eric Adjei Boakye: Department of Population Science and Policy, School of Medicine, Southern Illinois University, Springfield, IL 62794, USA
Melanie S. Jefferson: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Caitlin G. Allen: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
John L. Pearce: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Hong Li: Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
Chanita Hughes Halbert: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA

IJERPH, 2021, vol. 18, issue 22, 1-10

Abstract: The purpose of this study was to examine the association between neighborhood social deprivation and individual-level characteristics on breast cancer staging in African American and white breast cancer patients. We established a retrospective cohort of patients with breast cancer diagnosed from 1996 to 2015 using the South Carolina Central Cancer Registry. We abstracted sociodemographic and clinical variables from the registry and linked these data to a county-level composite that captured neighborhood social conditions—the social deprivation index (SDI). Data were analyzed using chi-square tests, Student’s t -test, and multivariable ordinal regression analysis to evaluate associations. The study sample included 52,803 female patients with breast cancer. Results from the multivariable ordinal regression model demonstrate that higher SDI (OR = 1.06, 95% CI: 1.02–1.10), African American race (OR = 1.35, 95% CI: 1.29–1.41), and being unmarried (OR = 1.17, 95% CI: 1.13–1.22) were associated with a distant stage at diagnosis. Higher tumor grade, younger age, and more recent year of diagnosis were also associated with distant-stage diagnosis. As a proxy for neighborhood context, the SDI can be used by cancer registries and related population-based studies to identify geographic areas that could be prioritized for cancer prevention and control efforts.

Keywords: african american; breast cancer; social deprivation index (SDI); cancer stage; race; health disparities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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