Associations between social drivers of health and breast cancer stage at diagnosis among U.S. Black women
Abstract U.S. Black women have disproportionately high breast cancer mortality, partly due to later-stage diagnoses. We examined how social drivers of health (SDOH) relate to stage at diagnosis by analyzing data from 4,995 breast cancer survivors in the Black Women’s Health Study, Carolina Breast Ca...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2025-08-01
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| Series: | npj Breast Cancer |
| Online Access: | https://doi.org/10.1038/s41523-025-00804-0 |
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| author | Mollie E. Barnard Bo Qin Marc A. Emerson Etienne X. Holder Matthew R. Dunn Shromona Sarkar Nuo N. Xu Yutong Li Christine B. Ambrosone Elisa V. Bandera Julie R. Palmer Melissa A. Troester Terry Hyslop the Breast Cancer Research Foundation’s Health Equity Initiative |
| author_facet | Mollie E. Barnard Bo Qin Marc A. Emerson Etienne X. Holder Matthew R. Dunn Shromona Sarkar Nuo N. Xu Yutong Li Christine B. Ambrosone Elisa V. Bandera Julie R. Palmer Melissa A. Troester Terry Hyslop the Breast Cancer Research Foundation’s Health Equity Initiative |
| author_sort | Mollie E. Barnard |
| collection | DOAJ |
| description | Abstract U.S. Black women have disproportionately high breast cancer mortality, partly due to later-stage diagnoses. We examined how social drivers of health (SDOH) relate to stage at diagnosis by analyzing data from 4,995 breast cancer survivors in the Black Women’s Health Study, Carolina Breast Cancer Study, and Women’s Circle of Health Studies. SDOH were self-reported and stage was ascertained from medical records. We used polytomous logistic regression to estimate odds ratios (ORs) for diagnosis at stages III/IV or II versus stage I (referent), adjusting for age, insurance status, and income. Meta-analyzed results indicated that underutilization of screening mammography (OR = 3.21, 95% CI 1.90–5.43) and income below the federal poverty line (OR = 1.91, 95% CI 1.17–3.10) were significantly associated with later stage diagnosis (III/IV). ORs for lack of insurance and lower education were above 1.0, but not consistently statistically significant. These findings substantiate the importance of the affordability and utilization of breast cancer screening. |
| format | Article |
| id | doaj-art-be33ebd3f59c4182b976da69af46968e |
| institution | Kabale University |
| issn | 2374-4677 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Breast Cancer |
| spelling | doaj-art-be33ebd3f59c4182b976da69af46968e2025-08-20T03:46:25ZengNature Portfolionpj Breast Cancer2374-46772025-08-011111910.1038/s41523-025-00804-0Associations between social drivers of health and breast cancer stage at diagnosis among U.S. Black womenMollie E. Barnard0Bo Qin1Marc A. Emerson2Etienne X. Holder3Matthew R. Dunn4Shromona Sarkar5Nuo N. Xu6Yutong Li7Christine B. Ambrosone8Elisa V. Bandera9Julie R. Palmer10Melissa A. Troester11Terry Hyslop12the Breast Cancer Research Foundation’s Health Equity InitiativeSlone Epidemiology Center, Boston University Chobanian & Avedisian School of MedicineRutgers Cancer InstituteUniversity of North Carolina Lineberger Comprehensive Cancer CenterSlone Epidemiology Center, Boston University Chobanian & Avedisian School of MedicineUniversity of North Carolina Lineberger Comprehensive Cancer CenterRutgers Cancer InstituteSlone Epidemiology Center, Boston University Chobanian & Avedisian School of MedicineDivision of Biostatistics/Bioinformatics, Thomas Jefferson UniversityRoswell Park Comprehensive Cancer CenterRutgers Cancer InstituteSlone Epidemiology Center, Boston University Chobanian & Avedisian School of MedicineUniversity of North Carolina Lineberger Comprehensive Cancer CenterDivision of Biostatistics/Bioinformatics, Thomas Jefferson UniversityAbstract U.S. Black women have disproportionately high breast cancer mortality, partly due to later-stage diagnoses. We examined how social drivers of health (SDOH) relate to stage at diagnosis by analyzing data from 4,995 breast cancer survivors in the Black Women’s Health Study, Carolina Breast Cancer Study, and Women’s Circle of Health Studies. SDOH were self-reported and stage was ascertained from medical records. We used polytomous logistic regression to estimate odds ratios (ORs) for diagnosis at stages III/IV or II versus stage I (referent), adjusting for age, insurance status, and income. Meta-analyzed results indicated that underutilization of screening mammography (OR = 3.21, 95% CI 1.90–5.43) and income below the federal poverty line (OR = 1.91, 95% CI 1.17–3.10) were significantly associated with later stage diagnosis (III/IV). ORs for lack of insurance and lower education were above 1.0, but not consistently statistically significant. These findings substantiate the importance of the affordability and utilization of breast cancer screening.https://doi.org/10.1038/s41523-025-00804-0 |
| spellingShingle | Mollie E. Barnard Bo Qin Marc A. Emerson Etienne X. Holder Matthew R. Dunn Shromona Sarkar Nuo N. Xu Yutong Li Christine B. Ambrosone Elisa V. Bandera Julie R. Palmer Melissa A. Troester Terry Hyslop the Breast Cancer Research Foundation’s Health Equity Initiative Associations between social drivers of health and breast cancer stage at diagnosis among U.S. Black women npj Breast Cancer |
| title | Associations between social drivers of health and breast cancer stage at diagnosis among U.S. Black women |
| title_full | Associations between social drivers of health and breast cancer stage at diagnosis among U.S. Black women |
| title_fullStr | Associations between social drivers of health and breast cancer stage at diagnosis among U.S. Black women |
| title_full_unstemmed | Associations between social drivers of health and breast cancer stage at diagnosis among U.S. Black women |
| title_short | Associations between social drivers of health and breast cancer stage at diagnosis among U.S. Black women |
| title_sort | associations between social drivers of health and breast cancer stage at diagnosis among u s black women |
| url | https://doi.org/10.1038/s41523-025-00804-0 |
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