Neighborhood Change and Distant Metastasis at Diagnosis of Breast Cancer

• Published in: Annals of epidemiology Vol. 18; no. 1; pp. 43 - 47
• Main Authors: Barrett, Richard E., PhD, Cho, Young Ik, PhD, Weaver, Kathryn E., PhD, Ryu, Kirak, MA, Campbell, Richard T., PhD, Dolecek, Therese A., PhD, Warnecke, Richard B., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2008
• Subjects: Adult; African Americans; Age Factors; Breast Cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - epidemiology; Distant Metastasis; Ethnic Groups; Female; Health Disparities; Hispanics; Humans; Illinois; Internal Medicine; Multilevel; Neighborhoods; Neoplasm Metastasis - diagnosis; Socioeconomic Factors; Socioeconomic Status; Stage at Diagnosis; Whites; Illinois; SES; Health Disparities; SF3; Neighborhoods; Surveillance, Epidemiology and End Results; Summary File 3 (2000 Census); Summary Tape File (1990 Census); FQHC; African Americans; Socioeconomic Status; STF3; Whites; Breast Cancer; Illinois State Cancer Registry; federally qualified health center; Distant Metastasis; Multilevel; medically underserved area; MUA; SEER; Stage at Diagnosis; ISCR; Hispanics
• ISSN: 1047-2797; 1873-2585
• DOI: 10.1016/j.annepidem.2007.07.001

Purpose To test whether upward socioeconomic neighborhood change has an effect on probability of distant metastasis at diagnosis of breast cancer among women who live there. Methods Census tract data (N = 1,137) from Cook County. IL, from 1990 and 2000 and cancer registry data for female breast cancer cases for these census tracts from 1994–2000 (N = 21,516) were used. A multilevel model of 1990 baseline socioeconomic status (SES) of neighborhoods and degree of neighborhood change 1990–2000 (compositional characteristics) and patient's age and race/Hispanic status (individual characteristics) was constructed to predict distant metastasis (vs. local and regional stage) at diagnosis. Results While residence in a census tract with lower baseline SES in 1990 (higher concentrated disadvantage and immigration and lower concentrated affluence) and being African American were associated with increased odds of distant metastasis at diagnosis, residence in an improving census tract was also associated with increased odds of distant metastasis at diagnosis. Conclusions Paradoxically, both measures of initial neighborhood disadvantage and upward neighborhood socioeconomic change were independently associated with greater odds of distant metastasis at diagnosis of breast cancer. Neighborhood social and economic change can affect health.