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    Research Grants Awarded

    Psychosocial and socioeconomic risk factors for breast cancer incidence and stage at diagnosis among U.S. black women

    Study Section:
    Breast Cancer Disparities

    Scientific Abstract:
    Breast cancer is the most commonly occurring cancer among U.S. black women, and breast cancer mortality is higher among black women than white women. Black women in the U.S. live in less advantaged circumstances than white women and they are subject to greater stress from crime and poorer facilities and services. They are also subject to greater interpersonal violence. Exposure to these stressors could weaken the immune system or lead to poorer health habits, resulting in an increased risk of developing breast cancer. These factors could also discourage use of the health care system, resulting in later stages at breast cancer diagnosis and higher breast cancer mortality. We will use data from our ongoing follow-up study of 59,000 U.S. black women, the Black Women?s Health Study (BWHS), to assess the impact of the neighborhoods in which the women live and the violence that they have experienced on the risk of developing a first occurrence of breast cancer and on the stage at diagnosis. Participants enrolled in the BWHS in 1995 and they have provided health data biennially. From 1995 through 2005, over 1,000 incident cases of breast cancer have been identified. Information is available on the stage at breast cancer diagnosis, experiences of interpersonal violence across the lifecourse, personal socioeconomic status (e.g., household income), and established breast cancer risk factors (e.g., age at menarche, age at menopause). Information on neighborhood socioeconomic factors from the 2000 Census has been linked to BWHS participants? addresses in 1995, 1997, 1999, 2001, and 2003. We will prospectively analyze characteristics of the women?s neighborhoods (e.g., % living below the poverty level, crime rate) and experiences of interpersonal violence in childhood and adulthood in relation to incidence of breast cancer and breast cancer stage. Incidence rate ratios with 95% confidence intervals will be estimated with control for confounding variables. In an effort to understand pathways leading to breast cancer, we will also assess the relation of neighborhood factors and violence to each other and to breast cancer risk factors. There has been virtually no research on effects of neighborhood socioeconomic factors and violence victimization on the occurrence of breast cancer in black women. The analyses will identify women who are at increased risk of developing breast cancer or of being diagnosed at a later stage. The results should help to clarify the pathways leading to the development of breast cancer.

    Lay Abstract:
    Breast cancer is the most commonly occurring cancer among U.S. black women, and black women are more likely to die from this cancer than white women. Black women in the U.S. generally live in less advantaged circumstances than white women and are more subject to stress from crime and poorer facilities and services. They are also more subject to interpersonal violence. Exposure to these stressors could weaken the immune system or lead to poorer health habits, resulting in an increased risk of developing breast cancer. Stress could discourage use of the health care system, with the result of breast cancer being diagnosed at later stages. Women whose cancer is diagnosed at a later stage are more likely to die than those whose cancer is detected and treated earlier. We will use data from our ongoing follow-up study of 59,000 U.S. black women, the Black Women?s Health Study (BWHS), to assess the impact of the neighborhoods in which the women live and the violence that they have experienced on their risk of developing breast cancer and the stage at diagnosis. The BWHS began in 1995 and participants have been contacted for information every two years. Data are available on many factors including occurrences of breast cancer, the stage at diagnosis, and experiences of interpersonal violence across the lifecourse. We have linked U.S. Census Bureau information on characteristics of the women?s neighborhoods to their addresses. There has been virtually no research on effects of neighborhood socioeconomic factors and experiences of violence on the occurrence of breast cancer in black women. Our goal is to identify women who are at increased risk of developing breast cancer or of being diagnosed at a later stage and to clarify pathways leading to the development of breast cancer.