dc.contributor.author | Ho, KL | |
dc.contributor.author | Shiels, MS | |
dc.contributor.author | Ramin, C | |
dc.contributor.author | Veiga, LHS | |
dc.contributor.author | Chen, Y | |
dc.contributor.author | Berrington de Gonzalez, A | |
dc.contributor.author | Vo, JB | |
dc.coverage.spatial | England | |
dc.date.accessioned | 2023-02-08T10:46:28Z | |
dc.date.available | 2023-02-08T10:46:28Z | |
dc.date.issued | 2023-01-03 | |
dc.identifier | 6851146 | |
dc.identifier.citation | JNCI Cancer Spectrum, 2022, pp. pkac083 - | |
dc.identifier.issn | 2515-5091 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/5685 | |
dc.identifier.eissn | 2515-5091 | |
dc.identifier.eissn | 2515-5091 | |
dc.identifier.doi | 10.1093/jncics/pkac083 | |
dc.description.abstract | BACKGROUND: Disparities in cardiovascular disease mortality among breast cancer survivors are documented, but geographic factors by county-level socioeconomic status (SES) and rurality are not well described. METHODS: We analyzed 724 518 women diagnosed with localized or regional stage breast cancer between 2000 and 2017 within Surveillance, Epidemiology, and End Results Program-18 with follow-up until 2018. We calculated relative risks (RRs) of cardiovascular disease mortality using Poisson regression, accounting for age- and race-specific rates in the general population, according to county-level quintiles of SES (measured by Yost index), median income, and rurality at breast cancer diagnosis. We also calculated 10-year cumulative mortality risk of cardiovascular disease accounting for competing risks. RESULTS: Cardiovascular disease mortality was 41% higher among breast cancer survivors living in the lowest SES (RR = 1.41, 95% confidence interval [CI] = 1.36 to 1.46, Ptrend < .001) and poorest (RR = 1.41, 95% CI = 1.36 to 1.47, Ptrend < .001) counties compared with the highest SES and wealthiest counties, and 24% higher for most rural relative to most urban counties (RR = 1.24, 95% CI = 1.17 to 1.30, Ptrend < .001). Disparities for the lowest SES relative to highest SES counties were greatest among younger women aged 18-49 years (RR = 2.32, 95% CI = 1.90 to 2.83) and aged 50-59 years (RR = 2.01, 95% CI = 1.77 to 2.28) and within the first 5 years of breast cancer diagnosis (RR = 1.53, 95% CI = 1.44 to 1.64). In absolute terms, however, disparities were widest for women aged 60+ years, with approximately 2% higher 10-year cumulative cardiovascular disease mortality risk in the poorest compared with wealthiest counties. CONCLUSIONS: Geographic factors at breast cancer diagnosis were associated with increased cardiovascular disease mortality risk. Studies with individual- and county-level information are needed to inform public health interventions and reduce disparities among breast cancer survivors. | |
dc.format | Print-Electronic | |
dc.format.extent | pkac083 - | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | OXFORD UNIV PRESS | |
dc.relation.ispartof | JNCI Cancer Spectrum | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.title | County-level geographic disparities in cardiovascular disease mortality among US breast cancer survivors, 2000-2018. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2022-11-14 | |
dc.date.updated | 2023-02-08T10:45:58Z | |
rioxxterms.version | VoR | |
rioxxterms.versionofrecord | 10.1093/jncics/pkac083 | |
rioxxterms.licenseref.startdate | 2022-11-29 | |
rioxxterms.type | Journal Article/Review | |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/36445023 | |
pubs.organisational-group | /ICR | |
pubs.publication-status | Published online | |
pubs.publisher-url | http://dx.doi.org/10.1093/jncics/pkac083 | |
icr.researchteam | Clinical Cancer Epidemiol | |
dc.contributor.icrauthor | Berrington de Gonzalez, Amy | |
icr.provenance | Deposited by Mr Arek Surman on 2023-02-08. Deposit type is initial. No. of files: 1. Files: pkac083.pdf | |