Breast cancer is one of the most frequently diagnosed cancers among women in the United States, and it is the second leading cause of cancer-related deaths among Black and White women, affecting approximately 13% of women during their lifetime. However, Black women and women of low socioeconomic position are disproportionately more likely than White women and women of high socioeconomic position to be diagnosed with breast cancer before 40 years of age. Black women are also more likely to develop aggressive cancer and have poorer prognoses, with higher risk for mortality at all ages due to structural factors (such as racial residential segregation and marginalization). While there is evidence that neighborhood deprivation and socioeconomic position in adulthood is associated with breast cancer risk, the role of early life neighborhood deprivation and socioeconomic position in breast cancer etiology is unclear. Early life also represents a potentially sensitive period for later breast cancer risk due to puberty-related breast tissue development and physical and socioeconomic exposures and stressors.
Dr. Woo’s study will assess the extent to which early life and life course neighborhood deprivation and socioeconomic position explain observed racial and ethnic disparities in breast cancer risk using data from the NIEHS Sister Study. Cox proportional hazards models will be used to estimate the associations between incident breast cancer risk and:
- Early life socioeconomic position and neighborhood deprivation.
- Socioeconomic position trajectory.
Structural equation modeling will be used to evaluate adult socioeconomic position as a potential mediator of the early life socioeconomic position and breast cancer pathway.
This study will demonstrate the feasibility of using neighborhood deprivation indices in the assessment of early life socioeconomic position with applications for health disparities research on other chronic diseases over the life course.