Abstract PO-170: Associations of residential disadvantage and Hispanicity with important breast cancer risk factors among Hispanic women in Chicago

Abstract

Background: Hispanics are the second largest and fastest growing ethnic minority population in the United States (US). Hispanic women experience worse breast cancer (BC) outcomes when compared to non-Hispanic Whites. In the United States, obesity and breast density are established risk factors for BC in general and for Hispanic women specifically. We sought to evaluate associations of residential disadvantage and Hispanicity with two established BC risk factors (obesity and breast density) among Hispanic women in Metro Chicago. Methods: We included 13,816 Hispanic women from the Metro Chicago Breast Cancer Registry. Obesity was defined as body mass index, categorized as: normal weight (18.5–24.9kg/m2), overweight (25–29.9 kg/m2), obese (>=30–24.9kg/m2), and morbidly obese (>= 35kg/m2). Breast density was reported by the interpreting radiologist at mammography using the BIRADS categories which were dichotomized for this analysis as dense (heterogeneously or extremely dense) vs. not dense (fatty or scattered fibroglandular). Characteristics of residential census tracts at diagnosis were obtained from the 2010 U.S. Census. Hispanicity was defined using: percent Hispanic, percent foreign-born and percent Hispanics that speak English not well and not at all. Each variable was standardized and summed to create a score (inter-item reliability=0.76), which was dichotomized at the median for some analyses. Two established tract level measures of neighborhood socioeconomic status were defined. Neighborhood disadvantage was an equally weighted sum of the proportions of families with incomes below the poverty line, families receiving public assistance, persons unemployed, and female-headed households with children. Neighborhood affluence was an equally weighted sum of the proportions of families with income of $75,000 or more, adults with college education or more, and civilian labor force employed in professional and managerial occupations score. Results: Overall, 36%, 26% and 18% of women were overweight, obese and morbidly obese, respectively, and roughly 50% had dense breasts. Women living in high hispanicity neighborhoods tended to live in more disadvantaged neighborhoods, to lack private health insurance, and to be obese (p> 0.0001 for all). Hispanicity was not associated with breast density. After adjusting by age, parity, age, health insurance, age at first birth, parity, menopause, age at menarche, we observed that greater hispanicity was associated with increased prevalence of overweight and obesity, but the association of Hispanicity with obesity was largely explained by the addition of tract disadvantage into the model. Conclusions: Our results are consistent with previous cross-sectional studies and further suggest that neighborhood disadvantage accounts for most of the association of hispanicity with being overweight. Future studies could link residential histories to evaluate the role of cumulative, longer-term residence in high Hispanicity areas on these risk factors. Citation Format: Carola T. Sanchez Diaz, Garth H. Rauscher. Associations of residential disadvantage and Hispanicity with important breast cancer risk factors among Hispanic women in Chicago [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-170.