Prediagnostic Allostatic Load as a Predictor of Poorly Differentiated and Larger Sized Breast Cancers among Black Women in the Women's Circle of Health Follow-Up Study

Xing, Cathleen Y.; Doose, Michelle; Qin, Bo; Lin, Yong; Plascak, Jesse J.; Omene, Coral; He, Chunyan; Demissie, Kitaw; Hong, Chi-Chen; Bandera, Elisa V.; Llanos, Adana A.M.

doi:10.1158/1055-9965.epi-19-0712

Cited by 42 publications

(39 citation statements)

References 48 publications

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“…Table 2 describes the details of the study populations. Eight studies used data from large population databases (Acheampong et al, 2020;Beydoun et al, 2019;Hwang et al, 2014;Levine & Crimmins, 2014;Mattei et al, 2010;Parente et al, 2013;Robertson et al, 2017;Xing et al, 2020 A total of 47,520 participants were enrolled in these 12 studies. Among the studies using population databases, sample sizes ranged from 409 (Xing et al, 2020) to 13,628 (Acheampong et al, 2020), with an average of about 5,889 participants.…”

Section: Study and Participant Characteristicsmentioning

confidence: 99%

“…Eight studies used data from large population databases (Acheampong et al, 2020;Beydoun et al, 2019;Hwang et al, 2014;Levine & Crimmins, 2014;Mattei et al, 2010;Parente et al, 2013;Robertson et al, 2017;Xing et al, 2020 A total of 47,520 participants were enrolled in these 12 studies. Among the studies using population databases, sample sizes ranged from 409 (Xing et al, 2020) to 13,628 (Acheampong et al, 2020), with an average of about 5,889 participants. Across the studies, female participants were predominant, with 4 studies having only female participants (Parente et al, 2013;Ruini et al, 2015;Xing et al, 2020;Ye et al, 2017) and the others with percentage female ranging from 25% (Santacroce & Crandell, 2014) to 72% (Mattei et al, 2010).…”

Section: Study and Participant Characteristicsmentioning

confidence: 99%

“…Among the studies using population databases, sample sizes ranged from 409 (Xing et al, 2020) to 13,628 (Acheampong et al, 2020), with an average of about 5,889 participants. Across the studies, female participants were predominant, with 4 studies having only female participants (Parente et al, 2013;Ruini et al, 2015;Xing et al, 2020;Ye et al, 2017) and the others with percentage female ranging from 25% (Santacroce & Crandell, 2014) to 72% (Mattei et al, 2010). Only one study included exclusively men, as it examined the association of AL and resiliency in men undergoing prostate biopsy (Hughes Halbert et al, 2020).…”

Section: Study and Participant Characteristicsmentioning

confidence: 99%

“…Two studies reported estimation of more than one AL measure using different clusters of domains. One study computed AL measure 1 involving cardiovascular-metabolic systems and AL measure 2 involving cardiovascularmetabolic-immune systems (Xing et al, 2020). The other study computed normal AL using the cluster of cardiovascularmetabolic-immune systems; expanded AL using the cluster of cardiovascular-metabolic-immune-renal-hepatic-respiratory systems; and continuous AL using continuous z-scores for the same system cluster as expanded AL (Levine & Crimmins, 2014).…”

Section: Operationalization Of Al In Cancermentioning

confidence: 99%

“…Use of medications to control hypertension, diabetes, or hypercholesterolemia were considered only in 4 studies; of which three considered medication use directly in AL scoring (Mattei et al, 2010;Robertson et al, 2017;Xing et al, 2020), while the fourth included medication use as a covariate associated with biomarker level (Acheampong et al, 2020). For instance, in one study, if the participant was on antihypertensive medications, the SBP and DBP were increased by 10 mmHg and 5 mmHg respectively and for betablockers, the HDL was increased by 10% (Robertson et al, 2017).…”

Section: Operationalization Of Al In Cancermentioning

confidence: 99%

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Allostatic Load in Cancer: A Systematic Review and Mini Meta-Analysis

Mathew

Doorenbos

et al. 2020

Biological Research For Nursing

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Background: Individuals with cancer experience stress throughout the cancer trajectory. Allostatic load (AL), a cumulative multi-system measure, may have a greater value in stress assessment and the associated biological burden than individual biomarkers. A better understanding of the use of AL and its operationalization in cancer could aid in early detection and prevention or alleviation of AL in this population. Purpose: To consolidate findings on the operationalization, antecedents, and outcomes of AL in cancer. Methods: Seven databases (CINAHL, Ovid MEDLINE, Web of Science, APA PsycInfo, Scopus, Embase, and Cochrane CENTRAL) were searched for articles published through April 2020. The NIH tools were used to assess study quality. Results: Twelve studies met inclusion criteria for this review. Although variability existed in the estimation of AL, biomarkers of cardiovascular, metabolic, and immune systems were mostly used. Associations of AL with cancer-specific variables were examined mostly utilizing population-databases. Significant associations of AL with variables such as cancer-related stress, positive cancer history, post traumatic growth, resilience, tumor pathology, and cancer-specific mortality were found. Mini meta-analysis found that a one-unit increase in AL was associated with a 9% increased risk of cancer-specific mortality. Conclusion: This review reveals heterogeneity in operationalization of AL in cancer research and lack of clarity regarding causal direction between AL and cancer. Nevertheless, AL holds a significant promise in cancer research and practice. AL could be included as a screening tool for high-risk individuals or a health outcome in cancer. Optimal standardized approaches to measure AL would improve its clinical utility.

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Section: Study and Participant Characteristicsmentioning

confidence: 99%

Section: Study and Participant Characteristicsmentioning

confidence: 99%

Section: Study and Participant Characteristicsmentioning

confidence: 99%

Section: Operationalization Of Al In Cancermentioning

confidence: 99%

Section: Operationalization Of Al In Cancermentioning

confidence: 99%

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Allostatic Load in Cancer: A Systematic Review and Mini Meta-Analysis

Mathew

Doorenbos

et al. 2020

Biological Research For Nursing

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Association of Allostatic Load With Overall Mortality Among Patients With Metastatic Non–Small Cell Lung Cancer

Obeng‐Gyasi

Carson

et al. 2022

JAMA Netw Open

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Key Points Question Is there an association among allostatic load (AL), social determinants of health (SDHs), and overall mortality in patients with metastatic non–small cell lung cancer (NSCLC)? Findings In this cross-sectional study of 143 patients with metastatic NSCLC, elevated AL was associated with adverse SDHs and worse overall mortality. Meaning These findings suggest that AL should be considered as a biological correlate of SDHs and a prognostic marker for overall mortality among patients with metastatic NSCLC.

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Assessment of Racial Disparity in Survival Outcomes for Early Hormone Receptor–Positive Breast Cancer After Adjusting for Insurance Status and Neighborhood Deprivation

et al. 2022

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IMPORTANCE Racial disparities in survival outcomes among Black women with hormone receptor-positive breast cancer have been reported. However, the association between individual-level and neighborhood-level social determinants of health on such disparities has not been well studied.OBJECTIVE To evaluate the association between race and clinical outcomes (ie, relapse-free interval and overall survival) adjusting for individual insurance coverage and neighborhood deprivation index (NDI), measured using zip code of residence, in women with breast cancer.DESIGN, SETTING, AND PARTICIPANTS This was a post hoc analysis of 9719 women with breast cancer in the Trial Assigning Individualized Options for Treatment, a randomized clinical trial conducted from April 7, 2006, to October 6, 2010. All participants received a diagnosis of hormone receptor-positive, ERBB2-negative, axillary node-negative breast cancer. The present data analysis was conducted from April 1 to October 22, 2021. MAIN OUTCOMES AND MEASURESA multivariate model was developed to evaluate the association between race and relapse-free interval and overall survival adjusting for insurance and NDI level at study entry, early discontinuation of endocrine therapy 4 years after initiation, and clinicopathologic characteristics of cancer. Median follow-up for clinical outcomes was 96 months.RESULTS A total of 9719 women (4.2% [n = 405] Asian; 7.1% [n = 693] Black; 84.3% [n = 8189] White; 4.4% [n = 403] others/not specified) were included; 9.1% of included women [n = 889] were Hispanic or Latino. Median (SD) age was 56 (9.2) years. In multivariate models, Black race compared with White race was associated with statistically significant shorter relapse-free interval (hazard ratio [HR], 1.39; 95% CI, 1.05-1.84; P = .02) and overall survival (HR, 1.49; 95% CI, 1.10-2.99; P = .009), adjusting for insurance and NDI level at study entry and other factors. Although uninsured status was not associated with clinical outcomes, patients with Medicare (HR, 1.30; 95% CI, 1.01-1.68; P = .04) and Medicaid (HR, 1.44; 95% CI, 1.01-2.05; P = .05) had shorter overall survival compared with those with private insurance. Participants living in neighborhoods in the highest NDI quartile experienced shorter overall survival compared with those in the lowest quartile (HR, 1.34; 95% CI, 1.01-1.77; P = .04), regardless of self-identified race. CONCLUSIONS AND RELEVANCEThe findings of this post hoc analysis of a randomized clinical trial suggest that Black women with breast cancer have significantly shorter relapse-free interval and overall survival compared with White women. Early discontinuation of endocrine therapy, clinicopathologic characteristics, insurance coverage, and NDI do not fully explain the observed disparity.

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Prediagnostic Allostatic Load as a Predictor of Poorly Differentiated and Larger Sized Breast Cancers among Black Women in the Women's Circle of Health Follow-Up Study

Cited by 42 publications

References 48 publications

Allostatic Load in Cancer: A Systematic Review and Mini Meta-Analysis

Allostatic Load in Cancer: A Systematic Review and Mini Meta-Analysis

Association of Allostatic Load With Overall Mortality Among Patients With Metastatic Non–Small Cell Lung Cancer

Assessment of Racial Disparity in Survival Outcomes for Early Hormone Receptor–Positive Breast Cancer After Adjusting for Insurance Status and Neighborhood Deprivation

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