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Allostatic Load and Racial and Rural Disparities in Breast Cancer Survival.

Yufan Guan1, Roger T Anderson1, Supraja Gururaj2

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Summary
This summary is machine-generated.

High allostatic load (AL) is linked to worse breast cancer survival. While AL showed a trend towards explaining racial and rural survival disparities, this association did not reach statistical significance in the study.

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Area of Science:

  • Oncology
  • Health Disparities
  • Biomedical Science

Background:

  • Racial and geographic disparities in breast cancer survival persist.
  • Chronic stress, measured by allostatic load (AL), may contribute to these disparities.
  • The role of AL in breast cancer prognosis is not well understood.

Purpose of the Study:

  • To evaluate the association between allostatic load (AL) and overall survival in breast cancer patients.
  • To assess the contribution of AL to racial and rural disparities in breast cancer survival.

Main Methods:

  • A cohort study of 3069 women with stage I-III breast cancer (2014-2024) at the University of Virginia.
  • Allostatic load (AL) derived from 14 biomarkers and medication history, categorized as low (≤3) or high (>3).
  • Cox proportional hazards models and Blinder-Oaxaca decomposition used to analyze overall survival and disparities.

Main Results:

  • High AL score was independently associated with an increased risk of mortality (HRs 1.26-1.53).
  • A higher mean AL score was observed in older, Black, rural, uninsured, unemployed, and retired patients.
  • Stratified analyses showed a larger HR for mortality associated with AL in rural Black patients (HR 3.33).

Conclusions:

  • High allostatic load (AL) is independently associated with worse overall survival in breast cancer patients.
  • The study found that AL did not significantly explain the observed racial and rural disparities in survival.
  • Further research is needed to fully understand the complex interplay between stress, AL, and breast cancer outcomes.