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Neighborhood factors like housing costs and crowded living conditions are linked to shorter breast cancer survival. This study developed a new framework to identify these neighborhood exposome-wide associations.

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Area of Science:

  • Environmental epidemiology
  • Cancer research
  • Geospatial analysis

Background:

  • Growing evidence highlights neighborhood context's impact on cancer outcomes.
  • The neighborhood exposome includes socioeconomic, demographic, and built environmental factors.
  • Understanding these factors is crucial for cancer survivorship.

Purpose of the Study:

  • To identify key neighborhood-level factors influencing breast cancer survival.
  • To determine the geographic scale at which these factors operate.
  • To develop a novel geographically sensitive neighborhood exposome-wide association study (gs-NWAS) framework.

Main Methods:

  • A cohort study of 2727 women diagnosed with breast cancer.
  • Development and application of a gs-NWAS framework assessing neighborhood factors at census tract, 1-km, and 5-km scales.
  • Analysis using Cox proportional hazards regression and elastic net regression, adjusting for individual-level confounders.

Main Results:

  • Four neighborhood exposome factors were associated with shorter breast cancer survival.
  • These factors included high housing costs for low-income households, recent residential moves, crowded living conditions, and public preschool density.
  • Specific geographic scales (tract, 1-km, or 5-km buffer) were identified for each significant factor.

Conclusions:

  • The gs-NWAS framework successfully identified neighborhood-level factors impacting breast cancer survival.
  • Housing, economic, and demographic factors within the neighborhood exposome are significant.
  • Further validation in diverse populations and adaptation of the framework are recommended.