Increasing Area Deprivation Index negatively impacts ovarian cancer survival

Demetra H. Hufnagel; Dineo Khabele; Fiona E. Yull; Pamela C. Hull; Joellen Schildkraut; Marta A. Crispens; Alicia Beeghly-Fadiel

doi:10.1016/j.canep.2021.102013

Increasing Area Deprivation Index negatively impacts ovarian cancer survival

Demetra H. Hufnagel, Dineo Khabele, Fiona E. Yull, Pamela C. Hull, Joellen Schildkraut, Marta A. Crispens, Alicia Beeghly-Fadiel

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Introduction: While individual-level measures of socioeconomic status have been well-studied in relation to ovarian cancer survival, no studies to date have examined both state and national-level Area Deprivation Indices (ADIs), which incorporate neighborhood affluence and resources. Methods: We abstracted clinical data from medical records for ovarian cancer cases from the Vanderbilt University Medical Center and obtained ADIs from the Neighborhood Atlas®. Associations with clinical characteristics were assessed with Spearman correlations and Kruskal-Wallis tests; associations with progression-free survival (PFS) and overall survival (OS) were assessed with Cox proportional-hazards regression. Results: Among 184 cases, state and national ADIs were highly correlated, but not related to any cancer characteristics. In multivariable adjusted regression models, both were significantly associated with OS; each decile increase in state or national ADI corresponded to a 9 % or 10 % greater risk of death, respectively. Conclusions: Increasing area-level deprivation may negatively impact ovarian cancer survival.

Original language	English
Article number	102013
Journal	Cancer Epidemiology
Volume	74
DOIs	https://doi.org/10.1016/j.canep.2021.102013
State	Published - Oct 2021

Bibliographical note

Publisher Copyright:
© 2021

Funding

ABF, FEY, and MAC were supported in part by the National Institutes of Health (NIH) National Cancer Institute (NCI) Precision Medicine and Health Disparities Collaborative (PMHDC) Pilot Study U54 MD010722. ABF, MAC, DK, and FEY were supported in part by the NIH NCI grant R01 CA214043. ABF and MAC were also supported in part by the NIH NCI grant U54 CA163072. DHH was also supported in part by a 2018 Burroughs Wellcome Fund Physician-Scientist Institutional Award to Vanderbilt University [ID: 1018894]. These funding sources had no role in study design; collection, analysis, or interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

Funders	Funder number
NCI/NIH	R01 CA214043, U54 CA163072
National Institutes of Health (NIH)
Burroughs Wellcome Fund
Vanderbilt University	1018894
National Institute on Minority Health and Health Disparities (NIMHD)	U54MD010722
Institut National Du Cancer	U54 MD010722

Keywords

Ovarian neoplasms
Prognosis
Socioeconomic factors
Survival

ASJC Scopus subject areas

Epidemiology
Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.canep.2021.102013

Cite this

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title = "Increasing Area Deprivation Index negatively impacts ovarian cancer survival",

abstract = "Introduction: While individual-level measures of socioeconomic status have been well-studied in relation to ovarian cancer survival, no studies to date have examined both state and national-level Area Deprivation Indices (ADIs), which incorporate neighborhood affluence and resources. Methods: We abstracted clinical data from medical records for ovarian cancer cases from the Vanderbilt University Medical Center and obtained ADIs from the Neighborhood Atlas{\textregistered}. Associations with clinical characteristics were assessed with Spearman correlations and Kruskal-Wallis tests; associations with progression-free survival (PFS) and overall survival (OS) were assessed with Cox proportional-hazards regression. Results: Among 184 cases, state and national ADIs were highly correlated, but not related to any cancer characteristics. In multivariable adjusted regression models, both were significantly associated with OS; each decile increase in state or national ADI corresponded to a 9 % or 10 % greater risk of death, respectively. Conclusions: Increasing area-level deprivation may negatively impact ovarian cancer survival.",

keywords = "Ovarian neoplasms, Prognosis, Socioeconomic factors, Survival",

author = "Hufnagel, {Demetra H.} and Dineo Khabele and Yull, {Fiona E.} and Hull, {Pamela C.} and Joellen Schildkraut and Crispens, {Marta A.} and Alicia Beeghly-Fadiel",

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year = "2021",

month = oct,

doi = "10.1016/j.canep.2021.102013",

language = "English",

volume = "74",

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AU - Hufnagel, Demetra H.

AU - Khabele, Dineo

AU - Yull, Fiona E.

AU - Hull, Pamela C.

AU - Schildkraut, Joellen

AU - Crispens, Marta A.

AU - Beeghly-Fadiel, Alicia

PY - 2021/10

Y1 - 2021/10

N2 - Introduction: While individual-level measures of socioeconomic status have been well-studied in relation to ovarian cancer survival, no studies to date have examined both state and national-level Area Deprivation Indices (ADIs), which incorporate neighborhood affluence and resources. Methods: We abstracted clinical data from medical records for ovarian cancer cases from the Vanderbilt University Medical Center and obtained ADIs from the Neighborhood Atlas®. Associations with clinical characteristics were assessed with Spearman correlations and Kruskal-Wallis tests; associations with progression-free survival (PFS) and overall survival (OS) were assessed with Cox proportional-hazards regression. Results: Among 184 cases, state and national ADIs were highly correlated, but not related to any cancer characteristics. In multivariable adjusted regression models, both were significantly associated with OS; each decile increase in state or national ADI corresponded to a 9 % or 10 % greater risk of death, respectively. Conclusions: Increasing area-level deprivation may negatively impact ovarian cancer survival.

AB - Introduction: While individual-level measures of socioeconomic status have been well-studied in relation to ovarian cancer survival, no studies to date have examined both state and national-level Area Deprivation Indices (ADIs), which incorporate neighborhood affluence and resources. Methods: We abstracted clinical data from medical records for ovarian cancer cases from the Vanderbilt University Medical Center and obtained ADIs from the Neighborhood Atlas®. Associations with clinical characteristics were assessed with Spearman correlations and Kruskal-Wallis tests; associations with progression-free survival (PFS) and overall survival (OS) were assessed with Cox proportional-hazards regression. Results: Among 184 cases, state and national ADIs were highly correlated, but not related to any cancer characteristics. In multivariable adjusted regression models, both were significantly associated with OS; each decile increase in state or national ADI corresponded to a 9 % or 10 % greater risk of death, respectively. Conclusions: Increasing area-level deprivation may negatively impact ovarian cancer survival.

KW - Ovarian neoplasms

KW - Prognosis

KW - Socioeconomic factors

KW - Survival

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JO - Cancer Epidemiology

JF - Cancer Epidemiology

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Increasing Area Deprivation Index negatively impacts ovarian cancer survival

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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