Effect of neighborhood and individual-level socioeconomic factors on breast cancer screening adherence in a multi-ethnic study

Gillian Kasper, Mahsa Momen, Kristen A. Sorice, Kiara N. Mayhand, Elizabeth A. Handorf, Evelyn T. Gonzalez, Amie Devlin, Kirsten Brownstein, Nestor Esnaola, Susan G. Fisher, Shannon M. Lynch

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Although mammography can significantly reduce breast cancer mortality, many women do not receive their annual breast cancer screening. Differences in screening adherence exist by race/ethnicity, socioeconomic status (SES), and insurance status. However, more detailed investigations into the impact of neighborhood disadvantage and access to resources on screening adherence are lacking. Methods: We comprehensively examined the effect of individual social, economic, and demographic factors (n = 34 variables), as well as neighborhood level SES (nSES) indicators (n = 10 variables) on breast cancer screening adherence across a multi-ethnic population (n = 472). In this cross-sectional study, participants were surveyed from 2017 to 2018. The data was analyzed using univariate regression and LASSO for variable reduction. Significant predictors were carried forward into final multivariable mixed-effect logistic regression models where odds ratios (OR), 95% confidence intervals and p-values were reported. Results: Nineteen percent of participants were non-adherent to breast screening guidelines. Race/ethnicity was not associated with adherence; however, increasing age (OR = 0.97, 95%CI = 0.95–0.99, p = 0.01), renting a home (OR = 0.53, 95%CI = 0.30–0.94, p = 0.04), food insecurity (OR 0.46, 95%CI = 0.22–0.94, p = 0.01), and overcrowding (OR = 0.58, 95% CI = 0.32–0.94, p = 0.01) were significantly associated with lower breast cancer screening adherence. Conclusion: Socioeconomic indicators at the individual and neighborhood levels impact low breast cancer screening adherence and may help to inform future screening interventions.

Original languageEnglish
Article number63
Pages (from-to)63
JournalBmc Public Health
Volume24
Issue number1
DOIs
StatePublished - Dec 2 2024

Keywords

  • Breast cancer screening
  • Health disparities
  • Neighborhood
  • Social determinants of health
  • Breast Neoplasms/diagnosis
  • Cross-Sectional Studies
  • Early Detection of Cancer
  • Humans
  • Female
  • Socioeconomic Factors
  • Social Class

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