Disadvantaged neighborhoods and racial disparity in breast cancer outcomes: the biological link

• Type of Material: Article
• Authors: Geetanjali Saini, Georgia State University; Angela Ogden, Georgia State University; Lauren McCullough, Emory University; Mylin Torres, Emory University; Padmashree Rida, Georgia State University; Ritu Aneja, Georgia State University
• Language: English
• Date: 2019-07-01
• Publisher: Springer
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © Springer Nature Switzerland AG 2019.
• Final Published Version (URL): http://dx.doi.org/10.1007/s10552-019-01180-4
• Title of Journal or Parent Work: Cancer Causes & Control
• Volume: 30
• Issue: 7
• Start Page: 677
• End Page: 686
• Grant/Funding Information: This work was supported by grants to RA from the National Cancer Institute, including U01 CA179671 and R01 CA169127
• Keywords: Epigenetics; Public, Environmental & Occupational Health; Telomere length; United States; Geographic access; Health disparities; Physical activity; Urban neighborhood; Tumor supressor genes; DNA methylation; Life Sciences & Biomedicine; African American; Oncology; Neighborhood disadvantage; Racial disparities; Inflammation; Oxidative stress; Triple-negative breast cancer; Science & Technology
• Research Categories: Health Sciences, Oncology; Health Sciences, Public Health; Sociology, Public and Social Welfare; Health Sciences, Epidemiology

Abstract

Neighborhoods encompass complex environments comprised of unique economic, physical, and social characteristics that have a profound impact on the residing individual’s health and, collectively, on the community’s wellbeing. Neighborhood disadvantage (ND) is one of several factors that prominently contributes to racial breast cancer (BC) health disparities in American women. African American (AA) women develop more aggressive breast cancer features, such as triple-negative receptor status and more advanced histologic grade and tumor stage, and suffer worse clinical outcomes than European American (EA) women. While the adverse effects of neighborhood disadvantage on health, including increased risk of cancer and decreased longevity, have recently come into focus, the specific molecular mechanisms by which neighborhood disadvantage increases BC risk and worsens BC outcomes (survivorship, recurrence, mortality) are not fully elucidated. This review illuminates the probable biological links between neighborhood disadvantage and predominantly BC risk, with an emphasis on stress reactivity and inflammation, epigenetics and telomere length in response to adverse neighborhood conditions.