Explorative Analysis of Female Triple Negative Breast Cancer Incidence: spatial disparity and its association with race and environmental factors in Wisconsin

Authors: Yuhong Zhou*, Institute for Health & Equity, Medical College of Wisconsin, Sima Namin, Institute for Health & Equity, Medical College of Wisconsin, Tobi Cawthra, Advancing a Healthier Wisconsin Endowment, Medical College of Wisconsin, Melinda Stolley, Department of Medicine, Medical College of Wisconsin, Jessica Olson, Institute for Health & Equity, Medical College of Wisconsin, Sandra Millon-Underwood, College of Nursing, University of Wisconsin Milwaukee, Kirsten Beyer, Institute for Health & Equity, Medical College of Wisconsin
Topics: Medical and Health Geography, Applied Geography, Environment
Keywords: Triple Negative Breast Cancer, Geospatial Mapping, Spatial Pattern, Race, Environmental Factors
Session Type: Poster
Day: 4/4/2019
Start / End Time: 3:05 PM / 4:45 PM
Room: Lincoln 2, Marriott, Exhibition Level
Presentation File: No File Uploaded

Studies on triple negative breast cancer (TNBC) have increased recently because of limited treatment options and poor prognosis associated with this tumor type. However, it has received little attention in geographical literature. Without knowledge of the spatial distribution of TNBC burden, it is difficult to identify related environmental risk factors, target resources to areas of need, and set priorities for treatment and health care access. Using Wisconsin Cancer Reporting System data from 2011-2015 for TNBC diagnoses, we applied a disease mapping method adaptive spatial ļ¬ltering to understand the geographic variation in female TNBC incidence in Wisconsin. We then derived incidence rate at a small geography level and linked it with race and environment-related cancer risk factors. Our statistical results reveal that neighborhoods with a higher TNBC incidence rate have a higher proportion of African-American residents than surrounding lower incidence areas. However, several areas with high incidence have relatively low populations of African-American residents, suggesting possible environmental, behavioral, or unknown genetic risk factors contributing to the observed spatial disparity. Although majority of the environmental factors being examined is significantly correlated with local TNBC incidence, the correlation between TNBC incidence and PM2.5 concentration is relatively higher. The study not only enhances our knowledge about TNBC incidence in Wisconsin from a spatial perspective, but indicates its potential linkage to environmental contaminants. Further explorations on other factors (e.g. health care access, obesity, breastfeeding, etc.) will help elucidate the unexplained spatial variation in TNBC and potentially reveal new preventative measures to reduce disparities in incidence.

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