Breast cancer research and treatment · 2026
Subjective socioeconomic status moderates the relationship between objective neighborhood disadvantage and quality of life in middle- and older-aged women with breast cancer.
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Plotke Rachel L, Kanaya Millan R, Popok Paula J, Webster Sarah N, Hansen Jenna L, Krueger Mason J, Roberts Mary, Ebrahimi Sara, Saez-Clarke Estefany, Taub Chloe J, Goel Neha, Antoni Michael H
Аннотация
PURPOSE: Living in a disadvantaged neighborhood is linked to higher mortality rates and poorer quality of life (QoL) among patients with breast cancer (BC). Subjective socioeconomic status (SSS), reflecting one's perceived socioeconomic "rank" or social standing relative to others, may be associated with differences in the relationship between objective neighborhood disadvantage and QoL. Therefore, we sought to evaluate whether SSS moderated the association between objective neighborhood disadvantage and QoL in middle- and older-aged women undergoing BC treatment.
METHODS: Women (≥ 50yrs) diagnosed with non-metastatic BC participating in a stress management trial completed a baseline assessment of SSS (MacArthur Network Sociodemographic Questionnaire) and QoL (Functional Assessment of Cancer Therapy-Breast) in the weeks after surgery. The Area Deprivation Index (ADI), which ranks the degree of neighborhood disadvantage via participants' addresses, measured objective neighborhood disadvantage. Multivariate linear regressions related ADI, SSS, and QoL, adjusting for age, cancer stage, and race/ethnicity.
RESULTS: Greater SSS relative to the community (B = 3.60, SE = 1.12, p=.002) and the USA (B = 3.01, SE = 1.09, p=.006) related to better QoL. Also, SSS USA interacted with ADI in predicting QoL (B = 0.95, SE = 0.45, p=.038), such that greater ADI related to poorer QoL in women with lower but not higher SSS.
CONCLUSION: Greater SSS relative to one's community and the USA population related to better QoL in women treated for BC. Conversely, greater objective neighborhood disadvantage related to poorer QoL but not among those with greater SSS. Future work could examine whether SSS is a modifiable intervention target through coping effectiveness training, or by enhancing community and social engagement.
METHODS: Women (≥ 50yrs) diagnosed with non-metastatic BC participating in a stress management trial completed a baseline assessment of SSS (MacArthur Network Sociodemographic Questionnaire) and QoL (Functional Assessment of Cancer Therapy-Breast) in the weeks after surgery. The Area Deprivation Index (ADI), which ranks the degree of neighborhood disadvantage via participants' addresses, measured objective neighborhood disadvantage. Multivariate linear regressions related ADI, SSS, and QoL, adjusting for age, cancer stage, and race/ethnicity.
RESULTS: Greater SSS relative to the community (B = 3.60, SE = 1.12, p=.002) and the USA (B = 3.01, SE = 1.09, p=.006) related to better QoL. Also, SSS USA interacted with ADI in predicting QoL (B = 0.95, SE = 0.45, p=.038), such that greater ADI related to poorer QoL in women with lower but not higher SSS.
CONCLUSION: Greater SSS relative to one's community and the USA population related to better QoL in women treated for BC. Conversely, greater objective neighborhood disadvantage related to poorer QoL but not among those with greater SSS. Future work could examine whether SSS is a modifiable intervention target through coping effectiveness training, or by enhancing community and social engagement.