Abstract
Abstract
Purpose
It remains unclear why individuals living in disadvantaged neighborhoods have shorter non-small cell lung cancer (NSCLC) survival. It is possible that living in these deprived areas is linked with increased risk of developing aggressive NSCLC biology. Here, we explored the association of somatic KRAS mutations, which are associated with shorter survival in NSCLC patients, and 11 definitions of neighborhood disadvantage spanning socioeconomic and structural environmental elements.
Methods
We analyzed data from 429 NSCLC patients treated at a Comprehensive Cancer Center from 2015 to 2018. Data were abstracted from medical records and each patient’s home address was used to assign publicly available indices of neighborhood disadvantage. Prevalence Ratios (PRs) for the presence of somatic KRAS mutations were estimated using modified Poisson regression models adjusted for age, sex, smoking status, race/ethnicity, educational attainment, cancer stage, and histology.
Results
In the NSCLC cohort, 29% had KRAS mutation-positive tumors. We found that five deprivation indices of socioeconomic disadvantage were associated with KRAS mutation. A one decile increase in several of these socioeconomic disadvantage indices was associated with a 1.06 to 1.14 increased risk of KRAS mutation. Measures of built structural environment were not associated with KRAS mutation status.
Conclusion
Socioeconomic disadvantage at the neighborhood level is associated with higher risk of KRAS mutation while disadvantage related to built environmental structural measures was inversely associated. Our results indicate not only that neighborhood disadvantage may contribute to aggressive NSCLC biology, but the pathways linking biology to disadvantage are likely operating through socioeconomic-related stress.
Funder
The National Cancer Institute of the National Institutes of Health
NIH Clinical Scientist Institutional Career Development Program Award
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Oncology,General Medicine
Reference49 articles.
1. Adie Y, Kats DJ, Tlimat A, Perzynski A, Dalton J, Gunzler D, Tarabichi Y (2020) Neighborhood disadvantage and lung cancer incidence in ever-smokers at a safety net health-care system: a retrospective study. Chest 157:1021–1029. https://doi.org/10.1016/j.chest.2019.11.033
2. Agency for Toxic Substances and Disease Registry (2020) CDC Social Vulnerability Index. Accessed 11 Dec 2020. https://www.atsdr.cdc.gov/placeandhealth/svi/index.html.
3. Amzanam I, Mambetsariev I, Gupta R, Achuthan S, Wang Y, Pharaon R, Massarelli E, Koczywas M, Reckamp K, Salgia R (2020) Role of immunotherapy and co-mutations on KRAS-mutant non-small cell lung cancer survival. J Thorac Dis 12:5086–5095. https://doi.org/10.21037/jtd.2020.04.18
4. Antunes JLF (2016) The impact of unemployment on cancer mortality, and how to avoid it. Ann Transl Med 4:56
5. Bender R, Lange S (2001) Adjusting for multiple testing—when and how? J Clin Epidemiol 54:343–349
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献