Roswell Park Comprehensive Cancer Center, Medical Oncology, Buffalo, NY, USA.
State University of New York at Buffalo, Epidemiology and Environmental Health, Buffalo, NY, USA.
JNCI Cancer Spectr. 2024 Jul 1;8(4). doi: 10.1093/jncics/pkae057.
There are few studies of social support and other social determinants of health after breast cancer diagnosis and their associations with mortality; results have been inconclusive. Further, it is not known if observed associations are specific to women with breast cancer diagnosis or if associations would be similar among healthy women.
Women with incident, pathologically confirmed invasive breast cancer, stage I-IV (n = 1012), and healthy frequency age-matched participants (n = 2036) answered a social support questionnaire in prospective follow-up of a population-based case-control study, the Western New York Exposures and Breast Cancer Study. At interview, all participants were aged 35-79 years and resident of 2 counties in Western New York State. Mortality status was ascertained from the National Death Index. Participants were queried regarding the number of their close friends, frequency of seeing them, household size, household income, and marital status. Hazard ratios (HRs) and 95% confidence intervals (CIs) for breast cancer-specific mortality (breast cancer women only) and all-cause mortality were estimated.
Lower household income was associated with higher all-cause mortality among women diagnosed with breast cancer (HR = 2.48, 95% CI = 1.24 to 4.97) and similarly among the healthy women (HR = 2.63, 95% CI = 1.25 to 5.53). Number and frequency of seeing friends, marital status, and household size were not associated with mortality, either among breast cancer patients or among healthy women.
Among those diagnosed with breast cancer and healthy women, lower income was associated with more than twice the mortality. Marital status, household size, and number or frequency of meeting friends were not associated with survival.
针对乳腺癌诊断后的社会支持和其他社会决定因素及其与死亡率的关系，研究甚少，结果尚无定论。此外，尚不清楚所观察到的关联是否特定于乳腺癌患者，或者在健康女性中是否存在类似的关联。
在一项基于人群的病例对照研究——西纽约州暴露与乳腺癌研究中，纳入了 1012 名患有Ⅰ-Ⅳ期浸润性乳腺癌的女性（病例组）和 2036 名年龄匹配的健康女性（对照组）。在随访过程中，所有参与者在被诊断患有乳腺癌时（年龄 35-79 岁）和居住在纽约州西部的 2 个县时，都回答了一份社会支持问卷。通过国家死亡索引确定了所有参与者的死亡状态。参与者被询问了他们的亲密朋友数量、与他们见面的频率、家庭规模、家庭收入和婚姻状况。估计了乳腺癌特异性死亡率（仅乳腺癌患者）和全因死亡率的危险比（HR）和 95%置信区间（CI）。
在被诊断患有乳腺癌的女性（HR=2.48，95%CI=1.24 至 4.97）和健康女性（HR=2.63，95%CI=1.25 至 5.53）中，较低的家庭收入与更高的全因死亡率相关。在乳腺癌患者和健康女性中，朋友数量和见面频率、婚姻状况和家庭规模与死亡率均无关。
在诊断患有乳腺癌的女性和健康女性中，较低的收入与死亡率增加两倍以上有关。婚姻状况、家庭规模和与朋友见面的次数或频率与生存无关。
