Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto Street, 3rd Floor 302-J, Los Angeles, CA, 90,032, USA.
Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.
Sci Rep. 2024 Aug 26;14(1):19729. doi: 10.1038/s41598-024-70841-5.
Racial differences in breast cancer morbidity and mortality have been examined between Black/African American women and White women as part of efforts to characterize multilevel drivers of disease risk and outcomes. Current models of cancer disparities recognize the significance of physiological stress responses, yet data on stress hormones in Black/African American women with breast cancer and their social risk factors are limited. We examined cortisol levels in Black/African American breast cancer patients and tested their association with social and clinical factors to understand the relationship between stress responses and women's lived experiences. Seventy-two patients who completed primary surgical treatment were included in this cross-sectional study. Data on sociodemographic characteristics and chronic diseases were obtained by self-report. Breast cancer stage and diagnosis date were abstracted from electronic health records. Cortisol levels were determined from saliva samples. Compared to those without hypertension, patients with hypertension were 6.84 (95% CI 1.33, 35.0) times as likely to have high cortisol (p = 0.02). The odds of having high cortisol increased by 1.42 (95% CI 1.03, 1.95, p = 0.03) times for every point increase in negative life events. Hypertension and negative life events are associated with high cortisol levels in Black/African American patients. These findings illustrate the importance of understanding the lived experiences of these patients to enhance cancer health equity.
种族差异在乳腺癌发病率和死亡率已被研究黑/非裔美国女性和白种人之间的一部分努力描绘多层次的疾病风险和结果的驱动因素。目前的癌症差异模型认识到生理应激反应的意义，但关于应激激素的黑/非裔美国乳腺癌患者及其社会风险因素的数据有限。我们研究了皮质醇水平在黑/非裔美国乳腺癌患者，并测试其与社会和临床因素的关联，以了解应激反应与妇女的生活经历之间的关系。 72 名完成主要手术治疗的患者被纳入这项横断面研究。社会人口统计学特征和慢性疾病的数据通过自我报告获得。乳腺癌分期和诊断日期从电子健康记录中提取。皮质醇水平从唾液样本中确定。与没有高血压的患者相比，患有高血压的患者发生高皮质醇的可能性高 6.84 倍（95%CI 1.33，35.0）（p=0.02）。每增加一个点的负性生活事件，发生高皮质醇的几率就会增加 1.42 倍（95%CI 1.03，1.95，p=0.03）。高血压和负性生活事件与黑/非裔美国患者的高皮质醇水平有关。这些发现说明了理解这些患者的生活经历对于增强癌症健康公平的重要性。
