ArticleBreast cancer research and treatment2023
Effects of neighborhood disadvantage on cortisol and interviewer-rated anxiety symptoms in breast cancer patients initiating treatment.
Article in Breast cancer research and treatment, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 12 citations in OpenAlex.
- Cognitive behavioral stress management effects on cancer-related distress and neuroendocrine signaling in breast cancer: differential effects by neighborhood disadvantage.Breast cancer research and treatment · 2025Trial
- Associations between neighborhood disadvantage, cannabis use, and patient-reported outcomes among patients with cancer.Drug and alcohol dependence reports · 2026Article
- Cancer Related Fatigue and its Association with Depression and Anxiety in the Patients with Advanced Gastric Cancer.Journal of gastrointestinal cancer · 2026Article
- Distinct Sources of Social Adversity, Stress, and Coping Mechanisms among Patients with Breast Cancer to Identify Areas for Intervention.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Sex-based associations between neighborhood disadvantage and brain-gut alterations in individuals with irritable bowel syndrome.Biology of sex differences · 2025Article
- Geospatial Genomics: Operationalizing Multilevel Conceptual Frameworks of Cancer Health Outcomes to Account for Gene-Person-Place Relationships.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- A Neighborhood-Level Hispanic Paradox: The Interaction among Hispanic Density, Neighborhood Disadvantage, and Survival in Patients with Breast Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Gerotherapeutics: aging mechanism-based pharmaceutical and behavioral interventions to reduce cancer racial and ethnic disparities.Journal of the National Cancer Institute · 2025Review
- ZIP Code to Genomic Code: Neighborhood Disadvantage, Aggressive Breast Cancer Biology, and Breast Cancer Outcomes.Annals of surgery · 2024Article
- Structural Racism as a Contributor to Lung Cancer Incidence and Mortality Rates Among Black Populations in the United States.Cancer control : journal of the Moffitt Cancer CenterArticle
- Social support moderates the impact of neighborhood disadvantage on serum cortisol levels in post-surgical breast cancer patients.International journal of clinical and health psychology : IJCHPArticle
- Article
- Advancing health psychology research in oncology: Biobehavioral models, stress pathways, and stress-management interventions for cancer patients.International journal of clinical and health psychology : IJCHPArticle
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
purposeShorter breast cancer (BC) survival outcomes persist by neighborhood disadvantage independent of patient, tumor, and treatment characteristics. This suggests unaccounted mechanisms by which neighborhood disadvantage "gets under the skin" to impact BC survival outcomes. Here, we evaluate the relationship between neighborhood disadvantage and clinical and neuroendocrine markers of stress in BC patients.
methodsWomen with stage 0-III BC were enrolled 2-10 weeks post-surgery and before initiating adjuvant treatment in a study examining stress and stress management processes. Women provided an afternoon-evening (PM) serum cortisol sample and were administered the Hamilton Anxiety Rating Scale (HAM-A). Home addresses were used to determine the Area Deprivation Index (ADI), a validated measure of neighborhood disadvantage. Multiple regression assessed the relationship between ADI and PM serum cortisol and the presence of elevated HAM-A symptoms.
resultsOur sample (n = 225) was predominately middle-aged (M = 50.4 years; range 23-70 years), non-Hispanic White (64.3%), with stage I (38.1%), or II (38.6%) disease. The majority (n = 175) lived in advantaged neighborhoods (ADI 1-3). After controlling for age, stage, and surgery type, women from high ADI (4-10) (vs low ADI) neighborhoods had higher PM cortisol levels (β = 0.19, 95% CI [0.24, 5.00], p = 0.031) and were nearly two times as likely to report the presence of elevated anxiety symptoms (OR = 1.96, 95% CI [1.00, 3.86], p = 0.050).
conclusionNeighborhood disadvantage is significantly associated with higher levels of PM cortisol and elevated anxiety symptoms suggesting stress pathways could potentially contribute to relationships between neighborhood disadvantage and BC survival.
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