Abstract A015: Social vulnerability and breast cancer incidence in the United States: A county-level bivariate analysis

Background: The Social Vulnerability Index (SVI) assesses the overall vulnerability to external stressors of a geographic area by scoring 16 United States Census variables related to four overall categories: housing type and transportation, household characteristics, racial and ethnic minority status, and socioeconomic status. Previous research suggests that areas with lower socioeconomic status have higher incidence rates of breast cancer, but the relationship between the SVI and breast cancer incidence has been less well studied. Methods: Data from the North American Association of Central Cancer Registries (NAACCR), containing county-level incidence rate data for all breast cancer cases reported to cancer registries, was used to create a choropleth map in ArcGIS Pro. The SVI for each county in the United States provided by the Centers for Disease Control and Prevention (CDC) was used to create a choropleth map to identify areas of highest vulnerability. The breast cancer and SVI maps were combined into a bivariate choropleth map to identify counties with overlapping high breast cancer incidence and high social vulnerability. A bivariate spatial association was performed using Lee’s L statistic to identify areas of statistically significant high and low SVI and high and low breast cancer incidence. Results: Perimeter regions around the United States have the highest SVI, with a few other high SVI counties scattered throughout the country. Breast cancer incidence rates were elevated in the midwestern and eastern portions of the United States, with the highest incidence rates per capita in a few counties in the northwest. When analyzing the bivariate spatial association, Lee’s L was statistically significant. The bivariate maps identified areas of high SVI and high breast cancer incidence rates scattered throughout the country, with many of the southeastern counties falling into this category. Areas of low social vulnerability and high breast cancer incidence rates were primarily concentrated in the midwestern states. The southwestern portion of the United States had a statistically significant spatial association with high SVI and low breast cancer incidence rates. Conclusions: Areas with high social vulnerability and high incidence rates of breast cancer are primarily observed in the southeastern region of the United States. Further research would be beneficial to understand the specific underlying risk factors contributing to the statistically significant spatial associations in the southwest region. Identifying geographic areas of high SVI and high breast cancer incidence can assist in targeting screening and prevention programs to areas of need. Citation Format: Anna Marie Pavy, Cassie Odahowski, Monique J. Brown, Stella Self, Lauren E. McCullough, Susan E. Steck. Social vulnerability and breast cancer incidence in the United States: A county-level bivariate analysis [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A015.