Abstract A090: An evaluation of neighborhood socioeconomic status indices in relation to breast cancer stage among Black women in the US

Abstract Introduction: Breast cancer (BC) mortality remains disproportionately high among Black women in the U.S., partly due to later-stage diagnoses. Although multiple neighborhood socioeconomic status (nSES) indices have been considered in cancer research, it remains unclear whether these indices are associated with stage at diagnosis. This study evaluates three common nSES indices—Yost Index, Neighborhood Deprivation Index (NDI), and Social Vulnerability Index (SVI)—and their associations with BC stage at diagnosis among Black women. Methods: We used data from self-identified Black women diagnosed with invasive BC from the Black Women’s Health Study (BWHS; n=1,777), the Carolina Breast Cancer Study Phase 3 (CBCS; n=1,493), and the Women’s Circle of Health Study/Women’s Circle of Health Follow-up Study (WCHS/WCHFS; n=1,528). Stage at diagnosis was obtained from medical records and cancer registries. Residential addresses at or before diagnosis were geocoded to 2010 Census tracts and linked to each nSES index, which were categorized into quintiles based on national rankings. For each study, age-adjusted polytomous logistic regressions estimated odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between each nSES index and BC stage, comparing stage 2 and combined stages 3+4 (due to few stage 4 cases) with stage 1. Fixed-effects meta-analysis pooled results across studies. Results: Women living in socioeconomically disadvantaged neighborhoods were estimated to have a higher odds of being diagnosed at advanced stage BC across all three indices, although variability in magnitudes of association was observed across indices and studies. ORs comparing the most disadvantaged neighborhoods to the highest nSES for stages 3+4 versus stage 1, based on meta-analysis, were 1.73 (95% CI: 0.94–3.18) for the Yost Index, 1.79 (95% CI: 0.96–3.34) for the NDI, and 1.86 (95% CI: 0.99–3.52) for the SVI. In analyses within individual studies, the NDI and SVI were the strongest predictors of advanced-stage diagnosis in BWHS (OR=1.92, 95% CI: 1.15–3.21; OR=1.75, 95% CI: 1.10–2.78, respectively); CBCS showed statistically significant associations for all indices, ranging from NDI (OR=1.95; 95% CI: 1.26–3.03) to Yost (OR=2.23; 95% CI: 1.33–3.75); and in WCHS/WCHFS, only the Yost Index was statistically significant (OR=1.70; 95% CI: 1.06–2.73). Analyses stratified by individual-level social drivers of health are ongoing. Conclusions: Our preliminary findings suggest that the Yost Index, NDI, and SVI are associated with BC stage at diagnosis among U.S. Black women, such that women who live in more disadvantaged areas are more likely to be diagnosed at a later stage of breast cancer. Understanding the performance of these indices is critical for identifying high-risk groups and informing equitable resource distribution. Acknowledgements: Supported by the Estée Lauder Companies Charitable Foundation through the Health Equity Initiative of the Breast Cancer Research Foundation. Citation Format: Bo Qin, Etienne X. Holder, Marc A. Emerson, Mollie E. Barnard, Shromona Sarkar, Nuo N. Xu, Matthew R. Dunn, Yutong Li, Scarlett Lin . Gomez, Terry Hyslop, Christine B. Ambrosone, Elisa V. Bandera, Julie R. Palmer, Melissa A. Troester. An evaluation of neighborhood socioeconomic status indices in relation to breast cancer stage among Black women in the US 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 A090.