Further insights on social determinants of health: Investigating racial disparities and estimated household income in relation to staging of newly diagnosed breast cancer.

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e22529 Background: The incidence of breast cancer in high-income countries has risen by over 20% in the past two decades, with higher incomes relating to higher incidence rates of breast cancer. Racial disparities relating to breast cancer have also been observed, with African American women being diagnosed with more aggressive and advanced-stage breast cancer. We aimed to study how racial disparities and household income relate to breast cancer staging at the time of diagnosis. Methods: A retrospective cohort study was conducted on 1000 breast cancer patients in Aultman hospital cancer center in Canton, Ohio. Patients with a diagnosis of breast cancer diagnosed between 2010-2020 were included in the study. Data including age, zip code, race, and tumor stage at the time of diagnosis was collected. Further, zip code information was used to estimate median household income by searching available US income statistics. For statistical analysis, the Pearson correlation and linear regression model were used, with p< 0.05 defining statistical significance. Results: Patients ranged from 25-95 years old. The percentage of patients with breast cancer staging of 0, I, II, III, and IV was 1.9%, 47.7%, 26.2%, 6.1%, and 18.1% respectively. When separated by income bracket, 86.6% of the study population was found to be within the $44,251-$88,450 income bracket. Regarding income and breast cancer stage, a correlation coefficient of -0.019 (p 0.557) was found. Further, the population of study was found to be 51.4% Caucasian, 2% African American, 0% Hispanic, 0.3% Asian, and 46.3% other races. Regarding race and breast cancer stage, a correlation coefficient of -0.174 (p < 0.01) was found. Conclusions: This study found no significant relationship between income and stage at the time of diagnosis. A limitation to our study was the use of estimated household income rather than exact patient reported income. However, a significant relationship was found between race and breast cancer staging, with earlier stage breast cancer detected among Caucasian women, and later stages among other races at the time of diagnosis. These findings emphasize the need to address racial disparities and access to care to improve upon breast cancer screening and early-stage detection.