Journal
LUNG CANCER
Volume 173, Issue -, Pages 21-27Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.lungcan.2022.08.022
Keywords
Lung cancer; Neighborhood socioeconomic status; Disadvantage; Health disparities; PM2.5 exposure
Categories
Funding
- City of Hope Paul Calabresi Career Development Award for Clinical Oncology [K12 CA001727]
- National Institutes of Health [CA058420, CA164974]
- Karin Grunebaum Cancer Research Foundation
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Living in neighborhoods with concentrated disadvantage may increase the risk of lung cancer in Black women who have never smoked. Understanding and targeting non-tobacco-related factors in disadvantaged neighborhoods could help achieve health equity.
Background: Compared to women of other races who have never smoked, Black women have a higher risk of lung cancer. Whether neighborhood disadvantage, which Black women experience at higher rates than other women, is linked to never-smoking lung cancer risk remains unclear. This study investigates the association of neighborhood disadvantage and lung cancer risk in Black never-smoking women. Methods and materials: This research utilized data from the Black Women's Health Study, a prospective cohort of 59,000 Black women recruited from across the US in 1995 and followed by biennial questionnaires. Associations of lung cancer incidence with neighborhood-level factors (including two composite variables derived from Census Bureau data: neighborhood socioeconomic status and neighborhood concentrated disadvantage), secondhand smoke exposure, and PM2.5 were estimated using Fine-Gray subdistribution hazard models. Results: Among 37,650 never-smokers, 77 were diagnosed with lung cancer during follow-up from 1995 to 2018. The adjusted subdistribution hazard ratio (sHR) of lung cancer incidence with ten unit increase in neighborhood concentrated disadvantage index was 1.30 (95 % CI: 1.04, 1.63, p = 0.023). Exposure to secondhand smoke at work was associated with increased risk (sHR = 1.93, 95 % CI: 1.21, 3.10, p = 0.006), but exposure to secondhand smoke at home and PM2.5 was not. Conclusion: Worse neighborhood concentrated disadvantage was associated with increased lung cancer risk in Black women who never smoked. These findings suggest that non-tobacco-related factors in disadvantaged neighborhoods may be linked to lung cancer risk in Black women and that these factors must be understood and targeted to achieve health equity.
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