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The Association between Mediated Deprivation and Ovarian Cancer Survival among African American Women.

Publication ,  Journal Article
Lawson, AB; Kim, J; Johnson, C; Ratnapradipa, KL; Alberg, AJ; Akonde, M; Hastert, T; Bandera, EV; Terry, P; Mandle, H; Cote, ML; Bondy, M ...
Published in: Cancers (Basel)
October 4, 2023

BACKGROUND: Deprivation indices are often used to adjust for socio-economic disparities in health studies. Their role has been partially evaluated for certain population-level cancer outcomes, but examination of their role in ovarian cancer is limited. In this study, we evaluated a range of well-recognized deprivation indices in relation to cancer survival in a cohort of self-identified Black women diagnosed with ovarian cancer. This study aimed to determine if clinical or diagnostic characteristics lie on a mediating pathway between socioeconomic status (SES) and deprivation and ovarian cancer survival in a minority population that experiences worse survival from ovarian cancer. METHODS: We used mediation analysis to look at the direct and indirect causal effects of deprivation indices with main mediators of the SEER stage at diagnosis and residual disease. The analysis employed Bayesian structural equation models with variable selection. We applied a joint Bayesian structural model for the mediator, including a Weibull mixed model for the vital outcome with deprivation as exposure. We selected modifiers via a Monte Carlo model selection procedure. RESULTS: The results suggest that high SES-related indices, such as Yost, Kolak urbanicity (URB), mobility (MOB) and SES dimensions, and concentrated disadvantage index (CDI), all have a significant impact on improved survival. In contrast, area deprivation index (ADI)/Singh, and area level poverty (POV) did not have a major impact. In some cases, the indirect effects have very wide credible intervals, so the total effect is not well estimated despite the estimation of the direct effect. CONCLUSIONS: First, it is clear that commonly used indices such as Yost, or CDI both significantly impact the survival experience of Black women diagnosed with epithelial ovarian cancer. In addition, the Kolak dimension indices (URB, MOB, mixed immigrant: MICA and SES) also demonstrate a significant association, depending on the mediator. Mediation effects differ according to the mediator chosen.

Duke Scholars

Published In

Cancers (Basel)

DOI

ISSN

2072-6694

Publication Date

October 4, 2023

Volume

15

Issue

19

Location

Switzerland

Related Subject Headings

  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Citation

APA
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ICMJE
MLA
NLM
Lawson, A. B., Kim, J., Johnson, C., Ratnapradipa, K. L., Alberg, A. J., Akonde, M., … Peters, E. S. (2023). The Association between Mediated Deprivation and Ovarian Cancer Survival among African American Women. Cancers (Basel), 15(19). https://doi.org/10.3390/cancers15194848
Lawson, Andrew B., Joanne Kim, Courtney Johnson, Kendra L. Ratnapradipa, Anthony J. Alberg, Maxwell Akonde, Theresa Hastert, et al. “The Association between Mediated Deprivation and Ovarian Cancer Survival among African American Women.Cancers (Basel) 15, no. 19 (October 4, 2023). https://doi.org/10.3390/cancers15194848.
Lawson AB, Kim J, Johnson C, Ratnapradipa KL, Alberg AJ, Akonde M, et al. The Association between Mediated Deprivation and Ovarian Cancer Survival among African American Women. Cancers (Basel). 2023 Oct 4;15(19).
Lawson, Andrew B., et al. “The Association between Mediated Deprivation and Ovarian Cancer Survival among African American Women.Cancers (Basel), vol. 15, no. 19, Oct. 2023. Pubmed, doi:10.3390/cancers15194848.
Lawson AB, Kim J, Johnson C, Ratnapradipa KL, Alberg AJ, Akonde M, Hastert T, Bandera EV, Terry P, Mandle H, Cote ML, Bondy M, Marks J, Peres LC, Schildkraut J, Peters ES. The Association between Mediated Deprivation and Ovarian Cancer Survival among African American Women. Cancers (Basel). 2023 Oct 4;15(19).

Published In

Cancers (Basel)

DOI

ISSN

2072-6694

Publication Date

October 4, 2023

Volume

15

Issue

19

Location

Switzerland

Related Subject Headings

  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis