评价邻里不利因素与肿瘤生物学代表性指标Oncotype DX评分之间的关联。即使在考虑个体层面、肿瘤和治疗特征后，生活在不利邻里的妇女乳腺癌患者的生存时间较短。这表明邻里不利因素可能通过未考虑的社会和生物机制对乳腺癌生存产生影响。 本项横断面研究包括了来自2004年至2019年美国国家癌症数据库的I期和II期ER+/HER2-乳腺癌患者的Oncotype DX评分数据。多元回归模型考察了邻里收入水平对Oncotype DX评分的关联，并控制了年龄、种族/民族、医疗保险、临床分期和教育水平等变量。Cox回归分析了整体生存情况。 在选择的294,283名乳腺癌患者中，大多数为非西班牙裔白人（n=237,197, 80.6%），非西班牙裔黑人占7.6%（n=22,495），其他族裔占4.5%（n=13,383）。27.1%的人口（n=79,254）生活在最不利的邻里，年均邻里收入低于48,000美元，而59.62%的人口（n=175,305）生活在中等收入水平为48,000美元以上的邻里。在控制年龄、种族/民族、医疗保险、邻里教育水平和病理分期后，生活在不利邻里的患者与生活在有利邻里的患者相比，高风险和低风险Oncotype DX评分的风险更大 [OR=1.04 (1.01-1.07), P=0.0067]。 本研究采用转化流行病学方法，揭示了生活在最不利邻里的妇女具有更具侵袭性的肿瘤生物学特征，这通过Oncotype DX评分得出。版权所有 © 2023 Wolters Kluwer Health, Inc. 保留所有权利。

Evaluate the association between neighborhood disadvantage and Oncotype DX score, a surrogate for tumor biology, among a national cohort.Women living in disadvantaged neighborhoods have shorter breast cancer (BC) survival, even after accounting for individual-level, tumor, and treatment characteristics. This suggests unaccounted social and biological mechanisms by which neighborhood disadvantage may impact BC survival.This cross-sectional study included Stage I and II, ER+ /HER2- BC patients with Oncotype DX score data from the National Cancer Database from 2004-2019. Multivariate regression models tested the association of neighborhood-level income on Oncotype DX score controlling for age, race/ethnicity, insurance, clinical stage, and education. Cox regression assessed overall survival.Of the 294,283 total BC patients selected, the majority were non-Hispanic White (n=237,197, 80.6%) with 7.6% non-Hispanic Black (n=22,495) and 4.5% Other (n=13,383). 27.1% (n=79,7254) of the population lived in the most disadvantaged neighborhoods with an annual neighborhood-level income of <$48,000 while 59.62% (n=175,305) lived in neighborhoods with a median-level income of >$48,000. On multivariate analysis controlling for age, race/ethnicity, insurance status, neighborhood-level education, and pathologic stage, patients in disadvantaged neighborhoods had a greater risk of high- versus low-risk Oncotype DX scores compared to those in advantaged neighborhoods [OR=1.04 (1.01-1.07), P=0.0067].This study takes a translational epidemiologic approach to identify that women living in the most disadvantaged neighborhoods have more aggressive tumor biology, as determined by the Oncotype DX score.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.