Background
Methods for evidence acquisition and synthesis
Search strategy
Eligibility criteria
Selection strategy
Data extraction and synthesis
Statistical analysis
Results
Total number of studies | Number of studies by breast cancer outcomeΨ | ||
---|---|---|---|
(n=31) | Incidence/risk | Mortality | |
(n=27) | (n=7) | ||
Publication years
| |||
2010-2013* | 9 | 6 | 3 |
2000-2009 | 11 | 11 | 1 |
1990-1999 | 9 | 9 | 2 |
1980-1989 | 1 | 1 | 0 |
1970-1979 | 1 | 0 | 1 |
Study design
| |||
Cross-sectional | 25 | 23 | 5 |
Longitudinal | 4 | 2 | 2 |
Case–control | 2 | 2 | 0 |
Country
| |||
U.S.± | 23 | 21 | 3 |
Canada± | 3 | 3 | 0 |
U.K. | 2 | 2 | 1 |
Australia | 2 | 1 | 2 |
Italy | 1 | 1 | 0 |
Switzerland | 1 | 0 | 1 |
Geographic unit
| |||
Census tract | 8 | 8 | 0 |
Census block group | 8 | 8 | 0 |
County | 5 | 4 | 3 |
Zip/Postal code | 3 | 3 | 0 |
Other | 7 | 9 | 4 |
Racial composition
| |||
White/European | 11 | 10 | 1 |
African American/Black | 9 | 8 | 1 |
Hispanic | 7 | 7 | 0 |
Asian/Pacific Islanders | 5 | 5 | 0 |
American Indian/Native Alaskan | 1 | 1 | 0 |
Other | 2 | 2 | 0 |
No data | 18 | 16 | 6 |
Author, year (location) | Individual-level data source; area level data source | Study design and sample characteristics | Geographic location and unit | Main area based measures (measurement) | Outcome |
---|---|---|---|---|---|
[26]Blot, 1977 (United States) | NIH publication on US cancer mortality by county; 1960 US Census | Cross-sectional; ≥ 20 years old | Contiguous US; county | Income (Median family income, categorized into 2 groups: <50%, >50% by region and population-size) | Mortality |
[17]Devesa, 1980 (United States) | Third national cancer survey 1969–1971; US Census 1970 | Cross-sectional Females ≥ 15 years; n=20,914 cases; 92.5% white, 7.5% black | 18 US Standard Metropolitan Statistical Areas; Census Tracts | Education (Median years of education categorized into 5 groups for Whites: <10, 10–10.9, 11–11.9, 12–12.9, and ≥13 years; categorized into 3 groups for blacks: <10, 10–10.9, and ≥11 years) Income (Median family income categorized into 5 groups for Whites: <$9,000, $9,000-10,999, $11,000-12,999, $13,000-14,999, ≥$15,000; and categorized into 3 groups for blacks: <$5,000, $5000-6,999, ≥$7,000) | Incidence |
[20]Krieger, 1990 (United States) | SEER 1979–1981; US Census 1980 | Cross-sectional; Females; n=4,454 cases; 86% white, 9% black, 5% Hispanic | San Francisco Bay Area; Census block group | Occupational class composition (% employed in “working class” occupations, categorized into 2 groups ≤ 66% and >66% in working class occupations); Poverty (% living below poverty, categorized into two groups (≥20% and < 20%) | Incidence |
[16]Baquet, 1991 (United States) | SEER 1978–1982; US Census 1980 | Cross-sectional; Females; ≥ 25 years old | San Francisco/Oakland, Atlanta, Detroit; Census tract | Education (Median years of education, categorized into 4 groups: <high school, high school graduates, some college, at least 4 years of college) Income (Median family income, categorized into 4 groups: <$15,000, $15,000-24,999, $25,000-29,999, ≥$30,000) | Incidence |
[23]Williams, 1991 (Australia) | Victorian Cancer Registry 1982–1983 Melbourne statistical division 1979–1983; Australian Census 1981 | Cross-sectional; Females; 40–74 years old | Melbourne; Local government area | Composite SES (Based on occupational status, income, educational attainment, family instability, persons living in low standard housing likely to have difficulty with English, categorized into deciles) | Incidence mortality |
[21]Nasca, 1992 (United States) | New York State Cancer Registry 1978–1982; US Census 1980 | Cross-sectional | New York state exclusive of New York City; Minor civil divisions | Urbanization (Population density: [persons/square miles], categorized into quinitles | Incidence |
[22]Pollock, 1997 (United Kingdom) | The Thames Cancer Registry 1987–1992; UK Census 1991 | Cross-sectional; Females; 40–99 years old; n=22,399 cases | South Thames; Enumeration district | Composite SES “Townsend Index of Social Deprivation” (based on % unemployed, % private household lacking a car, % private household not owner occupied, % private household subject to overcrowding; categorized into deciles) | Incidence mortality |
[30]Gorey, 1998 (Canada) | Ontario cancer registry 1986–1993; Canadian Census 1991 | Cross-sectional; Females; ≥ 25 years old; n=1,3227 cases | Metropolitan Toronto; Census tract | Poverty (annual household income adjusted for household size, categorized into low (≥23% households below low-income cutoff) and high (<7% of households below criterion)) | Incidence |
[34]Liu, 1998 (United States) | The Los Angeles County Surveillance Program 1979–1992; US Census 1970, 1980, 1990 | Cross-sectional; Females; ≥ 15 years old; n=82,453 cases; 77.9% white, 9.1% black, 9.0% Hispanic, 3.2% Asian, <1% other | Los Angeles County; Census tract | Composite SES (Based on weighted average educational attainment and median household income; categorized into quintiles) | Incidence |
[39]Prehn, 1998 (United States) | Northern California cancer center’s greater Bay Area cancer registry 1988–1992; US Census 1990 | Cross-sectional; Females; n=22,757 cases; 100% white | San Francisco Bay Area and 20 counties from adjoining regions; Census block group | Education (% with college education, categorized into 2 groups: ≥45% vs. <45%); Income (Median household income, categorized into 2 groups ≥ $50000 and <$50000); Occupational Class (% employed in working class occupations, categorized into 2 groups ≤50% and >50% working class); Poverty (% below poverty level, categorized into 2 groups ≤5% vs.>5%) | Incidence |
[33]Krieger, 1999 (United States) | Population-based cancer registry 1988–1992; US Census 1990 | Cross-sectional; Females; n=16,120 cases; 78% white, 7% black, 7% Hispanic, 8% Asian | San Francisco Bay Area; Census block group | Composite SES (Combination of occupational class (% employed in “working class” and “professional” occupations) and poverty (% below poverty level); categorized into 3 groups: 1) professional (non-poor and poor), 2) working class, non-poor, 3) working class, poor) | Incidence |
[35]Mackillop, 2000 (Canada and United States) | Ontario Cancer Registry (1989–1993); SEER 1988–1992; Canadian Census 1991 and US Census 1990 | Cross-sectional | Ontario, Canada; 9 SEER regions in US; Enumeration area in Canada and census tract in the U.S. | Income (Median household income, categorized into deciles. Race-specific deciles in the US for secondary analysis) Natural log of relative income for regression | Incidence |
[40]Reynolds, 2004 (United States) | The California Teachers Study cohort with annual linkage to the California Cancer Registry, baseline in 1995 with follow up through Dec 1999; US Census 1990 | Prospective cohort; Females; 21–108 years at baseline; n=114,927 | California; region | Urbanization (a priori specification of urban counties, categorized into San Francisco Bay area, Southern Coastal area, rest of California) | Incidence |
[42]Robert, 2004 (United States) | Population-based case control study 1988–1995; US Census 1990 | Case–control; Females; 20–79 years old; n=7,179 cases, 7,488 controls | Wisconsin; Census tract and Zip code | Composite SES (Based on median income, % adults below poverty, % unemployed, % college graduate, categorized into quintiles) Urbanization (Residence in census-defined “urban areas”, categorized into 3 groups: 100% rural, mixed rural/urban, 100% urban) | Risk |
[18]Hall, 2005 (United States) | North Carolina State Registry 1995–1999; US Census 1990 | Cross-sectional; Females; 27,989 cases, 82% white, 18% non-white | North Carolina; County | Metropolitan areas (Urban Influence Code based on by adjacency or non-adjacency to a Metropolitan Area, and size of the largest communities, categorized into 3 groups- metropolitan; non-metropolitan adjacent to metropolitan; non-metropolitan, nonadjacent to metropolitan areas) | Incidence |
[41]Reynolds, 2005 (United States) | The California Cancer Registry 1988–1997; US Census 1990 | Cross-sectional; Females; ≥20 years old; 176,302 cases | California; Block group | Composite SES (Based on % with college degree, median family income and % employed in managerial/professional occupations, categorized into quartiles) Urbanization (Population size and density, categorized into 4 groups -urban suburban, city, small town/rural) | Incidence |
[32]Krieger, 2006 (United States) | Northern California Cancer Center’s San Franciso; Oakland SEER Registry, Los Angeles Surveillance program, Massachusetts Cancer registry 1978–1982, 1988–1992, 1998-2002/ US Census 1980, 1990, 2000 | Cross-sectional; Females; 154,083 cases | San Francisco/ Oakland, Los Angeles county, Massachusetts; Census tract | Composite SES (% below poverty level and % high income ho'useholds (defined as ≥4 times the US median household income), categorized into 5 groups: 1) <5% poverty-<10% high income, 2) <5% poverty-≥10% high income, 3) 5-9% poverty, 4) 10-19% poverty, 5) ≥20% poverty) | Incidence |
[44]Shack, 2008 (United Kingdom) | English cancer registries 1998–2003; UK Census 2001 and government databases | Cross-sectional; Females; 210,020 cases | 8 UK cancer registries; Postal code of residence | Income deprivation (Based on the income domain of the Index of Multiple Deprivation, categorized into quintiles) | Incidence |
[46]Webster, 2008 (United States) | The Massachusetts Cancer Registry 1987–1993; US Census 1980, 1990 | Case–control; Females; 548 cases, 490 controls | Cape Cod, Massachusetts; Census block group | Composite SES (Based on median income, % adults below poverty, % unemployed, % college graduate, categorized into quintiles) Poverty (% of adults below poverty level, categorized into 3 groups based on the 20th and 80th percentiles of control women) | Risk |
[28]Clegg, 2009 (United States) | National Longitudinal Mortality Study and SEER, 1973–2001; US Census 1970, 1980, 1990 | Cross-sectional; Females; ≥ 25 years old; 1739 cases; 78% white, 7% black, 4% Mexican, 1% other Hispanic, 4% Asian/Pacific Islander, 2% other | 11 SEER regions | Urbanization (Census definition of urban/rural) | Incidence |
[4] Harper, 2009 (United States) | SEER 1987–2004; US Census 1990 | Cross-sectional | SEER regions; County | Poverty (% below poverty level, categorized into 4 groups: <10%, 10-14%, 15-19%, ≥20%) | Incidence mortality |
[19]Hausaer, 2009 (United States) | NAACCR Registries 1997–2004; USDA 2003 | Cross-sectional; Females; 50–74 years old; 587,408 cases; 100% white | 29 population-based cancer registries in the North American Association of Central Cancer Registries (NAACCR); County | Poverty (% below poverty level, categorized into 3 groups: <10%, 10-19%, ≥20%) Urbanization (US Dept. of Agriculture codes and population size, categorized into urban, suburban and rural areas) | Incidence |
[29]Dobson, 2010 (Australia) | Australian Longitudinal Study on Women’s Health, baseline survey in 1996 with follow up through 2006; The Australian Standard Geographic Classification | Longitudinal; Females; 70–75 years at baseline; 12,400 with 2,803 breast cancer deaths | Australia | Area of residence (Road distance to the closest service center, a measure of population size) | Mortality |
[31]Keegan, 2010 (United States) | The California Cancer Registry 1988–2004; US Census 2000 | Cross-sectional; Females; 12,563 cases; 100% Hispanic | California/ Cross-sectional; Block groups averaged over census tracts (for SES) | Composite Hispanic Enclave (Based on % linguistically isolated overall and who speak Spanish, speak limited English, speak limited English and speak Spanish, % recent immigrants, % Hispanic, % foreign-born) Composite SES (Based on income, occupation, and housing costs, categorized into quintiles) Combined SES and Hispanic Enclave (Combination of SES and Hispanic enclave, categorized into 4 groups: low SES-high enclave, high SES-low enclave, low SES-low enclave, high SES-high enclave) | Incidence |
[45]Spadea, 2010 (Italy) | The Turin Longitudinal Study and the Piedmont Cancer Registry, 1985–1999; Italian Census 1971 | Cross-sectional; Females; 30–84 years old; 9,203 cases | Turin, Italy; Census tract | Composite SES (Based on % manual workers, % with low education, % tenants, % living % in houses without bath, % families with a single parent with children, and a crowding index, categorized into quintiles) Relative Index of Inequality (Ratio of regression-based rates for extreme points of the social hierarchy) | Incidence/Risk |
[27]Borugian, 2011 (Canada) | The Canadian Cancer Registry 1992–2004; Canadian Census 1991, 1996, 2001, 2006 | Cross-sectional; Females; ≥19 years old; 226,169 cases | Canada; postal code | Income (Average income per single person equivalent in the enumeration area or dissemination area, categorized into quintiles) | Incidence |
[47]Yost, 2001 (United States) | The California Cancer Registry 1988–1992 US Census 1990 | Cross-sectional; Females; ≥15 years old; 97,227 cases; 80% white, 6% black, 9% Hispanic, 5% Asian | California; Census block group | Composite SES (Based on education index, proportion with a blue-collar job, % in workforce without a job, median household income, % below 200% poverty level, median rent, median house value, categorized into quintiles) | Incidence |
[37]Palmer, 2012 (United States) | The Black Women’s Health Study, baseline in 1995 with follow-up through 2009; US Census 2000 | Longitudinal; Females; 21–69 years at baseline; total n=55,896, analysis on n=1,343 cases with geocoded data; 100% black | 17 US states; Census block group | Composite SES (Based on median household income, median housing value, % household receiving interest, dividends or net rental income, % with college degree, % employed in managerial, executive or professional specialty, % families with children headed by a single female; categorized into quintiles) | Incidence |
[38]Panczak, 2012 (Switzerland) | The Swiss National Cohort 2001–2008;Swiss Census 2000 | Longitudinal; Females; ≥ 30 years old; n=4,300,000 (including males), breast cancer deaths unknown | Switzerland; Neighborhood boundaries | Swiss-SEP Index (SES composite measure based on occupational status, income, educational attainment, family instability, persons living in low standard housing likely to have difficulty with English, categorized into deciles) | Mortality |
[43]Schlichting, 2012 (United States) | SEER 2000–2007; US Census 2000 | Cross-sectional; Females n=34,3627 cases; 75% white, 9% black, 9% Hispanic, 7% Asian/Pacific Islander, <1% American Indian/ Native Alaskan | 17 SEER regions; County | Education (% without high school degree, categorized into quartiles) Poverty (% below federal poverty level, categorized into three groups (<10%, 20-19%, ≥20%) Urbanization (Rural–urban continuum definition per US Dept. of Agriculture, categorized into metro counties and non-metro counties) | Incidence |
[36]Markossian, 2012 (United States) | SEER 1992-2007 | Cross-sectional; Females; ≥15 years old; n= 23,500 cases; 69% white, 31% black | Georgia (15 counties; County | Urban/Rural residence (County-level urban/rural residence) | Mortality |
Data sources
Study design and sample characteristics
Area-Based Residential (ABR) measures
Geographic unit
Associations between ABR measures and breast cancer incidence
Author, year (location) | Main area based measure/contrast | Stratification variable | Age-adjusted rates per 100,000 | Ratio measures | P-value trend |
---|---|---|---|---|---|
Education
| |||||
[17]Devesa, 1980 (United States) | Highest vs. lowest education | Whites | a95.9 vs. 71.9 | b 1.33 | |
Blacks | a52.0 vs. 43.8 | b1.19 | |||
[16]Baquet, 1991 (United States) | Highest vs. lowest education | White | 116 vs. 80.2 | b Rate Ratio: 1.45 | <0.01 |
Black | 77.4 vs. 70.3 | b Rate Ratio: 1.10 | 0.17 | ||
[39]Prehn, 1998 (United States) | Highest vs. lowest education | c Rate Ratio: 1.18 (1.13-1.22) | |||
[43]Schlichting, 2012 (United States) | Lowest vs. highest education | All races | c Rate Ratio: IBC: 1.20 (1.12-1.30) Non-IBC: 0.87 (0.86-0.88) | ||
Non-Hispanic White | c Rate Ratio: IBC: 1.20 (1.09-1.32) Non-IBC: 0.96 (0.95-0.97) | ||||
Black | c Rate Ratio: IBC: 1.28 (1.04-1.58) Non-IBC: 1.00 (0.97-1.03) | ||||
Income
| |||||
[17]Devesa, 1980 (United States) | Highest vs. lowest income | Whites | a93.4 vs. 68.4 | b1.37 | |
Blacks | a48.2 vs. 47.3 | b1.02 | |||
[16]Baquet, 1991 (United States) | Highest vs. lowest income | White | 104.3 vs. 80.7 | b Rate Ratio: 1.29 | <0.01 |
Black | 108.0 vs. 67.9 | b Rate Ratio: 1.59 | 0.27 | ||
[39]Prehn, 1998 (United States) | Highest vs. lowest income | c Rate Ratio: 1.15 (1.11-1.19) | |||
[35]Mackillop, 2000 (Canada and United States) | Highest vs. lowest income | Ontario | c Rate Ratio: 1.10 (1.04-1.16) | ||
US | c Rate Ratio: 1.35 (1.31-1.40) | ||||
[27]Borugian, 2011 (Canada) | Lowest vs. highest income§ | c Rate Ratio: 0.85 (0.84-0.86) | |||
Poverty
| |||||
[20]Krieger, 1990 (United States) | Lowest vs. highest poverty | Black, <40 years, High working class | 11.1 vs. 9.0 | b Rate Ratio: 1.23 | |
Black, <40 years, Low working class | 18.6 vs. 13.5 | b Rate Ratio: 1.38 | |||
Black, ≥40 years, High working class | 155.5 vs. 172.4 | b Rate Ratio: 0.90 | |||
Black, ≥40 years, Low working class | 238.7 vs. 256.8 | b Rate Ratio: 0.93 | |||
White, <40 years, High working class | 9.0 vs. 14.0 | b Rate Ratio: 0.64 | |||
White, <40 years, Low working class | 9.2 vs. 5.3 | b Rate Ratio: 1.74 | |||
White, ≥40 years, High working class | 214.7 vs. 209.9 | b Rate Ratio: 1.02 | |||
White, ≥40 years, Low working class | 248.8 vs. 284.8 | b Rate Ratio: 0.87 | |||
[30]Gorey, 1998 (Canada) | Lowest vs. highest poverty | 113.23 vs. 127.65 | Standardized incidence rate Ratio: 0.89 (0.80-0.99) | ||
[39]Prehn, 1998 (United States) | Lowest vs. highest poverty | c Rate ratio: 1.11 (1.08-1.14) | |||
[46]Webster, 2008 (United States) | Lowest vs. highest poverty | Diagnosis year: 1990 | d 1.27 (0.85-1.92) | ||
Diagnosis year: 1980 | d 0.94 (0.59-1.48) | ||||
[4]Harper, 2009 (United States) | Highest vs. lowest poverty | Diagnosis Year: 1987 | 328.7 vs. 381.6 | b 0.86 | |
Diagnosis Year: 2004 | 302.2 vs. 345.3 | b 0.88 | |||
[19]Hausauer, 2009 (United States) | Highest vs. lowest poverty | Diagnosis Year: 2001 | 337.6 (326.2 – 349.2) vs. 370.4 (365.8-375.1) | b 0.91 | |
Diagnosis Year: 2004 | 305.1 (294.5-316.1) vs. 322.4 (318.2-326.6) | b 0.95 | |||
[43]Schlichting, 2012 (United States) | Highest vs. lowest poverty§ | All races | c Rate Ratio: IBC: 1.24 (1.12-1.37) Non-IBC: 0.86 (0.84-0.87) | ||
Non-Hispanic white | c Rate Ratio: IBC: 1.12 (0.99-1.27) Non-IBC: 0.87 (0.86-0.89) | ||||
Black | c Rate Ratio: IBC: 1.32 (1.01-1.72) Non-IBC: 1.02 (0.98-1.06) | ||||
Composite SES
| |||||
[23]Williams, 1991 (Australia) | Highest vs. lowest SES | 203 vs. 146 | b Rate Ratio: 1.39 | <0.001 | |
[22]Pollock, 1997 (United Kingdom) | Highest vs. lowest SES | SIR: 105 (95–115) vs. 95 (84–107) | b Standardized Incidence Rate Ratio: 1.11 | ||
[34]Liu, 1998 (United States) | Highest vs. lowest SES | c Relative Risk: 1.53 (1.49-1.57) | 0.0001 | ||
[33]Krieger, 1999 (United States) | Working class poor vs. Professional | Asian and Pacific Islander | c Rate Ratio: 0.8 (0.7-1.0) | 0.07 | |
Black | c Rate Ratio: 1.0 (0.9-1.1) | 0.89 | |||
Hispanic | c Rate Ratio: 0.5 (0.4-0.7) | 0.00 | |||
White | c Rate Ratio: 1.2 (1.1-1.3) | 0.12 | |||
[47]Yost, 2001 (United States) | Highest vs. lowest SES | Whites 15–49 years | 1.78 (1.7-1.9) | <0.0001 | |
Whites 50–64 years | 1.26 (1.2-1.3) | <0.0001 | |||
Whites 65+ years | 1.21 (1.2-1.3) | <0.0001 | |||
Blacks 15–49 years | 1.70 (1.5-1.9) | 0.026 | |||
Blacks 50–64 years | 1.20 (1.1-1.4) | 0.008 | |||
Blacks 65+ years | 1.16 (1.0-1.3) | 0.574 | |||
Hispanics 15–49 years | 2.61 (2.4-2.8) | <0.0001 | |||
Hispanics 50–64 years | 1.85 (1.7-2.0) | <0.0001 | |||
Hispanics 65+ years | 1.78 (1.7-1.9) | <0.0001 | |||
Asian/Others 15–49 years | 2.26 (2.0-2.5) | 0.0001 | |||
Asian/Others 50–64 years | 1.61 (1.5-1.8) | 0.0016 | |||
Asian/Others 65+ years | 1.54 (1.4-1.7) | <0.0001 | |||
[42]Robert, 2004 (United States) | Highest vs. lowest SES | e Odds Ratios: 1.20 (1.05-1.37) | |||
[41]Reynolds, 2005 (United States) | Highest vs. lowest SES | c Rate Ratio: 1.59 (1.53-1.64) | <0.01 | ||
[32]Krieger, 2006 (United States) | Highest vs. lowest SES | San Francisco Bay Area | c IRR 1978–1982: 1.23 (1.10-1.38) 1988–1992: 1.40 (1.30-1.50) 1998–2002: 1.53 (1.43-1.65) | 1978-1982: p=0.000; 1988–1992: p=0.000; 1998–2002 p=0.000 | |
San Francisco Bay Area, non-Hispanic White | c IRR 1978–1982: 1.25 (1.07-1.45) 1988–1992: 0.96 (0.86-1.08) 1998–2002: 1.21 (1.06-1.38) | 1978-1982: p=0.001; 1988–1992: p=0.368; 1998–2002 p=.000 | |||
San Francisco Bay Area, Black | c IRR 1978–1982: 0.82 (0.34-1.99) 1988–1992: 1.19 (0.84-1.68) 1998–2002: 0.90 (0.67-1.20) | 1978-1982: p=0.159; 1988–1992: p=0.192; 1998–2002 p=0.495 | |||
Los Angeles county | c IRR 1978–1982: 1.51 (1.40-1.63) 1988–1992: 1.72 (1.64-1.81) 1998–2002: 1.79 (1.71-1.87) | 1978-1982: p=0.000; 1988–1992: p=0.000; 1998–2002 p=0.000 | |||
Los Angeles county, non-Hispanic White | c IRR 1978–1982: 0.85 (0.77-0.93) 1988–1992: 1.16 (1.08-1.25) 1998–2002: 1.19 (1.11-1.26) | 1978-1982: p=0.000; 1988–1992: p=0.000; 1998–2002 p=0.000 | |||
Los Angeles county, Black | c IRR 1978–1982: 1.13 (0.47-2.71) 1988–1992: 1.15 (0.82-1.60) 1998–2002: 1.21 (0.98-1.51) | 1978-1982: p=0.027; 1988–1992: p=0.000; 1998–2002 p=0.003 | |||
Massachusetts | c IRR 1988–1992: 0.95 (0.88-1.02) 1998–2002: 1.35 (1.28-1.42) | 1988-1992: p=0.020; 1998–2002 p=0.000 | |||
Massachusetts, non-Hispanic White | c IRR 1998–2002: 1.14 (1.07-1.21) | 1998-2002: p=0.000 | |||
Massachusetts, Black | c IRR 1988–1992: 0.80 (0.35-1.83) 1998–2002: 0.68 (0.42-1.11) | 1988-1992: 0=0.223; 1998–2002 p=0.911 | |||
[44]Shack, 2008 (United Kingdom) | Lowest vs. highest SES§ | c 0.84 (0.82-0.85) | |||
[46]Webster, 2008 (United States) | Highest vs. lowest SES | Diagnosis year: 1990 | d 1.30 (0.86-1.96) | ||
10 years prior to diagnosis: 1980 | d 1.69 (1.10-2.59) | ||||
[31]Keegan, 2010 (United States) | Highest vs. lowest SES | c Rate Ratio: 1.79 (1.68-1.92) | |||
[45]Spadea, 2010 (Italy) | Lowest vs. highest SES§ | f 0.91 (0.84-0.98) | |||
[37]Palmer, 2012 (United States) | Highest vs. lowest SES | g Rate Ratio: 0.92 (0.77-1.10) | 0.54 | ||
Occupational class
| |||||
[20]Krieger, 1990 (United States) | Highest vs. lowest working class | Black, <40 years | OR: 0.57 (0.32-1.04) | ||
Black, ≥40 years | OR: 0.68 (0.53-0.88) | ||||
White, <40 years | OR: 1.04 (0.82-1.32) | ||||
White, ≥40 years | OR: 0.86 (0.81-0.92) | ||||
[39]Prehn, 1998 (United States) | Lowest vs. highest working class | c Rate Ratio: 1.13 (1.09-1.17) | |||
Urbanization
| |||||
[21]Nasca, 1992 (United States) | Urban vs. rural | SIR: 107 (104–110) vs. 83 (81–86) | b Standardized Incidence Rate Ratio: 1.29 | <0.03 | |
[40]Reynolds, 2004 (United States) | Urban vs. less urban | e Hazard Ratio: 1.33 (1.10-1.62) | |||
[42]Robert, 2004 (United States) | Urban vs. rural | e Odds Ratios: 1.17 (1.06-1.28) | |||
[18]Hall, 2005 (United States) | Metropolitan vs. non-Metropolitan non-adjacent | White | 122.7 vs. 104.0 | Rate Ratio: 1.18 | |
Non-White | 107.3 vs. 108.0 | Rate Ratio: 0.99 | |||
Urban vs. rural | White | 116.6 vs. 98.8 | b Rate Ratio: 1.18 | ||
Non-white | 91.0 vs. 100.9 | b Rate Ratio: 0.90 | |||
[41]Reynolds, 2005 (United States) | Urban vs. small town/rural | c Rate Ratio: 0.98 (0.94-1.01) | |||
[28]Clegg, 2009 (United States) | Rural vs. urban § | 157.6 vs. 147.1 | h 1.06 (0.94-1.19) | ||
[19]Hausauer, 2009 (United States) | Urban vs. rural | Diagnosis year: 2001 | 375.1 (371.9-378.3) vs. 306.2 (292.9-320.1) | b 1.23 | |
Diagnosis year: 2004 | 323.5 (320.6-326.4) vs. 283.1 (270.5-295.1) | b 1.14 | |||
[43]Schlichting, 2012 (United States) | Non-metro vs. metro§ | All races | c Rate Ratio: IBC: 0.99 (0.90-1.08) Non-IBC: 0.94 (0.93-0.95) | ||
Non-Hispanic white | c Rate Ratio: IBC: 0.95 (0.85-1.05) Non-IBC: 0.88 (0.87-0.89) | ||||
Black | c Rate Ratio: IBC: 1.40 (1.06-1.81) Non-IBC: 0.97 (0.92-1.01) | ||||
Hispanic enclave
| |||||
[31]Keegan, 2010 (United States) | Lowest enclave vs. highest enclave | c Rate Ratio: 1.79 (1.67-1.92) | |||
High SES low enclave vs. low SES high enclave | c Rate Ratio: 1.56 (1.50-1.63) | ||||
Relative index of inequality
| |||||
[45]Spadea, 2010 (Italy) | Relative Index of Inequality | f 0.92 (0.82-1.02) | |||
Natural log of relative income
| |||||
[35]Mackillop, 2000 (Canada and United States) | Natural log of relative income for regression | Ontario | c Rate Ratio: 1.04 (1.00-1.08) | ||
US | c Rate Ratio: 1.14 (1.12-1.17) |
Education
Meta analysis- education
Income
Meta analysis- income
Poverty
Meta-analysis- poverty
Composite SES
Meta-analysis- composite SES
Occupational class
Urbanization
Meta-analysis- urbanization
Hispanic enclave
Other ABR measures
Associations between ABR measures and breast cancer mortality
Author, year (location) | Main area based measure/contrast | Stratification variable | Age-adjusted rates per 100,000 | Ratio measures | P-value Trend |
---|---|---|---|---|---|
Income
| |||||
[26]Blot, 1977 (United States) | High income vs. low income | Northeast, <10,000 | a 25.2 vs. 24.1 | ||
South, <10,000 | a 18.0 vs. 16.2 | b Rate Ratio: 1.05 | |||
Central, <10,000 | a 22.0 vs. 20.9 | b Rate Ratio: 1.11 | |||
West, <10,000 | a 20.7 vs. 20.3 | b Rate Ratio: 1.05 | |||
Northeast, 250,000+ | a 30.2 vs.28.1 | b Rate Ratio: 0.99 | |||
South, 250,000+ | a 25.1 vs. 22.9 | b Rate Ratio: 1.07 | |||
Central, 250,000+ | a 28.6 vs. 26.4 | b Rate Ratio: 1.08 | |||
West, 250,000+ | a 26.8 vs. 23.6 | b Rate Ratio: 1.14 | |||
Poverty
| |||||
[4]Harper, 2009 (United States) | Highest vs. lowest SES | Year of death: 1987 | 85.1 vs. 102.7 | b 0.83 | |
Year of death: 2004 | 76.3 vs. 74.4 | b 1.02 | |||
Composite SES
| |||||
[23]Williams, 1991 (Australia) | Highest vs. lowest SES | a 68 vs. 57 | b Rate Ratio: 1.19 | ||
[22]Pollock, 1997 (United Kingdom) | Highest vs. lowest SES | SMR: 99 (84–116) vs. 111 (93–132) | b Rate Ratio: 0.89 | ||
[38]Panczak, 2012 (Switzerland) | Lowest vs. highest SES | c Hazard Ratio: 0.96 (0.87-1.05) | 0.826 | ||
Urbanization
| |||||
[29]Dobson, 2010 (Australia) | Remote vs. major urban centers | d Hazard Ratio: 0.47 (0.06-3.42) | |||
[36]Markossian, 2012 (United States) | Rural vs. urban | e Hazard Ratio: 1.04 (0.85-1.26) | 0.748 |