Abstract
Association of social determinants of health (SDH), allostatic load (AL) and incident cancers in the multi-ethnic study of atherosclerosis (MESA)
Journal of clinical oncology, v 42(16_suppl), 10562
01 Jun 2024
Abstract
Background: AL may represent accumulated physiologic stress from adverse SDH. We assess the relationship of AL and incident cancer risk in MESA, a cohort free of cardiovascular disease (CVD) at baseline.
Methods: MESA participants at Exam 1 (July 2000-August 2002) were included, except those with prevalent cancers other than non-melanoma skin, median follow-up, 16.5 years. We assigned the composite AL measure 1 point for each individual biomarker in the worst quartile for total cholesterol, high density lipoprotein cholesterol, C-reactive protein, and IL-6. One point each was assigned for BMI>25 or <18kg/m 2 ; creatinine>1.2mg/dL (women) or >1.4mg/dL(men), systolic (≥140mmHg), diastolic (≥90mmHg) blood pressure; heart rate>100bpm; coronary artery calcium score>0 and history of diabetes. AL score (mean=3.09, SD=1.76) ranged 0-12. Other covariates included sociodemographic variables. Where missing, data for individual biomarkers were imputed using Multivariate Imputation by Chained Equations in R prior to calculating AL score. Cox regression models assessed AL in the whole population and stratified by race/ethnicity.
Results: 6808 participants comprised the analytic sample; 1022 (15%) were diagnosed with new cancer during follow-up. Chinese (adjusted hazard ratio [aHR], 95% confidence interval [95%CI], 0.46,0.36-0.60) and Hispanic/Latino (aHR,95%CI 0.60,0.50-0.72) participants were less likely to develop new cancers compared with White participants. Each AL point increase was associated with increased new cancer risk (aHR,95%CI 1.07,1.03-1.11). In models stratified by race/ethnicity, AL association with new cancer risk persisted only for Black (aHR,95%CI 1.07, 1.00-1.14, p=0.04) and Hispanic/Latino (aHR,95%CI 1.17, 1.07-1.28, p=0.001) participants.
Conclusions: AL as a composite measure of physiologic stress and self-reported Chinese and Hispanic/Latino race/ethnicity independently correlated with incident cancer risk in a cohort free of CVD at baseline. Race/ethnicity may moderate the effects of AL. [Table: see text]
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Details
- Title
- Association of social determinants of health (SDH), allostatic load (AL) and incident cancers in the multi-ethnic study of atherosclerosis (MESA)
- Creators
- Ruth C. Carlos - University of MichiganSarah Bell - University of MichiganHassan Mirboluk - Johns Hopkins UniversityPaniz Charkhchi - Johns Hopkins UniversityMaya C Doyle - University of ChicagoJana A Hirsch - Drexel UniversityWendy S Post - Johns Hopkins UniversityGelareh Sadigh - University of California, Irvine
- Publication Details
- Journal of clinical oncology, v 42(16_suppl), 10562
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics
- Web of Science ID
- WOS:001275557402417
- Other Identifier
- 991021889615204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology