Cancer
Association between National Area Deprivation Index and Incident Bone Health Outcomes Among Newly Diagnosed Breast Cancer Patients Iridian Guzman* Iridian Guzman Marybeth Ingle
Background:Breast Cancer (BC) patients are susceptible to bone loss. This study aims to evaluate the association between national area deprivation index (ADI), a national ranking of neighborhood sociodemographic disadvantage, and bone health outcomes among newly diagnosed BC patients.
Methods:Newly diagnosed BC patients were retrospectively evaluated from 01/2019-01/2021. Bone health outcomes were osteopenia, osteoporosis & bone fracture. ADI was distributed into quartiles (Q1= least disadvantaged, Q4= most disadvantaged). A multivariable logistic regression model evaluated the likelihood of having a bone health outcome diagnosis using ADI as the primary predictor while adjusting for age, race/ethnicity, employment status, insurance, body mass index (BMI), hypertension, palliative care referrals, vitamin D, hormone therapy, chemotherapy, breast cancer surgery, and bone screening. A multivariable cox proportional hazard model evaluated the association between ADI and time from diagnosis to first bone health outcome diagnosis.
Results:Patients (n=3,011) were older (Median=68), White (55%), non-smokers (63%) with Medicare (58%). 21% of patients had osteopenia, 20% osteoporosis & 1% had bone fractures during follow up. Compared to the least deprived patients, those in Q3 (OR=0.74; 95%CI: 0.56,0.98) and Q4 (OR=0.66; 95%CI:0.49,0.90) were less likely to have an osteoporosis diagnosis. Similarly, time to osteoporosis diagnosis after a BC diagnosis was 27% & 21% longer for Q4 (95% CI: 0.57,0.92) & Q3 (95%CI: 0.63,0.99) patients, respectively compared to Q1 patients.
Conclusion:20% of BC patients also had a diagnosis of osteoporosis. Disadvantaged patients were less likely to have an osteoporosis diagnosis and time to osteoporosis diagnosis after BC diagnosis was longer for disadvantaged patients. Common BC treatments, along with age, impact bone health and survivorship. Future studies should focus on interventions to improve bone health for disadvantaged patients.