Abstract 3701: Health disparity characteristics on growth patterns of breast cancer mortality trends among the US Counties, 1989-2010

Proceedings: AACR 106th Annual Meeting 2015; April 18-22, 2015; Philadelphia, PA Background: Group-based trajectory models are increasingly being applied to address questions related to the development of cancer mortalities over time and, more recently, there is a need to move away from the interpretation of trajectory groups as distinct entities. In this study, we aim to identify trajectory-patterns which have distinct epidemiologic disparity among US counties, and to assess whether health disparities in the socioeconomic characteristics are associated with a greater women health burden in breast cancer. Methods: Cases of breast cancer diagnosed between 1989 and 2010 were selected from Center for Disease Control's WONDER Online Databases using International Classification of Diseases for Malignant neoplasm of breast (ICD 10 - C50). Age-adjusted mortality rates of breast cancer between 1989 and 2010 were calculated by counties as well as race (African American and White). Growth patterns were identified using Growth Mixture Modeling (GMM) method and disparity characteristics including socioeconomic attributes were investigated through National Cancer Institute's Surveillance Epidemiology and End Results (SEER) County Attributes Dataset. Results: We identified the following three growth sub-patterns in the trajectories of breast cancer mortality rates between 1989 and 2010 among US counties: (1) a majority (61%) following a gradual decreasing trajectories, (2) a non-decreasing trajectories (31%), and the remainder following a trajectory with relatively rapid decreasing (7%). We compared disparity characteristics of education level, median household income, poverty percentage, percentages of older ages (65+) and younger ages (<18), and rural-urban continuum among above three sub-patterns. Conclusions: There is heterogeneity of the socioeconomic characteristics that are highly associated with growth patterns in trajectories of breast cancer mortality rates. Growth mixture models are an effective tool to be able to capture health disparities in heterogeneity among counties in the trajectory of breast cancer mortality. Note: This abstract was not presented at the meeting. Citation Format: Wonsuk Yoo, George Rust, Shun Zhang, James Lillard. Health disparity characteristics on growth patterns of breast cancer mortality trends among the US Counties, 1989-2010. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3701. doi:10.1158/1538-7445.AM2015-3701