Neighborhood deprivation and nativity in breast cancer stage at diagnosis among U.S.- and Latin America–born women.

Abstract

e13512 Background: Stage at diagnosis strongly predicts breast cancer outcomes. Socioeconomic and structural factors affect access to screening, yet the relative impact of neighborhood deprivation versus immigration status on stage at presentation remains unclear. Methods: We conducted a retrospective cohort study of women ≥18 years diagnosed with breast cancer (2010–2024) at a South Florida cancer center. Analyses included U.S.-born women and women born in Latin America. Neighborhood deprivation was measured using the Area Deprivation Index (ADI), categorized into quartiles (Q1 least deprived–Q4 most deprived). Late-stage diagnosis (LSD) was defined as stage III–IV. Multivariable logistic regression assessed associations between ADI, nativity, and late-stage diagnosis, adjusting for age, with tests for trend. Results: Among 1,235 women (726 Latin America–born; 509 U.S.-born), 20.4% presented with LSD. LSD did not differ by nativity (22.1% U.S.-born vs 19.2% Latin America–born; p = 0.24), and nativity was not independently associated with LSD after adjustment (OR 1.27, 95% CI 0.96–1.69). Higher neighborhood deprivation was strongly associated with LSD, with increasing odds across ADI quartiles (Q2 vs Q1 OR 1.51, Q3 vs Q1 OR 2.49; p-trend < 0.001). In secondary analyses, U.S.-born women had higher adjusted odds of all-cause mortality (OR 1.72, 95% CI 1.04–2.88), while ADI was not independently associated with mortality. Conclusions: Neighborhood deprivation was independently associated with breast cancer LSD, whereas nativity was not. U.S.-born women demonstrated higher all-cause mortality in secondary analyses. Together, these findings highlight the dominant role of neighborhood-level socioeconomic conditions in breast cancer disparities, independent of nativity. Cohort characteristics and outcomes. Characteristic / Outcome Estimate Measure Total analytic cohort 1,235 women — Latin America–born 726 (58.8%) — U.S.-born 509 (41.2%) — Late-stage disease (overall) 252 (20.4%) — Late-stage disease by nativity 22.1% vs 19.2% p = 0.24 Late-stage disease by ADI Increasing Q1→Q4 p < 0.001 ADI (per quartile increase) OR 1.51 (95% CI 1.25–1.83) p-trend < 0.001 All-cause mortality (overall) 66 (5.2%) — Mortality by nativity (adjusted) OR 1.72 (95% CI 1.04–2.88) p < 0.05