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Impact of navigation and neighborhoods on breast cancer survivorship

This study aims to understand the impact of navigation and neighborhoods on breast cancer survivorship by linking neighborhood, registry, and community data. It examines associations between neighborhood characteristics and quality of life, and strengthens the community-research partnership. Initial results from the Greater Bay Area Cancer Registry and Shanti Project data linkage are presented.

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Impact of navigation and neighborhoods on breast cancer survivorship

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  1. Impact of navigation and neighborhoods on breast cancer survivorship Debby Oh, MSc, PhD

  2. Greater Bay Area Cancer Registry Source: Shanti Project FY17-18 Impact Report

  3. PURPOSE: To develop a multilevel data infrastructure to understand how navigation and neighborhood impact survivorship by linking neighborhood, registry, and community data Greater Bay Area Cancer Registry

  4. Study Aims Aim 1: Link data sources Neighborhood Data Built and social Environment Cancer Registry Data Tumor Clinical Demographics Community Data Navigation QoL Aim 3: Strengthen community-research partnership Aim 2: Examine associations between neighborhood and QoL Greater Bay Area Cancer Registry

  5. Today’s presentation Shanti Project Data Linkage Initial Results Greater Bay Area Cancer Registry

  6. Shanti Project Greater Bay Area Cancer Registry

  7. Greater Bay Area Cancer Registry Source: Shanti Project FY17-18 Impact Report

  8. Greater Bay Area Cancer Registry Source: Shanti Project FY17-18 Impact Report

  9. Greater Bay Area Cancer Registry Source: Shanti Project FY17-18 Impact Report

  10. Data Linkage Greater Bay Area Cancer Registry

  11. IRB approval IRB approval with waiver of informed consent Minimal risk study Will not adversely affect the rights and welfare of the subjects Cannot be conducted practicably without a waiver of informed consent Greater Bay Area Cancer Registry

  12. Linkage Conducted at GBACR using LinkPlus Link using: First/Last name, social security number (SSN), date of birth (DOB), address, date of diagnosis, registry maiden name, registry alias name Complete SSN and DOB utilized to reduce number of ambiguous links Linkage was completed, datasets transferred via secure File Transfer Protocol (FTP) Greater Bay Area Cancer Registry

  13. Initial Results Greater Bay Area Cancer Registry

  14. Focus Groups Themes Transportation Safety Social cohesion/support Housing cost/condition Food environment Resources Gentrification Greater Bay Area Cancer Registry

  15. “I like my neighborhood because it’s very convenient….very accessible to many bus lines because I do not drive – even as unreliable as MUNI is, there are many bus lines to take me to my doctor’s appointments, etc.” Shanti client Greater Bay Area Cancer Registry

  16. “I live in the Tenderloin—it’s stressful….it’s noisy, there’s drug activity, I mean you see people using needles, on crack, right in front of you. It’s very frustrating, dealing with my own issues….and stress kills. Knowing you have cancer – my mind NEVER rests.” Shanti client Greater Bay Area Cancer Registry

  17. “No neighbors—I get on the elevator and no one says hello….but that doesn’t matter to me.” Shanti client Greater Bay Area Cancer Registry

  18. Demographics Shanti cases vs all other breast cancer in San Francisco Shanti cases had lower proportion of: Non-Hispanic whites (24% vs 50%) Age 70 years and older (9% vs 31%) Married (38% vs 48%) Private insurance (41% vs 66%) Greater Bay Area Cancer Registry

  19. Tumor and Treatment Characteristics Shanti cases had a higher proportion of: Regional tumors (35% vs 20%) Mastectomy (34% vs 27%) Chemotherapy (48% vs 27%) Radiation (57% vs 51%) Shanti cases vs all other breast cancer in San Francisco Greater Bay Area Cancer Registry

  20. Neighborhood Shanti cases vs all other breast cancer in San Francisco* Shanti cases had: Lower neighborhood SES Higher % foreign born Less commuting by car • *Data limited to 2006-2016 cases to link to Census 2010 data. nSES quintiles based on California state data Greater Bay Area Cancer Registry

  21. Next steps Aim 1: Link data sources Neighborhood Data Built and social Environment Cancer Registry Data Tumor Clinical Demographics Community Data Navigation QoL Aim 3: Strengthen community-research partnership Aim 2: Examine associations between neighborhood and QoL Greater Bay Area Cancer Registry

  22. Study Team UCSF Salma Shariff-Marco Laura Allen Debby Oh Scarlett Lin Gomez Jennifer Jain Alison Canchola Shanti Judith Harkins Alyssa Nickel Public Health Institute Robert McLaughlin Funding California Breast Cancer Research Program Greater Bay Area Cancer Registry

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