Góes, E. F. et al. (2024) The intersection of race/ethnicity and socioeconomic status: inequalities in breast and cervical cancer mortality in 20,665,005 adult women from the 100 million Brazilian cohort. Ethnicity and Health, 29(1), pp. 46-61. (doi: 10.1080/13557858.2023.2245183) (PMID:37642313)
![[img]](https://eprints.gla.ac.uk/style/images/fileicons/text.png) |
Text
304504.pdf - Published Version Available under License Creative Commons Attribution. 1MB |
Abstract
Objectives There is limited evidence regarding the impact of race/racism and its intersection with socioeconomic status (SES) on breast and cervical cancer, the two most common female cancers globally. We investigated racial inequalities in breast and cervical cancer mortality and whether SES (education and household conditions) interacted with race/ethnicity. Design The 100 Million Brazilian Cohort data were linked to the Brazilian Mortality Database, 2004–2015 (n = 20,665,005 adult women). We analysed the association between self-reported race/ethnicity (White/‘Parda’(Brown)/Black/Asian/Indigenous) and cancer mortality using Poisson regression, adjusting for age, calendar year, education, household conditions and area of residence. Additive and multiplicative interactions were assessed. Results Cervical cancer mortality rates were higher among Indigenous (adjusted Mortality rate ratio = 1.80, 95%CI 1.39–2.33), Asian (1.63, 1.20–2.22), ‘Parda’(Brown) (1.27, 1.21–1.33) and Black (1.18, 1.09–1.28) women vs White women. Breast cancer mortality rates were higher among Black (1.10, 1.04–1.17) vs White women. Racial inequalities in cervical cancer mortality were larger among women of poor household conditions, and low education (P for multiplicative interaction <0.001, and 0.02, respectively). Compared to White women living in completely adequate (3–4) household conditions, the risk of cervical cancer mortality in Black women with 3–4, 1–2, and none adequate conditions was 1.10 (1.01–1.21), 1.48 (1.28–1.71), and 2.03 (1.56–2.63), respectively (Relative excess risk due to interaction-RERI = 0.78, 0.18–1.38). Among ‘Parda’(Brown) women the risk was 1.18 (1.11–1.25), 1.68 (1.56–1.81), and 1.84 (1.63–2.08), respectively (RERI = 0.52, 0.16–0.87). Compared to high-educated White women, the risk in high-, middle- and low-educated Black women was 1.14 (0.83–1.55), 1.93 (1.57–2.38) and 2.75 (2.33–3.25), respectively (RERI = 0.36, −0.05–0.77). Among ‘Parda’(Brown) women the risk was 1.09 (0.91–1.31), 1.99 (1.70–2.33) and 3.03 (2.61–3.52), respectively (RERI = 0.68, 0.48–0.88). No interactions were found for breast cancer. Conclusion Low SES magnified racial inequalities in cervical cancer mortality. The intersection between race/ethnicity, SES and gender needs to be addressed to reduce racial health inequalities.
| Item Type: | Articles |
|---|---|
| Additional Information: | This work was supported by the National Institute for Health and Care Research (NIHR) under Grant [GHRG /16/137/99] and the Foundation for the Support of Research (Fundação deAmparo à Pesquisa do Estado da Bahia - FAPESB) under Grant [Universal Notice / Edital Univer-sal, APP0089/2016]. EMLA is a National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq fellow [CNPq N° 12/2017 - Research productivity scholarship - PQ Processo 306295/2017-2]. Cidacs-Fiocruz is a recipient of core funding from Wellcome Trust [201912/B/16]. SVK and AHL acknowledge funding from the Medical Research Council - MRC [MC_UU_00022/2]. SVK additionally acknowledges funding from a NHS Research Scotland - NRS Senior Clinical Fellowship [SCAF/15/02]. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Katikireddi, Professor Vittal and Leyland, Professor Alastair |
| Authors: | Góes, E. F., Guimarães, J. M.N., Almeida, M. d. C. C., Gabrielli, L., Katikireddi, S. V., Campos, A. C., Alvim Matos, S. M., Patrão, A. L., de Oliveira Costa, A. C., Quaresma, M., Leyland, A. H., Barreto, M. L., dos-Santos-Silva, I., and Aquino, E. M.L. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
| Journal Name: | Ethnicity and Health |
| Publisher: | Taylor & Francis |
| ISSN: | 1355-7858 |
| ISSN (Online): | 1465-3419 |
| Published Online: | 08 August 2023 |
| Copyright Holders: | Copyright: © 2023 The Author(s) |
| First Published: | First published in Ethnicity and Health 29(1):46-61 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
University Staff: Request a correction | Enlighten Editors: Update this record
Funder and Project Information
Funder and Project Information