Breast Cancer Mortality Linked to Socioeconomic Status and Screening

Breast cancer patients with locally advanced, ER-positive tumors who attend cancer screening and live in zip codes with higher levels of educational attainment have better survival, according to a study published October 29, 2021, in JAMA Open Network.

“By linking SEER-Medicare data to physical tumor specimens, additional connections may be revealed among biology, access to health care, and disparities in breast cancer outcomes. The findings of this population-based cohort study suggest that tumor screening and socioeconomic status are associated with survival in patients who have locally advanced, ER-positive tumors, even when clinical and genomic factors are incorporated,” wrote the team, led by led by Timothy Robinson, Ph.D., from the H. Lee Moffitt Cancer Center in Tampa, FL.

One of the limitations of the study, which used data from populations in Hawaii and Iowa, was that it was “unable to be used to analyze representative numbers of Black women. However, the creation of a more racially diverse study cohort is a priority and a topic of active future investigation due to known associations between race and breast tumor biology and molecular subtype,” wrote the researchers.

“Although the team didn’t directly investigate any potential interventions, co-author Michaela Dinan, PhD, from Yale University said the study highlights that socioeconomic disparities in breast cancer outcomes remain even after all other factors have been considered.

“‘In other words, clinicians should be aware that patients from resource-poor neighborhoods may be at risk for worse outcomes and keep this in mind during the course of patient care so as to hopefully help level the playing field,’ she told,” reported Allegretto.


Robinson TJ, Wilson LE, Marcom PK, et al. Analysis of Sociodemographic, Clinical, and Genomic Factors Associated With Breast Cancer Mortality in the Linked Surveillance, Epidemiology, and End Results and Medicare Database. JAMA Netw Open. 2021;4(10):e2131020. doi:10.1001/jamanetworkopen.2021.31020. Published online October 29, 2021, at Accessed November 15, 2021.

Allegretto, Amerigo. Screening, socioeconomic status linked to breast cancer mortality. Published online October 29, 2021, at Accessed November 15, 2021.