Abstract C128: The intersection of structural violence, environmental inequalities, and family history: Study design and methodology

Introduction Breast cancer is the most commonly diagnosed cancer in American women, and women of color bear a disproportionate burden of breast cancer morbidity and mortality. Breast cancer risk is influenced by harmful social forces (“structural violence”), environmental inequality, and familial history, but the independent effects of each of these factors explain less than half of breast cancer diagnoses. Combining these distinct risk domains is expected to improve the ability to predict risk for breast cancer, but few studies have collected data that will allow for assessment of combined risk factors in each domain. Study Description We are undertaking a secondary data analysis of data gathered from women who underwent a mammography screening and answered questionnaires about family history of cancer (N=600 women consented). We aim to assess the relationships between ecological indicators of structural violence, environmental exposures, and clusters of high familial risk of cancer. Further, we aim to characterize whether breast density, an early risk factor for later breast cancer that will be extracted from mammography notes using Natural Language Processing, is associated with structural violence, familial risk, and environmental exposures. The project goals will be revised over quarterly meetings with our partner organization Sisters Working It Out (SWIO), and SWIO will facilitate dissemination of research results to neighborhoods with traditionally low mammogram rates. A full conceptual model and causal diagram of the study aims will be presented for discussion, along with details on the analytical approaches used for the creation of the environmental index and natural language processing. Discussion and Expected Findings Our study will provide a more detailed understanding of how knowledge of structural violence can complement knowledge of family history and environmental exposures to identify women who may be at increased risk for breast cancer. Additionally, it will suggest possible routes of intervention that could occur before breast cancer develops invasive potential. As the study will begin the analytic component in October, presentation at the AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Underserved will provide a valuable space for discussion of the methodology and study design.

Citation Format: Jyotsna Jagai, SWIO Sisters Working it Out, Kent Hoskins, Sage Kim, Maria Argos, Susan Hong, Molly Scannell Bryan. The intersection of structural violence, environmental inequalities, and family history: Study design and methodology [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C128.