Abstract C086: A summary of findings from the Breast Cancer, Race and Place (BCRP) study on structural racism and breast cancer survival disparities in the United States, based in Milwaukee, WI

Racial disparities in breast cancer survival are significant, with only 68% of US Black women diagnosed with breast cancer remaining alive 10 years post-diagnosis, compared to 84% of White women. However, the size of racial disparities in breast cancer mortality varies geographically across the US. Such geographical variation suggests that disparities are not inevitable, and this variation has not been explained. Structural racism and racial residential segregation are widely considered to contribute to health disparities and may partially explain geographical variation in the size of the disparities. While some studies have shown that segregation is related to poor survival, others have found that this is not always the case, and some studies highlight the case of ethnic enclaves, which may be protective. The NCI funded Breast Cancer, Race and Place (BCRP) study is a national study of structural racism and breast cancer survival with three aims: (1) Construct new metrics of structural racism at the local level for the largest US metropolitan areas, (2) Determine whether these measures are related to breast cancer survival disparities among Black, Hispanic and Non-Hispanic White women, and whether relationships are mediated by local stressors, social resources, or opportunities, and (3) Explore the ways in which Black and Hispanic breast cancer survivors in a highly segregated metropolitan area (Milwaukee, WI) navigate cancer survivorship in the context of segregation. The project is supported by an interdisciplinary research team and a community advisory board. We have published several studies based on this work with others in review or in preparation and share an overview of this body of work here. This summary of findings includes: (1) a description of new measures of contemporary racial bias and property location based bias (redlining) in mortgage lending, (2) a direct association between redlining and breast cancer survival in older women diagnosed with breast cancer in the US, (3) collaborative work using these metrics in other cohorts and locations, (4) a clear gradient association between historic redlining and contemporary redlining, (5) new evidence of potential mediating factors, (6) qualitative evidence of lived experience of Black and Hispanic survivors in Milwaukee, WI, and (7) a new web-based tool to explore and download mortgage lending bias metrics. We hope that this work will support the development of multi-sectoral interventions to reduce cancer disparities by targeting local systems and policies, including in the housing sector.

Citation Format: Kirsten M. M. Beyer, BCRP Team. A summary of findings from the Breast Cancer, Race and Place (BCRP) study on structural racism and breast cancer survival disparities in the United States, based in Milwaukee, WI [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C086.