{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T01:50:44Z","timestamp":1785894644897,"version":"3.56.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"National Institutes of Health\/National Cancer Institute"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>There are marked racial\/ethnic disparities in breast cancer mortality. Cultural racism, expressed through societal norms, stereotypes, and implicit biases, may contribute. We utilized a previously validated state-level multidomain latent measure, the cultural racism factor (CRF). Using data from the Surveillance, Epidemiology, and End Results Program (2018-2020), we evaluated associations between CRF and risk of death using Cox proportional hazards (PH) model with state as random effect. We examined time-varying effects and conducted race- and ethnicity-stratified analyses. Among 225\u2009991 patients, 63% were non-Hispanic (NH) White, 12% were NH Black, and 16% were Hispanic. In the overall cohort, patients in higher CRF states experienced 8% higher risk of death per unit increase in CRF after adjusting for covariates (aHR\u00a0=\u00a01.08; 95% CI, 1.05-1.11). Time-varying models revealed strongest effects early in follow-up (baseline HR\u00a0=\u00a01.30; 95% CI, 1.08-1.57), with attenuation over time (interaction HR\u00a0=\u00a00.99; 95% CI, 0.99-1.00). NH Black women exhibited a pattern suggestive of early elevated mortality risk that attenuated over follow-up (baseline HR\u00a0=\u00a01.14; 95% CI, 0.96-1.35; interaction HR\u00a0=\u00a00.99; 95% CI, 0.97-1.00). In conclusion, cultural racism is associated with breast cancer survival at the population level, with the strongest time-dependent effects observed early in follow-up.<\/jats:p>","DOI":"10.1093\/aje\/kwag126","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T11:33:26Z","timestamp":1780400006000},"page":"2212-2221","source":"Crossref","is-referenced-by-count":0,"title":["Association of cultural racism with breast cancer survival among US adults, 2018-2020"],"prefix":"10.1093","volume":"195","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4470-4248","authenticated-orcid":false,"given":"Anjali","family":"Gupta","sequence":"first","affiliation":[{"name":"Stanford University School of Medicine , Stanford, CA ,","place":["United States"]},{"name":"Department of Population Health Sciences, Duke University School of Medicine , Durham, NC ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oyomoare L","family":"Osazuwa-Peters","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Duke University School of Medicine , Durham, NC ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2264-6390","authenticated-orcid":false,"given":"Andrea","family":"Thoumi","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Duke University School of Medicine , Durham, NC ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo G","family":"Quezada-Pinedo","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Duke University School of Medicine , Durham, NC ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4815-5947","authenticated-orcid":false,"given":"Nancy","family":"Krieger","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, Harvard T.H. 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