{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T02:33:37Z","timestamp":1794278017567,"version":"4.9.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["2P30CA016520"],"award-info":[{"award-number":["2P30CA016520"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["7K08CA241390"],"award-info":[{"award-number":["7K08CA241390"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P50CA244690"],"award-info":[{"award-number":["P50CA244690"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001006","name":"Breast Cancer Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001006","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Neighborhood deprivation and other sociodemographic factors are associated with breast cancer outcomes, but in Philadelphia, the country\u2019s poorest large city, these factors have been understudied. We examined their association with stage at breast cancer diagnosis and treatment delay (&gt;60\u00a0days after diagnosis).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We identified women aged \u226518\u00a0years with breast cancer at an academic health system based in Philadelphia from 2011 to 2019. The Area Deprivation Index (ADI) was calculated across the cohort and grouped into quartiles: ADI 1 = least deprived, ADI 4 = most deprived. Multivariable logistic regression estimated sociodemographic associations with advanced stage (III\u2013IV) at diagnosis and treatment delay.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Overall, 11,108 patients were identified. White patients constituted a larger proportion of the least versus most deprived group (ADI 1 = 84.4% vs. ADI 4 = 50.9%), while the proportion of Black patients was highest in the most deprived group (ADI 1 = 3.9% vs. ADI 4 = 41.5%). Patients in the ADI\u00a04 group (vs. ADI 1; odds ratio [OR] 1.48, 95% confidence interval [CI] 1.19\u20131.84), who identified as Black (vs. White; OR 1.35, 95% CI 1.11\u20131.63), and with Medicaid insurance (OR 1.94, 95% CI 1.51\u20132.49) or no insurance (OR 2.21, 95% CI 1.27\u20133.67) versus\u00a0privately insured patients had higher odds of presenting with advanced stage\u00a0(all <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). Patients who identified as Asian, had Medicaid insurance or no insurance, were &gt;70\u00a0years of age, and presented with advanced stage were less likely to receive treatment within 60 days, while patients in the ADI 2\u20134 group were twice as likely to receive treatment within 60 days as patients in the ADI\u00a01 group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Neighborhood deprivation was associated with advanced stage at presentation, but not treatment delay, for patients with breast cancer in the Philadelphia metropolitan area, suggesting neighborhood-level opportunities to facilitate screening and more early-stage diagnoses.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1245\/s10434-025-17367-w","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T14:12:59Z","timestamp":1747059179000},"page":"5500-5509","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association of Neighborhood Deprivation with Stage at Diagnosis and Treatment Delay for Breast Cancer in Philadelphia"],"prefix":"10.1245","volume":"32","author":[{"given":"Isabel C.","family":"Yoon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephany","family":"Perez-Rojas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavya","family":"Ancha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leisha C.","family":"Elmore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina M.","family":"Mateo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret S.","family":"Pichardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia C.","family":"Tchou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer Q.","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca A.","family":"Hubbard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0876-975X","authenticated-orcid":false,"given":"Oluwadamilola M.","family":"Fayanju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"issue":"12","key":"17367_CR1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.39593","volume":"4","author":"E Cheng","year":"2021","unstructured":"Cheng E, et al. 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Fayanju is supported by the National Institutes of Health (NIH) under award numbers 7K08CA241390-03 (Principal Investigator [PI]: Fayanju) and P50CA244690 (PI: Schnoll), the Breast Cancer Research Foundation, and philanthropic funds from the Haas family. She also reports research support unrelated to this work from the NIH under award number U48DP006801 (PI: Fayanju) and Gilead Sciences, Inc. This work was also supported by the Electronic Phenotyping Resource (EPR) at Abramson Cancer Center under NIH award number 2P30CA016520-45 (PI: Vonderheide). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Rebecca A. Hubbard reports institutional grants from Pfizer and Merck, as well as institutional payment for teaching from Johnson & Johnson. Isabel C. Yoon, Stephany Perez-Rojas, Bhavya Ancha, Leisha C. Elmore, Alina M. Mateo, Margaret S. Pichardo, Julia C. Tchou, and Jennifer Q. Zhang have no conflicts of interest to declare that may be relevant to the contents of this study. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}