Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul;149(8):5231-5240.
doi: 10.1007/s00432-022-04455-7. Epub 2022 Nov 16.

Neighborhood disadvantage is associated with KRAS-mutated non-small cell lung cancer risk

Sam E Wing #  1 , Marta M Jankowska #  1 , Xiaoke Zou  1 , Ernesto Sosa  1 , Jiue-An Yang  1 , Tarik Benmarhnia  2   3 , Susan L Neuhausen  1 , Rebecca Nelson  4 , Ravi Salgia  5 , Stacy W Gray  1   5 , Loretta Erhunmwunsee  6   7
Affiliations

Neighborhood disadvantage is associated with KRAS-mutated non-small cell lung cancer risk

Sam E Wing et al. J Cancer Res Clin Oncol. 2023 Jul.

Abstract

Purpose: It remains unclear why individuals living in disadvantaged neighborhoods have shorter non-small cell lung cancer (NSCLC) survival. It is possible that living in these deprived areas is linked with increased risk of developing aggressive NSCLC biology. Here, we explored the association of somatic KRAS mutations, which are associated with shorter survival in NSCLC patients, and 11 definitions of neighborhood disadvantage spanning socioeconomic and structural environmental elements.

Methods: We analyzed data from 429 NSCLC patients treated at a Comprehensive Cancer Center from 2015 to 2018. Data were abstracted from medical records and each patient's home address was used to assign publicly available indices of neighborhood disadvantage. Prevalence Ratios (PRs) for the presence of somatic KRAS mutations were estimated using modified Poisson regression models adjusted for age, sex, smoking status, race/ethnicity, educational attainment, cancer stage, and histology.

Results: In the NSCLC cohort, 29% had KRAS mutation-positive tumors. We found that five deprivation indices of socioeconomic disadvantage were associated with KRAS mutation. A one decile increase in several of these socioeconomic disadvantage indices was associated with a 1.06 to 1.14 increased risk of KRAS mutation. Measures of built structural environment were not associated with KRAS mutation status.

Conclusion: Socioeconomic disadvantage at the neighborhood level is associated with higher risk of KRAS mutation while disadvantage related to built environmental structural measures was inversely associated. Our results indicate not only that neighborhood disadvantage may contribute to aggressive NSCLC biology, but the pathways linking biology to disadvantage are likely operating through socioeconomic-related stress.

Keywords: Health disparities; KRAS mutations; Molecular epidemiology; Neighborhood socioeconomic status; Non-small cell lung cancer.

PubMed Disclaimer

Conflict of interest statement

The authors declare no potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Correlations between the 11 neighborhood disadvantage indices. Pearson’s correlation matrix of neighborhood disadvantage indices measured in census tracts of the study area. Size of the circle indicates absolute value of the correlation, while color indicates negativity and positivity of the correlation
See this image and copyright information in PMC

References

    1. Adie Y, Kats DJ, Tlimat A, Perzynski A, Dalton J, Gunzler D, Tarabichi Y (2020) Neighborhood disadvantage and lung cancer incidence in ever-smokers at a safety net health-care system: a retrospective study. Chest 157:1021–1029. 10.1016/j.chest.2019.11.033 - PMC - PubMed
    1. Agency for Toxic Substances and Disease Registry (2020) CDC Social Vulnerability Index. Accessed 11 Dec 2020. https://www.atsdr.cdc.gov/placeandhealth/svi/index.html.
    1. Amzanam I, Mambetsariev I, Gupta R, Achuthan S, Wang Y, Pharaon R, Massarelli E, Koczywas M, Reckamp K, Salgia R (2020) Role of immunotherapy and co-mutations on KRAS-mutant non-small cell lung cancer survival. J Thorac Dis 12:5086–5095. 10.21037/jtd.2020.04.18 - PMC - PubMed
    1. Antunes JLF (2016) The impact of unemployment on cancer mortality, and how to avoid it. Ann Transl Med 4:56 - PMC - PubMed
    1. Bender R, Lange S (2001) Adjusting for multiple testing—when and how? J Clin Epidemiol 54:343–349 - PubMed

MeSH terms

Substances