An exploratory evaluation of potential breast cancer risk factors in a Middletown hotspot

Researcher(s)

  • Ajay Hatkar, Applied Mathematics, University of Pennsylvania

Faculty Mentor(s)

  • Scott Siegel, , ChristianaCare

Abstract

Background

Previous research has identified an area in Middletown, Delaware as a breast cancer (BC) ‘hotspot,’ characterized by higher-than-average rates of advanced (stage 2A and above) BC in women under age 50. The present study aims to conduct an exploratory analysis of possible risk factors that may be contributing to this pattern in Middletown.

Methods

A retrospective review of BC patients (N = 102) who resided in Middletown between 2012-2020 was conducted at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute (HFGCCRI). Electronic health record and registry data were abstracted which included patient demographics, clinical and screening histories, and residential history. Four subgroups based on age (<50 years/ ≥50 years) and stage of diagnosis (early/advanced) were compared using descriptive and inferential statistical tests.

Results

Although no significant difference in screening rates was observed between age and stage groups, over 51% of patients either never underwent screening or had not been screened within the past 36 months. Women under age 50 with advanced BC had the lowest rate of previous screenings (38.9%) and the highest rate of not having been screened within the past 36 months (72.2%). Residency periods were shorter in younger patients with women >50 with advanced BC compared to other groups.

Discussion

Findings indicate that inadequate screening could be contributing to the increased advanced BC rates in this hotspot. Despite similar screening rates across groups, 51% of all patients have never been screened or were not screened recently, highlighting a potential gap in preventive care. Shorter residency periods among younger patients with advanced BC suggest that other factors, such as recent relocation or difficulty in accessing medical care, could be impacting this community. Further investigation into environmental and healthcare access factors is needed to better understand and address the elevated incidence of advanced BC in Middletown.