County-level socioeconomic status, rurality, and second primary cancer risk among breast cancer survivors in the United States.

ABSTRACT:

Background

Breast cancer survivors have an increased risk of second primary cancers (SPCs), the role of county-level socioeconomic status and rurality-factors that may influence access to treatment, surveillance, and preventive care-remains understudied.

Methods

We identified 721,957 women with localized/regional first primary breast cancer who survived ≥ 1 year in 17 Surveillance, Epidemiology, and End Results registries (2000-2018). We used Cox regression to assess associations between county-level median household income (proxy for socioeconomic status), rurality, and their joint effects on invasive SPC risk, adjusting for demographic and clinical factors. We examined risk for all SPCs, non-breast SPCs, and the three most common SPC sites (breast, lung/bronchus, colorecta

SUBMITTER: Ho K 

PROVIDER: S-EPMC12630244 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature