Abstract A094: Neighborhood deprivation and perceived discrimination among endometrial cancer survivors

Abstract Background: Neighborhood deprivation, characterized by limited access to housing and socioeconomic resources, is linked to worse cancer survival. Individuals living in deprived neighborhoods experience greater psychosocial stressors. Yet, the relationship between neighborhood deprivation and perceived discrimination, a widely studied psychosocial stressor, remains understudied among endometrial cancer survivors. Methods: We used cross-sectional data from the Carolina Endometrial Cancer Study enrollment survey. Survivors self-reported sociodemographics, discrimination experiences, and quality of life; baseline residential addresses were geocoded. Neighborhood deprivation, measured using the Area Deprivation Index (ADI), was derived from 17 census indicators of poverty, education, housing, and employment in North Carolina. Neighborhood ADI scores were categorized into quintiles, with the lowest (Q1) as affluent and highest (Q5) as socioeconomically vulnerable. Perceived discrimination was measured using the 9-item Everyday Discrimination Scale and dichotomized at more than one experience. Survivors attributed discrimination to identity factors such as ancestry, gender, race, age, religion, height, weight, physical appearance, sexual orientation, and education/income level. Overall and race-stratified modified Poisson regression models with robust standard errors estimated prevalence ratios (PRs), adjusting for age at diagnosis and geographic region. Results: Among 782 endometrial cancer survivors (58% White, 44% at least college educated, 78% urban), nearly half reported experiencing at least one instance of discrimination in the last year. Discrimination was more common among White than Black survivors (49% vs. 42%; P<0.0001) and among urban than rural survivors (82% vs. 18%; P=0.01). In the total population, ADI was not associated with overall discrimination prevalence. Among Black survivors, those living in vulnerable (Q5) compared to affluent (Q1) neighborhoods were less likely to perceive discrimination (aPR=0.72; 95% CI: 0.53, 0.99). In identity-specific (e.g., ancestry, gender, race, etc.) models, living in a vulnerable (Q5) vs affluent (Q1) neighborhood was associated with physical appearance-based discrimination (aPR=3.23; 95% CI: 1.06, 9.85). Models for other sources of discrimination did not show statistically significant associations. While living in a vulnerable (Q5) vs. affluent (Q1) neighborhood was not associated with race-attributed discrimination overall (aPR=0.95; 95% CI: 0.54, 1.70); the association was negative among Black survivors (aPR=0.48; 95% CI: 0.28, 0.81). Conclusions: Neighborhood deprivation limits survivors’ access to resources within social and built environments. Notably, Black women in disadvantaged neighborhoods perceived less discrimination, suggesting that neighborhood context may affect both exposure and recognition of discrimination. Our findings highlight the importance of considering intersecting social and geographic factors when addressing barriers to survivorship care. Citation Format: Jordyn A. Brown, Chantel L. Martin, Mya L. Roberson, Ganga Bey, Chelsea Anderson, Marc Peterson, Jamie Hunter, Shawn Smith, Stephenie Black-Grant, Victoria L. Bae-Jump, Andrew F. Olshan, Hazel B. Nichols. Neighborhood deprivation and perceived discrimination among endometrial cancer survivors [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A094.