Abstract 7386: Economic deprivation and cardiovascular disease risk among long-term breast cancer survivors

Abstract Background and Purpose: Disparities in cardiovascular disease (CVD) mortality among breast cancer (BC) survivors are well documented. There has been notable progress in identifying and mitigating risk factors for poor health outcomes and improved quality of life for long-term BC survivors. However, the unique impact of structural determinants of health, and the intersections of the community-level and individual-level economic deprivation that perpetuate inequities in BC incidence, screening, treatment options, and risk of comorbidities, are still not cogently described in the literature. Persistent, chronic, or transient poverty exacerbates CVD risk and poor health outcomes among BC survivors. This observational study examined the associations between measures of economic deprivation and CVD outcomes in a national sample of female BC survivors. Methods: This study used National Health Interview Survey 1999-2022 cohort data to examine the prevalence of CVD, (angina, stroke, myocardial infarction and coronary artery disease) among female BC survivors. We evaluated correlational and logistic models of association between socio-demographic characteristics, health behaviors, comorbid conditions, and family poverty-income ratio (PIR) as well as interaction terms between PIR and select predictor variables. Results: The impact of family PIR varied across different age cohorts and race/ethnicity categories. Race was not independently associated with CVD risk in this population, but significantly moderated the relationship between poverty status and CVD risk among Black breast cancer patients compared to White and Asian breast cancer patients OR=0.08 (95% CI 0.01-0.65) Additionally for middle-aged breast cancer survivors (45-64 yrs), higher socioeconomic status offers substantial protection against CVD (OR=0.0405; 95% CI 0.17-0.96) compared to patients <45yrs and older patients (≥65yrs). While at very advanced ages (>85yrs), the protective effect of higher socioeconomic status becomes less relevant in determining CVD risk. Higher PIR (>5 and 1-4) confers strong protective effects against CVD particularly during the initial seven-year period after BC diagnosis and even among women who seek routine follow-up care (OR=0.52; 95% CI 0.30-0.92). Conclusions and Implications: Economic deprivation as measured by the poverty income ratio is signaled as an important determinant of cardiovascular disease (CVD) risk among certain subpopulations of breast cancer patients, and its effect is magnified when intertwined with other determinants and sociodemographic characteristics. Citation Format: Robina Josiah Willock, Daniel Parks, Samah Nabi, Desiree Rivers, Chaohua Li. Economic deprivation and cardiovascular disease risk among long-term breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7386.